Opinion

Support for ‘death with dignity,’ always. Euthanasia, never

Brittany Maynard was a California woman who championed the right to die when confronted with a certain and painful death. She ended her life in 2014 in Oregon. California passed a “Death with Dignity” law in 2016.
Brittany Maynard was a California woman who championed the right to die when confronted with a certain and painful death. She ended her life in 2014 in Oregon. California passed a “Death with Dignity” law in 2016. AP

The real issue is quality of life vs. quantity of life. Perhaps the only chronic, debilitating disease that has a painless way out is kidney failure. When a patient determines their life is no longer tolerable, he or she can just stop dialysis and pass within two weeks.

But what about the rest of those people who have reached the end stages of incurable diseases? The bed-bound people with stage 4 cancer, or emphysema or heart failure? Death for them is miserable, filled with unremitting pain as they suffocate in their own fluids and worse, despite hospice or palliative care. Durable powers of attorney are more often than not ignored. Just ask our poor emergency room docs about administering inappropriate CPR.

After four failed attempts, the people of California passed a “Death with Dignity ACT,” also called “physician assisted dying.” It was modeled on a similar law in Oregon which allows people deemed terminally ill with a life expectancy of no more than six months, confirmed by two physicians, to be given a prescription for a lethal number of barbiturates or opiates. The only gray area in the law is that patients are "capable of making and communicating health care decisions “ on their own. After making the request, they must also wait two weeks to make certain this is their wish.

The drugs are sent home with the patient to be taken at a time and place of their choosing, presumably after the pain of their disease has lowered their quality of life to nil.

California’s End of Life law is in effect but challenges remain; one is being considered by the state supreme court.

California’s law passed in 2016 after nationwide publicity surrounding Brittany Maynard. The UC Berkeley graduate with a Master’s in Education was diagnosed with brain cancer in January, 2014. When the cancer became more aggressive in April, she moved to Oregon and established residency. Oregon had passed a DWD law in 1997, following Washington in 1996.

Maynard died on Nov. 2, 2014, with pills provided by her doctor. She wrote a final Facebook post saying goodbye to friends.

Since 2015, some 218 people in Oregon have qualified for the act and have received a prescription to end their lives.

In 2017 in California, 577 individuals qualified and received life-ending prescriptions. Of those, 374 died from ingesting the drug(s). Most, 90 percent, were age 60 or older and 83 percent were in hospice or receiving palliative care. This is not euthanasia, which has a history of abuse.

I need only a few sentences about euthanasia. This would be the direct involvement of a physician in the death of the patient. Even if the doc had the patient take the pills in his/her office, it would qualify. For years euthanasia, in the form of a one-way trip to the O.R. with an anesthesiologist, has been legal in Holland. Dr. Jack Kevorkian’s carbon monoxide machine is euthanasia.

Such procedures should never be legalized; they’re the first step on a slippery moral slope. Consider the early 1940s when the Nazis euthanized roughly 70,000 mentally and physically disabled people, calling them “mercy killings.”

Many people will not like my support for Death With Dignity laws; some will see a parallel with laws permitting pregnant women the choice of terminating their pregnancies.

But I do not see why we should not have freedom in the choice of how we die.

Paul Golden is a doctor and mental health advocate. Paul@mdgolden.comwww.mdgolden.com

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