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Tuesday, September 23, 2008

I-1000: It’s About Choice

posted by on September 23 at 9:15 AM

I’m listening to a report on KUOW right now about 1-1000, the Death With Dignity Initiative. Two widows are discussing the deaths of their husbands. One widow plans to vote for I-1000, the other plans to vote against it.

The woman voting for the initiative—whose husband died of brain cancer—wants terminally ill people to have a choice at the end of their lives, a choice to end their suffering and hasten an inevitable, rapidly approaching death. The woman voting against the initiative wants… well, she wants to have a good death, a peaceful death, like the one her husband, um, enjoyed. “I would like to be enveloped in the love of a good caregiver I would get,” she says.

That’s nice. We should all be so lucky to enjoy Hallmark deaths, enveloped in the love of good caregivers and under the care of “pain management” professionals. But not everyone is going to be so lucky. Some of us will have to endure deaths that are gruesome and protracted and excruciating, deaths involving pain that cannot be managed, deaths that our loving caregivers can only stand helplessly by and witness.

“You don’t know how you’re going to feel at the end of your life,” the widow planning to vote for I-1000 says. “I want to have the choices available to me.”

Exactly. If I-1000 is approved by Washington state voters, the widow opposed to the initiative will not be compelled to end her life with the assistance of a physician. She can choose pain meds and the love of caregivers and die a “natural” death. (What’s so “natural” about pain management anyway?) But if I-1000 is rejected, the widow that plans to vote in favor of it will not have the same choice. She will not be able to choose to end her life, and end her suffering, if the pain becomes to much for her to bear.

And that’s what the debate about I-1000 is really all about. Choice. Your body, your death, your choice. The passage of I-1000 doesn’t impose anything on terminally ill people who reject physician-assisted suicide for religious reasons. But the rejection of I-1000 imposes the values of others on terminally ill people that would like to make that choice for themselves.

And, I’m sorry, but there’s nothing about physician-assisted suicide—or, as it should be called, end-of-life pain management—that precludes the presence of loving caregivers. You can be surrounded by love and have access to the best medical care available and still conclude—reasonably and rationally—that you would rather not spend the last few moments of your life in blinding pain or zonked out of your mind on just enough morphine to (hopefully) deaden your pain but not enough to deaden you.

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Republicans: for hands off government but POLICING YOUR BODY TILL ITS DEATH.

(then charging an inheritance tax thereafter, even!!)

Posted by Non | September 23, 2008 9:12 AM

If you are ok with Euthanasia why are you using euphemisms like assisted suicide or end of life management?

Posted by Mike | September 23, 2008 9:28 AM

I don't understand why you can't just point to us down here in Oregon and say "See? They aren't loading the elderly into death camps down there! You can have this choice without destroying civilization!"

But then I also don't know why we can't do that with gay marriage or gays in the military. I suppose this would be another version of how every electorate thinks they are special, special people with special, special problems that have never been solved elsewhere before.

Posted by ryan | September 23, 2008 9:31 AM

At the end of my mother's life, she was basically suffocating to death. The tumor next to her esophogus was cutting off her airway and she couldn't breathe. We were actively involved in "pain management" but there isn't enough pain management in the world to make you comfortable while you suffocate. Eventually, after days of struggling for breath in a morphine stupor, surrounded by loving caregivers, she finally passed.
I can't help but believe that people who are against I-1000 have never watched someone die like this.

Posted by jean genie | September 23, 2008 9:37 AM

I want a T-1000 initiative. Where you get the legal option of jumping into a vat of molten metal.

Seriously? Every cancer death is different. Dying of liver failure, as my mother did, is pretty comfortable except for the dementia. Dying of lung cancer is excrutiating and horrible. The patient should have the option of deciding how they exit this world. Anyone who says otherwise has never watched a family member succumb to cancer.

Posted by Big Sven | September 23, 2008 9:43 AM

My mother suffocated to death in front of me on March 31.

Posted by Dan Savage | September 23, 2008 9:46 AM

I have said this before, but I feel that the only way people will have the compassion to vote for this is when we reach 50% death of baby boomers, so that they have had to watch their friends and loved ones die in a horrible way.

Humans are assholes. They tend to only have compassion if they have experienced something first hand.

Posted by Original Monique | September 23, 2008 10:04 AM

if this initiative isn't passed by washington state voters and i'm ever ill and facing certain death, can i go to oregon for my "assisted suicide"? must i become an oregon resident beforehand? i think coos bay would be a good spot for my final sunset.

