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05.07.08: Compassion & Choices President Barbara Coombs Lee Hits the Airwaves in Sacramento
On April 29, Compassion & Choices President Barbara Coombs Lee discussed the Right to Know End-of-Life Options Act on Sacramento’s talk radio station, KFBK-AM.
The Right to Know Act requires a physician to provide counsel on the range of end-of-life care options available, upon a dying patient’s request. These options include hospice care, voluntary stopping eating and drinking, refusal or withdrawing of life-sustaining treatments, palliative care and palliative sedation.
Lee spoke before the hearing for the bill, which later received a 7-3 vote in favor by California’s Assembly Judiciary Committee. It is now headed to the full Assembly floor for a vote.
“Dying patients don’t even know that they can stop the search for a cure with futile and burdensome care, and they can concentrate on just caring and treating their symptoms in a hospice or palliative care environment,” she said. “There are peaceful and humane ways to die; people just don’t know about them.”
Listen to the radio segment (MP3)
05.06.08: Judith Fleming Passes Peacefully
After a six month battle with cancer, former Compassion & Choices CEO Judith Fleming died peacefully in her sleep. She passed away at 2:15 p.m. on May 5, 2008, surrounded by friends and family.
In the hours before she died, Judith expressed deep appreciation for all the love and tenderness she felt from those around her. Those who knew her are blessed beyond words to have walked life’s path at her side, for however short a distance.
05.05.08: New Hampshire Retirement Community Practices “Slow Medicine”
Residents at a New Hampshire retirement community enjoy the practice of “slow medicine,” a research-based approach to end-of-life care allowing them to refuse aggressive and costly treatments.
Kendal at Hanover, affiliated with Dartmouth Medical School, is unique among care facilities in that physicians and residents thoroughly discuss health care options and treatment implications. A physician may point out that the physical and financial costs of an aging patient undergoing a surgery, hospitalization or other intensive procedure may outweigh the benefits of such treatment. Residents may choose to refuse medication, nutrition or resuscitation upon cardiac arrest.
As people live longer, it becomes crucial to make informed decisions about end-of-life care. This philosophy of patient autonomy is reflected in California’s Right to Know End-of-Life Options Act. The bill requires a physician to provide counsel on the range of care options available, upon a dying patient’s request. These options include hospice care, voluntary stopping eating and drinking, refusal or withdrawing of life-sustaining treatments, palliative care and palliative sedation. On April 29, the bill passed in a 7-3 vote by the Assembly Judiciary Committee.
Read about Kendal at Hanover in the New York Times
05.01.08: Colorado Bill Would Protect Patients from Medical Mergers that Limit Access and Care
A bill that would prevent hospital mergers from compromising patient care received approval by the Colorado House and Senate and will now be considered by Gov. Bill Ritter.
If passed, the bill would clarify the Colorado attorney general’s authority to include conducting hearings and reviewing proposed mergers for negative impacts to patient care.
The legislation comes in light of a pending deal between the Sisters of Charity of Leavenworth Health System, a Catholic entity, and the nonsectarian Exempla Healthcare System. Colorado Attorney General John Suthers declined to prohibit the transaction on the grounds that he had no legal basis. Opponents of the deal complained it would force patients to seek hospitals outside Jefferson County for certain reproductive and end-of-life treatment.
“We have had hospitals merging at a cancerous rate in Colorado, at some times approaching monopolies,” said Rep. Morgan Carroll, the bill’s House sponsor. “I cannot think of a more dangerous place for monopolies than in health care. At a time when we are trying to increase access and improve quality of care, it is exactly the wrong time to eliminate access to key services.”
Read the Denver Business Journal article
04.29.08: California Right to Know Act Clears its First Hurdle
The California Right to Know End-of-Life Options Act (AB 2747) cleared its first hurdle today with a 7-3 vote in favor by the Assembly Judiciary Committee.
