Britanny Maynard

[Laurettas]

Thank you, Canadian daughter for your kind words. No, I don't think it would have made any difference in my uncle's case. As far as I can remember, he wasn't terminal, at least not imminently nor was he in excessive pain. If he would have reached out for counseling to accept his situation, that would have been good but obviously he chose not to do that. I always thought that my aunt and uncle were close since they chose to work together in business throughout their lives. However, my aunt was totally shocked by what he did. And she was not angry at him, just had all of the joy and life ripped from her. One time she sat there with no expression and said, "I don't know but I just don't think that was the right thing for Carl to do." It just broke my heart because she had always been such a vivacious person. She began a downward spiral into dementia and was institutionalized within a couple of years.

[robinkaye]

His dismissive portrayal of Americans as "obsessed" with "cheating death," as "manic" and desperately trying to "endlessly extend life." His selection of the age of 75 as "a good time to stop." Anybody who worries about pressure being placed on the elderly and the vulnerable in society must be alarmed

I think Emanuel's recent article is nuts. I also thinks its likely he will change his mind, time will tell. I absolutely don't want to start another subject but just adding that Emanuel's attitude in the recent article which he has written about before was what alarmed many people knowing he was the architect/inspiration for the ACA and worked with Congress on the draft. Clearly, in his own words, he is not to big on treating people when the outcomes are less than optimal. At least so far he is only talking about himself.
So, to your question, no I don't like that kind of thing.

I was shocked to find myself agreeing with Emanuel about anything but I agree with him that it's our right to die just don't codify it in law. Once that right is by statute then who is anyone to decide that only certain people have a right to die, all kinds of maladies might make the list. Will we insure that a doctor has a right to refuse based on his religious beliefs or whatever objection he might have. Will the patients rights trump the doctors? Just because we write a law one way doesn't mean it won't get changed and changed again.

I realize the old article was before the Oregon law but it doesn't negate the historical and legal perspective Emanuel offered. I don't know how well the law in Oregon is working. I've seen anecdotal evidence of problems. The woman denied chemo but offered assistance to die was just about as wrong as you can get. It may be the law is working just fine in most cases. I wonder why Oregon requires a six month residency, what's wrong with seeking help with dying just like visiting a cancer center in another state.

[Lisahopes]

So, whose right prevails? The one who wants assisted suicide or the one who will be afraid for his life because of it? And this is only cancer patients. If one adds in the disabled and the elderly, I would think that the ones who would fear assisted suicide would much outweigh those wanting it. This would seem to be pretty obvious in Oregon since only two-tenths of one percent of those who die in that state choose assisted suicide. Whose right is more important? Fear of being coerced into dying or even being euthanized can be very terrifying. How can we determine whose fear doesn't matter?

If so few people are wanting it, wherein lies the slippery slope? And if the existence of the right is widely known only those who are interested would raise the subject. Where is the problem here?

Like JDepp says, it seems to me that you generally view suicide as the same as euthanasia and view those who suffer longer to have shown more love and have been more loved. The way your uncle left without sharing his decisionmaking process with his wife would obviously leave her feeling guilty and depressed. Taking a decision together and carrying it out is not the same thing by a long shot.

[Lisahopes]

The posters who judge this poor woman's choices and condemn her right are disgraceful. They claim that it a slippery slope for handicapped folks and then these very same critics say that these options and risks already exist. Makes no sense at all.

Lisa, I just read through all of the posts and can't find anyone judging Brittany. If I missed it please reference. Some are concerned with how we go about sanctioning euthanasia, it was not an attack on Brittany. Some people here say they wouldn't choose euthanasia but don't deny Brittany her right. There is a difference between questioning the implementation of a law and condemning Brittany or her right which no one did. The rights granted by "man" can be changed or taken away.

Perhaps you should re-read it.

Arguing against the law that made Britanny's route possible is a judgement in of itself. There have been a number of claims that one should be willing to endure sufferring due to possible abuses of the law but the truth is, just like the mercy killing of a pet, this cannot be about loved ones feeling more comfortable with the process or possible abuses of law (which haven't materialised as evidenced in the tiny percentages of people who choose to go this route). It about the person who is dying being released from suffering and the living coping with that. On my mom's last day on this earth the doctor said he had given her something because she was agitated but she could no longer speak. Did I want him to take her off it so I could still engage her? NO, of course not. It wasn't about me "doing all I could" to feel like a better caretaker. It was about her only.

