Hawaii’s World

By A.A. Smyser

Tuesday, February 23, 1999

Demanding compliance
with living wills

BILL Perry's wife Pat, aged 88, as he is, looked up from a gurney at Queen's Hospital Emergency Room and told him, "I'm in horrible pain. Let me die."

In the dark of the morning soon after 5 a.m. on Dec. 31 she had been hit by a car while going to get the morning newspaper out of their mailbox in the Kahaluu area. He is a late sleeper and didn't know about it until a neighbor woke him with the news.

She was still on the street being tended by paramedics who came promptly. Perry followed the ambulance in his car. On the subject of death, Pat and Bill understood each other. They had plans for killing themselves when it seemed appropriate.

Bill knew his wife meant it when she asked to be allowed to die. He was able to get her living will faxed to the emergency room from Kaiser Koolau Clinic. A final paragraph gave him power of attorney to act for her.

He said he told the emergency personnel to get her out of pain or let her die. They said she wasn't terminal and that pain medication had to be withheld until they learned whether there was internal bleeding.

Then he did what he says he wouldn't do now -- signed a form allowing surgery on her broken leg with bones protruding through the skin in order to get her pain relief.

Next time he saw her was in intensive care -- unconscious and hooked up to an array of tubes and piping intended for life-saving efforts neither he nor she wanted.

When he asked to have the tubes disconnected he was told by a physician that would be euthanasia or murder.

The physician said it wasn't possible, even though Perry had his wife's living will and power of attorney and requested it. Even though friends at a hospital family conference, including their minister, supported his request. Even though their son, newly arrived from the mainland, supported it.

Finally after a second family conference following the arrival of their daughter from the East Coast, the physician assented to see if Patricia Perry could breathe on her own without a respirator. This was Jan. 6, and she could. But the next day she died.

Bill, who had been willing to let her bleed to death a week earlier, got a bill for 18 pints of blood instead.

Bill now is on a crusade. He is outraged. He told his story at a state House of Representatives Health Committee hearing and will re-tell it wherever he thinks he can do some good. His documentation includes the bill for blood, the living will, the death certificate and the police report on how she was hit by a car whose 18-year-old driver had been trying to clear leaves from his windshield.

People in the Death With Dignity movement say William Perry is far from alone. Living wills regularly are ignored. Attorney Jeffrey Crabtree volunteered over 2,000 hours to draft living will legislation and fight for its enactment. His interest was spurred by his experience with his mother in a years-long coma after a hiking fall.

Crabtree says there are a lot of cases like the Perrys'. He alone is aware of a half dozen in the last few months.

THE Star-Bulletin on Jan. 29 published a letter from JoAnn Goebert, whose late husband was both a physician and attorney. He lectured and wrote on the subject of living wills. He had a very specific living will, she said, yet compliance was delayed. Often a single word such as "reasonable" can create a question or doubt, she found.

Nationally, Hemlock Society U.S.A. is encouraging the formation of volunteer committees to help achieve compliance with living wills. The idea of suing those who don't comply is drawing favorable reactions.

A.A. Smyser is the contributing editor
and former editor of the the Star-Bulletin
His column runs Tuesday and Thursday.

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