Friday, June 26, 2015

Is there a right to die?

     John Loder was a sound engineer in London. He recorded high volume rock bands like Big Black, so perhaps it was not surprising that he frequently had headaches.
In 2003 the headaches got worse, and he was diagnosed with a brain tumor: malignant, inoperable.
     It took him almost two years to die.
     "In August 2005, my mum called me and said he can't get out of bed," said his daughter, Natasha Loder. "They took him to the Institute of Neurology in London. He had the brain scan, and we got called in. The doctor said, 'Look, the news is grim. The tumor has gone from a golf ball to a grapefruit. He's going to die soon.'"
     Loder was telling me this because she is the health correspondent for The Economist, the British news magazine which Friday publishes "The Right to Die: Why assisted suicide should be legal," detailing how the push to allow patients to make end-of-life decisions is gaining traction across the developed world. California might make it legal later this month.      I've known Loder for four years since she arrived in Chicago, and she never before flagged a subject that the magazine is featuring.
     But this one is personal, even though her father's end was better than many.
"It was a relatively quick death, a good death," she said. "Over the last few days, he was dying, it was clear he was dying. But one of the things about brain tumors, it makes you sleepy, so that was kind of wonderful. We didn't know if he was conscious, but he seemed to respond to our touch."
     John Loder was 59. His end was relatively peaceful. But what if it hadn't been?
     "It wasn't until afterward I started feeling quite angry, that there was never any option for him," said Loder. "Nobody is fighting for the rights of the dying."
     The arguments against assisted suicide are familiar: that it's a slippery slope, leading straight to euthanasia and the Nazis. That poor people and those who don't want to create a financial burden will embrace it. That elderly people will be pressured by their families. That it implies people who are severely disabled can't have quality lives.
     The best counter argument is this: assisted suicide is already legal in three states — Oregon, Vermont and Washington State — and permitted in Montana (it was briefly allowed in New Mexico but now is in legal limbo) and these problems are not widespread. Only about 1,100 people have gotten Death With Dignity prescriptions since the law went into effect in 1998.
     "Oregon isn't a slippery slope," said Loder, pointing out that just knowing the option is available is a comfort to the dying.
     "This takes away the fear from death," she said. "Of the people who have been given the drug in Oregon, two-thirds took it and one-third never took it. They just wanted it there, to know, 'If this is ever too much for me, I could take it.' "
     The Economist polled 15 nations about right-to-die: the majority of citizens in 13, including two-thirds in the United States, support it, with only Russia and Poland against.
"There's a lot of support," Loder said.
     Given how the discussion of Obamacare pivoted on an idealized view of health care: waving the boogeyman of socialized medicine at people who don't have any health insurance at all, it'll be interesting to see if this subject is the next moral issue to make headlines. But the reality is there.
     "We don't all die at age of 90 in our sleep after a wonderful life. For a lot of people dying is terrible," Loder said. "My father was relatively lucky, but had the cancer been somewhere else he could have been in agony. Many people are dying long and protracted deaths, full of suffering and loss of dignity. It could happen to you, it could happen to me, it could happen to anybody."
I said that in American we have a far easier time dictating what other people do based on our own moral values, and a much harder time with anything that suggests people have the right to apply their own values to their own lives.
     "Let's have the debate," she said. "You do live in a democracy, and most people do support the idea of being able to help those who are terminally ill have choices."

29 comments:

  1. Robbie the RobotJune 26, 2015 at 7:32 AM

    Why should this right be limited to the terminally ill? Isn't this just a basic liberty, right of self determination, and privacy. I support the right of assisted suicide for people who didn't get tickets to the Grateful Dead concerts, didn't get asked to the prom, have a bad toothache, are upset that there has not been a sequel to Howard the Duck, or don't want to go to work today. It's their life, their choice, no one else's business. Period. There should be assisted suicide hotlines, and emergency vehicles dispatched at request at public expense with painless lethal injections. It should be a crime to interfere.

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    1. Stick to oil pan jokes.

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    2. Robbie the RobotJune 27, 2015 at 5:32 AM

      I was not joking. That's my position.

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  2. People who haven't done elder care often don't understand. Right now, at least hospice can allow no artificial methods of keeping a person alive. I certainly agree with assisted death in extreme cases, such as the one here.

    My father had to be placed in memory care, when my elderly mom could no longer handle his dementia at home. THis was very expensive and after a while when he stopped eating or being able to swallow hospice took over. We didn't feel he should be draining funds that my mom might need when she was older, or running in and out of hospitals with a tube in his throat, while I his POA ran back and forth. They lived a block away from me, moving back, after so many years in Florida since they retired. THey needed someone nearby. It was very stressfull, they wre difficult and I had to cut back work hours and handle all the business matters and insur. matters. No small feat. My sibligs weren't in the area.

    What happens to those having to wait 2 yrs for Medicaid if they can't afford private care and the elder becomes unamangeable?

    When assholes who knew little told us to get him artificially fed, while he had no quality of life and didn't even know his family and was fully incontinent and in a wheel chair(alz. attacks the nervous system too) why don't you come over at 3am and clean up his poop and keep him from wondering off or getting violent or why don't you pay the many grand a month to keep him alive.

