End-of-Life Choice, Palliative Care and Counseling

Legal Aid in Dying

Compassion & Choices Montana Unsurprised That Latest Polling Confirms Support for End-of-Life Choices Regardless of Party Affiliation

by Compassion & Choices staff
April 8, 2013

73% of Montanans Oppose “Physician Imprisonment Act”

(Helena) The overwhelming majority of Montanans, to the tune of 82 percent, believe that end-of-life choices are private decisions that should be made without government interference, according to an April 2013 poll of likely voters conducted by Global Strategy Group.

A memo released by Global Strategy Group reveals that “Voters want to know they have a legal option to end their own life in a humane and dignified way: More than 7 of 10 voters (71%) say that if they were terminally ill and in severe distress, they would want the legal option to end their own life in a humane and dignified way.” The memo further goes on to say, “Broad majorities of Montanans strongly support legal end-of-life choices and strongly reject any efforts to criminalize doctors for complying with their patients’ wishes. Furthermore, these data suggest that legislators will pay a real price for supporting efforts to penalize and criminalize doctors for doing so. Ultimately, Montanans support the choice for others, want to be able to make the legal choice for themselves, and believe there is no role for government when it comes to making that choice.”

Nearly three-quarters of voters across party lines oppose HB505, which would send doctors to prison for providing medication that would allow the patient to end his or her own life in a humane and dignified way. 67 percent of voters say they would be less likely to vote for a legislator who supported such a proposal, including 53 percent who said they would be much less likely.

Emily Bentley, Campaign Manager for Compassion & Choices Montana, says, “This latest polling is consistent with what we know about Montana values. People in our state agree that privacy is important and individual freedom is worth protecting. They do not want to see their doctor imprisoned for providing what they believe is good medicine. Lawmakers should pay attention.”

Compassion & Choices Applauds Montana Committee’s Rejection of “Physician Imprisonment Act”

by Compassion & Choices Staff
April 3, 2013

HB505 Fails to Clear Senate Judiciary Committee on Tie Vote

(Helena, MT) – HB505, an extreme bill that would degenerate Montana’s currently legal practice of aid in dying into a felony, failed to clear the Senate Judiciary Committee this morning. The bill was tabled on a tie vote, 6-6. The following statement can be attributed to Emily Bentley, Campaign Manager, Compassion & Choices Montana.

“This bill is a gross intrusion into the physician-patient relationship: it would stifle discussions of end-of-life options and prohibit physicians from providing aid in dying to terminally ill patients who request it. HB 505 would deny suffering, terminally ill Montanans the freedom to choose aid in dying because it would imprison doctors who support their patients’ decisions to end their suffering. Montanans overwhelmingly support aid in dying. This should be the end of the Physician Imprisonment Act.”

Dedicated to a Cause

by Barbara Coombs Lee
March 26, 2013

Last Wednesday, March 20, the Connecticut Assembly’s Public Health Committee began its consideration of a bill modeled after Oregon’s Death with Dignity Act. What a day! In my 22 years of legislative work, this hearing was the most grueling — and the most inspiring — I have ever witnessed.  Compassion & Choices volunteers and supporters showed themselves to be as passionate, judicious, intelligent and dedicated as citizens can ever be. They are committed to a world of justice and mercy. And they trust in democracy to make it so.

They came because they want choice and control in their own mortal endings. But mostly, they came for others who could not — their neighbors and loved ones and people unknown to them. They came that others need not suffer against their will, and that all may have the opportunity to face death in comfort and peace of mind. My heart swelled as I sat with them and heard the witness of these decent, altruistic, dedicated people.

The day began early, as aid-in-dying supporters travelled hours to Hartford by bus, car and train to be in line by 7:00 am.  Sign-up began at 9, but being in line by 7 helped ensure an opportunity to speak. The hearing began at 10 and our bill, Compassionate Aid in Dying for Terminally Ill Patients (HB 6645), came up about noon. Representative Betsy Ritter, the bill’s chief sponsor, spoke with eloquence and authority. Other legislators followed, and then the committee shifted gears and heard unrelated bills.

For many hours our supporters kept each other’s spirits up as they sat patiently through testimony about nursing technicians, dental hygienists, something called advance practice collaboration agreements, and tattoo artist licensure.

Some of our valiant and dedicated supporters just had to leave when their bus departed or their backs gave out. But others stayed until 1 am for their chance to speak. Yes, you read that right — they endured this process from 7 am until 1 am without complaint!!

