May 2007 Vol. 26. No. 5

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.

Art Therapy Color and patience tease creativity from participants
End of life compassion: Shall we have a choice about ending our lives?
May is Older Americans Month
Try out: STAR auditions set May 6,7
Pay attention to your medications
Tribute to Sister Ann McGuinn, CSJ
Redwood Community Action Agency provides low-cost rehab loans

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End of life compassion
Shall we have a choice about ending our lives?

YES
by Patty Berg

Assembly Bill 374 is about choice. It is about the choice of how a terminally ill patient with six months or less to live wishes to spend their last remaining days on this earth.

How much suffering, both physical and spiritual, would you want in your last days? Do you believe you should have the right to control your last days? These answers hold the key to what you will decide. I believe that this choice is between you, your family and your religious views - and that your choices should not be constrained by the beliefs or views of your neighbor.

With Assembly Bill 374, the California Compassionate Choices Act, terminally ill patients of sound mind may choose how much suffering they are willing to endure during the final six months of their lives. This is a choice about suffering, not about living and dying. Terminally ill means just that - the patient will die.

To ensure that this choice is restricted only to those patients for whom it is intended, my joint authors and I have laid out a thorough and carefully regulated process.

The bill prohibits those who are depressed or coerced to partake of this process. The coerced are simply disqualified. The depressed are referred to a psychologist for evaluation and cannot go through the process until declared mentally capable. Family members or inheritors who attempt coercion are subject to the full prosecution of the legal system.

The California Compassionate Choices Act requires that two physicians agree the patient has only six months to live. The patient must wait through two cooling-off periods. If not a hospice patient, he or she must be evaluated by one of the two physicians to detect depression at the onset of the first oral request to ensure they are capable of making such a decision.

The measure protects life while expanding the full continuum of end-of-life care. This measure is about privacy. It is about personal choices, and for your choices to be different from my choices. That's how freedom works.

Patty Berg is the First District assemblywoman in the California legislature. She is the founding director of the Area 1 Agency on Aging.

NO
by Judy Burns, MD
The University of Washington Medical School's web site lists many reasons why physician-assisted suicide is not in the best interest of society and individuals. I hope the California Legislature will again defeat Assemblywoman Patty Berg's new attempt to make it legal in California.

In the 22 years I have been practicing medicine, I have seen great improvement and growing information in the ability to care for dying patients - especially through Hospice - where dying patients and their families are assisted through the many facets of the dying process, pain control included. I have seen letters to the editor testifying to the thankfulness families feel for this assistance. It has not been my experience that people die in agonizing pain. True, it is difficult for the person and their loved ones - as all loss is.

My own experience with my father dying at home, some of my patients, and what others have reflected to me about their family members dying has been a notable sense of the sacred which is present in the process. It has reminded me of my experience being with laboring women and the sacred mystery of a new life entering the world. Birth and death have their natural processes to go through, surrounded by their distinct mystery and rituals, leading to transition, or eternal life in the belief of many. Something is lost if it is terminated by an act of will - for the person, their loved ones and society.

True, physicians are busy, and it is hard to be there physically with the dying person when they are too weak to come into the office. The home visits I have made have been enriching and humbling. "Compassion" means to "suffer with." This is hard for us to do - so much easier to take a pill. I always regret the times I didn't make the effort to make a home visit.

The bill states the person must have only six months to live. This is very difficult for physicians to be sure of. I recently had a patient die who moved to this area 18 months ago with recurrent breast cancer metastasized to the bones. She declined further therapy (except through Hospice) and decided with the help of her family to live whatever time she had left the best she could. She lived 18 months longer than I believed possible.

In conclusion, support for Patty Berg's bill and for physician-assisted suicide comes down to personal autonomy trumping communal safeguards and medical standards that have existed for centuries, no matter what the societal consequences or risks. The choice of a few would also involve the complicit act of a profession that has always been identified as healing. Physicians have a duty to never be collaborators in ending someone's life, even if the motives be compassionate.

Judy Burns is an Arcata physician.