Posted by cineaste | September 23, 2008 10:21 AM

@2- Mike...if you look up the definition of euthanasia you will find there is nothing offensive about that word. It actually defines assisted suicide very well.

Thanks for pointing that out.

Posted by jean genie | September 23, 2008 10:22 AM

I am hesitant to completely support the legalization of assisted suicide. And it's not because I don't agree with the completely reasonable arguments made here. I simply worry about abuse. If such a procedure is mainstreamed, how long is it before selfless parents are choosing to end their lives because they feel they are a burden on their children or loved ones? Do we really trust our fucked-up health care system to monitor this so that it is never abused, so that no one's asshole son or daughter says to a parent whose prolonged terminal illness has become inconvenient: "you know mom/dad, you do have a choice". Shudder.

Posted by Christy O | September 23, 2008 10:24 AM

Dan, I'm sorry to hear that about your mom. You have my deepest sympathy and understanding.

Posted by jean genie | September 23, 2008 10:24 AM

Oh, and also: Evil insurance companies already make completely-about-the-dollar choices regarding what they "cover" and what they don't, often taking the choice away from people altogether. How long is it before an insurance company says: "An indefinite period in ICU or high-care assisted living: not covered. A short, painless death: covered."

Posted by Christy O | September 23, 2008 10:31 AM


What's to keep them from doing that now? When someone is seriously ill, forcing them to stay home will move their death along much faster than hooking them up to machines in a hospital.

Posted by keshmeshi | September 23, 2008 10:42 AM

I want to die in my bed, with my love beside me and my cats. If I can't have that I'll kill myself now.

Posted by crazycatguy | September 23, 2008 11:02 AM

I don't believe the "potential for abuse" argument is valid, reasonable or justified.

Every public policy in this country has the potential for abuse. Yet there are no abortion camps, no death camps, no concentration camps. Most people obey most driving laws. Adam and Steve don't want to also marry Fido and Trigger.

Anything and everything can and will be abused eventually. That's just the world. But what that is inherently good, right or decent is ever abused on an institutional level? And the fact that some individuals might make poor choices is not enough reason to keep the majority from making a choice at all.

First, do the right thing. Then deal with the people who actually do the wrong thing. But don't start by denying everyone something which should legally be theirs.

Posted by whatevernevermind | September 23, 2008 11:07 AM

When I die, I want to go peacefully in my sleep like my grandfather did, not screaming in terror like the passengers in his car.

Posted by ouch | September 23, 2008 11:12 AM

Jean genie I never said there was anything offensive about the word euthanasia.

Posted by Mike | September 23, 2008 11:29 AM

I'll just repeat myself, for the sake of @10:

We don't need to discuss the "potential for abuse" in a vacuum. There are places in the world, and in the US, where assisted suicide is legal, and there is little to no evidence of abuse. Stop pretending there may be issues and realize that the worry of abuse is overblown.

Posted by ryan | September 23, 2008 11:33 AM

Spot-on Dan.

Voting YES on 1000 gives terminally ill patients the option of choosing when and how to end their suffering. Nothing more, nothing less. It makes sense to keep that decision out of the hands of government, out of the hands of the church hierarchy, and in the hands of terminally ill patients where it belongs.

Posted by Gloria | September 23, 2008 11:43 AM

For anyone who is interested, Former Gov. Booth Gardner has a post up at Huffington Post:

Give it a read!

Posted by Friend of a Friend | September 23, 2008 11:54 AM

Original Monique is right.

The sad thing is that people make horrible, inhumane choices *even when the evidence is right in front of them.*

I've had family members tell me they won't sign the DNR for their parent, who lies groaning in agony 5 feet away, because "I don't want people in my family pointing fingers at me." Their concern for their own reputation outweighs the agony of their loved one - it blows my mind every time. I have said "maybe you should consider what your father wants instead of what you want" in a dozen different ways, and at best I'm met with blank stares.

Most people are horrible, horrible things.

Posted by Yeek | September 23, 2008 11:58 AM

@4 and Dan, I wish I could tell you both more than a trite "I'm sorry", but I don't know what to say. No one should have to suffer like that and families shouldn't have to witness that suffering, but they suffer and we watch.

I was 17 last December 14 when my dad died at home of pancreatic cancer that had metastasized. He didn't even recognize me for the last 24 hours of his life. After that, I will always support assisted suicide. He often told me he wished he could end his life on his own terms, with dignity, and I wished I could have granted that to him. Unfortunately, there are those who have never witnessed that kind of suffering who take it upon themselves to deny those are suffering so badly false "compassion" and "save" them.

