Tuesday, September 15, 2015

The Right to Die: Kevorkian Revised

California is on the brink of something big. A monumental decision in human rights, tail-gating the epic Supreme Court ruling on gay marriage, but unlike the law of marriage, where one’s life is just beginning, this law meets us at the end of it. The Right to Die Bill, better known as the Death with Dignity Act, Physician Assisted Suicide, or even “Kevorkian Revised,” is nestled on the desk of California governor Jerry Brown, awaiting his inscribed approval. But will he give it or will he condemn thousands of suffering Californians to a painful, embarrassing death?

For years, a handful of states in the US have been proposing and passing bills and laws allowing one to make their own decision on when they prefer to die. Some people have likened this process to Dr. Jack Kevorkian’s practices of the 1990s, where he assisted in ending the lives of 130 patients, all of whom he claimed were terminally ill, though this has been disputed. It is alleged that often times he didn't even verify that the patients were ill, and ended up assisting a few who simply suffered from severe depression. But in spite of his misguided practices, Kevorkian may have been on the right track. In the midst of his own failings, ones that would eventually land him in prison for second-degree murder in Michigan, Oregon passed a state law that would allow individuals who were terminally ill to choose to end their own lives. This would help them avoid a long and drawn out death that would end in nothing but extreme pain and humiliation. In 1994, the Death with Dignity Act was signed into law.

But the law was not without its opposition. Like many bills, misinformation had been spread thick, coating more gullible minds and manipulating them into a stealth support system around the nation. Many warned of the inevitable slippery slope: if we start killing terminally ill patients, why not the mentally ill? Why not the mentally and physically disabled? Why not kill people who don’t want to die but whose children are trying to get the inheritance, or who don’t want to bother with the costly care of a sick parent? Why not kill the Kardashians? (But seriously, why not the Kardashians?). A few claimed prescribing a deadly medication was against the Hippocratic Oath. Others claim suicide is the easy way out, that these people are weak, that they’ve simply given up. One Archbishop claimed the law would provide insurance companies an easy way out, denying patients appropriate care in favor of an easier and much cheaper solution. Some cite religious factors, that if you end your own life, you’re going to hell.

First off, multiple safeguards have been put in place to ensure that we cannot go on a genocidal killing spree of the various “plagues” of society, as Hitler may have done. Oregon state law and the California bill specifically state that only individuals who have been diagnosed by two separate physicians as terminally ill and expected to die within 6 months may receive this medication. These individuals are also expected to undergo intensive mental health examinations to ensure they are of sound mind and body to make such a decision. Once provided the medication, no one can administer it except the patient themselves. The medication is mixed into a drink; the patient is required to drink it themselves without the assistance of any physician, family member, or friend. If they cannot administer the medication themselves, they cannot utilize it. In short, if you can’t hold your own glass and swallow your own medicine, you will have to wait out the rest of your life until you pass away naturally. There is virtually no chance of someone else rubbing you out. Sadly one man had ordered his medicine but was waiting until the right time, and he ended up having a severe stroke, leaving him incapable of giving himself the medication. He suffered until his last day.

Some individuals have been concerned about providing doctors the power to “do harm” in contrast with the Hippocratic Oath they swear upon licensing. Doctors themselves have grappled with the decision in prescribing deadly medications. This was briefly mentioned in the documentary, How to Die in Oregon. One doctor finally came to realize when her patient Cody asked for the script, she would be doing more harm in forcing her to suffer through the pain of terminal cancer in her last months than to ease her into a quick and gentle eternal slumber.

The easy way out. I can only imagine the reaction some of the benefactors of this law would give when they hear that. All of these individuals have fought. All of them have suffered. They have faced numerous chemotherapy  and radiation treatments, they have stumbled through the side effects, the nausea, the weakness, the hair loss and weight loss, and the surgeries and tests in hopes of battling their diseases into remission. And sadly, they failed. Their efforts were not enough. Their bodies could not muster the strength and the antibodies to silence the invading cells once and for all. They rode into a war some of us will someday fight ourselves, a war all of us will have witnessed with our loved ones. And after all they have been through, they deserve that peaceful death, in their own time, with their own choice, adorned with the dignity they have earned. Cody tried her best to get through it on her own, to arrive at the moment where she would naturally “float away” without the medicine. She had ordered the medication and it sat in her cabinet for nearly a year as she outlived her life expectancy. Initially she had planned the date to die, but decided against it, because she was not suffering at that time. Suddenly, after months of extended comfort, fluid began to build up around her lower abdomen, creating so much pressure that her organs were displaced and her ribcage was shifting upwards, compressing her chest cavity. Draining the fluids offered only temporary relief and she was often hurting, struggling to keep foods down, incapable of keeping most of her pain management pills down. Doctors informed her that in spite of the cancer, her body was strong, and she could continue to live on in severe pain for several more months. There would be no floating away. It was time to go.

