A human life is valuable, and that value should be honored. It sometimes seems that honoring life in America can be an uneven undertaking. We’re one of the few developed countries that still has a death sentence, and we value our right to own guns over the statistics that prove how many innocent lives are lost to those guns. We have an ongoing controversy over pro-life versus pro-choice views, and the next frontier is likely to be the right-to-die via assisted dying.
Assisted dying is when a terminally ill, mentally competent adult makes the choice of their own free will (after meeting strict legal safeguards) to take prescribed medication which will end their life. The term is often used interchangeably with physician-assisted suicide (PAS), which involves a doctor deliberately providing a person with the knowledge and/or means required to commit suicide, including counseling about lethal doses of drugs and prescribing or supplying such lethal drugs. The conversation was brought main stream by Dr. Jack Kevorkian, aka “Dr. Death,” in the 1980s. He made headlines when he said, "Dying is not a crime."
In the United States, there are assisted dying laws restricted to terminally ill and mentally competent adults in Oregon, Montana, Washington, California and Vermont. It is also legal in the Netherlands, Luxembourg and Switzerland. A well-publicized case of the right to die with dignity was that of Brittany Maynard, a 29-year-old woman diagnosed with terminal brain cancer. She considered dying in hospice care in her hometown of San Francisco, but because the rest of her body was young and healthy, she was afraid she would linger in hospice care for weeks or possibly months. She could have possibly developed potentially morphine-resistant pain, suffered personality changes, and lost her verbal, cognitive and motor skills.
She had to uproot her family and move to Oregon to have the option to use the medical practice of aid in dying. It enabled her to end her dying process when it became unbearable. Brittany was fortunate to have the resources, time and flexibility to make the move to Oregon. She used her final days advocating for the right of all individuals to die with dignity. Brittany died peacefully on November 1, 2014, surrounded by her loved ones in Portland, OR. She outlived her prognosis by two months, but was able to choose to die “when the time was right.”
As medical technology outstrips our ability to have ready ethical direction, we may have unintentionally focused on life at all costs without consideration for the quality of that life. I wondered if hospice wasn’t just a slow form of assisted dying until my husband opted to go into hospice care. He was in hospice for six weeks, and the final ten days, when he was off all of his meds except for some comfort medications, were difficult for him. He had little awareness, but his face was tense. He was restless and had difficulty keeping his TTO2 tracheotomy clean so he could breathe. I assisted him as best I could and almost drowned him in the process. I think it would have been an act of great mercy if he’d had the option to end his life before those final ten days.
Since the Oregon Death with Dignity Act (DWDA) took effect in 1997, 859 patients have died by self-administration of a lethal dose of a prescription medication. In 2014, 155 prescriptions were written for lethal medications in Oregon, resulting in 105 deaths (in the remaining cases, the medication was not ingested). About 68.6 percent of the patients had malignant cancer, and the most commonly ingested lethal medication was secobarbital (60 percent of cases). About 67.6 percent of the patients were 65 years of age or older. The time from ingestion to death ranged from a few minutes to 4.5 days.
While assisted suicide can be a slippery slope and should be monitored carefully to ensure that it’s restricted to voluntary use when medically appropriate, I think it should be an option for the terminally ill. As Brittany Maynard said, “Who has the right to say I don’t deserve this choice?”