The bill requires a physician to provide counsel on the range of care options available, upon a dying patient’s request. These options include hospice care, voluntary stopping eating and drinking, refusal or withdrawing of life-sustaining treatments, palliative care and palliative sedation.
A wide range of witnesses offered supportive testimony, including retired internist Alan Carpenter; Mary Stompe, daughter of a deceased cancer patient; the California Nurses Association; the California Psychological Association; the Gray Panthers; and Compassion & Choices.
“AB 2747 empowers patients by requiring informed consent for treatment at the end of life,” said Dr. Carpenter in his testimony. “I strongly support this bill to guide medical practice for terminally ill and their health care providers.”
If passed, the bill would follow the bold precedent set by California 30 years ago when the state began offering its residents the right to health care advance directives.
“It’s time that terminally ill patients have all the information they need to make timely and informed decisions regarding their end-of-life care,” said California Assemblywoman Patty Berg, a co-sponsor of the Right to Know Act.
“Knowledge is power,” said Barbara Coombs Lee, president of Compassion & Choices. “Patients who are disempowered don’t know they can stop their pacemaker or their heart medicine, or that they can be sedated if their symptoms become unbearable. Empowered patients get better care and have more peaceful deaths.”
Learn more
04.21.08: Work by Compassion & Choices of New York Leads to Palliative Care Panel
A new advisory panel helps New York take a positive step in improving their palliative care, thanks to the work of the state’s Compassion & Choices affiliate.
The Palliative Care Education and Training Council will guide New York’s Health Commissioner, Richard F. Daines, M.D., on best practices in pain management and end-of-life care.
“Many medical experts as well as patients and family members have experienced or witnessed the undertreatment of pain,” said Commissioner Daines in a press release. “The members of this new council will help us ensure that New Yorkers with advanced, life-limiting illness receive the effective, compassionate palliative care they deserve.”
The advisory council is one component of New York’s landmark Palliative Care Education and Training Act, enacted this year. Initiated by the New York Compassion & Choices affiliate after four years of work, the legislation addresses the urgent health care crisis caused by undertreating pain. Aside from the advisory council, the law calls for creating specialized palliative care training programs at the undergraduate and graduate level, state Centers for Palliative Care Excellence and palliative care resource centers to help physicians treat pain.
The next meeting will be July 18, 2008 and will feature palliative care education models and presentations. Meetings are held quarterly and are open to the public.
04.02.08: Compassion & Choices President Barbara Coombs Lee Hits the Airwaves in Denver
 On March 31, Compassion & Choices President Barbara Coombs Lee discussed Oregon’s landmark Death with Dignity law with Denver talk radio show host Mike Rosen.
Coombs Lee shared essential information about Oregon’s aid-in-dying legislation with Colorado listeners, including how many people have used the Oregon law, how the safeguards work and how insurance is administered. She also emphasized the support aid in dying has garnered among key medical organizations such as the American Medical Student Association and the American Medical Women’s Association.
“Oregonians love their law,” she told Rosen. “It is an enormous comfort to them to know that if that nightmare happens, if they become completely agonized in their dying, that they have a way out. It improves quality of their life tremendously.”
Listen to the radio show (MP3)
04.01.08: Support for Washington Initiative Continues to Gain Momentum
Washington’s Initiative 1000 continues to gain mainstream support, as that state’s citizens decide whether or not to put an Oregon-style aid-in-dying law on the ballot.
The newest allies in Washington’s fight for the right to end-of-life choice include the American Medical Student Association and American Medical Women’s Association.
By officially endorsing the proposed ballot initiative, these organizations publicly announce their support for terminally ill, mentally competent adult Washington residents to have the option to request, receive and self-administer life-ending medication to achieve a peaceful death.
In September 2007, AMWA’s board of directors announced the organization’s support of aid in dying in a position paper, emphasizing the importance of appropriate language. The student medical association, a longtime aid-in-dying supporter, approved a similar policy in March.
