The article below, from the Lynn, Massachusetts newspaper, The Daily Item, is interesting for its reporting on a physician’s insight that the top three reasons the Oregon reports say people request assistance in suicide–“loss of control, loss of enjoyment and feeling like a burden to others”–are all symptoms of treatable depression. It is also good to read that minds are changing as people become informed about the dangers of legal assisted suicide. If Question 2 passes in Massachusetts, it will be a tragedy not for that state and a threat to others, including Vermont; it will surely energize the people who hope to legalize assisted suicide here.
Question 2: Bay State voters soon to decide matter of life and death By Kait Taylor and Sean Leonard / The Daily Item
Steve Crawford, communications director for the Dignity 2012 campaign in support of physician-assisted suicide, recalls the trauma of witnessing his father’s death by suffocation eight years ago at the end of his battle with cancer.
He acknowledges palliative and hospice care has come a long way in treating pain.
“But there’s not a lot that medicine can do for shortness of breath and it is not an attractive way to go,” he said, explaining why he supports Question 2 on the Nov. 6 ballot, the so-called Death with Dignity law.
A yes vote on Question 2 would support a law to allow doctors to prescribe lethal medication to a terminally ill patient diagnosed with six months or less to live, after the patient has made at least two requests – one verbal and one written and with a waiting period between the two – for the life-ending drug as an option to avoid suffering.
Opponents, however, maintain that physician-assisted suicide – approved by voters in Oregon and in Washington State, and allowed by the judicial system in Montana – is contrary to the mission of our medical system to care for patients regardless of their condition.
Opponents also maintain it may rob patients of quality time with loved ones and that there’s never 100 percent certainty in length-of-life diagnoses.
Dr. Kerry Pound, a Marblehead resident and pediatric physician at North Shore Medical Center in Salem, said she’s against the measure because there aren’t enough safeguards in the law to protect patients from choosing physician-assisted suicide as a result of depression.
“There are a lot of problems with this law, particularly with the psych aspect and that it does not require a psych evaluation (of patients who request a lethal drug),” she said.
Pound said the top three reasons terminally ill patients choose to end their lives – loss of control, loss of enjoyment and feeling like a burden to others – are all symptoms of clinical depression that leads to suicide, and all are symptoms of clinical depression that she said can be treated.
Without a psychiatric evaluation and consultation, she said, the patient “is not fully informed and the choice you make is the end; it’s a permanent mistake.”
What’s more, Pound said, “A prediction of six months to live is unbelievably unreliable. I have a friend who was told she had weeks to live and she had a year left to live… That year she spent with her 3-year-old son and I just thought, ‘He might remember her now where he wouldn’t have otherwise.'”
Representatives of both sides of Question 2 visited The Daily Item last week in separate editorial board meetings to express their views.
Joining Crawford among proponents of the measure was Dignity 2012 Campaign Director Michael Clarke. Joining Pound was opposition campaign spokesman Andy Hoglund and Rabbi David J. Meyer of Temple Emanu-El in Marblehead.
Rabbi Meyer said he has given several sermons urging his congregation to vote against Question 2, based on the overall concept as well as agreeing with Pound that the legislation is flawed.
“A physician who might prescribe life-ending drugs might have no clue what the history of depression is with the patient. Clinical depression is rather typical in terminal cases, and it can be treated. I’ve seen it,” Meyer said. “This (law) does not recognize that hospice and palliative care have improved so much in the last decade … (Under this law) patients are just given 100 pills to take at home and nobody has to be present; next of kin doesn’t even have to be notified.”
Meyer added, “There are issues in Jewish ethical tradition about active euthanasia. Jewish tradition guides me to say that death should be allowed to take place if that is the desire by removing impediments to death – pulling the plug so to speak.
“The Jewish tradition is very much concerned about compassionate care and that goes back to the Middle Ages. But it’s the flaws in this legislation that really caught my attention.
“On the surface, who doesn’t want their loved one to die a good death, a death with dignity? That’s what we all want. But because of the potential ramifications of this law – and slippery slope elements of it – that can turn the right to a good death to a duty to die in order to save resources.”
Clarke strongly disagrees that there are no safeguards in the Death with Dignity law.
“If a person is suffering from clinical depression; if a person cannot communicate health care decisions because of dementia or Alzheimer’s, they will not qualify for the law,” Clarke said. “Doctors are required to refer any patient they feel is suffering from clinical depression or who is being coerced, to undergo a psychological evaluation.
“What you see in Washington and Oregon is that it’s really only used by 70 people a year, with the most extreme cases of cancer, ALS and emphysema, and it’s used right at the very end of their life. What’s interesting in Oregon is that nearly half the people who request the prescription don’t use it. They just want it there for that peace of mind, that if I do wake up and there is pain and I do cross this line, it’s there for me.”
Crawford is adamant that Death with Dignity is not suicide.
“Suicide is typically viewed as someone who is of sound body but suffering from depression or despair. That’s not what these people are. Most of them desperately want to live but they’ve lost the battle with their disease. It’s not a question of life and death, it’s a question of how much suffering they endure,” Crawford said, adding there are “thousands of doctors” in Massachusetts who support Death with Dignity.
Clarke added, “The most important thing about this law is not only that it’s voluntary for the patient, it’s voluntary for the health care providers. No one is forced to participate in this law and doctors can excuse themselves for any reason; ethical, philosophical or spiritual … While there are some people whose faith would guide them not to choose this law, there are other people who want this option and I don’t think it’s right to deny it based on another person’s faith-based objection.”
Pound, for her part, said she could never understand any doctor choosing to prescribe a lethal dosage of medicine. She said the Massachusetts Medical Society is against Question 2, as is the American Medical Association.
“The AMA is clear, that this basically corrupts what is our foundation, to do no harm,” Pound said.
Hogland, of the organized opposition to Question 2, said, “This campaign is about education. I’m very confident that as we get the word out and explain what this law actually does, I like our chances (of defeating it).”
Read the ballot question and more at itemlive’s election page