California enacts "right to die" legislation

[wisconsinguy]

California has become the 5th state to enact right to die legislation. I read through some of the criteria, and it parallels closely the other states that have such laws. In my opinion, it both protects the patient , and treats the patient humanely...giving them the right to choose. I have posted on this site before about my feelings regarding this issue. In my 40 some years as a nurse, many of those decades being in critical care, I have seen the evolution of pain control, and countless end of life situations. From babies, through accidents, and of course, the senior citizen population. I have always tried to be an upfront and avid supporter of patient comfort, and when that time approaches, a supporter in their right to die choices. Many times, it has been family and loved ones that had to make these choices.

This is my point: I believe we all have a right to live as pain free as we choose. When we feel that level of discomfort is no longer tolerable using conventional pain relief meds, we have to right to end our lives. So, as states slowly come around to this kind of enlightenment, I hope we show our support in this kind of legislation. WG2

[Kenny]

California has become the 5th state to enact right to die legislation. I read through some of the criteria, and it parallels closely the other states that have such laws. In my opinion, it both protects the patient , and treats the patient humanely...giving them the right to choose. I have posted on this site before about my feelings regarding this issue. In my 40 some years as a nurse, many of those decades being in critical care, I have seen the evolution of pain control, and countless end of life situations. From babies, through accidents, and of course, the senior citizen population. I have always tried to be an upfront and avid supporter of patient comfort, and when that time approaches, a supporter in their right to die choices. Many times, it has been family and loved ones that had to make these choices.

This is my point: I believe we all have a right to live as pain free as we choose. When we feel that level of discomfort is no longer tolerable using conventional pain relief meds, we have to right to end our lives. So, as states slowly come around to this kind of enlightenment, I hope we show our support in this kind of legislation. WG2

Thanks for that. A complex subject, well stated.

[Rudynate]

In theory, I support the right to end one's life in certain circumstances. But the whole topic makes me very sad and generally gives me the willies.

[+ SundayZip]

This is my point: I believe we all have a right to live as pain free as we choose. When we feel that level of discomfort is no longer tolerable using conventional pain relief meds, we have to right to end our lives. So, as states slowly come around to this kind of enlightenment, I hope we show our support in this kind of legislation. WG2

 

Thank-you. I hope more states follow suit. I suspect Death With Dignity legislation will follow the political map; blue states first and deep red states resisting to the very end.

[Kenny]

Thank-you. I hope more states follow suit. I suspect Death With Dignity legislation will follow the political map; blue states first and deep red states resisting to the very end.

Yes, red states truly adore human suffering, so they will be laggards in this.

[+ Funguy]

I suspect that most people who have not experienced hopeless pain will not truly understand the blessing this law presents.

Many years ago I had a 96 y. o. uncle who had end stage bone cancer. One of his vertebrae was fractured and his doctor would not give him anything stronger than 5 mg vicodin because he was concerned that my uncle WOULD GET ADDICTED!!! One day i got a call from my aunt for help - i immediately got him some morphine and told him to take as much as he needed (he got the drift.) As he experimented with higher and higher doses he found that even this would not hold off the pain. He finally made his peace with all who mattered and took the rest of the bottle. Everybody who mattered felt this was a blessing.

[liubit]

I am a firm, staunch believer in the right to end your pain if you so wish. I do not think it is humane to unnecessarily prolong suffering. Nobody gives it a second thought when it is done for dogs. Why not for humans? Kudos to California.

[+ sync]

I, too, support "right to die" legislation. However, we all know that humans can misconstrue, misuse, and/or abuse just about anything. We need to be prepared for some bumps and scrapes as more states adopt and more individuals partake of this new legislation.

[+ poolboy48220]

I think of this in the same terms the Clinton administration's policy used about abortion: it should be safe, legal, and rare.

[+ Keith30309]

Thanks again @wisconsinguy - for relaying the good news and also sharing your insights so artfully.

 

Like [uSER=9945]@funguy[/uSER] I watched a loved one suffer at the hands of an unenlightened medical establishment, where the last weeks of life were spent being subjected to pointless 'procedures' that seemed more appropriate to a chamber of horrors than a place of healing.

More recently, I was privileged to be a part of the passing of another loved one - a very different experience where hospice workers were true angels of mercy. There was no pain and suffering, just peaceful rest in the company of family at their home.

 

I hope that this enlightened attitude spreads everywhere and, one day, noone will spend their last days in agony.