Adding further credence to the strength of I-1000, a Thurston County, Wash., judge in February refused to give in to aid-in-dying opponents by declining their request to add the word “suicide” to the ballot or official voters’ pamphlet description.
Read about the Judge’s decision in the Seattle Times
Read about the Washington campaign in the Belltown Messenger
Visit the “Yes on I-1000” campaign Web site
03.20.08: Compassion & Choices CEO Judith Fleming Resigns
 We are deeply saddened to report that our beloved CEO, Judith Fleming, resigned from Compassion & Choices on March 15. Judith was diagnosed with lung cancer in October and entered hospice care shortly before her resignation. Compassion & Choices President Barbara Coombs Lee and End-of-Life Consultation Director Helen Beum are fighting hard to ensure Judith receives the pain management she needs. Judith’s pain has been well managed since she began hospice care. Her family is with her, and we’re happy to note her trademark pluck and wit are still intact.
You can receive ongoing reports of her condition and write tributes to Judith by visiting her Caring Bridge page.
If you’d like to honor Judith’s tenure as CEO with a gift to Compassion & Choices, please contact Jane Sanders at 800.247.7421 or email her at jsanders@compassionandchoices.org.
03.18.08: Oregon Announces 10 Successful Years of Death with Dignity
More Oregon terminally ill patients chose to use the state’s Death with Dignity Act this year than ever before, according to a report released today by the Oregon Department of Human Services.
The 10th annual report confirms the safety and effectiveness of the landmark Oregon law. Death with Dignity’s many strict safeguards ensure the law does not unfairly target the poor, disabled or minority populations. Everyone who used the law in 2007 was mentally competent and within six months of death.
As in all previous years, many more people requested the lethal medication than used the prescriptions.
Of the 85 patients who requested and received life-ending medications in 2007, only 46 actually administered the medication to achieve a peaceful death. An additional three took medications prescribed prior to 2007. This is equivalent to 15.6 deaths from aid in dying per every 10,000 total deaths in Oregon. Since it was passed in 1997, 341 people have used the Death with Dignity law to end their lives.
A decade of data, along with studies by the State of Oregon and independent researchers, show that the law has greatly improved end-of-life care for all Oregonians.
“The reports each year have found that all dying patients in the state of Oregon have benefited from the improved care of physicians and health care providers as measured by clinical standards, the experience of hospice nurses, increased use of medical morphine, increased referrals to hospice and the second-lowest rates of in-hospital deaths and the second-highest rates of home deaths in the nation,” said Compassion & Choices President Barbara Coombs Lee. “None of opponents’ predicted problems have come true. To the contrary, Oregon is ranked second in the nation in quality care at the end-of-life. We urge other states to adopt similar laws.”
Read the report
03.17.08: American Medical Student Association Shows Strong Support for Aid in Dying
The American Medical Student Association renewed its support for aid in dying by updating its current position on the practice and adopting new policy.
The progressive group of more than 68,000 physicians and physicians-in-training joins the American Medical Women’s Association in leading the nation’s medical professionals toward respecting patient wishes with regard to end-of-life care. The student association first adopted a supportive aid-in-dying policy in the mid 1990’s. The new policy, approved at the group’s March convention, is similar to the one adopted by AMWA in 2007.
The student group’s position also supports the practice of aggressive pain management including palliative sedation, as well as provision of a full range of information to terminally ill patients about their legal end-of-life care options.
03.14.08: Jury Finds Failure to Treat Pain of Dying Cancer Patient Negligent
 An Omaha jury has decided in favor of the daughters of Frances Tolliver, an 85 year old woman who died of cancer while a resident of Hospice House, based on the nursing staff’s failure to provide Mrs. Tolliver adequate pain management in her final weeks of life.
Mrs. Tolliver’s daughters assert their mother suffered an unnecessarily painful death because the facility, called Hospice House, misrepresented itself and was inadequately prepared to treat her pain. They were represented by renowned trial lawyer Dave Domina and Compassion & Choices legal director Kathryn Tucker.