Here are a just few of the heroes:

Shannon Sanford, a Yale-educated nurse who did her masters thesis on Oregon’s Death with Dignity Act.  ”Compassion & Choices were great to me when I was working on my thesis.  I can stay to the bitter end,” she told us. She had to, attending the entire 15-hour hearing as the last person to testify at approximately 1:30 am.

It fell to Shannon to present the committee with letters from all over the state. The stack was nearly a foot high, making a thump on the table.

Placing her hand on this tower of paper, Shannon said:  ”I brought my friends who are all in support of House Bill 6645″.  A legislator asked, ”I have to know, how many people signed letters?”  Shannon had a snappy response despite sitting 15 hours in a hearing room:  ”I stopped counting after 1500.”

Hunt Williams traveled over an hour to the state Capitol and waited twelve more to tell his story.

Hunt told the committee the story of his manslaughter arrest for merely cleaning a weapon his terminally ill friend, John Welles, used when he was dying of cancer. Only due to the overwhelming support and advocacy in his community of Cornwall, Connecticut, was Hunt sentenced to accelerated rehabilitation, a process that took over a year. The committee and the entire room sat in complete silence as they listened to Hunt’s riveting experience.

“Thank you sir, thank you for giving testimony.  I think I was taken aback by what you had to say,” a stunned co-chair of the committee, Senator Terry Gerratana, said.

Gloria Blick, aged 91, is a passionate advocate for end-of-life choice, as is her son Dr. Gary Blick.

When called to testify, Gloria and Dr. Blick held hands and both walked confidently to the microphone and sat together supporting each other.  Luckily, Gloria has not had a significant illness, but with her active volunteerism in the senior community, she has witnessed first-hand the pain and suffering of those at end of life, and it disturbs her greatly.

She made it clear to the committee she had been too active and too well to see her life end in a slow, relentless spiral of deterioration. Nor would she want her family, including Dr. Blick, to suffer unnecessarily with her.  ”I would never want to do that to my son,” she said.

Lillian Kaplan sat for hours waiting for her opportunity to speak out in favor of HB 6645, offering moving testimony regarding the difficult and painful death of her son-in-law Steven Kahn, who wanted to die on his own terms.  Lillian read into testimony a letter Steven wrote prior to his death.

“I am writing to you so you will not have to wonder…I’m not asking for your approval, only that you honor my judgment,” he wrote.

At the conclusion of her testimony, the Senate Chair of the Committee respectfully asked her age:  ”Well, in a year and a half I will be 100.”

Lillian, Gloria, Gary and Shannon and so many others showed themselves to be amazing and inspiring advocates. It is an honor to be able to work beside them for choice and control at life’s end.

Wife Dying of Cancer No Option for Aid in Dying

Letter to the Editor
Montana Standard
March 19, 2013

I wish my wife had the option to discuss aid in dying with her physician.

My name is David “Doc” Moore. I am the current Republican Representative from House District 91 in Missoula County. Eleven years ago my wife passed away from Stage 4 malignant melanoma. She fought the disease for five years, and her quality of life was good up until the final three weeks, when she went downhill fast. My wife was a strong woman, but when her cancer came back it had spread to her lungs, liver, spleen and brain. The cancer in her liver was crushing her from the inside out making her breathing labored. When she finally slipped into a coma, we thought there would be relief.

Unfortunately, it was clear from her facial expressions and the constant death rattle that she was still suffering. Her pain ended only when she died. This was before the Baxter decision, so my wife did not have the option to use aid in dying. I wish she had the option to discuss this choice with her physician.

Most Montanans agree that it is not the government’s role to interfere in private medical decisions.

Politicians are the last people needed at the bedside of a dying person. House Bill 505 would allow the government to undermine the sacred relationship between doctor and patient. It is so broadly written that physicians will be scared of being second-guessed by prosecutors and legislators when treating dying patients for pain.

In Helena, we like to know what regular folks are thinking. Please email the Senate Judiciary Committee using the MT.gov website and call your senator at 406-444-4800. Tell them to VOTE NO on House Bill 505. Don’t put doctors in prison.

– David “Doc’’ Moore, R-Missoula

Support grows in Vermont for an end-of-life bill

Janice Lloyd, USA TODAY
March 22, 2013

Most states ban physician-assisted death, but a movement is growing to give terminal patients the right to choose their fate.

