It wouldn’t be the first time a family member with less than noble motives influenced an elderly person.
By Carrie Handy
In the last four years I have helped take care of several people—my husband’s parents and my own mother—who were in Hospice in the months before they died. I am also now a Hospice volunteer. My work with the dying has convinced me of two things: 1. that there is the potential for excellent palliative care for anyone with a terminal diagnosis; and 2. the potential for harm to the vulnerable inherent in Act 39 far outweighs any so-called “good” it can possibly do for the tiny minority of people who say they want this law for “peace of mind.” I say: Be careful what you wish for. The peace of mind it provides may be for the people who are taking care of you at the end of your life.
Sometimes worn-out caregivers become focused more on how their loved one’s experience affects them, than on the reality being experienced by the dying person. It’s easy to understand how the fears, ignorance and anxieties of able-bodied, healthy people, might be triggered in the presence of a disabled or dying person and color their attitudes. And yet fear is not reality. As my grandmother wisely observed at age 95, “You’re alive until you’re dead.” None of us wants to be pushed out of this world by someone else, however gentle or well-meaning the push.
Act 39 contains almost no safeguards against such “pushing” (see Act 39 Does Not…) In fact, the climate created by the very existence of legal assisted suicide is a prescription for misuse, abuse and coercion.
For example, Act 39 allows a patient whose ability to communicate is compromised, to request the lethal drugs through an interpreter—defined as a person who is “familiar” with that patient’s manner of communicating. This could be an heir who has financial motives for wanting the person to die before the illness consumes his financial resources. As any estate lawyer will attest, it wouldn’t be the first time a family member with less than noble motives influenced an elderly person to sign papers that were not in his or her best interest.
Also, once a patient has a prescription in hand, there is absolutely no oversight whatsoever for the collection or the ingestion of the drugs. Even if a person ultimately decides against suicide—he might be forced or persuaded to take a lethal dose by a misguided or unscrupulous caregiver. There would be no investigation of the person’s death and the cause of death would be documented as the underlying illness.
Putting suicide on the list of end of life ”treatment” options that doctors are required to offer to patients, will reduce choice for the vulnerable. Since Medicare does not pay for long term care, and Medicaid only kicks in when all assets are gone, it’s reasonable to project that poor people without resources may feel they have no other choice but to end their lives in this way, particularly when their doctors present it as a viable treatment option.
I believe the health care system can do better than to “treat” a suffering person by helping him kill himself. Palliative care and pain management have come a long way in the past 20 years, but not all people have access to the best that is available. Compared to almost every other state, Hospice, a viable palliative care choice for people with terminal diagnoses, is greatly underutilized in Vermont. Sadly, as our population ages and the burden on the health care system grows, it will become increasingly more challenging to find resources to improve palliative care in an environment where prescription death is an option. There have been cases in Oregon in which the state health plan denied treatment for people with terminal illnesses, but offered to pay for their prescription suicides instead.
Finally, it’s time to reclaim the meaning of “Dignity”. Needing help does not equal loss of dignity. For the disabled, and for those at the end of life, submitting to the service of others is a reality of life, but it is not undignified. My own mother, who died at age 90, spent the last six months of her life in Hospice care in her own home, with full time support from her children, who took turns caring for her. An exceptionally strong woman who raised 8 children, was widowed twice, and who lived alone for her last 20 years, my mother defined “independence.” Yet, in her frailty, she was able to accept gracefully help from the children she raised, giving us the ultimate gift in the twilight of her life by allowing us to serve her in the same way she once lovingly served us.
This is the ideal we should strive to provide all those who are dying. Vermont, we can do better than Act 39.