[+ honcho]

Like [uSER=9945]@funguy[/uSER] I watched a loved one suffer at the hands of an unenlightened medical establishment, where the last weeks of life were spent being subjected to pointless 'procedures' that seemed more appropriate to a chamber of horrors than a place of healing.

 

I wonder how much of this was driven by fear of malpractice suits brought against the hospital/doctor?

[wisconsinguy]

I suspect that most people who have not experienced hopeless pain will not truly understand the blessing this law presents.

Many years ago I had a 96 y. o. uncle who had end stage bone cancer. One of his vertebrae was fractured and his doctor would not give him anything stronger than 5 mg vicodin because he was concerned that my uncle WOULD GET ADDICTED!!! One day i got a call from my aunt for help - i immediately got him some morphine and told him to take as much as he needed (he got the drift.) As he experimented with higher and higher doses he found that even this would not hold off the pain. He finally made his peace with all who mattered and took the rest of the bottle. Everybody who mattered felt this was a blessing.

If any one of us needs that kind of intervention, I hope we can all have an advocate such as you!!!

[+ Funguy]

Thanks WG2 - and I also have my own stash!

[+ Keith30309]

I wonder how much of this was driven by fear of malpractice suits brought against the hospital/doctor?

 

Probably allot... I was young at the time but I suspect that the underlying assumption was that life was to be sustained at all costs lest the providers be found at fault and responsible for a death. Perhaps Funguy has a better, professional perspective of how things used to be.

 

In my more recent experience I didn't get any sense at all that there was any concern about any liability after the advance directive was validated. The family was given a "home kit" with liquid morphine and 2 other drugs I don't remember (pills that were crushed with a few drops of water in a spoon). I was very surprised to see the morphine put into the hands of the family with instructions to 'not be stingy' (paraphrasing). I can't imagine that happening 30 years ago.

[+ sync]

I'm curious to know if any of this legislation could/should be incorporated into living wills that have stipulations against any extraordinary life-prolonging measures.

[+ glennnn]

My dearest, best friend/brother of 72 years just died in April after over three years of excruciating pain confined to a bed 24/7. The hospice people were wonderful, but he was in constant pain and ready to go months before. My grief was 50% relief. I'm grateful others in California can now choose to be spared this torture.

 

One thought, how many of us have a final advancecd medical directive in place? Don't leave it to your family to have to make this horrendously difficult decision for you. Life is so uncertain. Plan ahead. You can do it all yourself on line at a site like Legal Zoom.

[gallahadesquire]

In Massachusetts, we do not have living wills. One can write an "advanced directive," but one must have someone else speak for them.

 

When my mother was terminally ill, pulling the plug as a no-brainer because she had taught me for 35 years that, if she were ever in that state, not to prolong her life.

 

Speak to your friends and relatives about what you want done, unless you want to become Terri Schiavo.

 

And yes, she had a phrase "to consider quality of life and economic detriment", i.e., what it was going to cost to keep her alive.

[+ glennnn]

PS. It will probably require a notarized signature.

[+ bashful]

Don't leave it to your family to have to make this horrendously difficult decision for you.

 

I agree. As hard as it was to respect their decisions (e.g. no feeding tubes), it was made easier knowing they had already thought it through.

[Guest]

Many years ago I had a 96 y. o. uncle who had end stage bone cancer. One of his vertebrae was fractured and his doctor would not give him anything stronger than 5 mg vicodin because he was concerned that my uncle WOULD GET ADDICTED!!!

 

That doctor was a complete moron and an asshole. There is always room for more pain relief, even if the doses may hasten death. That's different from deliberately offing the patient. Just because one doctor doesn't know how to treat terminal patients' pain doesn't mean that there aren't alternatives. The laws in all states which authorize doctor-assisted suicide state that a knowledgeable doctor must educate the patient about alternatives. The experience in those states show that in most cases, when patients are presented with alternatives, only a minority actually request life-ending drugs. And of those who do end up filling those prescriptions, only a relatively small fraction of those actually take the deadly cocktail. In my over 25 years of practice, I've never come to a point where I've wanted to say "Nothing more we can do. Maybe your best choice is to off yourself!". There are times when I've had to tell patients/family that a cure is no longer possible. And I've told them that some treatments I may offer may shorten their life. But I've never wanted to participate in intentionally killing a patient. This law won't change my mind. We've tried to find a doctor in our system who does want to participate. We asked oncologists, hospice doctors, palliative care doctors, but so far no takers. It looks as if we may have to hire an outside consultant if we want to "offer" death to our patients. Few doctors, especially those with frequent dealings with terminal patients, feel this law is needed. It makes me uncomfortable to know, however, that our HMO executives are all for offering this "benefit."