[canadiandaughter]

Laurettas, if he wasnt terminal or in any pain then I am sorry, but I don't see how his suicide is related to this conversation. I know personally what suicide attempts feel like for a family as we had one in mine just in January. It rocks your world in ways you never imagined. From my personal exp I would have to say that had my daughter been terminal and suffering, what she tried to do would have made sense to us, but being she wasn't, its a totally different story. I am dreading the day that my dad gets to the stage where he is lying in bed wasting away and suffering. He is my strong father and I know he would not want us to watch it. I would have no problem with him deciding to end his life on his terms. If it is a choice, then those that want it can choose, those that don't can opt out. Like I said earlier, some counselling should be involved be make sure it is the patients decision and not someone else pushing them to do it.

[stephenlamb]

Being a caregiver to my wife who was diagnosed at 29. I will half to walk this path no matter how cruel it becomes. I met my her at the age of sixteen at a out of state music festival with 25k people. Out of all of those people we found each other! now this love story is turning into a trategy. In July she wayed just over 70lbs and was starving to death she has a blocked colon and no options for sugery. This becam a topic of discussion. I needed to know what her wishes were knowing her death is going to require much suffering. I say all that to say this f@#$ politics and whoever thinks they have moral authority over our decisions !! #$# it all! Nothing will stand in the way of me getting what my wife wants deserves and needs!

[robinkaye]

Questioning a law does not equate to judging Brittany which again, no one did. Brittany used a law and was within her rights. It is the law being questioned. I don't judge or condemn Brittany but will continue to question the law. I will continue to be concerned that as a society we will become desensitized. It has happened elsewhere in history where one thing leads to another. We already have people talking about the right to kill a baby after it's born if it has downs or other defects. Well, if its okay to end a cancer patients suffering, surely it's okay to end the child's. Maybe sometime down the road states will deny resources and give you the means to end your life just like Oregon has done. No one seemed to have any problem with this. If the same letter had come from an insurance company all he'll would have broken loose on this board.
People have been grappling with subjects like this since civilization began, this is not unique to our era. We have the ability to look back and study what has gone before us. Nothing is either or and nothing comes without consequences, just be sure you know what those consequences might be.

This is going to be a long drawn out battle state by state and that is a good thing. I don't think anyone here defending the law has anything but good intentions, why can't the same people recognize the same in those that are opposed or question the law without recriminations.

Your mother is a good example of what I would guess probably happens many times everyday. I certainly would have done nothing different.

Currently 3 states have legalized Right to Die, 44 states makes it a felony and 4 (inc DC) have no law making assisted suicide either legal or illegal. I would be curious to know how often it's used in those 4 when there is no threat of prosecution, I doubt we will ever know which is not a bad thing.

[robinkaye]

Being a caregiver to my wife who was diagnosed at 29. I will half to walk this path no matter how cruel it becomes. I met my her at the age of sixteen at a out of state music festival with 25k people. Out of all of those people we found each other! now this love story is turning into a trategy. In July she wayed just over 70lbs and was starving to death she has a blocked colon and no options for sugery. This becam a topic of discussion. I needed to know what her wishes were knowing her death is going to require much suffering. I say all that to say this f@#$ politics and whoever thinks they have moral authority over our decisions !! #$# it all! Nothing will stand in the way of me getting what my wife wants deserves and needs!

Completely agree and I wouldn't need the states permission or anyone's blessing.

[Laurettas]

My concern lies in the fact that as attitudes change toward these issues, ultimately care changes. I noticed a marked difference in the care my FIL got in 1991 and the care that was offered to my husband 20 years later. I had to fight to have my husband hydrated in his last days while that was automatically done for my FIL. Why? Because so many people have decided that they don't want to be hooked up to tubes and machines. Also, the big glorification of home death. Those of us who are totally untrained cannot keep people as comfortable in the home as those who are trained to do it. As far as I am concerned, if everyone wants home death, there needs to be trained persons available 24 hours a day in the home for that to happen. I personally think that the better option is to have a hospice wing in every hospital, much like the birthing wings in hospitals. Places with a homey atmosphere but with trained personnel right outside the door to deal with issues as they come up.

Dr. Emanuel made a point in one example about a case in the Netherlands. One patient who had a medical crisis of some sort, did not want the assisted suicide or euthanasia that was offered to him but wanted to be treated for his crisis--a blockage or something. The attending physician didn't know what to do because in his experience people in that situation always chose the assisted death. When assisted suicide or euthanasia becomes standard of care, that will be the default point--and then people will fight to have something other than that done. It is already happening. Every so often there are reports of, usually nurses, who are euthanizing people without anyone's permission. Why? Because the overall attitude has changed in the medical profession and the culture and assisted death has become an option in many people's minds. It is one small step from thinking that some assisted death is OK to it becoming standard practice.

