Friday, September 9, 2011

What People Mean When They Say They Want to Die


 (originally published as a Statement for the BBC)
For a print version, click here
by William Toffler, MD
______________________________________________________

There has been a profound shift in attitude in my state since the voters of Oregon narrowly embraced assisted suicide 11 years ago.  A shift that, I believe, has been detrimental to our patients, degraded the quality of medical care, and compromised the integrity of my profession. 

Since assisted suicide has become an option, I have had at least a dozen patients discuss this option with me in my practice.  Most of the patients who have broached this issue weren't even terminal. 

One of my first encounters with this kind of request came from a patient with a progressive form of multiple sclerosis.  He was in a wheelchair yet lived a very active life. In fact, he was a general contractor and quite productive.  While I was seeing him, I asked him about how it affected his life.  He acknowledged that multiple sclerosis was a major challenge and told me that if he got too much worse, he might want to “just end it.” “ It sounds like you are telling me this because you might ultimately want assistance with your own assisted suicide- if things got a worse,” I said.  He nodded affirmatively, and seemed relieved that I seemed to really understand.

I told him that I could readily understand his fear and his frustration and even his belief that assisted suicide might be a good option for him. At the same time, I told him that should he become sicker or weaker, I would work to give him the best care and support available. I told him that no matter how debilitated he might become, that, at least to me, his life was, and would always be, inherently valuable. As such, I would not recommend, nor could I participate in his assisted-suicide.  He simply said, "Thank you."The truth is that we are not islands.  How physicians respond to the patient’s request has a profound effect, not only on a patient's choices, but also on their view of themselves and their inherent worth.

'I was afraid to leave my husband alone'”

Letter from Oregon resident, Kathryn Judson, Published in the Hawaii Free Press, February 15, 2011.  To view the original letter, click here and scroll down towards the bottom of the page.   

Dear Editor,

Hello from Oregon.

When my husband was seriously ill several years ago, I collapsed in a half-exhausted heap in a chair once I got him into the doctor's office, relieved that we were going to get badly needed help (or so I thought).

To my surprise and horror, during the exam I overheard the doctor giving my husband a sales pitch for assisted suicide. 'Think of what it will spare your wife, we need to think of her' he said, as a clincher.

Now, if the doctor had wanted to say 'I don't see any way I can help you, knowing what I know, and having the skills I have' that would have been one thing. If he'd wanted to opine that certain treatments weren't worth it as far as he could see, that would be one thing. But he was tempting my husband to commit suicide. And that is something different.

I was indignant that the doctor was not only trying to decide what was best for David, but also what was supposedly best for me (without even consulting me, no less).

We got a different doctor, and David lived another five years or so. But after that nightmare in the first doctor's office, and encounters with a 'death with dignity' inclined nurse, I was afraid to leave my husband alone again with doctors and nurses, for fear they'd morph from care providers to enemies, with no one around to stop them.

It's not a good thing, wondering who you can trust in a hospital or clinic. I hope you are spared this in Hawaii.

Sincerely,

Kathryn Judson, Oregon

" If my doctor had believed in assisted suicide, I would be dead"

I'm so glad doctor didn't assist me with thoughts of suicide
http://www.tcpalm.com/news/2010/oct/19/letter-im-so-glad-doctor-didnt... 

Letter, Tuesday, October 19, 2010

I disagree with Marshall Frank's column, "Florida ready for its own Death with Dignity Act, to give terminally ill patients a choice." Here in Oregon we have such a law. In other words, assisted suicide is legal. Our law was enacted via a ballot initiative that I voted for.

In 2000, I was diagnosed with cancer and told that I had six months to a year to live. I knew that our law had passed, but I didn't know exactly how to go about doing it. I tried to ask my doctor, but he didn't really answer me. I did not want to suffer. I wanted to die and I wanted my doctor to help me. Instead, he encouraged me to not give up and ultimately I decided to fight. I had both chemotherapy and radiation. I am so happy to be alive!

It is now nearly 10 years later. If my doctor had believed in
assisted suicide, I would be dead. I thank him and all my doctors for helping me choose "life with dignity." Assisted suicide should not be legal. Don't make Oregon's mistake.


Jeanette Hall
King City, Ore.

Thursday, September 8, 2011

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