Before she died, Mrs. Tolliver spent a month at Hospice House with the understanding she would receive adequate pain management and comfort care as she died of breast cancer. But her daughters attest that a Hospice House nurse chose not to apply a new morphine skin patch prescribed to Mrs. Tolliver since she did not want to ‘waste’ a patch on a dying person. Mrs. Tolliver lived longer than the nurse predicted and suffered a death full of pain and anxiety.
The case serves as a national call to end-of-life care providers around the nation. Thanks to this verdict, care facilities now will be forced to recognize the importance of providing appropriate end-of-life care. Such facilities claiming to provide comfort and end-of-life care must accurately represent themselves or suffer severe consequences as a result.
02.05.08: An Earnest Plea for Aid in Dying
Today the New York Times health columnist Jane Brody wrote a poignant personal essay advocating the need for choice at the end of life.
Brody cites the story of her high school biology teacher, who at 94 asks her to help him hasten his death. She abstains, but contemplates why someone could not take life-ending medication to peacefully achieve an end to suffering. She thinks about her mother, who attempted to hasten her death without the aid of a physician. Her mother’s life was saved, but Brody asks herself, saved for what? And she cites Dr. Timothy Quill’s experience, who wrote about his role in his father’s experience with aid in dying.
Brody weaves these examples into a thoughtful commentary about what to do when the cost of living outweighs the benefits. At that point, she says, she will be ready to go. She asks that her loved ones will support her when she does.
Read the New York Times story
01.29.08: Arizona Marchers Call for Aid-in-Dying Law
 Nearly 100 people assembled for a rally organized by Compassion & Choices at Arizona’s state capitol last week to advocate for Oregon-style aid-in-dying legislation.
This marks the third year in a row the Arizona chapter has coordinated the rally, and the sixth consecutive year state Rep. Linda Lopez, D-Tucson, has introduced the bill. She and her supporters appealed to legislative leaders to give House Bill 2387 a fair hearing. Lopez calls aid in dying ‘the civil-rights issue of our time.’
Many of those who attended the rally were driven by memories of loved ones’ bad deaths or strongly held personal convictions.
Just like Oregon’s Death with Dignity Act, the proposed Arizona measure would allow terminally ill, mentally competent people the right to direct their dying by obtaining medications from their physician to enable the patient to achieve a peaceful death.
Read the Arizona Republic story
Listen to the rally
01.09.08: Oregon-Style Aid-in-Dying Initiative Launched in Washington State
 Today Compassion & Choices announced it is working with former Gov. Booth Gardner on an important campaign to pass an Oregon-style aid-in-dying law in Washington State.
A broad coalition of Compassion & Choices affiliates, physicians, nurses, hospice patients, organizations and concerned residents is proposing an initiative for the 2008 ballot. This measure will give tremendous peace of mind to terminally ill patients who face the prospect of intolerable suffering. Specifically, this initiative would allow mentally competent, terminally ill adults in Washington State with six months or less to live the legal choice to access and self-administer life-ending medication under strict medical supervision.
"Oregon’s experience proves legalizing aid in dying brings hope and comfort to the terminally ill, whether they ever use it or not,” said Barbara Coombs Lee, President of Compassion & Choices. “Washingtonians deserve the same. Freedom of conscience is fundamental to our nation’s greatness. To die in accordance with ones deepest beliefs is surely part of that freedom.”
The initiative would:
• Allow patients with no hope of recovery the choice to end their life on their own terms. Currently our state restricts the legal freedom of terminally ill patients who face a lingering and painful death from making this compassionate, legitimate end-of-life choice.
• Give terminally ill adults the right to end their suffering. When facing the prospect of agonizing pain or loss of dignity at the end of life, patients should be able to make a legal choice to request, receive, and self-administer medication to die on their own terms.
• Require effective safeguards. To participate, a patient must undergo a waiting period, self-administer the oral medication and be: 1) at least 18 years old and a Washington State resident, 2) mentally capable of making and communicating health care decisions, and 3) within six months of death. Two physicians determine whether these criteria have been met.
