Valley Voices

Dying in California comes with a new option

Terry Petrovich of San Diego County was diagnosed in 2012 with stage four non-Hodgkin’s lymphoma.
Terry Petrovich of San Diego County was diagnosed in 2012 with stage four non-Hodgkin’s lymphoma. The Associated Press

As of June 9, the End of Life Option Act offers a dignified death for Californians with a terminal illness.

No, it doesn’t!

It’s suicide sugar coated with clever phrases. Taking a life is always wrong. And the government permitting death “options” continues down the slippery slope of eliminating society’s most vulnerable.

Without a doubt, the act will be embraced, vilified or misunderstood. But it is the law.

Oregon became the first state allowing terminally ill patients to end their lives with doctor-prescribed medication in 1997. I lived in Oregon when Measure 16’s Death with Dignity Act appeared on the 1994 ballot. After considerable prayer and thought, I voted “no.” It passed with 51 percent of the vote (and was later affirmed by 60 percent of the voters).

My vote was rooted in concerns about doctors having so much control. Rationally, I understand. Doctors examine patients based on objective medical tests and extensive research. Nonetheless, I was reluctant to prioritize the medical.

Like Oregon, patients in California are required only to inform physicians of their plans. No one knows a patient’s intentions unless she or he chooses to share it.

Why not include clergy if the person is religious? Shouldn’t family be involved?

Playing devil’s advocate, if dying patients want to consult clergy, they can! If wishing to discuss the End of Life Option Act with family, they can! However, not everyone is religious. What if the patient’s family has a history of anger or abuse?

Still, when voting in 1994, I couldn’t ignore my nagging thought: Why give so much power to the medical community?

Also like Oregon, California’s law requires that two physicians agree an adult patient (18 years or older) has an illness with six months or less to live. This is similar to the requirements for hospice care.

But there are differences from hospice. If either doctor questions the patient’s decision-making abilities, a third examination from a mental-health specialist evaluates the patient. Under the act, a person must make two oral and one written request to his doctor. There is a 15-day waiting period between appointments.

The cost of the medication – as many as 100 barbiturates or “sleeping pills” – is not covered by insurance. The high-end guesses I’ve found for the prescription’s price is $5,000. It may be lower and California may provide financial assistance for some. Preparation involves “crushing” pills and mixing them into a liquid. This “slurry” is then swallowed.

Death certificates will list the diagnosed terminal illness as the “cause of death.” Legally, it’s not suicide. No health professional can be accused of criminal activity, and benefits for survivors will be honored if the act’s guidelines are followed. All the requirements – there are more than I’ve mentioned – are patient-driven. From initial contact with doctors to ingesting the medication, the patient must personally take every step.

Will costs prohibit some from considering the act? Is that fair?

Since patients sign documents and prepare the medication, those with illnesses like Lou Gehrig’s disease or Parkinson’s can’t participate because of physical restrictions. Is that fair?

Why do people decide to end their lives? In an October 2015 U.S. News and World Report article, Oregon residents (1998-2014) using the Death with Dignity option were most concerned with “losing autonomy” and not being able to “engage in activities that make life enjoyable.” Pain was low on the list of reasons.

Remember, these reasons were from Oregonians facing devastating terminal illnesses.

Because I voted against Oregon’s Death With Dignity, I must be against California’s act. Right?

You would be wrong.

Really? And so you may ask of me: What do I think?

Excellent question. But first and foremost, that must be your question. What do you think?

Because I think hospice care is the best choice, I can’t imagine a better path to support my final days. However, I am reasonably healthy right now. Speculating is easy when life is easy. As a minister who has comforted the dying in hospitals and homes, in emergency rooms and nursing facilities, I’ve witnessed how life can suddenly shift.

My parents died difficult deaths. Dad’s lengthy dying from dementia in 2012 would’ve prevented him from considering the End of Life Option Act. He couldn’t make his own decisions. Mom’s shockingly rapid demise from cancer in 2013 would’ve meant the act’s steps were too slow and complicated.

But their deaths will not be mine.

Every person is unique. Every situation is different. People confident about their beliefs can change their minds when approaching death – and as death approaches them.

California residents now have more choices for end-of-life decisions. I fervently believe everyone needs to openly and honestly share her or his thoughts.

In order to start the process in California, a person must talk with a doctor.

But I hope that’s not where the conversation ends for the patient. Please let your loved ones hear your worries, fears and beliefs.

Your life and your decisions do matter.

Larry Patten of Fresno works in a Fresno hospice. He is a United Methodist clergy and a freelance writer. He maintains blogs at www.larrypatten.com and www.hospice-matters.com. Write to him at larry@larrypatten.com.

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