Sunday, January 11, 2015

Death with Dignity: a view of both sides

The story of Brittany Maynard has re-sparked the debate of the choosing the time of our deaths. She was diagnosed with terminal brain cancer and given six months to live. Brittany moved to Oregon in order to use the state’s Death with Dignity Act. She died on November 1, 2014 just 18 days before her 30th birthday. I’m on the fence with this debate. I feel so conflicted that I can’t make a decision. I see too much of both sides. Currently, Washington and Vermont have laws similar to Oregon’s. I will discuss Oregon’s law as well as the pros and cons of physician-assisted dying. During my research, I found long lists of pros and cons. I will focus on the top 3.

Oregon’s Death with Dignity Act legalizes physician-assisted dying with certain restrictions. Under the law, a competent adult who has been diagnosed with a terminal illness, which will take the patient’s life within six months, may request in writing from his or her physician, a lethal dose of medication with the purpose of ending the patient’s life. The law is voluntary and must be initiated by the patient. Once the request has been made, a physician will review the request and the patient’s medical records. It must be determined that the patient is free of any mental condition which could impair his or her judgment. A second, oral request is made before the prescription is written. The law protects doctors from liability and also states that the patient’s decision cannot effect his or her “life, health, or accident insurance or annuity policy.” The law also allows doctors, pharmacists or healthcare providers to refuse to participate if they have moral objections.

The first item on the pro list is the end of pain and suffering of the patient. I have seen patients who were dying of cancer and I could see they were in pain. If a person knew the pain they would be in at the end, would that person not have the right to avoid such pain? The second item on the pro list is a person should be allowed to die with dignity without fear of losing their physical or mental capacities. I also have seen individuals who were at the end of their illnesses who were not the same person. One person comes to mind. At the end of her illness, she was not herself and I know she wouldn’t want to be remembered like that. Lastly, patients can arrange their final goodbyes. Who wouldn’t want to say goodbye on their own terms?

The first item on the con list is doctors can mistakes about prognoses and patients may be ending their lives sooner than necessary. There are countless stories of patients given a few months to live who go on to live a few more years. Prognoses are often educated guesses. Second, pain and suffering can be relieved through palliative care. Palliative care is specialized medical care for people with serious illnesses with no cure intended. Palliative care is similar to hospice care. The focus is providing relief and the goal is to improve quality of life. A team of doctors, nurses and other specialists provide care. Lastly, doctors aiding in dying violates the Hippocratic Oath of “first do no harm.” Could the “first do no harm” be applied to helping a patient find relief in death? Could prolonging the inevitable be doing harm to the patient?

In conclusion, for me there are still a lot of questions. I know that many people cite religious beliefs for reasons against death with dignity. There are seven documented suicides in the Bible and each one is not condemned in the text. It is my belief that only God knows what is in someone’s mind and heart (Psalm 139:1-2). Only He knows someone’s true motives. I don’t know what I would do if I faced a prognosis as Brittany Maynard did. I know I would focus on my bucket list and saying goodbyes but I don’t know if I could take a lethal dose of a medicine. I do know that I cannot condemn those who chose to end their lives.