End-of-Life Choice, Palliative Care and Counseling

Massachusetts

Sep 21, 2012A Graceful Exit: Taking Charge at the End of Life

by Claudia Rowe
YES! Magazine
September 19, 2012

 

I was standing in my cubicle, a 24-year-old fact-checker envisioning a publishing career of glamor and greatness, suddenly shaking as I read the document my mother had mailed. It detailed her wish that I promise never to keep her or my father alive with artificial respirators, IV-drip nourishment, or anything else she deemed “extreme.”

I was horrified, and slightly angry. My mom was a 54-year-old literature professor who’d spent the 1970s eating whole grains and downing vitamins. She was healthier than anyone I knew. Why get so dramatic now? It seemed ghoulish, not to mention premature. But I scrawled my signature at the bottom of the page and shoved it into an envelope, my mother’s voice in my head, prodding me along.

As with the whole wheat and vitamins, my mother—back in 1990—was onto something long before it became conventional wisdom. But these days, Americans’ approach to aging and death is rapidly evolving, pushed both by the numbers and the grim reality behind them: In 40 years, there will be 19 million Americans over 85, all at high risk of losing the ability to care for themselves or dwindling away due to organ failure, dementia, or chronic illness. (The days of a sudden fatal heart attack are fading; by 2008, the death rate from coronary heart disease was down 72 percent from what it was in 1950.)

So while many seniors now live vigorous lives well into their 80s, no one gets a free pass. Eating right and exercising may merely forestall an inevitable and ruinously expensive decline. By 2050, the cost of dementia care alone is projected to total more than $1 trillion.

My mom’s decision to face her end came not from any of these facts, but from the nightmare of watching her own mother’s angry decline in a New York nursing home. “You’re all a bunch of rotten apples,” Grandma growled at visitors, the words erupting from her otherwise mute lips. And there she sat for three years, waiting to die. “Why can’t you just get me some pills so I can go?” she would sometimes wail.

The slide toward death was only slightly less awful for my father’s mother. Grandma Ada would greet me with a dazed smile—though it was impossible to know if she recognized the person standing in front of her wheelchair—before thrashing with involuntary spasms. An aide would come to restrain her, and then my dad and I would leave.

This cannot be right. This cannot be what we want for our parents—or ourselves. More

Sep 18, 2012Going Gently Into That Good Night

By Daniel Krieger
Narratively
September 18, 2012

If you’re dying and don’t care to wait around for death, you can always book your own appointment. One simple way to do this would be to stop eating and drinking; another would be to stop life-sustaining medicine or devices. Assuming you can decide on your own, both of these methods are good and kosher as far as the law goes. A third approach, however, ventures into a grayer area of legal and ethical terrain—quaffing a lethal cocktail. In the business of ending your life, the means matter a lot more than the final result.

These were three things my mother, Ann Krieger, was pondering when she reached the final leg of her terminal illness last year, a month before Mother’s Day. After several years of fighting colon cancer, her doctor broke the news that the cancer had spread and the treatment was no longer working. There was no more they could do.

“You’ve got months, not weeks,” he said.

“What should I do?” she asked. “Should I end it now?”

“No,” he said. “You don’t want to do that.”

Actually, my mother kind of did, but the doctor referred her to hospice and gave her information about palliative care, a mode of treatment that relieves the pain of patients with serious illnesses. But in my mother’s case, the physical distress was less acute than the existential. Coming to terms with the fact that you’re going to die is elusive. For some people, like her, an attempt to manage the logistics could make it seem more doable. She and my father had given this some thought and had very specific ideas about how they wanted their end-of-life matters handled.

Six years earlier, horrified by what was taking place with Terri Schiavo in Florida, they sat my sister and me down to give us instructions. Should it ever come down to it, my parents told us, they wanted no artificial resuscitation, experimental procedures, machines or IVs—none of that stuff. They just wanted us to make sure they would be allowed to die naturally. “The idea,” my father explained to me recently, “is to be pain-free, comfortable and not go through a lot of unnecessary, costly and painful treatments which won’t help anyway.”

My mother had first-hand experience with this 21 years ago when her mom, my grandma Trixie, who was in perfect health at 85, was struck by a hit-and-run driver near her home in Queens. The doctors at New York Hospital said she had severe trauma in her brainstem and wouldn’t wake up. She was hooked up to a ventilator. More

Sep 18, 2012Poll: Massachusetts Voters Support Medical Marijuana, Death With Dignity, Right to Repair Ballot Measures

By Robert Rizzuto
The Massachusetts Republican
September 18, 2012

 

If a new poll is any indication of what’s to come, the ballot initiatives in the hands of Massachusetts voters have a solid chance of passing on Nov. 6.

The latest Suffolk University/ WHDH News7 survey of 600 likely voters released late Monday night, shows overwhelming support for legalizing medical marijuana, allowing terminally ill patients to obtain drugs to end their life and a measure requiring auto manufacturers to provide local garages access to the same diagnostic and repair information as the dealerships.

The telephone poll, conducted between Sept. 13-16, revealed that 64 percent of those surveyed would vote to approve the “death with dignity” ballot initiative, allowing an ill patient to decide to die on their own terms rather than suffer through a terminal illness. More

Sep 6, 2012Massachusetts Death With Dignity Act: A Crime That Anyone Would Oppose It

By William D. Kickham
Boston Criminal Attorney Blog
September 2, 2012

As my readers know, this blog is normally reserved for strictly legal issues of criminal law – case decisions, primers on certain areas of Massachusetts criminal law, and backgrounders on criminal trial procedure.

Today I want to talk about a different crime of crime -a crime that’s not on the books in this state, yet goes on every day across not only the Commonwealth of Massachusetts, but indeed most of this nation. A crime that is both cruel and stunning, when one spends more than a minute thinking about it. That crime is the present legal inability of a terminally ill patient to choose a dignified and painless death, instead of a prolonged and dignity-robbing end to his or her life. Specifically, I’m talking about the ballot proposal that Massachusetts voters (that is, the voters who actually choose to spend fifteen minutes to go to their local polling place and actually vote,) will be offered this November. The ballot is Question Two, and is entitled “Massachusetts Death With Dignity Act.” This important ballot question, if passed by voters, would allow a physician who is licensed in Massachusetts to prescribe medication, at the request of a terminally ill patient who meets certain enumerated conditions, to end that person’s life.

As a Massachusetts criminal defense attorney, who sees the most hardened of criminal convicts treated with more dignity than this, I simply cannot believe that any compassionate, rational person would oppose this measure. It does nothing more than allow a terminally ill patient – if he or she wishes – to hasten an already inevitable, unavoidable, probably painful and undignified death. This is not suicide nor is it euthanasia, where someone else makes the decision and takes the steps necessary to end the patient’s life. Under this ballot proposal, which is modeled after similar laws approved by voters in three other states including Washington state and Oregon, a terminally ill patient will have the option of choosing a painless and dignified death if the PATIENT HIMSELF decides that his or her quality of life has become too degraded and/or too painful to continue on, when death is inevitable. NO ONE ELSE OTHER THAN THE PATIENT IS PERMITTED TO MAKE THAT DECISION under this ballot initiative.

However, reason and rationale, never mind compassion, often don’t rule in such public policy debates. More

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