Maybe I'm being bitter, but fuck off. If you've watched someone die and still don't support it, fine. You don't have to have it done. But if you've never watched it and still oppose it, fuck off and keep your false compassion. Real compassion requires hard choices sometimes.

Posted by Leslie N. | September 23, 2008 12:26 PM

If you don't have a physician who agrees with the premise of death with dignity you should change doctors. It amzes me that people spend more time choosing a sweater than a physician. When I had lymphoma several years ago I discussed what might happen if the chemo didn't work with my doctor. I told him that I wouldn't want to be in much pain and would probably have trouble sleeping. He replied that I could be sure that he would prescribe "whatever I needed to be comfortable". With that, we had just agreed that if things went bad he would make sure I would have access to all the meds I needed for a good O.D.. I was quite lucky and obviously never needed those meds.

Posted by inkweary | September 23, 2008 12:35 PM

agree with #23. there already is PLENTY of physician-assisted suicide out there in the form of morphine and other opiates. many people at the end of their lives get essentially unlimited painkillers through most doctors. it's just a matter of legalizing and dignifying the process.

death by prescription opiates is by far the #1 cause of death by overdose, and it's usually not teenagers trying to get really really high.

Posted by jrrrl | September 23, 2008 12:56 PM

Leslie@22- at the risk of turning this into a cancer caregivers' support network, I'm really sorry that you had to go through a pancreatic cancer death at 17. I could barely take it at 39. You got a shitty deal.

Posted by Big Sven | September 23, 2008 2:54 PM

Ugh. I listened to that on the way to work this morning and it left me screaming at the radio. I don't understand the anti-choice mind -- why do they act like they would be forced to abort their babies or kill themselves at the end of their lives? And how can they act like a lack of choice is actually a choice??

Posted by sloggerette | September 23, 2008 5:34 PM

If you're interested in attending a sober discussion on I-1000 before work downtown, the Muni-League is hosting one Thursday. See for more info.

Posted by Gabe Global | September 23, 2008 8:41 PM

Ugh. I listened to this too this morning. I don't know if you can find it Dan, but there is a great article I read once about the statistics coming out of Oregon.

Apparently, only half of the people who get the drugs end up actually using them. Some die before they get the chance to chug, and others just want to have it handy, just in case it gets really bad and it never ends up becoming so. In the end, most patients were comforted by just having the choice, which is what it's all about.

There's also touching stories about people who get to REALLY live their last days: having a party with friends or walking the beach before choosing their death date and place after all their finalities have been arranged and taken care of.

I know how I'm voting, I just hope others vote the same way.

Posted by Erin | September 23, 2008 10:42 PM

Why vote for I-1000?

So that your grandpa (or in my case my step-dad's dad) doesn't use a shotgun to end his life when he gets cancer and the pain and misery is too much.

Seriously, it was a bitch to clean it up.


Do it for him.

And the family that had to clean up afterwards, while we were dealing with the misery of death and loss.

Posted by Will in Seattle | September 24, 2008 12:04 AM

Here is a new article regarding why I-1000 is a bad idea:
Oregonian Editorial Board, “Washington state's assisted-suicide measure: Don't go there,” The Oregonian, September 20, 2008, at

Posted by Margaret Dore | September 25, 2008 12:37 PM

Here is another new article regarding why I-1000 is a bad idea:
Rita L. Marker, “Oregon’s Suicidal Approach to Health Care,” American Thinker, September 14, 2008, at

Posted by Margaret Dore | September 25, 2008 12:44 PM

I've often wondered how the phenomenon of the banality of evil must have looked in Nazi Germany. As a proud liberal reading articles like this one and posts written by commenters makes it perfectly clear.

I believe you are all reasonably intelligent, well meaning, and rational people who are completely blind to what is going on. You are pawns of the insurance industry and managed care programs looking for a cheap way to get out of paying for end-of-life care. You don't even know that the leader (Barbara Combs-Lee) of the assisted suicide movement in Oregon was a former managed care administrator who worked for a subsidiary of Aetna. Managed care and insurance companies are funding I 1000.

You fail to recognize the long-held oppression, prejudice, and discrimination faced by people with disabilities. You say "It isn't about people with disabilities, it's only available to the terminally ill." You are dead wrong!

Compassion and Choices has been breaking the law for years here in Washington State and you haven't heard a word about it. But you are naïve enough to think that when people as marginalized as people with disabilities are offed by these disability bigots somehow you'll hear about it and it will be stopped. You are just like neocons and fail to see the truth because you're lost in your self-righteousness.

It's amazing to see The Stranger take such a strong stand against social justice and disability rights.

Posted by yellowdogD | September 27, 2008 9:13 PM

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