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July 2005 Vol. 24. No. 7
Published by the Humboldt Senior Resource Center in Eureka, California. HSRC is a non-profit community-based organization offering services for senior citizens, multi-generational families and caregivers.
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Humboldt Senior Resource Center Back issues Table of Contents
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Death With Dignity in California? Bill renamed, is in senate committee: two local opinions "Yes" by Mary Dennison, R.N. The California Compassionate Choices Act (originally AB 654, now AB 651) is a good idea because there are people with pain that medication doesn't relieve. Many people would prefer to die than to live that way. If the bill becomes law, nobody would be able to kill another person under its provisions. The patient would have to make the decision to take the dose to end life. A safe review process requires the patient to have two doctors' diagnoses and a possible referral to a psychologist or psychiatrist for an evaluation of mental competence. The patient gets the medication and decides when to take it and when to die. The patient must be able to make these decisions. The California bill is stricter than Oregon's law, which has been in effect for seven years. Under Oregon's law, 207 people have taken advantage of the provision to end their lives. When I was 17 in 1938, my father had colon cancer which metastasized. It was cruel. That was my first time to think about becoming a nurse and doing something about this. But I found I couldn't help patients in severe pain anyway. What is it but punishment when people are so sick that they are dying and you can't give them enough medication to help them? The California Commission on Aging wrote a letter to the state legislature supporting the bill in mid-June. Commission Chairwoman Nancy Dolton wrote in her letter to Patty Berg, "The Commission is particularly concerned about the end-of-life care issues both for aging Californians and everyone in this life stage. Your bill provides compassionate choices for those able to self-determine their end-of-life care. Additionally, we are hopeful about the increase in knowledge and education of doctors and their patients about hospice, palliative and pain care measures that will result from the doctor-patient dialogue that this bill requires." While the California State Legislature (CSL) Advisory Council supports the bill, the CSL Joint Rules committee is still discussing it. Mary Dennison, R.N., of Eureka is a member of the California Commission on Aging and of the California Senior Legislature. She practiced public health nursing for many years before her retirement and was instrumental in bringing Humboldt County's public health senior clinics to our area. "No" by Judy Burns, M.D. Primum non nocere, first do no harm. This fundamental principle of the Hippocratic Oath helps protect patients and guide physicians. Assemblywoman Patty Berg's bill (AB 654, now AB 651) to legalize physician-assisted suicide directly violates this ethical rule. The California Medical Asssociation has strongly spoken out against this bill. It has recommended continued efforts to improve the medical support of patients with terminal illness through the better use of pain medications and palliative and hospice services. When the emphasis changes from attempts at curative treatments to care and support, these services help with symptom management, whether it be pain, nausea, depression or trouble breathing, and helping the patient and family to focus on relational, financial and spiritual concerns. To improve competency in this area, by 2006 all physicians have to complete 12 units of continuing medical education in pain management and end-of-life care. The marvels of modern medicine cannot always cure, but physicians should always be seen as caregivers, not as facilitators of suicide. Advanced Directives already give patients the choice whether to continue life-sustaining treatments when the burdens outweigh the benefits, including resuscitative measures. Using these directives the physician works as a partner with the patient and family, respecting the patient's autonomy. Therefore, there should not be a medical need to choose physician-assisted suicide. In the Netherlands, where this practice first became legal, the primary reason for choosing suicide was not pain relief or fear of dying alone, but the fear of being a burden. Nobody wishes to be dependent on or a burden to anyone else, but the natural circle of life often entails a dependency in our childhood and later with the aging of our minds and bodies. Judeo-Christian and other cultures have fostered the virtue of caring for the aged and infirm as a mark of a civilized society. That every human life has unique value not dependent on its ability to be useful, goes against the grain of our busy, productive, youth-biased culture. One reason why the late Pope John Paul II's passing moved so much of the world was the example he gave in his courageous battle with his own illness and death with dignity. There are many untold heroes who are examples of living and dying well. We need their encouragement as well as legal safeguards so that we are not tempted - through misguided compassion - to go down a slippery slope justifying death as a solution to the problem of life. The caring ideals that medicine and nursing are founded on should only be used to help families and society honor their elders and assist them lovingly through their passage to a natural death. Judy Burns is a physician practicing in Arcata. |
Senior News