As for healthcare companies and the easy way out, in the same documentary mentioned above, one man had been diagnosed as terminally ill and was denied treatment for chemotherapy by his insurance. He was, however, provided in his denial letter a solution. In being notified that he cannot receive what he believed may be lifesaving treatment, he was also informed of his option to request life-ending medications, which would be fully covered by his insurance. This understandably angered him, but let’s get a few things straight: he had no possible chance of survival and the treatments would have been largely ineffective anyways (once he went public with his complaint, the insurance company granted his treatment, and he died a few short weeks later). But I will not deny that this could be a very real possibility given the dastardly methods insurance companies have employed to save a buck over a life day in and day out. However, why prevent some people from having the option to avoid suffering because of a corrupt healthcare system? Address the system head on! Where is healthcare reform? Where are the checks and balances? These people shouldn’t have to suffer because billionaire insurance companies have lost their sense of humanity.

Religion? Bottom line: your religion is not their religion and you cannot use it to make laws for everyone.

Last year, Britney Maynard made headlines when she relocated from California to Oregon to take advantage of their Death with Dignity Act. Diagnosed with a terminal form of brain cancer, Britney had undergone multiple operations and treatments to battle the disease before recognizing that she would not win. Given that she had no right over her own life, she was left with little option than to move, but became a significant advocate and a public figurehead for getting similar laws passed in states that have not acquired such legislation. Britney passed away at the age of 29 at home surrounded by her loved ones.

As I watched How to Die in Oregon, I bawled after each patient took their medication and slipped into a calm and gentle darkness. I was torn in half in the moment. I have never seen someone pass away, and I couldn’t imagine standing there in a room watching someone I love take a mixture that would rip them out of my life in a matter of minutes. I would never be able to hug them enough, I would never be able to say enough to them before I finally had to say goodbye. I would never get enough of the sound of their voice or their smile before they slipped away from me. But, like many of you, I have watched my family members and friends suffer and wither away from cancer, from terminal diseases that render them helpless. I have seen my family, always strong, always proud, try to mask their embarrassment as someone had to feed them and clean the excess that dribbled down their chins, as someone had to wash them in spite of their deep-seated modesty, or wipe them after using the bathroom. They were lucky, I suppose, in that they never lived long enough to be confined to diapers, sitting in their own urine and feces like helpless infants until the nurse came ‘round again to change them. And they suffered. They hurt. They couldn’t bear the pain, the nausea, the weakness, the humiliation and embarrassment. As one family friend had put it, “I’m sick and tired of being sick and tired.” But we had no solution for them. Just make them comfortable. Pump them full of pain meds and wait for the inevitable, whenever that may come. But like Cody, sometimes they can’t keep the pain meds in. Sometimes, as they get closer to the end, the pain meds are rendered totally ineffective, and they suffer in their final days.

Cody died in the comfort of her own home. She was not weakened to the point of being bed-ridden; she was not strewn limply across her bed with tubes and needles feeding in and out of her. And because her fluids had been recently drained, she was not suffering at the moment. Cody was singing. She had gathered her family in her bedroom and her children and parents sang songs to her, light-hearted children’s songs she no doubt sang to her kids when they were young. They hugged and kissed, they said their goodbyes, and she took her medicine and lay down. In a matter of minutes, she breathed a sigh of relief, and slipped into a coma that would soon allow her to finally float away as she had always wanted.

This law must pass. We cannot condemn people to suffer in their final days because we fear the loss, because we fear the choices they’re making for themselves. I struggle to comprehend how we can be so humane as to inject our beloved pets and animals with a painless medicine to end their own suffering, but we refuse to allow it for human begins. We can’t treat each other as well as we treat our dogs. We deserve so much more than that, and our loved ones deserve more too. 

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