Hospice is the right choice for end of life care danger with physician assisted suicide

Physician point of view about Physician Assisted Suicide danger

Family and emotional issues leave assisted suicide open to abuse. 

Hospice care is a humane, less risky option.

Maine Voices: ‘Death with dignity’ bill well-meaning, but overlooks 
drawbacks- by Dr. Chuck Radis
PEAKS ISLAND, Maine — Last year, Betty Brown, my elderly Aunt Izzy’s best “friend,” was sentenced to up to 10 years in a West Virginia prison for financial exploitation of an elderly person. As my aunt’s heart failed, Ms. Brown had insinuated herself into every aspect of her life. She took her to doctor’s appointments and church, helped her organize her finances and eventually became her power of attorney.
At the same time, Ms. Brown drew down my aunt’s bank accounts and convinced Aunt Izzy to name Ms. Brown as the sole inheritor of her land and home. There is little doubt in my mind that if Aunt Izzy lived in Maine and the measures proposed under L.D. 347, the “death with dignity” bill, were in place, Betty Brown would have tried to convince my aunt to take her own life.I share this very personal story not because it is a rare occurrence, but because it is all too common. As a practicing physician in Maine for 32 years, I have seen the best and worst of human behavior directed toward those with terminal illnesses. Inheritances are often at stake. Bills are mounting. Patients worry about pain. Depression may cloud judgment. Every aspect of a dysfunctional family may become magnified.
Here’s an example. Years ago, I treated a woman with bladder cancer who suffered a stroke, could not speak and required a feeding tube for nutrition. A family member arrived from out of state and was livid that we were artificially keeping her sister alive. She demanded, as the power of attorney, that we pull the feeding tube, keep her loved one comfortable with narcotics and allow her to die in peace. 

A day went by, and another family member arrived, informing the staff that the sister who was the power of attorney was about to be removed from the will. A lawyer confirmed this. We kept the tube 
in.Can we really write a bill that protects people like my aunt? Can we create and fund a system that can deter people like Betty Brown, who slowly work their way into their victim’s life? Can a Legislature that could not properly supervise the Maine Turnpike Authority while a decade of embezzlement happened under its nose pass a law that safeguards our most frail population? I believe the answer is no.

The Hippocratic Oath states: “I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect.” Physicians must be compassionate in their end-of-life care, but they cannot judge whether the intentions of the “two or more witnesses who are … not interested persons,” as required by L.D. 347, are coercive or supportive. We are trained to treat, not to judge.

Sen. Roger Katz and other supporters of this proposal are good people who believe in individual choice, but they downplay the negative aspects of passing L.D. 347.

For one, we have a dysfunctional and poorly regulated health insurance industry. Stephanie Packer, a woman with scleroderma, recently spoke at a news conference about her experience in California, where a similar law was passed in 2015. Her health insurer denied coverage for a medical treatment for her scleroderma, but did agree to cover a lethal medication. With more and more physicians employed by large health care organizations, I am concerned that subtle pressure will be brought to bear to control health costs. The Hippocratic Oath may be an anachronism to some, but it can protect society from the worst abuses of our current health care system.

Lastly, I believe that with the growth of hospice, L.D. 347 is unnecessary. For many who support physician-assisted suicide, their greatest fear is of the unknown. Will my pain be unmanageable? Will I be a burden to my family? Will I lose control?
With hospice, each person’s end-of-life care can be humane, caring and supportive. Hospice not only treats the patient who has a terminal illness, but also helps family and friends navigate their own complex feelings toward death and dying. It is not about a pill or a shot. It is about community and hope. It protects those at risk – like my Aunt Izzy.

Dr. Chuck Radis of Peaks Island has practiced in Maine as both a primary care physician and a specialist in rheumatology, for 32 years.

My letter to the editor of The Forecaster response to Physician Assisted Suicide

My letter to the editor in the June 1, 2015 The Forecaster

http://www.theforecaster.net/news/print/2015/06/01/letter-asssited-suicide-bad-public-policy/234562

Of all the varied subjects I blog on about, the only one where I have any authority and public policy experience is when writing about physician assisted sucide.

