We all value our freedom to live by our own measure. Do you think we should have the freedom to die that way as well?
I keep promising myself and my family that I'm done writing about death and dying. But then something happens -- like the How To Die In Oregon movie or Jack Kevorkian's death -- and there I am again, wanting to challenge your thinking on what it means to die in the 21st century. Sometimes it seems there's a genuine movement going on here. Every time I turn around, someone is pushing our comfort zone on end-of-life decisions.
In my blog posts and my novel, I've tried to present all sides of the death with dignity argument. I've encouraged choice but have not taken a stand on what that choice ought to be. I've talked about end-of-life planning, letting parents live their own lives and make their own decisions, and even bioethics. But there's something about what one proponent called "The Holy Grail" of the dying argument -- assisted dying -- that still makes a lot of people squirm. With Dr. Kevorkian's death, I think it's time for us to take that bogeyman out of the closet, too.
Call it "medicide" like Kevorkian did, or the value-neutral "aid in death" like the folks at Compassion & Choices do. You can even pull out the old Greek term, "euthanasia," meaning good death, like author Robert Orfali, who watched his wife and soulmate die of an incurable disease. But it all comes down to the same question:
When a person has a disease that cannot be cured, do you think doctors should be allowed by law to end the patient's life by some painless means if the patient and his or her family request it?
A 2007 Gallup poll showed that 71 percent of Americans think they should.
But depending on the circumstances there are still a lot of people, including the jury that put Dr. Kevorkian in jail for nearly a decade, that believe that assisted dying is murder. Kevorkian had found a way around all that by building a "suicide machine" that would enable terminally ill patients to give themselves a lethal dose of medication. No one arrested him for that. He ended up in prison because he personally administered the medication to Thomas Youk, an ALS patient, who could not use his hands to take the medication himself.
I've spoken with palliative care experts and learned that palliative sedation is already legal in every state. That means, after exhausting other alternatives, physicians can provide sufficient pain medication to make the terminally ill patient unconscious and unaware of extreme pain while the disease progresses to death. The patient usually succumbs to dehydration, which takes about a week.
It's also legal for a terminally-ill patient to consciously refuse hydration or other life-sustaining interventions. Many states allow or regulate the rights of family members to request cessation of life-sustaining treatment for a terminally ill family member who cannot speak for themselves.
Does this all seem hypocritical to you? If a physician can write an order to sedate a patient until they die, why shouldn't they be able to give an injection to do it immediately? In the same vein (no pun intended), if a terminally-ill patient does not want to continue life-sustaining treatment and elects to die of dehydration, why can't they elect to end their life in one shot?
Now, I admit there are a lot of fine points to the argument, such as:
The U.S. Supreme Court made assisted dying a state issue in 1997. It's now legal in Oregon, Washington and Montana. Author Robert Orfali wants it to be legal in Hawaii, too. I asked Orfali, whose books include "Death With Dignity: The Case for Legalizing Physician-Assisted Dying and Euthanasia" and "Grieving a Soulmate," what he hoped Dr. Kevorkian's death would mean to people. He said:
"Kevorkian's contribution was to bring the practice of underground euthanasia out in the open. In the U.S., up to 24 percent of primary care physicians and 57 percent of oncologists report having been asked to hasten a patient's death, and about one-quarter say they complied. The underground practice is crude, unruly, and totally unregulated. The alternative is to legalize the practice with proper safeguards and make it another palliative-care option. Jack taught us that prohibition does not work."I found the reaction by L. Brooks Patterson, a former prosecutor and executive in Oakland County, CA, where Kevorkian was convicted, ironically similar:
"I don't think he was the right ambassador to represent the issue. It was the law be damned with him. The issue would have been better debated in a more serious arena than in the back of Jack's van. It was a sideshow. Helping people commit suicide in the back of a van is not dying with dignity."For my part, I hope that Jack Kevorkian's death will cause you to think, then take a personal stand on your end-of-life choice. That is the ultimate key to ensuring that you die with dignity, a dignity that's measured by your own belief system.
