End-of-Life Choice, Death with Dignity, Palliative Care and Counseling

Compassion & Choices

Supporters Celebrate Progress of Aid in Dying Legislation for Terminally Ill Coloradans

Following hearing, the House Judiciary Committees Advanced the Bill to the Full House

(Denver, Colorado – Feb 4, 2016) Despite the Colorado Senate’s inaction on the Colorado End of Life Options Act yesterday, advocates for the legislation are celebrating today as their bill moves to the House Floor.

“The campaign to give terminally ill Coloradans the option of medical aid in dying had a real victory today,” said Compassion & Choices Cultivation Manager Roland Halpern. “We applaud members of the House Judiciary Committee who listened to their constituents and agreed that people facing unbearable suffering at the end of life should have more options and more control over how they spend their final days and weeks. Where Senators tried to shut down debate yesterday, the House chose to trust Coloradans to have a serious conversation about the end of life.”

On Wednesday, SB16-025, the End of Life Options Act fell victim to partisan politics in the Colorado Senate Judiciary Committee; on Thursday, members of the House Judiciary committee voted six to five in favor of the bill, allowing the legislation to move to the House floor.

The Colorado End of Life Options Act is closely modeled after the Death With Dignity Act in Oregon, which has worked well for 17 years, without a single documented case of abuse or coercion. California recently became the 5th state to authorize the option of medical aid in dying and the 2nd state after Vermont in 2013 to do it via the legislature. The other three states that authorize this end-of-life option are Oregon (via referendum in 1994), Washington (via referendum in 2008) and Montana (via state Supreme Court decision in 2009). More than half the states have considered similar legislation in the past year.

Coloradans from across the state came to the Capitol on Thursday to testify in support of The Colorado End of Life Options Act, which would allow mentally capable, terminally ill adults the option to request a doctor’s prescription for medication that they could take, if their suffering becomes unbearable, to painlessly and peacefully die in their sleep.

Patti James, a 79 year-old nurse from Littleton who also has terminal cancer, testified at the House hearing and later expressed her gratitude: “I am a nurse who has seen too many difficult, painful deaths. I am also a woman with stage 3 lung cancer, which means a cruel and terrifying dying process is in my future. I want to thank the committee for truly hearing what we had to say and moving this legislation to the next step. I may not ultimately be able to access this compassionate option, but I hope other dying Coloradans can one day.”

Many Coloradans went to difficult lengths to get to the Capitol and have their voices heard. Joellyn Duesberry is a 71 year-old from Greenwood Village. She explained, “I have forfeited my privacy in order to be robustly vulnerable before all of you gathered here [because I] want my dying to be of some service to humanity.”

Dr. Lauri Costello, a family doctor from Durango, made it clear to members on the committee why she is confident supporting the Colorado End of Life Options Act: “The term ‘physician assisted suicide’ is, frankly, deeply offensive to me as a physician and to many of my physician colleagues.  This term does not refer to any legal medical procedure, and insinuates that physicians help their patients commit suicide.  Suicide and euthanasia are both illegal in all 50 States and will remain so.  Neither is remotely related to medical aid in dying, which this bill addresses.”

Dan Diaz, who was in Colorado last week, had his testimony read aloud to the House committee and provided video testimony given by his late wife, Brittany Maynard. Maynard had terminal brain cancer and moved from California to Oregon in 2014 to access that state’s Death with Dignity Act. Diaz testified, “As a Catholic, I believe it is not for me to judge someone else’s decision regarding their own end of life.  I respect those who might make a different decision if they were in Brittany’s shoes, so I don’t understand why they do not extend the same respect to those of us, and the 68% of Coloradans, that agree with Brittany and support End-of-Life Options for terminally ill individuals.”

Presidential Campaign Forum Raises End-of-Life Options Issue

End-of-Life Options Organization to Host Teleconference Before Nevada Primary

(Portland, OR – Feb. 4, 2016) In response to a unique question about end-of-life care options raised during a CNN presidential town hall last night by terminally ill supporter Jim Kinhan, Compassion & Choices announced today it will host a teleconference on the issue before the Nevada primary. The teleconference will take place on Feb. 16 at 8 p.m. EST/5pm PST, at a location still to be determined.