Canadiandaughter, I brought up the case about my aunt and uncle to give a concrete example to CRGuy's position of his rights having precedent over any one else's opinion. My uncle exercised his "right" to suicide but caused my aunt irreparable damage in the process. Our "rights" can sometimes cause much damage to others. And I am so very sorry about your daughter, her pain from whatever cause must have been tremendous for her to attempt that. I hope I understood you correctly and she did not die. If she didn't, I hope she is getting whatever help she needs. As far as your dad, don't try to anticipate what is going to happen. Looking at the big picture can be overwhelming. Just deal with each moment as it occurs and you will be able to accept things with much more peace. My anticipated fears for my husband were much worse than the reality. Also, if he is at home and his discomfort seems unrelenting, be sure to insist on IV pain meds. They are much more effective than patches or oral drugs. Especially if he is dehydrated. Drugs can't be delivered as effectively if there is dehydration.

What I came away with in Dr. Emanuel's articles is that ultimately people have an obsessive fear of natural death. People will do everything--exercise, diet, supplements, all sorts of medical procedures, etc. etc. to try to chase away death, and when that eventually fails and death becomes probable, they want to avoid the natural process by assisted suicide or euthanasia. Another thing is that so many people who are looking at a potential situation from the outside think that the situation would be something they would never want to experience or endure, while those who have actually gone through it, handle it much differently. For example, my BIL became very angry and bitter at God for allowing his cousin's daughter to die from cancer at 4 years old. He never saw her during that time and never talked to his cousin either. But he was mad! However, his cousin who sat there every moment of every day caring for her daughter and watching her die a pretty violent death, turned to God and found peace. We cannot look at a situation from the outside and know what it is actually like. Only if you are there experiencing everything can you know the value. Walking in and being present for a few minutes looking at what seems like a horrible situation is not the same as living it completely.

[jdepp]

When assisted suicide or euthanasia becomes standard of care, that will be the default point--and then people will fight to have something other than that done. It is already happening. Every so often there are reports of, usually nurses, who are euthanizing people without anyone's permission. Why? Because the overall attitude has changed in the medical profession and the culture and assisted death has become an option in many people's minds. It is one small step from thinking that some assisted death is OK to it becoming standard practice.

At the risk of repeating myself, I will say that I don't believe this is true and I don't think the experience in Oregon bears out the claim. Just the opposite: very few people use the right-to-die option, and there is no credible research suggesting any great paradigm shift in "medical attitudes" caused by the death with dignity act. Every piece of evidence offered for this has been anecdotal, personal, or at best a carefully selected isolated case.

What bothers me is that those who oppose the right-to-die option never seem to worry about the consequences of their beliefs on the Brittany Maynards. It is one thing to carry around a private fear about an imminent cultural shift or change in society or paradigm shift or slippery slope or what have you. It is quite another to use that fear -- again, nothing that has been validated in Oregon or anywhere else -- to justify denying Brittany Maynard the right to end her own life.

We are at a precarious moment in our history where the right-to-die movement could continue to spread or could be defeated. To my mind, those who would defeat it have to find something credible to say to Brittany Maynard -- to her face, real words to a real person -- to explain why they are willing to force her to die on their terms, not hers.

[Laurettas]

jdepp, I don't recall anyone saying that those like Brittany cannot orchestrate their deaths if they so choose. The objection comes because a minority want to codify it into law, forcing those in the medical profession to become complicit in their decision. The majority of physicians do not want to be involved in assisted suicide or euthanasia, the AMA is against it, the Hospice organization is against it, and from the polls I have seen recently, the majority of Americans are against it. I think when you have that many people, especially those in health care, who are expressing grave concerns, it might be prudent to listen to what they have to say.

I am not speculating about possible shifts that MIGHT occur. I have seen a change in my lifetime on how end of life issues are treated. It caused me personally a lot of added stress at a time when I was already off the scale with stress. I should not have had to argue with a doctor for an hour who was trying to force my husband to sign a document about end of life care when we had LEGALLY already had his wishes registered with the state. And as I stated before, there are those whose mindset has already changed and medical professionals have been prosecuted for euthanizing people without anyone's consent.

As far as having to guess about how to commit suicide on their own, I doubt that is any problem with the internet. Also, according to articles I have seen, between 15 to 20% of assisted suicides in the Netherlands have to have the intervention of a physician so they don't have it down to an art by any means. Maybe rather than pushing so hard for this sort of thing, we ought to start educating everyone to the reality of dying, that it is going to happen, that they can do much throughout their lives to prepare for it so that it isn't so very traumatic when the time comes.

