Wednesday, October 26, 2011

Care and Dignity

[ed.  With the demise of the Community Living Assistance Services and Support program (Class Act) from the 2010 Health Care law, American families still face a daunting problem in caring for the elderly.  Another issue involves the dignity of dying patients and their ability to influence how their final time (and suffering) is managed (below). These are two sides to the same coin - searching for solutions that better address the needs of the aging. Advances in medical technologies have extended our physical lives but may have also deepened the moral, emotional and economic uncertainties that surround prolonged care.]

by Paula Span, NY Times

Most fall weekends, you can find Randee Laikind buttonholing people at the Shelburne Falls Market in western Massachusetts, or wielding her clipboard on the town common in nearby Greenfield or Amherst.

“I try to be very polite,” she told me. “I say, ‘Would you consider signing this petition to put the Death With Dignity Act on the ballot, so Massachusetts citizens can vote on it?’”

Ms. Laikind, who’s 63 and no stranger to activism, has been a bit surprised by the response, or lack thereof. “I’ve never had anyone say no,” she said. “They don’t even ask me questions; they just say, ‘Where do I sign?’”

One Greenfield woman started crying. “She said, ‘If only this had been around last year when my father was dying.’” She added her signature, Ms. Laikind said. So did Ms. Laikind’s former internist, whom she ran into in a restaurant.

Since mid-September, a small cadre of similar volunteers has gathered about 70,000 voters’ signatures, aiming to make Massachusetts the fourth state where terminally ill patients may legally seek physicians’ help to end their lives. The organizers, who call their campaign Dignity 2012, need only 70,000 to put the question on the state ballot in November 2012, but to be sure they have enough to pass scrutiny, they’re aiming for 100,000. The signatures must be submitted by the end of November.

The proposed statute, closely modeled on an initiative that Washington State voters passed in 2008, would allow a patient who’s expected to die within six months to self-administer lethal medication.

It includes a long list of precautions and protections: a lot of physician counseling and information; two doctors verifying that the patient is mentally competent and acting voluntarily; a 15-day waiting period between a first and second request, and another 48 hours before the prescription can be filled. At least one of the two witnesses to the written request can’t be a relative or an heir. And of course, the patient can always change his or her mind.

“Thousands and thousands of people have personal experience that leads them to support this,” said Steve Crawford, a spokesman for Dignity 2012. “They understand that as advanced as our medical technology is, we can’t relieve everyone’s suffering. Those end-of-life decisions belong to the individual.”  (...)

We don’t know how things will play out in Massachusetts more than a year from now. But we do know, from Oregon’s long experience and Washington’s shorter one, what happens after all the furor, the ads, the charges and countercharges when a so-called death-with-dignity law actually takes effect.

What happens is less than one might expect.

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