Below is a partial transcript of the presidential town hall exchange between Hillary Clinton and Jim Kinhan, an 81-year-old supporter of Compassion & Choices dying from colon cancer, who wrote an op-ed about it published in the Concord Monitor.

KINHAN: “… I wonder what leadership you could offer within an executive role that might help advance the respectful conversation that is needed around this personal choice that people may make, as we age and deal with health issues or be the caregivers of those people, to help enhance their end of life with dignity.”

HILLARY CLINTON: “… this is the first time I’ve been asked that question … And I thank you for it, because we need to have a conversation in our country … So it is a crucial issue that people deserve to understand from their own ethical, religious, faith-based perspective … I want, as president, to try to catalyze that debate because I believe you’re right, this is going to become an issue more and more.”

“Options for end-of-life care are a big deal for millions of older Americans like Jim Kinhan and their baby boomer caregivers,” said Compassion & Choices Action Network President Barbara Coombs Lee, who was an ER and ICU nurse and physician assistant for 25 years. “Virtually every national and state poll shows voters from all political persuasions and demographic groups want autonomy to choose from the full range of end-of-life care options, including hospice, palliative care and medical aid in dying.”

“Most people want to die at home and avoid futile, painful, unwanted medical treatments that only extend their dying process and destroy their quality of life,” added Coombs Lee. “We are hosting this teleconference so journalists, politicians and voters unfamiliar with end-of-life care options can learn about and discuss this issue.”

Durable Power of Attorney for Healthcare – How to Make the Selection

By Sid Adelman

The closest most of us will come to experience torture will be at the end of our lives in we end up in the intensive care unit (ICU), a skilled nursing facility or in a dementia ward. The Institute of Medicine’s Key Findings and Recommendations in its Dying in America report suggests one way to avoid this nightmare scenario is to  designate “a surrogate/decision maker.” This step is important because this surrogate may be your only hope if you are unable to speak for yourself for avoiding the suffering and torture associated with unwanted and unnecessary medical procedures, tests and treatments that may be invasive, painful, or fraught with complications.

What is a Durable Power of Attorney (DPOA) for Healthcare

Your designated person or persons who will speak for you, but only if you are unable to speak for yourself or make medical decisions for yourself.  You might be in a coma, you might be sedated or you might be so confused that you are unable to make a rational decision. This designated person or persons will make sure your wishes are honored.

Isn’t my advance directive for healthcare enough?

Even though your doctor and the hospital have your advance directive on file, it might be overlooked, it might be inaccessible, it might not be apparent or it might be purposely ignored and that’s why you need your DPOA to be available, giving him/her the power to make decisions – with the understanding of what you want. 

How to select the DPOA

The optimal choice would be:

  1. A person who will do whatever is necessary to honor your wishes. A person with a backbone, willing to stand up to the medical establishment, to family and friends who “know better what you (or God) would want.”
  2. A person who is mentally competent, healthy, perhaps younger, forceful even as they age and be geographically accessible.
  3. It does not have to be a spouse or family member. Sometimes a dispassionate and unemotional friend would be a better choice.

You will want a second and maybe a third person as a backup in case the first DPOA is unavailable.

Communicating with your DPOA

If your intended DPOA accepts the role, you should provide them with a copy of your Advance Directive for Healthcare in which you have designated them as DPOA and made clear what you want done medically if you are unable to make decisions for yourself. The conversation should go beyond just the specifics of a ventilator, CPR, or a feeding tube, but should include the values and priorities that are important to you. They would include desire for control, level of pain you are willing to accept and much more. See the Compassion & Choices addenda – Values Worksheet and My Particular Wishes for a more complete list.