Nevertheless, physician assisted suicide is an issue where people push back, without regard to my expert advice. It's absolutely mystifiying how people are emotionally supportive of this very bad public policy. Since virtually no one who successfully accessed physician assisted suicide has returned to let us know how it worked for them, it seems stupid to me that anybody would want to immerse in this not researched practice.

I was asked to keep this letter to a 250 word minimum because, obviously, there was a lot more I could've written.  

Letter: Assisted suicide is bad public policy
Monday, June 1, 2015 at 9:11 am

Marian McCue's Capitol Notebook column about physician-assisted suicide ("Lawmakers weigh 'Death with Dignity' bill") did not provide balance to the subject. Moreover, the article was published in the same issue with a report about a parade marking the Memorial Day holiday, to tribute our veterans.

Tragically, 22 veterans a day are dying as a result of suicide. There is no death with dignity for the young veterans who are dying as a result of suicide.

In the proposed legislation, the bill would allow for the legal compounding of poisonous drugs for the purpose of ending a person's life. This prescription would be legal if a medical opinion is rendered that a person is facing an end-of-life diagnosis with a short life expectancy.

McCue quotes a proponent of the law as saying, "What business is it of the state to deny my right to choose?"

Well, here’s the truth. It's not the state that will compound the poisonous chemicals. Neither will the state be asked to create a prescription for the purpose of ordering the poisonous compounds from a mail-order compounding facility. In fact, the state won't deliver the poisons, either.

Rather, hospice and palliative care are the alternatives to physician-assisted suicide. Also, policies for protecting the mentally ill and the disabled from potential coercion were not clearly explained.

We justifiably mourn the premature loss of our veterans, while, at the same time, consider legalizing the slippery slope for a dangerous public policy.

Juliana L’Heureux
Topsham

Oregon's death with dignity law claims another young person

She was too young to die by suicide or from a brain tumor.

Of course, sympathy for the 29 year old Brittany Maynard who took her own life over the past weekend with the protection of Oregon's death with dignity law. Unfortunately, the law wasn't intended to end the lives of young people, like the now deceased Brittany Maynard. Rather, it was passed with the empathy many people felt for the terminally ill who were presented in television commercials as being old and frail. There were no television ads explaining how young people would also have access to this method of suicide.

Americans are being duped by sympathy into believing Ms. Brittay Maynard died with dignity. Yes, she had access to suicide drugs approved for the purpose of taking her own life under Oregon's death with dignity law. Nevertheless, her death was a tragic suicide. 

Suicide, in fact, is epidemic in American society. It's not being discussed because the mental health implications are a violation of patient confidentiality. But, when an obituary  of a young person reads, "died suddenly" or "died unexpectedly", the chances are the death was caused by suicide. There's virtually no dignity in promoting suicide, regardless of the reason or the wrong minded compassion invoked in taking one's own life.

Obviously, Ms. Maynard was not offered the opportunity for a cure for her brain tumor. Nevertheless, when she made the decision to end her life by suicide, she had already been diagnosed with a brain tumor.  I submit she may not have had the mental capacity to make a decision for suicide under Oregon's death with dignity law.  

It's my understanding, unless the regulations changed, that every request for suicide must have the medical imprimatur of a psychiatric evaluation. A person diagnosed with a brain tumor has an impaired ability to process information. It's dangerous to speculate how this slippery slope can be accelerated to include people with other brain anomalies like seizure disorders or traumatic cerebral injuries.

Ms. Maynard was too young to die for any reason. Nevertheless, she didn't have to die by suicide. In taking her own life, her death was no different than the suicide of the popular Robin Williams, who also chose to end life "on his own terms". There was no dignity in Williams death by hanging or Maynard's suicide with drugs. Death is death, suicide is taking one's own life.  

There's no dignity in suicide. It's even more tragic when a young person is offered the opportunity to add to the growing numbers of mortality already caused by this epidemic.