    Hospice stopped all his meds, that weren't working at this point anyway. Alz. meds only work in the early stages, tried to put some water or protein liquid in his mouth. He had no appetite anyway. Mom now is in Calif. at an asst living near my doc brother. She has no dementia but got past the point of being able living in her own house. I know she would approve of asst. suicide too if need be. Luckily she has no dementia. But hospice is the next best thing for those to keep in mind with elder care. They can come to a home too, and medicare pays even if the elder goes on medicare alternative insurance ( a bother I wouldn't recommend)

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    1. Medicare is better even if a bit more costly, since the alternatives esp. HMO plans for elders are limiting as to where tests can be sent to or taken, esp. if they are in a nursing home where the lab isn't in their plan.

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    2. I'm sorry you and your family had to go through that. You made a lot of sacrifices for your parents.

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    3. thanks, Coey, more and more have to these days, with nature not taking it's course or being allowed to- funny how those that did the least in family won't give credit or parents enabled them- but I told them off, don't worry about that ;)

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    4. And with a few exceptions, elder care seems to fall on the grown daughters more than the grown sons.

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  3. Many feel guilt over getting placing parents in elder care. But they should not as long as the place is decent. Not always so for Medicaid only homes. More and more middle aged grown children are picking up the stressful burdens of parents living longer and being sicker. It's not a matter of being lazy but that it becomes impossible. Some have to cut their work hours or quit and get ill themselves with the stress of it.

    Of course, I support this for younger people with painful cancers.

    So to hell with what Palin thinks of this matter. What does she know?

    Mr. S. did I detect a non approval of Obama care in your column?

    One can be sure that nursing homes, big pharma, eldercare specialist docs and hospitals wouldn't approve of this though. Think of the money they'd miss out on.

    Pardon the ramble.

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    1. Excuse the hasty writing.

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  4. Glad to see the Supreme Court upheld the health care law. If anything, that is even limited in scope, since Repubs tried to minimize it but compromises had to be done to pass it.

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  5. I recall the recent news story about the terminally ill young woman who moved with her family to Oregon so she would be eligible for assisted suicide. Sad, of course, but hopeful in some ways; with the medical assistance offered they were able to go through the process with strength, dignity, and minimal suffering.

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  6. Since our government recognizes criminal incidents that allow for the execution of human beings, I don't see why it should refuse relief of extreme pain and misery, loss of function, that can only be achieved through the ending of life. I respect the sanctity of life, but none of us expect to live forever. We should be allowed this option if and when it is needed.

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    1. good points, Sandy and Wendy

      dignity indeed, quality and not quantity

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    2. Perhaps those who have elder care experience, can move this disc. to the other blog, so Tom doesn't get upset.

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  7. Neil's column was about assisted suicide, but the discussion seems to have morphed to eldercare at the end of life, a related but different subject. Both worthy of consideration.

    That elegant maximizer Francois Vi, Duc de Rouchfoucauld famously wrote "Neither sun nor death can be looked at with a steady eye." But he lived at a time when natural death at a young age was common. And most people believed in an afterlife. Now that a large number of us dwell in "God's waiting room" for some time due to the wonders of modern medicine, it is a subject that becomes inescapable.

    As for assisted suicide the "slippery slope" fear seems to me ridiculous. Few people will chose to die for other than good reasons, the natural human instinct being to go with what Madam Du Barry said to her executioner: "encore un moment.monseur, un petite moment."

    Philip Larkin dealt with fear of death nicely in a poem titled "Aubade,"

    "There is a special way of being afraid
    No trick dispels. Religion used to try.
    That vast moth-eaten musical brocade
    Created to pretend we never die.
    And specious stuff that says 'No rational being
    Can fear a thing it will not feel,' not seeing
    That this is what we fear -- no sight, no sound
    No touch or taste or smell, nothing to think with,
    Nothing to love or link with,
    The anesthetic from which none come around."

    Tom Evans

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    1. Tate, but a lot of end of life or elder issues tie in with this as well.

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    2. excuse me, meant Tom, not Tate

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    3. Thanks for that poem, Tom. I always liked Larkin but didn't know that one.

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    4. He evidently wasn't an entirely likeable man, but a fine poet. That's only one stanza. I recommend the whole poem.

      Sorry if I rubbed Mr. Anonymous the wrong way. I wasn't really objecting to the comments shifting to encompass elder care problems. Only pointing out that it was a different, if related, subject from assisted suicide. With different issues.

      Tom

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  8. This is an issue I've thought about for many decades of my now-72yrs. The concept of individual choice is compelling, one I agree with. A slippery-slope counter-example, important though of limited applicability, is described in The New Yorker, 6/22/15: "Who Has the Right to a Dignified Death?" by Rachel Aviv.

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  9. The easy way would be if able to, take a bottle of sleeping pills and go peacefully but only for very old and terminally ill, not cause someone is just depressed. But then the problem is that the life insurance, that would pay for burial or for survivors, becomes null and void.

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  10. An eerie but apropos picture up on top.

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    1. That's what I was going for. The artwork, by the way, is "Transitorio/durevole" (Transitory/Durable) by Regina Silveira, on display at the Pomona College art museum earlier this year.

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  11. thanks for the details, Mr. S

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  12. I thought the name sounded Portuguese. (Brazilian style)

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  13. Of all the wonders that I have yet heard, it seems to me
    the most strange that men should fear; seeing that death,
    a necessary end, will come when it will come.

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