[wisconsinguy]

Gallahadesquire, I always look forward to your perspective due to your background. Glennn, I am so sorry about your best friend/brother. I would like to share my thoughts on the advance directives issue, or whatever your state calls it. These are my direct observations through the beginning when these directives came on the scene. These are also not potential scenario's, but situations I have been in. AND, these situations are left up to the nurse caring for the patient, and social services. The physicians are usually far, far away. Here goes: Mom, 80 yrs old and active. Lives alone in her own house, cares for her own yard, drives everywhere in a busy college town. Brought to the ER unresponsive, and a diagnosis of a ruptured cerebral aneurysm is made. Mom has advanced directives. She has hand written out her wishes. "No extraordinary life saving measure. If I can't eat by myself, no feeding tubes. I do not want to be on a respirator. Please keep me comfortable." She was bright, articulate, and lived an extraordinary life. Enter her son. Also an extraordinary individual. He and I become close friends during the two weeks I cared for his mother in ICU. He makes the decision to go ahead with the clipping of her aneurysm. With of course no guarantee of outcomes. Fast forward a couple of weeks. Mom is weaned off the ventilator, and is non-communicative, looks alert, has limited movement of one arm, and is being tube fed. As one neuro resident (both technically billant and equally arrogant) put it: "Yup, we saved mom so she can go to a nursing home so she can open up Christmas presents with her left hand."

My points about advanced directives:

1) They may be "on file" but, the physician/surgeon will always go to family and loved ones and ask, "What do you want us to do? Here are the options."

2) I have seen contentious family members put a legal halt to directives. Saying..."This is not what mom wanted. She told me something different last week." Enter of course, if there is money involved with mom's condition.

3) They are only a message board for wishes. They can be halted not just legally, but by someone saying..."That's not what I was told."

4) I choose not to have one. To me, it's a waste of ink. I do have five children, three of which are also nurses, and they are well aware of my choices. I even have my drug of choice dripping into my viens.

One of my nurse kids said: "Don't worry dad, we'll make sure you don't come home so we can take turns changing your diapers!" WG2

[+ SundayZip]

I understand why traditional physicians would oppose Death With Dignity legislation. They have been taught, from day one, that it is their duty to preserve life – at all costs. It would be difficult for them to believe that, when healing is no longer possible, when death is imminent and patients find their suffering unbearable, their role should shift from prolonging life to relieving suffering in accord with the patient’s wishes. I am thankful that some doctors are now learning that they can honor and respect the wishes of someone nearing the end life who says that, for them, the cost will be too high (and I'm not talking about financial costs).

[+ bigjoey]

The posts here all talk of "physical" pain. What of "mental" pain?" In the politics forum, there is a discussion of a young man wanting to be euthanized for being gay:

 

http://www.companyofmen.org/threads/euthanasia-for-being-gay.115106/

[+ SundayZip]

The posts here all talk of "physical" pain. What of "mental" pain?" In the politics forum, there is a discussion of a young man wanting to be euthanized for being gay:

 

http://www.companyofmen.org/threads/euthanasia-for-being-gay.115106/

 

The euthanasia for being gay article is interesting, but it reminds me of the slippery slope arguments that conservatives have used against gay marriage: "next they'll want to legalize marriage between a man and his child, or between a man and his goat". This gay man would never qualify for euthanasia under the laws being passed in the US. The California law is an example:

- Only adult residents that have a terminal illness that will lead to death within 6 months will qualify.

- Two licensed physicians must verify the patient’s mental competency, diagnosis, and prognosis. If they suspect that a psychiatric or psychological disorder or depression is causing impaired judgment, the patient must undergo an evaluation.

[wisconsinguy]

The posts here all talk of "physical" pain. What of "mental" pain?" In the politics forum, there is a discussion of a young man wanting to be euthanized for being gay:

 

http://www.companyofmen.org/threads/euthanasia-for-being-gay.115106/

I was talking to my former wife about the California issue. And, I also believe in the mental health component with this issue. What about the individual who goes to his mental health provider and says, " I have tried everything available to me for my depression. Every med and combo of meds on the market. I have gone through shock treatments, and hundreds of hrs of therapy...everything. I am sooo miserable I can barely stand one more moment on this planet. If you don't help me with assisted suicide, I'll find another way."