Janice M. Van Dyck is author of Finding Frances, a novel about a family dealing with end-of-life choices.
Rev. Amy Ziettlow: To Kevork or Not to Kevork, That Is the Question
Barbara Coombs Lee: Dogma vs. Dignity
Hillary St. Pierre: Why I Considered Assisted Suicide
Sue Doble: Don't Tell Me It's OK
Jack Kevorkian - Wikipedia, the free encyclopedia
Assisted Suicide Advocate Jack Kevorkian Dies at 83 - FoxNews.com
Assisted suicide advocate Kevorkian dies at age 83 - Yahoo! News
Burzynski: Cancer Is Serious Business
http://vimeo.com/24821365
I also have to say that I supported what Dr. Kevorkian did with helping those who were very ill and allowing them to not have to continue to endure the crippling pain or suffering. He really did care about all of his patients and I think he was a damn good doctor. As we well saw he never forced his patients under his care or made their decisions for them. He guided them through and that's what you want in a doctor and medical team. Their input, but you saying what gets to happen in the end.
This is a controversial topic and I thank you for such a well thought out and expressed piece.
Many like to make a judgment that something like this is morally wrong, but everyone has to do what would align with their circumstances. After all, it's your life. With the criticism pushed out of the way you truly have to decide what would make the most sense.
Slavery is wrong.
Over the past 20 years, almost exactly 3,400 doctors have been implicated in totally unnecessary deaths. The majority of innocent citizens died as a direct result of surgeries and procedures that were not needed. Countless thousands of others died from adverse drug reactions which ought never have been prescribed in the first place. About 400 were murdered outright, and 5,000 patients have been sexually assaulted.
Criminal surgeons cut open countless thousands of human chests for no better reason than to amass wealth. One New York eye surgeon admitted in court that, yes, he really had performed 10,000 unwarranted eye operations on the homeless, in his mad rush to untold riches.
All of which brings us to Jack Kevorkian - an unpolished man not driven by wealth - who actually sat with his patients; cried with them; felt their pain and coordinated their requested deaths with dignity.
The ignoble reality is that Jack Kevorkian was treated more shoddily by the press, the public and other MDs, than any of his miscreant peers, including those who murdered their spouses and shot down their coworkers.
As one who investigates bad doctoring for a living, I can fairly report that few people in the nation are more critical of errant physicians than I am.
But to my way of thinking, the only thing Jack Kevorkian was convicted of, was uncommon humanity.
I remember a friend of mine saying that his suffering was a good thing because it "brought him closer to God". I was so angry I wanted to spit nails. Ironically when her own father was diagnosed with lung cancer the following year she prayed for him to die peacefully before he suffered too much. Luckily he passed away in his sleep of an apparent heart attack well before the pain that those last several months can bring. I admit it was hard for me not to mention what she had previously said to me. I'm an atheist so I don't know if this way of thinking is common with theists but I can't believe a merciful and loving God would want anyone's last days on earth to be like this, perhaps I am wrong.
When my time comes, I can guarantee you I will check out on my own terms, regardless of who says what about it. Unlike many Americans, I refuse to give up what is unalienable.
•Is it our job to keep them alive or to help them die? It's your job to leave them alone, or do what they ask if you are a friend or loved one...
•Who should make the decision as to when a life ends? Why? The person, because it is their life...
•Is quality of life an issue? Of course it is, silly! Why in the world would one choose to die in agony if he could save themselves and their family the suffering and the money by "getting the black pill"?
If you take religion out of the picture, and make certain you are dealing with the patients wishes, I see no problem with this at all.
Dr. Jack was a brave man who stood up for his convictions in the face of grave personal consequences. We should all have the right to choose when to end our lives and we should be grateful for men/women, like Dr. Jack, who make the sacrifice to lead the way.
You can not use any religious or moral argument that will change my mind. And neither society nor the government can do anything about that decision should I ever have to make it.