Is it Really Death with Dignity

The Washington Post carried an article on March 17, 2010 about a new book called “Imperfect Endings” written by a daughter, Zoe FitzGerald Carter, who helped her mother, Mary, die. Mary had been suffering with Parkinson’s Disease for 20 years and decided in 2000 that she would kill herself and she wanted her daughters to help. This book is about the last year of Mary’s life.

Other people mentioned in the article excerpt below are Guth, Zoe’s husband, and Sarah and “Katherine,” Zoe’s sisters.

Here are some excerpts from the article (click here to read the whole thing):

At a family Christmas celebration in 2000, Mary was still walking. But shortly after a series of painful writhing episodes (uncontrollable jerking and twisting common in Parkinson’s patients), she took to her bed, moving only to use the bathroom. Zoe was never sure whether movement had become too physically painful or just too emotionally exhausting, but either way it was around this time that the woman who had once strived to capture the perfect brogue started pursuing the perfect death.

… A volunteer from the Hemlock Society visited the house and suggested placing a bag over Mary’s head and having her inhale helium; a Dupont Circle doctor met with Mary and Zoe to prescribe the sedative Seconal after a consultation to assess Mary’s mindset. In a catch-22 twist of logic, he would provide a means to die only to someone who was not depressed.

“The scenario of her trying to choke down Seconal was horrifying, and the Hemlock Society was even worse,” Zoe says. She was horrified by the legal implications of assisting her mother — even tacit approval felt like too much — and she was horrified by the casual glibness with which her mother discussed dying.

… Her [Zoe] father had died in 1994; Guth’s had fallen seriously ill in 1995 before eventually passing away in 1998, which was only shortly before Mary began contemplating suicide. “We had seven years of losing parents,” Guth says. “How much time can you put into each process, and what are the consequences if you don’t?”

Zoe was horrified that her mother would no longer be living, or maybe “horrified” is not the right word.

She was sad.

“I didn’t understand why,” she says, “she didn’t want to stay alive and be my mother.”

… After months of discussion, Mary had decided to end her life not with helium or Seconal but by starvation. The family had been told she would die in a matter of days, but after a week her body was still strong, though she appeared smaller each day, wasting into nothingness. She suffered. She begged Zoe and Sarah — “Katherine” hadn’t come down after all — for their blessing to allow her to take morphine.

On a baking hot evening in the middle of July, Zoe, her husband and Sarah said goodbye at their mother’s bedside. To prevent themselves from being implicated in Mary’s death, they had decided not to be in the room when she actually ingested the drug.

Mary FitzGerald Carter died a few days after the night of morphine, on July 11, 2001. Her passing brought grief and peace, both in Zoe’s ongoing relationship with her mother and in her relationship with her sisters.

Do we fool ourselves to think that there is dignity in dying just because we choose the method by and the time at which we die? Is there really dignity in starving oneself to death (a painful and slow process)? Is there really dignity in putting a plastic bag over your head as your body reacts violently while you are suffocating yourself to death?

There is no inherent dignity in dying, no matter how it occurs. It is not natural. The fact that most of humanity resists and struggles against it to the end is evidence that God did not intend for death to be part of life; but because of sin, we do have disease and disability, and ultimately, physical death.

I cannot and will not speak to what the family went through that year, nor am I condemning them for the decisions they chose.  I have never personally experience that kind of despair and can’t imagine how overwhelming the conflicting thoughts and emotions must be.

But feelings lie, and that is why we all need to consider caregiving options for ourselves and for our loved ones before we find ourselves in the midst of the emotional maelstrom that comes with end-of-life decisions.

Health Plans Forced to Provide Assisted Suicide Counseling

Another little gem found in H.R. 3962 Affordable Health Care for America Act involves the requirement for your health insurance plan to provide and pay for assisted suicide counseling.

Section 240 requires that all companies offering a qualified health benefits plan to “provide for the dissemination of information related to end-of-life planning to individuals seeking enrollment in Exchange-participating health benefits plans offered through the Exchange” [Sec. 240(a)(1)]. This section also explicitly states that the insurance company cannot promote suicide, assisted suicide, euthanasia, or mercy killing [Sec. 240(a)(3) and Sec. 240(d)(1)].

The problem is that this section does not “preempt or otherwise have any effect on State laws regarding advance care planning, palliative care, or end-of-life decision-making” [Sec. 240(d)(3)]. Oregon, the first state to legalize physician-assisted suicide, does not consider their legislation to have allowed “suicide, assisted suicide, euthanasia, or mercy killing.” Instead, they consider their legislation to have allowed patients to make a choice to face “death with dignity.” In fact, it is called the Oregon Death with Dignity Act, as is the Washington version passed into law last year.

Thus, your health insurance plan will now be required to promote and pay for “death with dignity” consultations in those states that have passed such legislation. Why is it that this bill is interested in promoting life-ending programs rather than life-saving or life-extending programs?

For more information on Oregon’s Death with Dignity Act, go to the Oregon Department of Human Services . For more information on Washington’s Death with Dignity Act, go to the Washington Department of Health.

H.R. 3962 is just plain wrong for America; it does not protect human life and our well-being at any age or any stage as it purports to do; instead it does exactly the opposite: it promotes death and the devaluation of human life.

It is imperative that you contact your senator or representative today via mail, phone calls, and emails. Go to the National Right to life for assistance with how to do this by clicking here.

[Corrected March 21, 2010]

The State of the States

This is the final part of my observations from the 2nd International Symposium on Euthanasia and Assisted Suicide. Click here to read Part 2, The Coming “E” Battle.

