Physician Assisted Suicide: Whose choice/voice is it?
by Nancy Brennan
If I am ever challenged with a diagnosis of terminal cancer, AIDS, Huntington’s Disease, MS, ALS, etc., I definitely want the choice to end my life on as much of my own terms as possible. I just might move lock, stock and barrel to Portland, Oregon and live out my days there. Let me explain. Euthanasia, a painless death, has been exercised, both overtly and covertly, around the world for centuries. Unfortunately, its misrepresentation, associated with Hitler, war atrocities and other negative happenings, keeps its beneficial principle from being accepted by many. Only since the mid 1980’s has a form of euthanasia, physician assisted suicide (PAS), been legally protected in a few countries in Europe. Dutch and Belgian citizens may elect a “painless death” to end the suffering of a host of incurable diseases our longer living civilization faces. At about the same time Europeans were granted PAS, state courts here were ruling on brain death, right to privacy, persistent vegetative states, respirators, and feeding tubes with decisions being appealed, overturned, you name it. Historically, legislation concerning medical practices has always been left to the individual states. Then, in 1994, voters in the state of Oregon went to the polls and approved Ballot Measure 16, which eventually became known as “THE OREGON DEATH WITH DIGNITY ACT” (29). Finally, a group of Americans had spoken and were granted a legally protected choice regarding physician assisted suicide. This triggered a rash of legislation across the country. Here in North Carolina where I reside, Senate Bill 145 “CREATING THE CRIMINAL OFFENSE OF PHYSICIAN-ASSISTED SUICIDE” was passed, taking away my choice (1).
Over the years many opinions have been expressed, evidence has been gathered, and statistics have been compiled concerning PAS. Pro-assisted suicide physician Jack Kevorkian, upon receiving the 1994 Humanist Hero Award by the American Humanist Association, stated in his acceptance speech that organized religion, organized medicine, and organized big money are the powers that influence legislation against it (Kevorkian, para.16). The amount of money hospitals, nursing homes, the pharmaceutical industry and other entities in the medical/health care industry could lose, totals in the billions (Kevorkian, para.17). So, if individuals are given the legal choice to end their lives, of course big money will always have something to say about law making at state and federal levels. I wonder if the political contributions made by these industries are drowning out the cries of the terminally ill. This is the voice the legislators are hearing and acting upon, “line my pockets” rather than “ease my pain”?
On May 26, 2004, Blaine Harden of The Washington Post reported that Attorney General John Ashcroft could not sanction doctors for prescribing overdoses under Oregon’s Death With Dignity Act. Ashcroft was trying to nullify the DWDA saying it violated the federal Controlled Substances Act. The U.S. Ninth Circuit Court of Appeals in San Francisco maintained that the DWDA fell under “medical practices”, which have historically been regulated by the states. Whose voice is Ashcroft listening to, certainly not that of Richard Holmes?
Holmes, one of the plaintiffs in the aforementioned suit was interviewed by National Public Radio in his home in Oregon back in March of 2003. When asked about the Attorney General’s claim that assisting in a suicide is not a legitimate medical purpose, the liver cancer victim replied, “It may be illegitimate for him, and that’s fine, but it’s legitimate for me…I would love to go to Washington, DC…and tell him, ‘You get in my shoes for a minute and just feel the way I feel and know what you’re facing. And if you don’t think that you want an easier way out, you’re nuts’” (2).
Also interviewed during the segment was Democratic Oregon senior senator Ron Wyden. Wyden, not a personal supporter of PAS, knows no reason why the Bush administration feels compelled to tell Oregonians how to live out their final days, “I do find it pretty odd that officials in Washington, DC, are willing to substitute their own personal and moral judgments on matters that have historically been left to their states, and they’re substituting their personal judgments after they’ve given great speeches pledging alliance to the power of the states. What they’re saying is states’ rights means it’s only if they happen to believe the state is right at any given time” (2-3). I agree with Mr. Wyden and I think the voices of pro-PAS Americans are being ignored. Politicians have already made up their minds, holding fast to their moral values and turning a deaf ear to any opinions contrary to their own.
There are others who believe palliative care or pain management is the solution, not PAS. In his book Hemlock’s Cup: The Struggle for Death with Dignity Donald Cox cites cases in which the terminal stage of many patients lives were not pain free even with medication (124). Dr.Timothy Quill, a former director of a hospice program states “Although I know we have measures to help control pain and lessen suffering, to think that people do not suffer in the process of dying is an illusion” (qtd in Cox 257). In 1991, Quill made headlines when a jury in northwestern New York failed to indict him for assisting a patient in taking her life. The burden of doctors, families and friends to not only watch a loved one endure pain, but also see their quality of life diminish, must be a heavy one. Where is the joy in life for someone with advanced ALS or MS when the body becomes a prison cell? For someone with Alzheimer’s when confusion is all they know?
In 1967, when I was six years old, I have a vague memory of going to the hospital to visit my paternal grandmother, Mommom Farley. She laughed and showed us the back of her head and said, “Doesn’t it look like a football?” She was referring to the shaved spot and stitches where they had removed a tumor. That was the last time I saw my father’s mother. Shortly after our visit, she was allowed to go home from the hospital to die in her own bed from the cancer that was eating her brain, lungs and female organs. I was told that she didn’t ask for pain medication, that they believed the part of her brain the cancer attacked had to do with sensing pain. She also couldn’t speak, but had some chalk and a little chalkboard. So if she needed the pain medication she could have written a message, right? Well I don’t want a chalkboard!
When I was nine years old my maternal grandmother, Mommom Kenney, fell and broke her hip. After going to the hospital she went to Daybreak Nursing Home to recuperate. She never came back home again. What I now understand is that my grandmother was suffering from Alzheimer’s disease.
Over the next three years my family visited my grandmother. It was scary, the screaming, moaning and crying I would hear. The horrible smells: urine, feces, germicide, old people dying, their breath when they talked. As a child, I knew what was deep down inside of them was so much older than what was inside of me, and it was rotting. The people started grabbing me and telling me all kinds of stories. Kitty was always going to take me to Europe! I just couldn’t go back anymore. My grandmother hadn’t known me in over two years. I was angry, sad, depressed and guilt ridden (and too young and sensitive to be exposed to this!).
I think Mommom Farley deserved the choice to end her suffering. And I think Mommom Kenney deserved the choice to die with dignity. I don’t know if either would have exercised their choice, but I believe they should have had it. I think you and I should too. You see I really don’t want to have to move to Oregon to have a choice. I want to be home with my family where I belong. So Mr. Ashcroft, North Carolina legislators, my fellow Americans, to borrow a few words from Patrick Henry’s speech given on March 23, 1775, “I know not what course others may take; but as for me, give me” the liberty to chose my own death!(2).
“Analysis: John Ashcroft issues federal order prohibiting doctor-assisted
suicide in Oregon.” Narr. Bob Edwards and Wendy Kaufman. Morning
Edition. Natl. Public Radio. Portland. 22 March 2002.EBSCOhost.
Newspaper Source. 1-2. CPCC Libraries, Charlotte, NC. 8 June 2004.
Cox, Donald W. Hemlock’s Cup: The Struggle for Death with Dignity. Buffalo:
Harden, Blaine “Court Rules on Aided Suicide” The Washington Post 27 May