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

Oregon News

Post-Brittany Maynard Poll: Most U.S. Doctors Now Support Aid in Dying

By Sean Crowley

For the first time, most American physicians believe by a 23 percent margin (54% vs. 31%) that patients with an “incurable and terminal” disease should have the option to choose death with dignity, also known as the medical practice of aid in dying.

That is the conclusion of an online survey conducted by Medscape of 17,000 U.S. doctors representing 28 medical specialties.

The previous Medscape survey on this issue in 2010 showed physicians support medical aid in dying by a five percent margin (46% vs. 41%).

“It represents a remarkable shift,” said Arthur Caplan, founding head of the division of bioethics at NYU Langone Medical Center, in an interview with NBC News. “If physician opposition continues to weaken, it is likely that despite fierce resistance from some religious groups and some in the disability community, more states will follow Oregon, Washington and Vermont, and legalize.”

The exact question wording in both the 2014 and 2010 surveys asking physicians if they support or oppose aid in dying, respectively, are below:

“I believe terminal illnesses such as metastatic cancers or degenerative neurological diseases rob a human of his/her dignity. Provided there is no shred of doubt that the disease is incurable and terminal, I would support a patient’s decision to end their life, and I would also wish the same option was available in my case should the need arise.”

“Physicians are healers. We are not instruments of death. This is wrong.”

Medscape conducted the 2014 poll between Sept. 18 and Nov. 12, so it received a significant part of the responses after the Oct. 6 launch of Brittany Maynard’s joint campaign with Compassion & Choices to authorize aid in dying in states nationwide.

In addition to death-with-dignity laws enacted in Oregon, Washington, and Vermont, courts in Montana and New Mexico have authorized aid in dying.

Brittany Maynard’s Story Inspires 20 Newspapers Across Nation to Endorse Death With Dignity

By Patti Brooks

Brittany Maynard’s historic joint partnership with Compassion & Choices to expand access to death with dignity nationwide has sparked a national conversation about end-of-life choice.

In fact, since our campaign launch on Oct. 6, Brittany has inspired at least 20 newspapers in 11 states to editorialize in support of the medical practice of aid in dying for terminally ill, mentally competent adults.

Below are excerpts of the 20 editorials in alphabetical order of the 11 states.

More

Brittany Maynard Releases New Video in Campaign to Authorize Death With Dignity in California, Nationwide

She Discusses Her Declining Health But Reserves Right Not to Take Life-Ending Medication

(Portland, OR – Oct. 30, 2014) Terminally ill 29-year-old Brittany Maynard has released a new video as part of her joint campaign with Compassion & Choices to expand access to death with dignity in California and other states nationwide. The video is available at http://www.thebrittanyfund.org/.

Brittany has an aggressive, fatal form of brain cancer, diagnosed on New Year’s Day. She and her family took on the incredibly difficult task of moving from the San Francisco Bay Area to Portland, Oregon, to access Oregon’s death-with-dignity law authorizing the medical practice of aid in dying. This medical practice offers terminally ill, mentally competent adults the option to request a prescription for medication they can take to end their dying process if it becomes unbearable.

Nearly nine million have watched her first video since it was posted on YouTube Oct. 6. And 3.5 million people have visited the campaign website to help expand access to death with dignity in Brittany’s name at www.thebrittanyfund.org.

“Brittany is a teacher by training, and now she is teaching the world that everyone deserves the opportunity to die with dignity. She is changing hearts and minds on an unprecedented scale on this basic human-rights issue,” said Compassion & Choices President Barbara Coombs Lee, who recently met with Brittany and her family. An attorney, who was an ER and ICU nurse and physician assistant for 25 years, Coombs Lee coauthored the law Brittany is accessing.

On New Year’s Day, after months of suffering through severe headaches, Brittany learned she had brain cancer. Three months later, after undergoing surgery, she found her brain tumor had grown massively. That is when physicians told her she would likely die within months. Brittany has had her life-ending medication since shortly after that. She tentatively planned to take the medication in early November, but she has made it clear that timing depends entirely on how rapidly her cancer progresses and the severity of her symptoms.

“If November 2 comes along and I’ve passed, I hope my family is still proud of me and the choices I made,” says Brittany in the new video at www.thebrittanyfund.org. “And if November 2 comes along and I’m still alive, I know that we’ll just still be moving forward as a family out of love for each other and that that decision will come later.

“It sounds so cliché: “We take things one day at a time,” but it’s like, that’s the only way to get through this,” says Brittany’s husband, Dan Diaz, in the video. “You take away all of the material stuff, all the nonsense that we all seem to latch onto as a society, and you realize that those moments are really what matter.”

“The worst thing that could happen to me is that I wait too long … My most terrifying set of seizures was about a week or so ago,” Brittany says in the video, which was recorded Oct. 13-14. “I remember looking at my husband’s face at one point and thinking, ‘I know this is my husband, but I can’t say his name,’ and ended up going to the hospital.”

“It’s not my job to tell her how to live, and it’s not my job to tell her how to die,” says Brittany’s mom, Debbie Ziegler, in the video. “It’s my job to love her through it.”

“Well if all my dreams came true I would somehow survive this, but I mostly likely won’t,” Brittany says in the video. “So beyond that, having been an only child for my mother, I want her to recover from this and not break down, you know, not suffer from any kind of depression. My husband is such a lovely man, I want him to – you know I understand everyone needs to grieve ­– but I want him to be happy, so I want him to have a family.”

“My goal of course is to influence this policy for positive change, and I would like to see all Americans have access to the same healthcare rights,” Brittany concludes in the video. “But beyond that public policy goal, my goals really are quite simple, and they mostly do boil down to my family and friends, and making sure they all know how important they are to me and how much I love them.”

In addition to Oregon, aid in dying is authorized in Washington, Montana, Vermont and New Mexico. Compassion & Choices has campaigns to authorize this medical practice in California, Colorado, Connecticut, Massachusetts and New Jersey.

Vermont Becomes First Legislature to Approve Death-with-Dignity Legislation

by Compassion & Choices Staff

CONTACT: Sean Crowley, 202-550-6524
[email protected]

Politics Shift as Lawmakers Embrace Nationwide Support for End-of-Life Choices

(Washington, D.C. – May 13, 2013) The nation’s leading end-of-life choice advocacy group, Compassion & Choices, praised the Vermont legislature for becoming the first legislative body in the nation to approve death-with-dignity legislation. Gov. Peter Shumlin has vowed to sign the bill into law.

“This historic legislative victory proves that the aid-in-dying issue is no longer the third rail of politics. In fact, it’s a winning issue on which Gov. Shumlin campaigned,” said Compassion & Choices President Barbara Coombs Lee, an ER and ICU nurse and physician assistant who co-authored the nation’s first Death-with-Dignity law in Oregon and was a senior advisor for the nation’s second Death-with-Dignity law in Washington state, both approved by ballot initiatives. “We congratulate Patient Choices Vermont for its leadership of this multi-year campaign. Their success shows aid in dying has become a legislative winner.” More

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.’ “