Death, with dignity

QUICK READ: Medicare paid $100 billion just for doctor and hospital bills during the last two months of patients’ lives. It’s estimated that as much as 50% of these expenses had no impact. Modern medicine has become so good at keeping the terminally ill alive by treating the complications of underlying disease that the inevitable process of dying has become much harder and is often prolonged unnecessarily despite the suffering of patients.

A story on followed the trip of a patient to Switzerland for a death with dignity. Her dying wish was to tell her story, with the hope that it would help the cause of all Americans one-day having access to this kind of death with dignity.

Here in the US, only a handful of states allow death with dignity although it’s routinely done at many hospitals via morphine IV drips. One-quarter of Medicare spending in the United States occurs in the last year of life is commonly interpreted as waste,” research authors wrote in a report on a study of such spending published in the journal Science. “But this interpretation presumes knowledge of who will die and when.… Those who end up dying are not the same as those who were sure to die.”

As Dr. Kevin MD said, “Medicare will pay $55,000 for patients with advanced breast cancer to receive the chemotherapy drug Avastin, even though it extends life only an average of a month and a half; it will pay $40,000 for a 93-year-old man with terminal cancer to get a surgically implanted defibrillator if he happens to have heart problems too”.

Our healthcare system loves to make money off the dying despite the fact that most patients probably would prefer death with dignity. The subject of assisted suicide is a taboo subject in a majority of states with no mention made of the suffering of terminally ill patients.

Switzerland is one of a handful of countries that allows assisted suicide. Usually, a note from two or three doctors plus, in some cases, medical records are enough for an IV cocktail to relieve a patient’s suffering and allow them death with dignity.

In Holland patients who are depressed can even request an assisted suicide if other options for treatment have failed. That could never happen here but it does happen at the hands of someone who is suffering.

If a patient is in constant pain and is terminal should they have the right to ask for a death with dignity? It’s a hard question to answer but when a patient and caregivers understand that death is part of life the decision and transition can be easier.

The American Medical Association opposes physician-assisted suicide, arguing that it can do more harm than good. The organization’s official ethical opinionstates that physician-assisted suicide is “fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control and would pose serious societal risks.” That is bullshit!

Controls can be implemented to ensure that only patients who are suffering are allowed to end their lives. A doctor is not a healer when cancer has spread throughout the body and the pain is immeasurable.

Anglican Archbishop Emeritus Desmond Tutu in 2016 threw his hefty moral weight behind a proposed assisted dying law in the United Kingdom. “People who are terminally ill should have the option of dignified and compassionate assisted dying,” Tutu said. “I hope that when the time comes, I hope I am treated with compassion and allowed to pass on to the next phase of life’s journey in the manner of my choice.”

On her final morning, a driver picked up David and Cindy from their hotel at 9:30 a.m., David told me later. At the clinic, he said they lay together on a bed, and a doctor set up an IV, with a long, thin tube running into Cindy’s hand. When she was ready, she told David she loved him. She thanked the doctor and the assistant who were in the room. Then she turned the dial. The drug rushed into her veins. Cindy said it felt cold. Then she fell asleep. That day, David wrote to me from Switzerland: “Cindy flew away at 11:11. She was brave and very thankful. I will love her always.”