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Massachusetts May Soon Change How the Nation Dies
Hugh Pickens writes "Lewis M. Cohen reports that this Election Day, Massachusetts is poised to approve the Death With Dignity Act, a modernized, sanitized, politically palatable term that replaces the now-antiquated expression 'physician-assisted suicide.' 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. But the Massachusetts ballot question has the potential to turn death with dignity from a legislative experiment into the new national norm, because 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). If the act passes in Massachusetts, other states that have previously had unsuccessful campaigns will certainly be emboldened to revisit this subject. The initiative would allow terminally ill patients with six months or less to live to request from their doctor a prescription for a lethal dose of a drug. Doctors do not have to offer the option at all, and patients must make three requests, two verbal and one written. They must self-administer the drug, which would be ingested. The patients must be deemed capable of making an informed decision. 'It's all about choice,' says George Eighmey, a key player in instituting the Oregon law, defending it against repeal and shepherding it into reality. 'You decide. No one else can decide for you. No can can force you into it, coerce you into it or even suggest it to you unless you make a statement: "I don't want to live like this any more" or "I'm interested in that law out there, doctor, can you give me something to alleviate this pain and suffering."'"
Predator drone attacks for everyone now.
Is it really that difficult to acquire a lethal dose of a drug without doctor assistance?
Or is this aiming to legally protect doctors who are assisting patients?
Yes, and yes.
At least this will allow someone to go with their family around (and without the mess).
Of course, doctors have been doing this sort of thing "off the books" forever. When I was a kid and a certain person I knew was dying, his doctor gave him a orders not to let his nurse inject him with this particular syringe of morphine (wink, wink).
What political party do you join when you don't like Bible-thumpers *or* hippies?
Where does this even mention "the elderly?" It mentions people with terminal ilnesses, which can start very young indeed.
No dude, sorry. Imagine that I'm paralyzed down half my body, can't breath without oxygen, can't take a piss without someone helping me, and knowing that there is no chance at all that I will ever get better, that in fact I will most likely get worse every day until the day I die. Sorry, there's no dignity in that. Let me go. Painlessly, cleanly, and by my own decision, but let me go. Freedom over your own body should be the ultimate freedom, telling someone in that position that you won't let them die isn't just insensitive, it's downright cruel and selfish.
I highly recommend Terry Pratchett's 2011 documentary "Choosing to Die." You may watch the full film on youtube here: http://www.youtube.com/watch?v=slZnfC-V1SY I found the documentary extremely informative and moving.
The reason why the elderly who are in medical care don't have dignity is because we as a civilization have setup a structure where such people are considered a drain on society.
Ever watched someone die of cancer? No matter how well cared-for they are, there is absolutely nothing dignified about it.
The "drain on society" has nothing to do with people dying a slow, painful and drawn-out death that can't be averted with modern medicine. Nice attempt to confuse the issue though.
> Is it really that difficult to acquire a lethal dose of a drug without doctor assistance?
Yes.
To elaborate: It's difficult to acquire a lethal dose of a drug that is easy to administer and will result in guaranteed, peaceful death without little to no chance of (partial) survival. Sure you can drink bleach or try to OD on alcohol or acetaminophen/paracetamol or any number of things. But they can be quite unpleasant and/or leave you alive but even worse off.
> Or is this aiming to legally protect doctors who are assisting patients?
Less so, I'd wager. Realistically, people rarely ask questions if someone suffering and wishing to die dies in their sleep. Doctor: "They died in their sleep last night". Family: "Ah, well their suffering is over at least". Pretty much never: "I bet you turned their morphine up you bastard!". Of course, that really requires the patient to be literally on their death bed, but either way I think the point of this is entirely a way to reduce suffering of the terminally ill and not really about doctor liability.
You'd think a country that executes prisoners humanely (as much as I'm opposed to death penalty, atleast they're not tortured) would want the atleast the same humane treatment for it's citizens that actually choose to die.
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Per the act: "The attending physician may sign the patient’s death certificate which shall list the underlying terminal disease as the cause of death." So the insurance company might not even get to know.