[canadiandaughter]

I am glad that your cousin or whatever it was managed to not be angry at god when his child died. I myself would have been praying that he take her fast and end her suffering and would have been angry to watch her hurt. I don't believe that if there becomes a time that assisted suicide is legalized in more places that it will be as bad as you think. The reason that the doctors and nurses now have started not hydrating people when death is close is to help them along. My daughter is a nurse and she said that often the nurse will move patients around a bit as sometimes that helps. I have a friend who is a nurse and she told the doctor to giver her mother LOTS of morphine when she was suffering at the end of her battle with cancer. My neighbors mother suffered and LONG time as she was young with a strong heart. SHe was begging for death to come. Like I said before, we would never treat our dogs like this, in fact we would be charged for animal cruelty for letting them suffer. People should have the choice, not the doctors caring for them, but the patients. When it comes near the end and you have to be so drugged up to handle the pain, what benefit is it to lay there and suffer? You can't communicate and there is no quality of life left. It is very had on a family to sit and wait. You are scared to leave as you want to be with your loved one when they pass. Assisted suicide would help all of that. It would take care of a lot of suffering for everyone. If you choose not to go that route, that is fine, each to their own!! That is the beauty of a law that allows choice.

[jdepp]

jdepp, I don't recall anyone saying that those like Brittany cannot orchestrate their deaths if they so choose.

I think we have a different idea about what supporting Brittany's right to choose really looks like.

To me, and to Brittany, it looked like Oregon. It did not look like telling a woman with aggressive brain cancer that she should either die painfully and slowly or else break the law by going on the internet and "figuring out" how to kill herself illegally.

As for whether there has been some major change in end-of-life treatment, two things. First, if it were true, there should be substantive research showing it; to my mind the Oregon experience refutes the claim. Second, even if everything you say were true, it would be hard to link any such "changed mentality" to the death-with-dignity act.

Finally, pointing out that "the majority" believes this or that only reminds me of other cases where people have sought to deny minority rights. Social change would never happen if the minority did not change minds.

[Laurettas]

Canadian daughter, only have a minute because grandkids are coming to spend the night! I have spoken with medical professionals who say that not hydrating someone at the end of life does not help them, and in the case of pain patches and oral meds, makes the pain killers nearly ineffective. As the body dehydrates, from what I understand the blood leaves the extremities and the skin and pools near the organs to keep them functioning, therefore the pain meds have no pathway via the bloodstream to be transported. I know of two cases in which people had nutrition and hydration taken away and it took them 12 and 14 days to die. My husband had an IV for the last 36 or so hours before he died while he was in the hospital. After the IV was inserted and morphine delivered by that means, he was calmer than he had been for the previous two weeks.

People have the choice, I will say it again and again. The means for suicide are readily available without having to involve the medical profession.

My daughter made the comment the other day that it is only during extreme pain could she ever consider dying a good choice. She said that she could never do what Brittany did because she would need the pain to make her aware that dying can be a positive thing. She could not visualize taking something to cause her death while she was feeling OK. I could explain the value in suffering but that requires some religious conversation and I don't know that this is the appropriate place. The suffering in life I have experienced has many times put things in proper perspective for me. I realize what is important and what is not.

[annalexandria]

Canadian daughter, only have a minute because grandkids are coming to spend the night! I have spoken with medical professionals who say that not hydrating someone at the end of life does not help them, and in the case of pain patches and oral meds, makes the pain killers nearly ineffective. As the body dehydrates, from what I understand the blood leaves the extremities and the skin and pools near the organs to keep them functioning, therefore the pain meds have no pathway via the bloodstream to be transported. I know of two cases in which people had nutrition and hydration taken away and it took them 12 and 14 days to die. My husband had an IV for the last 36 or so hours before he died while he was in the hospital. After the IV was inserted and morphine delivered by that means, he was calmer than he had been for the previous two weeks.

People have the choice, I will say it again and again. The means for suicide are readily available without having to involve the medical profession.

My daughter made the comment the other day that it is only during extreme pain could she ever consider dying a good choice. She said that she could never do what Brittany did because she would need the pain to make her aware that dying can be a positive thing. She could not visualize taking something to cause her death while she was feeling OK. I could explain the value in suffering but that requires some religious conversation and I don't know that this is the appropriate place. The suffering in life I have experienced has many times put things in proper perspective for me. I realize what is important and what is not.

No, Lauretta, this would probably NOT be the place to give us your perspective on your religious beliefs. Although it would be perhaps more honest of you if you would stop with the anecdotes and sweeping statements made sans evidence and just say that you object to this because of your own, very personal religious beliefs.
But if you admitted that, then you couldn't lecture the rest of us, now could you?

I'm glad you find suffering so personally useful. Of course, you've never actually experienced a diagnosis of stage 4 cancer, so your understanding of that is in reality quite limited (having also been a caregiver to a sister who died from this crap I can tell you in no uncertain terms that it is quite a different role when you are the one who is suffering and facing death).

Now I will bow out, before I say something I really regret. I honestly feel that we would benefit from having a forum that is strictly for patients only.