End-of-Life Choice, Palliative Care and Counseling

Posts Tagged ‘David Leven’

Aug 11, 2011Terminally ill should have choice of doctor’s aid in dying

THE BOSTON GLOBE
Letters to the Editor
August 11, 2011

THE ARTICLE “Drive begins to put assisted suicide law on ballot next year’’ (Metro, Aug. 4) uses the term “assisted suicide’’ to describe the proposed ballot measure that would permit terminally ill, mentally competent patients to obtain drugs to end their lives.

The article states that “only two states, Washington and Oregon, have legalized assisted suicide.’’ In fact, what is legal there and, by court ruling, in Montana is for physicians to prescribe life-ending medicines for terminally ill patients, who must take the medicines themselves. This distinction is important. It is not a suicide when a patient, having made a reasoned decision, hastens death by days or weeks with prescribed medicines. By controlling the timing and circumstances of their deaths, patients can prevent or end terrible suffering. Having this option gives great comfort to those who are dying, and many never take the drugs.

Typical suicides occur when people who could live choose to die, usually when depressed, in isolation, and often violently. On the other hand, terminally ill people cannot continue to live much longer. They discuss their options with physicians and usually family members and are not necessarily depressed; most receive excellent hospice care.

Physician aid in dying is a choice that all mentally competent, terminally ill people should have.

David C. Leven
Executive director
Compassion & Choices of New York
New York

CLICK HERE TO READ AND COMMENT ON THIS STORY AT THE BOSTON GLOBE

Jul 14, 2011Living a Life, and Choosing When to Die

THE NEW YORK TIMES
Letters to the Editor
July 14, 2011

Most of us would like to control the timing and circumstances of our deaths. Dudley Clendinen, who has A.L.S., has a plan to do so. He claims to have a way of ending his life that is “quiet and calm.” It appears to give him great comfort that he has the means to end his life if and when living becomes too unbearable. It also seems that this is a rational choice made after serious and thoughtful consideration.

Whether Mr. Clendinen will execute his plan is uncertain. Many dying people who obtain prescribed life-ending medicines (which they must take themselves) in states where aid in dying is a legally recognized option for the terminally ill never take the medicines.

Yet they and thousands of other dying people in those states are provided comfort knowing that this last-resort option is available. Every state should formally permit aid in dying for mentally competent dying adults.

DAVID C. LEVEN
Executive Director, Compassion
and Choices of New York

Pelham, N.Y., July 11, 2011

CLICK HERE TO READ AND COMMENT ON THIS LETTER AT THE NEW YORK TIMES

Aug 9, 2010Palliative Care Information Act will allow for better end-of-life choices

By David C. Leven
August 7, 2010
LoHud.com

The end of life is a difficult time for patients, their families, physicians and other health-care professionals involved with patient care. It is also an important time for discussions to take place between physicians, willing patients and family members to determine the best course of care for the patient during the last chapter of patients’ lives.

Having these discussions empowers patients or health-care agents or surrogates to make informed decisions about treatment in accordance with the patient’s goals of care and wishes. Unfortunately, despite the fact that most patients want to have these conversations with their physicians, recent studies reveal that these discussions often do not occur. This results in unwanted treatment and diminished quality of care.

A bill that has passed both houses of the state Legislature will, if signed into law, correct this problem. The Palliative Care Information Act is designed to ensure that patients diagnosed with a terminal illness, or decision-makers for those patients who have lost decisional capacity, will have the opportunity to receive information and counseling, if desired, regarding palliative care and end-of-life options appropriate to the patient. This includes prognosis and risks and benefits of the various options.

When dying patients receive information and counseling about their palliative and end-of-life care treatment alternatives, the quality of their end-of-life care is better than when discussions do not take place, their wishes are more often respected and they are referred to hospice sooner. Unfortunately, despite all of our efforts in recent years, hospice referral rates have not changed much and patients are referred much too often, if at all, only when close to death. This is in part due to the lack of discussions between physicians and patients until patients are very near death. The median length of stay in hospice, which provides excellent end-of-life care, is, sadly, only 17 to 19 days, with 33 percent enrolled for just eight days or less and another 33 percent enrolled for 31 days or less. The Palliative Care Information Act should ensure that timely hospice referrals are made.

With some 8,000 people dying each year in this region, the bill could have a positive impact on the quality of deaths of thousands of our residents yearly. Introduced by the chairs of the Assembly and Senate health committees, the bill was also co-sponsored by local Assembly members Amy Paulin, D-Scarsdale, and Sandra Galef, D-Ossining. The Palliative Care Information Act (S. 4498, A. 7617) should be approved by Gov. David Paterson. Support the bill by writing him at Executive Chamber, Albany, N.Y. 12224.

David Leven, a resident of Pelham, is the executive director of Compassion & Choices of New York, Pelham. Learn more at www.compassionandchoicesofny.org.