In November 2008, Washington joined Oregon as the only states in the United States to have legalized physician-assisted suicide. Montana was added shortly thereafter by judicial fiat; the Montana ruling is currently being appealed and will hopefully be overturned.

On May 22, 2009, the Oregonian reported the first death in Washington under the so-called Death with Dignity law. These legislative and judicial gains have emboldened those who want to legalize physician-assisted suicide and euthanasia nationwide to step up their efforts.

In fact, 2009 has already seen a number of attempts to pass Oregon-style “death with dignity” acts.  Some bills died in committee, some were defeated, and some are being delayed until the next legislative session.  Here are the six states that have been (or continue to be) targets for attack in 2009:

  • Connecticut
  • Hawaii
  • Massachusetts
  • New Hampshire
  • Pennsylvania
  • Vermont

For more information on these and other legislative and ballot initiative attempts to pass so-called death with dignity acts, please see the International Task Force on Euthanasia and Assisted Suicide website.

At the Symposium, Dr. Patricia O’Halloran from Washington stated that they learned some hard lessons in the passage of I-1000 (as Washington’s Death with Dignity ballot initiative was called). In polls taken after the vote, it was learned that the following talking points may have influenced the undecided voters to vote against the bill.  These points may be areas to be targeted for those who will be fighting the battle in another state.

  • Insurance companies may not pay for treatment (especially if the treatment is deemed too costly), but they will pay for physician-assisted suicide.
  • There is no familial notification required in Washington’s Death with Dignity law.
  • Depression is considered a legitimate reason  for requesting physician-assisted suicide.
  • Seniors and those with disabilities are at a greater risk then the general population.
  • The medical profession is against physician-assisted suicide.
  • Abuse of the statute in Oregon goes un-reported by the mainstream media.

The coalition that was formed to oppose Initiative-1000 is continuing in their battle as True Compassion AdvocatesClick here to see some of the advertisements they were able to air on television to help educate the public on what physician-assisted suicide really means for those who are terminally ill.

Attorney Margaret Dore, whose area of expertise is Elder Law, has spoken and written on various aspects of how to deal with end-of-life decisions. She said that one of the problems with physician-assisted suicide legislation is that it often states that patients must be able to “self-administer” the lethal doses of medication. According to Margaret, the problem with this wording is that the legal definition of “self-administer” is the act of ingesting. This phrase could mean that you put the pills in your mouth, or someone else can put the pills in your mouth, as long as you are ingesting the pills it’s considered “self-administered”. Margaret also noted that this phrase can be interpreted as someone putting something into your IV bag; so what is touted to be “self-administered” in reality can become, “other”-administered, which would no longer be suicide, but would cross that line into the realm of euthanasia.  She ended her session by encouraging pro-life folks to shape their arguments around “choice” and then show it as a lie. For more information on how to do this, see her article that was published by the King County Bar Association and the Washington State Bar Association.

The final thoughts I’d like to share with you come from William Toffler, MD.  He noted that during the first year that physician-assisted suicide was legal in Oregon, 14 physicians wrote 15 prescriptions for the lethal dose of medication. In 2008, after 10 years of so-called “death with dignity,” 45 physicians wrote 85 prescriptions for death. Click here to see the 2008 annual report from the Oregon Department of Human Services.

Dr. Toffler pointed to the Michigan Law Review Volume 106, Number 8 that has a collection of articles under the theme: “Glucksberg and Quill at Ten: Death, Dying and the Constitution.Click here to read an article of note called “Physician-Assisted Suicide in Oregon: A Medical Perspective” that details some of the irregularities in how “death with dignity” has been administered in Oregon and presents a few case studies.

Dr. Toffler said that the Oregon Health Plan (OHP) will not pay for chemotherapy, radiation treatments, or cancer surgery if the patient is expected to survive less than five years. He did note that OHP will pay for physician-assisted suicide as “comfort care.”

He also pointed out some erroneous reports in the mainstream media regarding Barbara Wagner (she was featured in a video during the battle against Initiative-1000 in Washington, click here and scroll down to see her video). Dr. Toffler noted that:

  • The drug her doctor recommended, Tarsova, is not an experimental drug;
  • Barbara never asked for physician-assisted suicide; OHP took it upon themselves to suggest it as a one of the medical procedures they would cover; and
  • No one had said that Barbara had less than six months to live (one of the legal parameters established in the act), yet OHP offered Barbara the option of physician-assisted suicide.

The final thoughts I was left with from the Euthanasia Symposium revolved around questions we should ask of proponents of physician-assisted suicide.

  1. Why is this available only to people with six months to live? Why not 6 years? Who set this limit and why?
  2. Why are doctors asked to participate in this? Why do we make those who are supposed to care for people the judge, jury, and executioner of someone?
  3. Why just overdoses of sleeping pills or other medication? Why not lethal injections as the surety of injections is much higher than taking an overdose of pills?
  4. Are so-called “death with dignity” laws in violation of the American with Disabilities Act? Usually, when someone is depressed and suicidal, he is not given a lethal overdose of medication with the blessing of  his doctor. Yet when someone with disabilities (with a terminal illness or not) is depressed and suicidal, the answer is for his doctor to prescribe a lethal overdose. Is this discriminatory?

For more on end-of-life issues, please see the websites such as the Euthanasia Prevention Coalition, the International Task Force on Euthanasia and Assisted Suicide, and Care Not Killing.

As Lionel Roosemont stated at the conference, “Are you ready for the coming ‘E’ battle?” Are you ready to fight for the most vulnerable in our society? Are you ready to speak not only for the pre-born child in the womb but also for those who are told by our society that their “lives are not worth living”?