Link to the 2012 Ballot Questions (pdf). This question is #2:
http://www.sec.state.ma.us/ele/elepdf/IFV-2012.pdf
Yes and no. Most people are not medical experts and, shouldn't have to become so just to die with some dignity.
The thing is, what kills one person may not kill another and most things that you can eaisly get your hands on, and even most prescriptions, are within dosage ranges that are quite safe. Yes, you can kill yourself many ways, but, many of those ways are less effective than you might think.
I personally knew a guy who tried to off himself with barbituates. He failed, woke up several days later. This is actually fairly common with that route.
Also many terminally ill patients are in no condition to do that research and administer the drugs without help.
Which is why, I think we really need the second... Doctors able to help.
I plan to vote for this one. I have worked among the medical community (at MGH no less), I have been there when my family had to have stern words with doctors who somehow interpreted our grandfather's DNR order as "Recessitate and put on a ventilator".
This is such an important issue for so many reasons. So many people in ongoing pain that don't need to be, so many families that need to move on. I hate to bring it to money but.... 50% of health care costs are spent in the last 5 years of life.....and for what? The fact that so many doctors opt to not have chemo and opt to die rather than hang on like so many of their patients are made to should say something.
Don't get me wrong, if someone wants to fight to the biter end, and get as many waking moments as possible, regardless of their quality, more power to them. However, what compassion is there in forcing people to go on living who have nothing to look forward to except deterioration in a bed?
I honestly think Bill Hicks described the situation best in his comical suggestion that we use terminally ill people as stunt doubles in action films. "Do you want your grandmother to die in a sterile hospital bed, he translucent skin so thin you can see the last beat of her heart, or do you want her to meet Chuck Norris?.... wow Chuck just kicked her head clear off, my grandma is no longer in pain...this is the best movie ever!"
"I opened my eyes, and everything went dark again"
Shouldn't the availability of such "end-of-life" drugs settle the "cruel and unusual" question in death penalty states? I mean if something like Propofol is so pleasant that it is the target of abuse, it should be perfectly fine for a pleasant, relaxing send off when a death row prisoner's time has come.
Bringing it back to "death with dignity", noone will force it, or even suggest it, but LWOP prisoners should also be offered the same option...
(lol - spell check on Propofol offers "Foolproof")
This issue is a bit more complicated than you think.
Doctor: "They died in their sleep last night". Family: "Ah, well their suffering is over at least". Pretty much never: "I bet you turned their morphine up you bastard!"
Pretty much never isn't good enough. If you're a doctor, are you really going to risk your career on the off chance that you get a family who is so overcome with rage that they demand a toxicology screen on their dead loved one? How about twice? How about 100 times over the course of your career? (sounds like a lot, but if you only practice for 20 years that would be less than one patient every two months). How about we have it nice and legal; so the decision is documented and acknowledged by the family and no one has to risk getting their life destroyed for doing what more and more people are of the opinion is the right thing to do.
No difference no, but the doctor could tell you exactly how much to take (too little will not be enough, too much will trigger the body's instinct to evacuate itself).. and of course there is the issue of not everyone knows where to get street drugs so those might not be an option they can access. I know I wouldn't have the first clue how to go about getting such things.
I'll take oblivion over living in my own filth, forgetting who I am every day, and being too frail to actually interact with the world.
Are you kidding? why I remenber a time when the days were just a blur and i had absolutely no bowel or bladder control. I was the center of everyone's world. All attention was paid to me. Everyone hung on my every move or utterance. I was the king of the universe. The day i stopped shitting in my pants was the day my life started going downhill. I welcome incontinence, my old friend's return.