• Mirror Oregon's "Death with Dignity" Act. Voters in Oregon passed an identical law by initiative ten years ago. The text of the Washington initiative is based on the sound Oregon law.
To qualify the "Death with Dignity" initiative for the November ballot, over 100,000 signatures need to be collected by volunteers by June 30, 2008. At least 3,000 volunteers are needed across the state to cover shifts at stores every week and gather signatures from friends and family.
If you would like to help with the campaign, please contact the political action committee It's My Decision directly at:
It's My Decision Committee
PO Box 21984
Seattle, WA 98111
Phone: (206) 633-2008
campaign@itsmydecision.org
Read The Seattle Times editorial
12.05.07: Hospital Sale Could Affect End-of-Life Care
The potential transfer of a Lutheran hospital to a Catholic health organization has some Denver-area physicians and citizens concerned women’s health care could suffer.
Compassion & Choices fears the sale could restrict patients’ rights to direct their own healthcare, including end-of-life care. Compassion & Choices Director of Community Relations, Roland Halpern, is spearheading a coalition of advocacy and nonprofit groups and concerned citizens to protest the effort.
Exempla physicians petitioned the Colorado attorney general to block the transfer. Attorney General John Suthers and his staff have given no indication how they would determine the case. Suthers has until Dec. 31 to decide if he will intervene.
Read the Denver Post article
Read the Coalition Letter to the Colorado Attorney Genera (PDF)
12.04.07: New York Times' Questionable Article: “Death in the Family”
 This weekend The New York Times Sunday Magazine published a lengthy article about Former Governor Booth Gardner and his support for an Oregon-style aid-in-dying law in Washington State.
By ignoring data from the Oregon experience, the article failed to accurately portray what legalized aid in dying might look like in Washington. This is a great disservice to Washington readers and voters, who can gain comfort from Oregon's ten years of experience with the Death with Dignity Act. Some troubling points:
• Bioethicist Susan Wolf speaks at length about her opposition to aid in dying on feminist grounds. Readers are told that women could be influenced by doctors into thinking their lives are not worthwhile, ascribing their “long-scripted cultural roles of sacrifice and suicide.”
Yet the Oregon experience has reflected no such trend. People who have used the 10-year-old law are nearly evenly split between men and women. Even Wolf admits that “Oregon’s experience may mute her worries about the vulnerability of women.”
• The author interviews Patricia King, an African-American bioethicist, who fears minorities would be hurt by an Oregon-style law. He vaguely cites King’s references to studies about disparity in health care among different ethnicities.
The Oregon data shows us that 10 years of the Death with Dignity Act does not disproportionately affect women, racial and ethnic minorities or other vulnerable populations. This information appeared in a widespread study published recently in the Journal of Medical Ethics.
• Readers are not presented with facts relevant to aid in dying and public opinion.
A majority of physicians—54 percent—and an overwhelming 70 percent of the general public believe they should have the right to legalized aid in dying, according to a national survey by HCD Research in October 2005.
• The author focuses on former Washington Governor Booth Gardner’s deteriorating condition due to Parkinson’s disease, painting him as a forgetful, feeble old man.
Gardner is a fighter willing to stand strong in opposition to the status quo-even if that means opposing the wishes of his extremely religious family. He is valiantly fighting for a law which he knows he will not live long enough to see enacted.
Washington State will be facing more divisive rhetoric in the months to come, and we hope that journalists and the media will respect the more then ten years of safe practice Oregon has experienced with its aid-in-dying law.
Read The New York Times Sunday Magazine article
11.05.07: Editorial: We Should Follow Oregon's Lead on Death with Dignity
An editorial in the San Jose Mercury News asserts that California should pass an Oregon-style aid in dying law. Data from Oregon’s 10-year experience with Death with Dignity supports the fact that the law’s safeguards have made it an effective option of last resort. Aid in dying has given dying Oregonians the option of comfort and choice, editors wrote.