Petition Drive to Overturn California Aid-in-Dying Law Fails

Compassion & Choices Working to Implement Law Inspired by Brittany Maynard

Toni Speaking

(Los Angeles, CA – Jan. 5, 2016) An attempt to overturn the state’s new aid-in-dying law has failed to collect enough signatures to qualify a referendum for the November ballot, according to news reports.

“An overwhelming majority of Californians supports the End of Life Option Act,” said Toni Broaddus, California campaign director for Compassion & Choices, which led the statewide campaign to pass the law. “Opponents simply could not inspire the people of California to take away options for people who are dying.”

Despite support from the Catholic Church, which encouraged parishioners to sign petitions during mass, the mostly volunteer effort fell short of collecting 365,880 signatures by the January 4 deadline to qualify for a referendum. According to the secretary of state’s website, the group that filed the petition raised less than $100,000 to try to overturn it.

Once it takes effect, The End of Life Option Act will give mentally capable, terminally ill adults facing intolerable suffering in the dying process the ability to ask their doctor for medication they can take to die gently in their sleep. California lawmakers passed the bipartisan law last fall during a special session on healthcare and it will not take effect until 90 days after the session ends sometime this year.

Compassion & Choices recently launched a bilingual campaign to educate terminally ill Californians, families and medical providers about the benefits and requirements of the End of Life Option law.

“We are utilizing all our resources to ensure every Californian has meaningful access, through their healthcare providers, to clearly understand the benefits and requirements of medical aid in dying as an end-of-life care option,” said Kat West, national director of policy & programs at Compassion & Choices. “We are educating both doctors and the public about the full range of options to relieve suffering at the end of life, including hospice, palliative care and medical aid in dying.”

Elizabeth Wallner

Terminally ill Californians and their families, physicians, and pharmacists can call a free hotline, 800-893-4548, to access bilingual information on the End of Life Option Act. Through this hotline, practicing physicians will be able to access Compassion & Choices’ free Doc2Doc consultation program to speak to doctors with years of experience in end-of-life care, including medical aid in dying. Pharmacists will also be able to access the Pharmacist2Pharmacist consultation program. For more information, visit www.endoflifeoption.org.

The news of the failed referendum effort was well received by End of Life Option Act supporter Elizabeth Wallner, a single mom from Sacramento living with stage IV colon cancer that has spread to her liver and lungs.

“Death doesn’t scare me,” she said. “What scares me more is to have my only son and my family watch me die slowly and painfully. I don’t want this agonizingly traumatic image to be their last memory of me.”

Tucson Unanimously Passes Resolution Supporting Aid in Dying

(Tucson, AZ – December 15, 2015) Tuesday, the Tucson City Council, including Mayor Jonathan Rothschild, approved a memorial resolution supporting aid in dying by a unanimous 7 – 0 vote. Medical aid in dying is already and authorized end-of-life option in 5 state including, most recently, California.

The memorial resolution will be presented to the Arizona Senate, urging legislators to support an aid in dying law in the upcoming legislative session. This effort was spearheaded by Mayor Jonathan Rothschild and Councilpersons, Steve Kozachick, Karin Uhlich and Richard Fimbres.

Although the memorial does not change the existing law prohibiting aid in dying, it recognizes the growing public support for expanding end-of-life options to include medical aid in dying.

The Memorial affirms that the City of Tucson:

  • Respects the diversity of perspectives of its citizens,
  • Supports equal protection within the diversity of perspectives on end-of-life decisions
  • Recognizes the practice of Aid in Dying as a legitimate individual liberty

Bisbee was the first Arizona municipality to publicly affirm support of aid in dying by passing a resolution of their own in September, 2015. After Tuesday’s vote, Tucson becomes the largest city in Arizona to publically recognize the rights of terminally ill, mentally competent adults to have access to a full range of end-of-life options, including aid in dying.

Tucson joins municipalities such as Los Angeles and San Francisco, which passed similar resolutions in the run up to that state adopting the End-of-Life Option Act earlier this year. Compassion & Choices applauds this effort by the Tucson City Council and is optimistic that the Arizona Legislature will respond by making aid-in-dying legislation a top priority in the coming year.