The term suicide -- which is generally defined as the "act or an instance of intentionally killing oneself"-- is not specifically used in the Scriptures; however, the injunction against killing embodied in the Ten Commandments, i.e., "Thou shalt not kill" (Exodus 20:13), dealing with the unlawful homicide of another human being, would also forbid the murder of self. The very fact that the Almighty is the Giver Of All Life and "formeth the spirit of man within him" (Zechariah 12:1), tells us that it is not within our right to arbitrarily terminate our own life, against His permission. "Because man goeth to his long home, and the mourners go about the streets: Or ever the silver cord be loosed, or the golden bowl be broken, or the pitcher be broken at the fountain, or the wheel broken at the cistern. Then shall the dust return to the Earth as it was: and the spirit shall return unto God Who gave it" (Ecclesiastes 12:5-7).
To understand suicide to be sin against God and against self, is in keeping with the LORD Jesus Christ's statement concerning the Spirit of the Moral Law, where "love is the fulfilling of the Law" (Romans 13:10). "37 Jesus said unto him, Thou shalt love the LORD thy God with all thy heart, and with all thy soul, and with all thy mind. 38 This is the First and Great Commandment. 39 And the second is like unto it, Thou shalt love thy neighbour as thyself" (Matthew 22:37-39). God requires, both in His Law and Gospel, that all moral agents choose the highest good of God, and of our being in general, for its own sake, as our ultimate purpose in life, i.e., a supreme love for God and an equal love of our neighbour as we would love ourselves. "For no man ever yet hated his own flesh; but nourisheth and cherisheth it, even as the LORD the Church" (Ephesians 5:29).
Neither the modern legal nor medical definitions of suicide entail the Scriptural aspect of suicide being the transgression of the Moral Law, where both God and man are denied the love that are rightfully due them. "If a man say, I love God, and hateth his brother [much less, himself], he is a liar: for he that loveth not his brother [or, himself] whom he hath seen, how can he love God Whom he hath not seen?" (1John 4:20). The supreme hatred of one's self and life, where a morally capable individual voluntarily terminates his own life, is also preeminent contempt of the "God [Who] Is Love" (4:16). Especially for True Christians, the very idea of disposing of our own lives as if we were the masters of them, is unthinkable. "For none of us liveth to himself, and no man dieth to himself" (Romans 14:7).
http://www.whatsaiththescripture.com/Fellowship/What.Bible.Says.Suicide.html
I always just thought "Thou shalt not kill" extended to self, but apparently there's more to it.
Or in other words, we don't like seeing sick old people. So we try to kill them off.
The reason why the elderly who are in medical care don't have dignity is because we as a civilization have setup a structure where such people are considered a drain on society.
We don't think they are a drain on society. We think they are cash-cows. We can take their (and/or possibly their family's) life-time accumulated wealth, all the money their health insurance (or Medicaid) will allow, and pour it into high cost healthcare.
They aren't a drain on a society, only to the people that love them. For everyone else, they are an opportunity.
I can't believe what a bunch of ignorant wild speculation is contained in the comments on this page. No one has even bothered to find out what Massachusetts Ballot Question 2 actually proposes. But it's simple enough in a nutshell.
It would be assured that the patient is adult, informed, and competent; ORIGINATES the action HIMSELF; is really facing imminent and certain death as determined by both attending and consulting physicians; confirms his wish three times with plenty of time enforced to think it over; and has to sign a form in the presence of witnesses meeting prescribed qualifications. Medication would be prescribed which would be certain to result in a humane death. I have been told by the opposition it consists of 100 Seconals to dissolve in water and drink promptly[1], but the measure does not appear to specify such. A big overdose of morphine would work just as well if not better (yes, morphine can be taken orally; it just requires more of it). It's what is used now "off the record" in hospitals when a patient is in irreversible unbearable agony and his body is betraying his dignity, if he is lucky enough to have access to a physician or nurse willing to risk everything to REALLY help him the only way that counts. Don't pretend it doesn't and won't happen even without the protection of the law. The law just prevents criminalization of what is one of the kindest and most caring acts it is possible to undertake.
It is prescribed that the death certificate shall specify the cause of death as the diagnosed disease, NOT "suicide". This is important. The patient is not "choosing death". That is HOGWASH. The patient is choosing the MANNER and TIMING of death. That is all. The death is already ordained.