The piece reflects the frustration Californians feel, noting in particular the frustration with the California Medical Association, and their vote last week to continue opposing aid in dying. Polls show that an overwhelming majority of Californians favor an Oregon-style law.
Read the article (PDF)
11.01.07: A Decade of Dignity: Oregon's 10-Year Anniversary
On Oct. 27, Compassion & Choices marked a decade of dignity, and celebrated the 10th Anniversary of Oregon's landmark law with a black-tie dinner, attended by 250 supporters.
We have a lot of cause for celebration. The past 10 years have been a learning experience for Oregon’s citizens, patients, physicians, hospice workers, lawmakers—and for the organization itself. We’ve learned that the law has delivered hope, comfort and choice to thousands of Oregonians. We've learned that the fears and scare-tactics used by opponents have not materialized. Doctors throughout the state have sharpened their strategies for pain care, they’ve learned to recognize and treat depression among the terminally ill and they’ve referred more patients to hospice than ever.
We’re proud to have set the gold standard for end-of-life care in Oregon with carefully drafted aid-in-dying legislation, and we look forward to other states following such common sense policy.
Read the Oregonian op-ed
Read the Oregon Public Broadcasting article
Read the Medford Mail Tribune op-ed
10.18.07: Constitutional Challenge Asserts that Dying Montanans Have Right to Control Their Own Death
Two terminally ill Montanans today filed suit against the state of Montana for the right to die on their own terms. They are joined by Compassion & Choices and four local Montana physicians.
The case contends that competent terminally ill Montanans are guaranteed privacy and dignity by the Montana State Constitution. These guarantees protect the right of such patients to control their own death by obtaining medications from their physician to enable the patient to achieve a peaceful death, if they so choose.
Robert Baxter, 75, a retired truck driver from Billings, and Steven Stoelb, 53, a former logger and forest technician from Livingston, are represented by Mark S. Connell, a Missoula attorney and Kathryn Tucker, Legal Affairs Director for Compassion & Choices. Baxter suffers from lymphocytic leukemia and Stoelb has Ehlers-Danlos Syndrome.
The suit challenges Montana’s homicide statutes on several grounds under the Montana Constitution.
“This law adversely affects terminally ill patients who want to exercise a measure of control over their dying processes,” Tucker said. “Physicians who would respect the request of their terminally ill patients seeking to exercise some measure of control over their deaths have potential criminal exposure to a felony prosecution. As a result, patients cannot expect to have their wishes about how they die, specifically including a request for assistance in hastening inevitable death, respected by their doctors.”
Montana legal commentators, including Scott Fisk in an article in the Montana Law Review, have said that the success of previous lawsuits in favor of privacy rights and personal autonomy sets a good precedent for the case. As the court explained in State v. Burns in 1992, “Montana adheres to [some] of the most stringent protection[s] of its citizens’ right to privacy in the country.”
Montana’s constitution provides unusually strong protections for residents’ rights to individual dignity and privacy: “The dignity of the human being is inviolable,” the constitution states in Article II, section four.
Watch the Montana CBS news story
Read the Bozeman Daily Chronicle article
10.02.07: Her Death, Her Way
 Compassion & Choices client Lovelle Svart said goodbye to the world on Friday in much the way she lived. Diagnosed with lung cancer in 2002, the fiercely independent woman was told in June of this year that she had six months or less to live. She decided to document her final days in a video diary series hosted by the Oregonian newspaper.
Sunday's feature story would be her last installment.
The article gives a touching account of Lovelle's preparations for her last day on earth, ordering food platters, charging her car battery so her sister would be able to drive her 2006 Scion and dancing her beloved polka.
Svart became an unsung hero of the battle to defend Oregon's unique law from the Ashcroft directive when she became one of the first patient-plaintiffs in the case that would make it all the way to the Supreme Court.
Watch Lovelle's video diary
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