On average, people don’t even want to think about the ends of their lives, but many have experiences with loved ones that provide a warning. We have heard: “My mother’s drugs kept her alive so she could feel the pain from her cancer for years. My husband was a genius engineer, but now he can’t remember one moment from the next. My wife had a stroke and has been unconscious in the nursing home for years—she gets food put down a tube. My son had a brain tumor that never stopped hurting.”
There are so many stories like these that we have heard partly as a physician, but even more so as a member of a retirement community where almost everyone around me is older than I am. At least half of the people in this community, many of them doctors and nurses, have expressed the desire for a West Virginia law which we will describe below. If at all possible, they want to be saved from miserable unending pain and suffering before death.'
Likely you have heard of an Oregon Law referred to as Death with Dignity. It was passed in 1994. There are now 8 other states (Washington State, Vermont, Colorado, California, Washington, DC, Hawaii, New Jersey, Maine) that have similar laws. They all provide for a person to voluntarily end his or her life by ingesting a large overdose of medication. That is definitely a step in the right direction as far as we are concerned, but let me go on and elaborate on what we think we should do here in West Virginia, something of an improvement as we see it.
For one thing all of the state laws already in place allow a person to end his or her life by drinking a high over-dose of medication. None allow for IV injection. The bad tasting oral meds are unpleasant and not everyone who takes the dose dies. Some vomit the medication up. Others just survive.
Canada passed a Death with Dignity Law in 2017 that allows for IV medication, and there are several European countries that allow the same.
Following their example, we want West Virginia to pass a law that allows for the possibility of IV as well as oral medications. We, several other doctors and I, would like to have an End of Life Choices Act in West Virginia. We have approached several legislators with the details of just such a law.
The new West Virginia model law would include:
1) The possibility of a person writing a living will that would clearly state what his or her preference would be for the end of life. The living will would be legally binding.
2) The possibility of appointing a Medical Power of Attorney who can act in a person’s best interest when that person can no longer act for himself. The Medical Power of Attorney would have already been made to understand the patient’s wishes. The Medical Power of Attorney will be denied any monetary reward for the decisions made. No family member who will inherit any part of a person’s possessions could fill this roll.
3) Allowing a person to electively end his or her life as long as two doctors have already agreed that there is little likelihood of improving the person’s medical status, and that the issue is not just psychological.
4) Clarification that death would be attributed to the medically diagnosed condition, not suicide. Life insurance should not be cancelled because the patient had elected to take the lethal dose.
5) Possible use of IV medications which may be administered by someone other than the patient.
6) Clarification that no doctor can be forced to assist a patient’s dying if his own personal or religious beliefs rule such an action out; however, the doctor may not stand in the way of a patient turning to an alternative physician when the patient prefers it.
7) Clarification that a hospital may refuse to allow assisted dying if it violates its religious commitments. But that hospital may not prevent a patient transferring to another facility if the patient prefers it.
8) An absolute prohibition that any patient be forced to end life early. Such a decision is totally up to the patient and may not be forced on him or her in any way.
Decades ago, kids actually died of measles as well as polio. Generations ago, so many women died in childbirth that they didn’t have to concern themselves with end of life choices. There have been so many alterations in medicine and our human lives over the years that some of us actually live on to a hundred plus years. Generally speaking, we may well be lucky to do so, but not always.
Please consider that you might be grateful to leave your life when you choose if living can bring only more overwhelming misery. That doesn’t mean that you hate your family or that they will be glad to be rid of you. It rather means that you will all share the sorrow and that they will want to be with you and hold onto you as you move out of your pain and suffering to a better place.
If you agree, please also consider informing your legislators so they can act on your behalf in the coming session. Of course, the legislators have their own feelings, but their job is to work for you. And if you educate them about the depth and meaning of your beliefs, perhaps they will see that the new model law is a good one.