The measure would specifically outlaw (and prescribe punishment for) coercing the patient, forging a patient request, or suppressing a recission by a patient of his own request. It would not allow the active participation in the ending of the patient's life. Contrary to the opposition hysteria, it is specifically NOT, repeat NOT, an assisted suicide measure. It is a lifting of sanction against suicide under controlled circumstances, and an above-board way for the patient to acquire the means without the risk of screwing up and having the effort come out badly. It is nothing MORE than this.
Anyone who opposes this measure is a DAMNED EVIL BASTARD who should rot in hell.
[1] The opposition expresses horror at this "dangerous" (WHA???) method of self termination, as if falling asleep for the final time is some kind of torture.
The major need for a doctor and prescription drugs is to make sure the job is done right the first time, and in a way that will not traumatize your relatives (beyond the fact you're going to be a corpse at the end of the process). A failed suicide will leave a very real chance of you being even worse off, and under the current system, kept alive in that state and possibly in a padded room to boot.
For the same reason, that doctors are there to supervise lethal injection executions, a doctor will need to be there to make sure that the method and means are sound and also to ensure that there are no conditions that might complicate the process.
Additionally, the law ensures that you have assistance without that assistant being charged with a crime afterward. Suicides using perfectly effective methods can easily fail, and when they are done by disabled people, are much more likely to fail without assistance.
I don't know how I feel about legal suicide myself. In theory, they aren't impinging on my rights simply by doing so, so it's not my business.
On the other hand, I don't condone it, and if it became subsidized by government money (at some point in the future), then I would then be forced to have an opinion on it because then I become responsible for paying for it.
Hopefully, someone does the smart thing and leaves the funding for the actual actions to a nice, private charity organization made up of people who agree with it.
One slight item missing from the article...
"Due to the fear of mass suicides from the mental anguish caused by elections, the Death With Dignity Act would be suspended three months prior to all elections. "Not wanting to live like this (being exposed to non-stop presidential advertisements)" would not be sufficient excuse to superseded a very important aspect of the law, said spokesperson Dr. Marcia Angell. Everyone choosing this option must be "deemed capable of making an informed decision." It's well documented that during an election season, this is virtually, if not completely impossible."
You're missing the point.
The point is to die openly and with dignity. You can tell people you're going to do it. You can arrange things legally. You can say goodbye. They might even want to hold your hand or be in the next room when you do it.
It's completely different than letting somebody come home to a dead body or get a phone call from the police because the neighbors are complaining about a bad smell...
No sig today...
As a resident of Massachusetts, I plan on voting for this as well. The reason? When I was a kid, a friend of my parents died of inoperable brain cancer. In the end, he suffered terribly and even at age 10 I could see needlessly. He didn't die with dignity, he died in misery. I would think if I ever found myself in that situation that once the doctors told me, "Look, the seizures are going to get worse, everything is going to get really bad" that I would while I still had my facilities I could say, "That's not how I want to go, I don't want my children to remember their father like that."
With that all said, I hope to never be there, but I want the option and more over I want to give the option to others.
Yes Francis, the world has gone crazy.
"A bullet works, too, but it leaves more of a mess for someone to clean up. I understand haning one's self isn't a bad way to go. Slitting your wrists might be a little painful, particularly if the blade isn't sharp."
For the sake of someone who might consider any of these things they are all bad ways to go. Most people don't know enough about bullets and human anatomy to be certain they don't end up a vegetable or paralyzed. Hanging is a horrible way to go along with drowning, it is a slow and painful process and most of the rope you would buy at the store will stretch when your weight is applied. My aunt hung herself on a closet door and I'll never forget the long fingernail grooves in the door.
Suicide is extremely selfish but if someone is going to do it a combination of drugs to put you to sleep and a heavy gas are what you need. Take strong pain killers, muscle relaxers, etc. Get a CO2 tank and a solenoid you can put on a timer then go into an enclosed space like a closet. The drugs put you to sleep, the gas makes sure you don't wake up. If I'm wrong somehow, or you didn't have enough drugs, or you otherwise find it unpleasant, just open the door to the enclosed space.