End-of-Life Choice, Palliative Care and Counseling

Massachusetts

Patrick, Citing Personal Experience, Voted Yes on Death with Dignity

by Rachel Zimmerman
CommonHealth
November 8, 2012

For the record, Gov. Deval Patrick said his decision to vote in favor of physician assisted suicide was motivated largely by his experience with his mother near the end of her life, The Associated Press reports.

The measure was defeated by a narrow margin here in Massachusetts. But as Carey noted in a recent post, much of the passion in favor of the measure came from people who had actually witnessed a loved one die under painful conditions with much suffering; these survivors yearned for a more graceful and dignified path to death for the ones they loved.

And indeed, the AP writes:

Gov. Deval Patrick says his decision to vote for a ballot question that would have legalized physician-assisted suicide for the terminally ill was motivated largely by personal considerations.

Patrick told reporters Wednesday that he supported the question after his experience with his mother at the end of her life.

Patrick also pointed to the death of his grandmother some years earlier.

Patrick said he knew how important it was for his mother and grandmother to have some measure of control at the end of their lives, although he’s not sure they would have used the medication the question would have legalized.

Massachusetts Vote May Change How the Nation Dies

by Lewis M. Cohen
Slate
October 29, 2012

This Election Day, Massachusetts is poised to approve the Death With Dignity Act. “Death with dignity” is a modernized, sanitized, politically palatable term that replaces the now-antiquated expression “physician-assisted suicide.” Four polls conducted in the past couple of months have shown strong support for the ballot question, although a well-funded media blitz by the opposition is kicking in during the final several weeks and may influence voter opinions.

Oregon’s Death With Dignity Act has been in effect for the past 14 years, and the state of Washington followed suit with a similar law in 2008. Despite concerns of skeptics, the sky has not fallen; civilization in the Northwest remains intact; the poor, disenfranchised, elderly, and vulnerable have not been victimized; and Oregon has become a leader in the provision of excellent palliative medicine services.

But the Massachusetts ballot question has the potential to turn death with dignity from a legislative experiment into the new national norm. The state is the home of America’s leading medical publication (the New England Journal of Medicine), hospital (Massachusetts General), and four medical schools (Harvard, Boston University, University of Massachusetts, and Tufts).  Passage of the law would represent a crucial milestone for the death with dignity movement, especially since 42 percent of the state is Catholic and the church hierarchy vehemently opposes assisted dying. Vermont and New Jersey are already entertaining similar legislature, and if the act passes in Massachusetts, other states that have previously had unsuccessful campaigns will certainly be emboldened to revisit this subject. More

Death With Dignity in Massachusetts

by Lauren Mackler
Huffington Post
October 23, 2012

Watching a loved one die without dignity is devastating. Sadly, both of my parents experienced prolonged, painful, and what I considered to be, unnecessarily inhumane deaths.

Twelve years ago I attempted to discuss end-of-life planning with my mother and father. Because I believe that death is simply a transition to another plane of existence, I tend to approach the topic in a rather direct and practical way, as was the case with my parents back in 2000. I suggested that they do end-of-life planning in advance, to ensure clarity about their wishes and to avoid any potential family conflict. But because neither of my parents were able to discuss or plan for death, at the end they were each kept alive by artificial means and suffered heart-wrenching deaths.

Following emergency surgery for a ruptured intestine, my 90-year-old father languished on a hospital respirator for more than a month. During this time, I happened upon a documentary on HBO called How to Die in Oregon. The film is about the Death with Dignity laws in Oregon and Washington, which allow mentally competent, terminally-ill adults to voluntarily request and receive a prescription medication to hasten their death. How to Die in Oregon doesn’t tell people how they should die, but it shows how having more options for end-of-life care gives people more peace of mind in their final days.

I had always felt conflicted about physician-assisted suicide. But after watching the How to Die in Oregon documentary, I became convinced that Death with Dignity should be a legal option for any adult facing terminal illness. On November 6, 2012, the Death with Dignity Initiative (also known as Question 2) will appear on the general election ballot in my home state of Massachusetts. More

A Method for Dying With Dignity

by Marcia Angell
The Boston Globe
September 29, 2012

On Nov. 6, Massachusetts voters will decide whether physicians may provide a dying patient, whose suffering has become unbearable, with medication to bring about an earlier, more peaceful death if the patient chooses and the physician agrees. On the ballot will be a Death with Dignity Act — Question 2 — that is virtually identical to the law that has been in effect in Oregon for nearly 15 years.

Good palliative care is adequate for the great majority of dying patients, but not all. Most pain can be eased, but other symptoms are harder to deal with — weakness, loss of control of bodily functions, shortness of breath, and nausea — and the drugs to treat these symptoms often produce unacceptable side effects. Even worse for many dying patients is the existential suffering. They know their condition is inexorably downhill, and they find it meaningless to soldier on.

This is not a matter of life versus death, but about the timing and manner of an inevitable death. That is why many prefer the term “physician-assisted dying” to “physician-assisted suicide.” In the usual suicide someone with a normal life expectancy chooses death over life. Terminally ill patients don’t have that choice. More

A 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