Dick and Ginny Walters envision a new approach to dying for Vermont residents: They want terminally ill patients with a prognosis of less than six months to live to have the right to request and take life-ending medication.

The Shelburne, Vt., retirees — he’s 88, she’s 87 — say they are both healthy and fit. They have devoted the past 10 years to the cause, meeting with supporters in their living room to track legislation — including the bill “Patient Choice and Control at End of Life.” It passed the Vermont Senate in February and goes to the House this month.

Although assisted dying is illegal in most states and opponents have been fighting proposals for the past 15 years, support is growing in Vermont and other parts of the Northeast. Connecticut and New Jersey legislators are also examining measures.

“It makes ultimate sense to people who have lived their lives in an independent way and don’t want to be reduced to an infantile existence and having other people make decisions for them,” Dick Walters says. “It’s taken us a long time, but we think Vermont will do this now.”

Vermont would be the first state to pass a doctor-assisted-death bill through the legislative process. Oregon and Washington voters passed similar bills in voter referendums. Massachusetts voters defeated a measure, 51% to 49%, in November.

“We may have lost this time in Massachusetts, but we won in the region,” says Barbara Coombs Lee, president of Compassion and Choices, a non-profit group dedicated to protecting the rights of the terminally ill. “I think the movements in the other states are evidence of that. Vermont is close to passing. In subsequent efforts, Massachusetts will have a leg up.”

Proponents of the Massachusetts measure were outspent 5 to 1 by religious, medical and disability groups, including the Roman Catholic Church, says Coombs Lee. Cardinal Sean O’Malley of Boston said in a statement after the vote that “we can do better than offering them the means to end their life.”

Walters says the Vermont mind-set is different: “Vermonters have a strong belief for respecting each other’s beliefs.”

When his time comes, Walters says, he doesn’t know whether he’d choose to end his life, but his father asked him for help “and it wasn’t legal to do it. It was really hard on me to not be able to help him. I’ve been bothered a long time by his suffering.”

He says a group of Vermont friends, including many retired physicians, got the idea to organize after Oregon passed the first referendum allowing physician-assisted dying in 1997. Oregon’s law went into effect in 1998, and a similar law went into effect in in Washington in 2009.

The Oregon law requires a patient to get two physicians to say he or she is terminally ill (expected to die within six months), to be mentally competent, an adult 18 or older and a resident of the state. The patient has to be physically able to swallow the medication; someone else can’t administer it. The written request for the medication must have two witnesses, one of whom cannot be an heir, and the patient must also make two oral requests.

“There are two waiting periods,” says Peg Sandeen, executive director of Death With Dignity, an advocacy group that helped write the laws. “The person is certain about what he wants.”

Sandeen says when the U.S. Supreme Court ruled 6-3 in favor of Oregon voters in 2006 the ruling paved the way for other states to create their own laws.

But fights continue: In Montana, a bill is pending that calls for imprisoning and fining a person “who aided or solicited a suicide.” The Montana Supreme Court ruled in 2008 that a state law protects doctors from prosecution for helping terminally ill patients die.

Physician Diana Barnard, a hospice and palliative care doctor in Weybridge, Vt., says “citizens are telling us they want this bill to pass. My professional responsibility is to supply the medication.”

Diana Barnard, a physician, says, “Recognizing that the end of your life is coming is important for so many reasons.”(Photo: Handout)

She says most patients want to know when they’re dying, but most doctors don’t know how to have that conversation.

“Recognizing that the end of your life is coming is important for so many reasons,” she says. “You get a chance to say goodbye to people, have closure on big issues. I always ask patients: ‘If time were short, what would be important to you?’ It’s criminal to not let people do this.”

Another part of the Oregon law requires the Health Department to track the number of people who request the medication, those who take it, and the doctors involved. In 2012, 115 requested it, a record number. Among that group, 77 took it and died. Sixty-one doctors filled orders for medications, one fewer than in 2011.

Dick Walters isn’t surprised more patients didn’t take the medication they requested.

“Just having the choice and knowing the medication is available can make a huge difference,” he says. “I think this thing will change how people talk about death and improve end-of-life care.”

Even in hospice care, when patients have stopped taking medical measures to prolong life, someone else administers the medication that helps control pain and eventually aids in ending life.

“That can leave an enormous amount of guilt on the family member,” Coombs Lee says.

“Laws like the one in Oregon relieve the family of the responsibility. It empowers the patient to be in control — to let the family be there, and say ‘Hold me while I do this.’ “