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Thursday, July 24, 2008

Fighting to the Death

posted by on July 24 at 18:18 PM

Washington’s death-with-dignity petition qualified for the November ballot today, according to Secretary of State Sam Reed. I-1000, if passed by a majority of voters, would allow alert yet terminally ill patients to self administer life-ending medication prescribed by a physician. More info is over here.

The measure, based on an Oregon law passed in 1998, is sponsored by the Death With Dignity campaign, supported by a consortium of progressive health and legal groups, including the Washington State Public Health Association and the National Women’s Law Center. It is opposed the No on Assisted Suicide Campaign, backed discreetly by anti-abortion organizations and Catholic groups and churches.

“Nobody, not the government and not the church, should tell you how much you have to suffer if you are terminally ill,” Nancy Niedzielski, one of the measure’s primary backers, said in a statement released this afternoon. Two years ago she watched her husband die a miserable death and promised him she would “change the law in Washington state.”

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You know, ma always said vegetables were healthy.

Posted by Mr. Poe | July 24, 2008 8:38 PM

The first initiative I ever worked on was Initiative 120. We barely squeaked by, but now our state is pro-choice as a result.

Sadly, Initiative 119, the death with dignity initiative, didn't pass that year.

I'm sure we'll be arguing this for years.

Posted by Will in Seattle | July 24, 2008 10:20 PM

This election is gonna be...just awesome! New president, new parks, new transit, and now new housing opportunities...

Posted by Jeremiah | July 24, 2008 10:45 PM

You fail to mention that the doctors of this state overwhelmingly reject I-1000, the Physician-Assisted Suicide Initiative. I think you are misrepresenting the debate by painting the opponents as just a bunch of crazy Catholics.

The Washington State Medical Association (WSMA) opposes Initiative-1000, the measure to legalize physician-assisted suicide in Washington state. The opposition was emphatically voted on at the WSMA's annual meeting last year.

"We believe physician-assisted suicide is fundamentally incompatible with the role of physicians as healers," said WSMA President Brian P. Wicks, MD. "Patients put their trust in physicians and that bond of trust would be irrevocably harmed by the provisions of this dangerous initiative."

The WSMA has opposed assisted suicide since 1991 when a similar initiative was proposed and defeated. The state medical associations in 49 states oppose assisted suicide and the Oregon Medical Association supported repeal of the state's "Death with Dignity Act" in 1997, characterizing it as "fundamentally flawed." Washington's Initiative-1000 is virtually identical to this flawed Act. The American Medical Association is also opposed to physician-assisted suicide.

"Initiative-1000 gives doctors power which we do not want and which we believe is contrary to good medical practice," said Wicks. "The initiative is a dangerous distraction from symptom-directed end-of-life care that provides comfort for dying patients and their families. Our focus should remain on caring for terminally ill patients and should never shift toward helping them kill themselves."

I-1000 has some special problems that should worry even those not opposed to assisted suicide in principle, according to Wicks.

"Under I-1000, if a physician prescribes a lethal overdose, when that physician completes the death certificate, he or she is required -- actually required -- to list the underlying disease (say lung cancer) as the cause of death, even when the doctor knows full well that the patient died due to the suicidal overdose he or she prescribed," Wicks said. "To my knowledge, there's no other situation in medicine in which the death certificate is deliberately falsified -- and in which this falsification is mandated by law."

The proposed initiative would allow doctors to prescribe a lethal overdose of barbiturates or other drugs to patients over 17 years old who a physician believes to have a life expectancy of six months or less.

If we vote "no," we are voting to protect the most vulnerable people in society, including those without health insurance. Of course the HMOs and hospitals have an interest in convincing terminally ill patients just to have a $20 prescription filled so they can control their costs. They need to get us out of the hospital or nursing home as quickly as possible. If you think about the economic interests here, it's clear that the poorest members of our society and those with dimentia will be the first to be taken advantage of. Is it any surprise that the health care industry likes assisted suicide?

Read the full text of the initiative and don't fall for the slogans.

Posted by Dave in Bremerton | July 24, 2008 11:55 PM

Hey doctors.

Shut up and do what people tell you to do. You don't own someone else's life, or body, yo're not God to judge others, and you work for us -- not the other way around.

Got it?

You can try to stir up alarm about horror stories, they haven't happened in Oregon at all.

And it's not suicide when you are going to die anyway.

What are you into -- pain?

Posted by PC | July 25, 2008 12:18 AM

It's strange that we first want doctors to play God by using all sorts of technology to keep us alive when our bodies actually don't really want to go on, and then are told that we shouldn't play God by ending the ordeal we have thus created.

And Dave (@4): if you can't actually *heal* someone, only prolong the agony, isn't it merciful to stop it? FYI, even in the Netherlands, where some form of euthanasia is already allowed, nobody has yet noticed any trend to let it deteriorate into some sort of eugenics. People are actually better than you portray them here.

Posted by M'thew | July 25, 2008 1:22 AM

To paraphrase Monty Python - there's nothing wrong with you that modern medicine can't expensively prolong.

Posted by Mr. X | July 25, 2008 9:31 AM

Are all the doctors really against death with dignity, or is it only the AMA hierarchy? (A bit like the Catholic Church hierarchy).

The AMA only represents about half of doctors anyway, and most of all health care workers - including those who work in hospice and see patients at the end of their lives - are very strongly in favor of I-1000.

Posted by Really | July 25, 2008 10:17 AM

Either they should allow death with dignity or they should allow doctors to drug seriously ill and dying patients to the point of feeling no pain. Our culture is obsessed with suffering as some sort of morality play.

Posted by keshmeshi | July 25, 2008 10:25 AM

@4 According to the University of Washington's bioethics reference page, surveys show half of physicians support physician assisted suicide, even though professional organizations of doctors come out against the practice. The professional organizations are usually concerned about how the public will view the profession in its role of "First do no harm." What you have stated is one legitimate argument against the cause; it's not a be-all-end-all statement as you make it sound. There are many reasons why this initiative could be a good thing.

People who are already sick and dying will be given greater freedom to choose how they die. It will provide one more reason for doctors and patients to discuss, openly, how death should and will be handled. Too many people are afraid to discuss death, even when it is imminent. Why shouldn't someone who is only facing two more months of pain and suffering be able to step away from that if they want to? I think it is compassionate and wise as a society to let people have some say in the way they bring about death.

Also, you misstate one thing—the judgment is not made by "a physician." It must be made by two separate physicians. And they must each agree that the patient has fewer than six months left to live.

There is no evidence that this law would lead to poor and uninsured being encouraged to take lethal doses of drugs to end their lives sooner—that would be incredibly irresponsible behavior, and illegal behavior on any doctor's part. And any doctor who did that should be brought up on charges.

Please don't use fear and hyperbole to take choice and autonomy away from the sick and dying.

Posted by Jessica Knapp | July 25, 2008 10:43 AM

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