Forum draws diverse views on right to die
Social and civil rights activist Ah Quon McElrath asked a simple question: "Why is it we have found it so difficult to give an individual the right to choose living or dying?"
Varied responses from six other panelists reflected the diverse views across the country on controversial right-to-die questions.
Tackling the issues at the recent American Bar Association convention, some panelists pointed to Oregon's 1997 Death with Dignity law as the answer, while others advocated improved pain care and use of hospice for end-of-life care.
"We're talking around the point," McElrath said. "I'm 90. It's not just pain, it's other considerations. What if I can't control what I do, if I can't drive or go out? Will he (the doctor) give me something to end my life?"
Dr. Brian Issell of the Cancer Research Center of Hawaii said he will relieve a patient's suffering, but he will not help anyone end their life. However, he said he explained to one patient with terminal cancer that the end can be hastened by not eating or drinking fluids for one or two weeks.
"Don't we have the right to say we don't want to be on Earth?" asked Chicago health care lawyer Miles Zaremski, moderating the discussion during the ABA's annual meeting at the Hawaii Convention Center.
"Yes, you do," Issell said. He described how a terminally ill older woman with no family who wanted closure called the custodial security in a high-rise building and said she was going to jump from the lanai at a certain time, and she did.
Kathryn Tucker, general counsel for Compassion & Choices, an advocacy organization for more end-of-life choices, said she hears horror stories like that every day at her job.
She said "suicide" is an incendiary word, but there is very strong support for physician assistance for patients "seeking to preserve self in making a choice."
Kenneth Kipnis, University of Hawaii professor of philosophy, said the Oregon law is one end-of-life model where a doctor writes a prescription for the patient. Another involves actual administering of a drug, which is done in the Netherlands, he said.
None of the fears about Oregon's physician-assisted suicide law -- the only one in the country -- have materialized, Tucker said. "To the contrary, patients enrolled overwhelmingly in hospice. We respect the right of a patient to not jump from a lanai."
William Colby, the first lawyer to litigate the right-to-die question in the U.S. Supreme Court with the Nancy Cruzan case, said he doesn't support physician-assisted death for personal reasons.
"There is a lot more to be done with palliative care and hospice," he said. With the "waving of aging" and accelerated medical technology, he said, "We are going to have a long time to talk about these questions."
People in Oregon have talked about the issues more than anywhere else so "they've gotten better at death and dying than the rest of us," he said.
Barbara Coombs-Lee, president of Compassion & Choices, said, "Support among people is very high for personal control of the end of their life. It is so very different from entrenched politicians, who are not necessarily responsive to public needs."
"We've talked about death and dying (in Hawaii) for 20 years," McElrath said, describing failed efforts to pass a law similar to Oregon's. "Invariably, religious interests come out."
James Pietsch, University of Hawaii Elder Care Law Program director, said an 1896 Hawaii law still in effect says doctors can provide "remedial agents" for a hopeless disease, and there is no law against suicide.
"Remedial to me is relieving suffering," Issell said.
Colby also questioned what "remedial agents" were when that law was written 110 years ago.
Pietsch said the Cruzan case "made it clear medical interventions can be refused by a competent patient or surrogates. "The issue remains: Can you positively give something to hasten death rather than remove something?"