25 Comments

Thank you Thom; you are 'spot on.' Regardless of my religious views (or anyone else's), if someone wants 'death with dignity', they should have it. This is a health care issue between a patient and doctor/staff and NONE OF MY BUSINESS. Just like women's reproductive healthcare; provide it. Another woman's reproductive health is NONE OF MY BUSINESS.

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I live in Oregon. Unfortunately, our Death With Dignity covers only a few terminal

conditions. A person with Alzheimer’s doesn’t qualify. They have no choice but to live out their life as their brain leaves their body behind on some back ward of a memory care facility without any quality of life. This is NOT compassionate, dignified, or humane. Our animals get a more dignified death than people. Something is terribly wrong about this inhumane situation.

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I agree that our animals get a more dignified death than humans. I can see the side about Alzheimer's - that the patient doesn't get a "real" choice. At the same time, I have friends with spouses with Alzheimer's and there is some semblance of recognition of their state of life. But under the law, this person would have to agree with an amount of sentience. In Colorado we have choices - but I have no idea how they treat people with Alzheimer's. It is indeed a question that should be determined by a physician and the family. I liken it to abortion - between the patient and their physician.

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I was not aware of this. Yes, something is terribly wrong. Is something being done to help change this situation?

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Not in the USA that I know of. Amy Bloom wrote a memoir about taking her husband to Dignatas in Zurich, Switzerland to die. To do that, of course, takes a long, involved process, a lot of money, and a timely calculation before too much dementia has occurred. In our “land of the free” the right to die a dignified death ought to be a human right for those who choose to end their life rather than to be kept alive against their will.

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Jan 24, 2023·edited Jan 24, 2023Liked by Thom Hartmann

The sister of a friend of mine down in Portland, who was a columnist for the Oregonian, was suffering from lung cancer, a particularly difficult way to exit the world. She decided that as soon as her complications started to become difficult to handle, she would drink the legal peace cocktail. She had friends over for a little farewell party, and then when the time came, she retired to her room with her closest family and went off to sleep and to all that comes next. Is this not so much better than agonizing through the tortures of end-stage cancer, leaving your loved ones with the memories of you in misery? Is this not much more life-affirming than a post-mortem funeral or wake? We're all heading to the same destiny. Especially in western culture, we need to eschew the terror and loathing of death as some kind of failure, and we definitely need to remove it from rigid religiosity and the capitalist greed of the medical industry. We need to be teaching our children from early on that we will someday leave the world, so we need to live each moment while we're here with gratitude, service and as much joy as we can muster. When it's time to go, those are the only treasures we can carry with us on our journey, leaving our friends and family with the memory of a life well lived. As Tecumseh said, "When it comes your time to die, be not like those whose hearts are filled with the fear of death, so that when their time comes, they weep and pray for a little more time to live their lives over again in a different way. Sing your death song and die like a hero going home!'

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Jan 24, 2023·edited Jan 24, 2023

"When it comes your time to die, be not like those whose hearts are filled with the fear of death, so that when their time comes, they weep and pray for a little more time to live their lives over again in a different way. Sing your death song and die like a hero going home!"

.

DUDE.

whoa. to go Out

on A High Note:

that's a Yahtzee.

.

sometimes when the Hospital

gets ahold of us they leave

us with some pretty potent

painkillers. I've always Be-

lieved in hanging on to

a Few for Posterity's

Sake: never Know

when they might

Come In Handy.

.

GREAT Comment.

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Isn't it interesting that the people who talk the most about personal freedom and individual rights are the very ones who fight so hard against and stand in the way of the most personal and consequential decisions we ever have to make?

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It is the year 2023 A.D. and yet the culture from the dark ages is still with us. The dems need to run on death with dignity, everyone has a right to health care, everyone has a right to food, women have a right to abortion, old people have a right to social security, young people have a right to financial security, Americans need to work towards a Utopia not a dystopia, with campaign finance reform and a maximum wage 3 to 20 times the minimum wage. The right wingers want to go back to the dark ages, when they get there, they will be begging for another FDR.

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My wife was dying from an aggressive form of colon cancer, and we discussed finding two doctors to approve an end of life for her (her oncologist refused to be one of them). With a few months or so left, our health insurance provided a Home Hospice arrangement. She was kept comfortable with pain medication, and every few days someone would stop by to make sure she was okay. When death was near, the family gathered bedside. She departed this life with the Third of Strauss's Last Songs, one of our favorites, on the stereo, and in the arms of her daughter.

I now believe in the Home Hospice.

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How very beautiful. Yes, hospice is the other option in many cases for a death with dignity. I'm grateful for you to have had this wonderful, sacred experience with your wife as she bade farewell, and may your hearts be forever one.

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We live in two different Americas. One ruled by quasi fascist, white, Christian nattionalists, the other by open minded, all inclusive, seculars.

Some of us are more fortunate than the others, but how long will it last? The quasi fascists are fanatics and are backed by billionaires and millionaires, who are hell bent on making all of America the same theocratic, racist, plutocratic country.

We are captives by our sources of income. My 2nd great grandfather settled in the tall pines of Ashley Co, AR and became a pig farmer. His son homesteaded 160 acres and then sold it for $160 to a carpet bagger that built a saw milll and a town named after himself, Crossett. Today it is owned by Charles Koch as the Georgia Pacific company's pulp mill and is, or was known, as Cancer Capital USA.

There is not a family in the town that hasn't experienced loss due to cancer, and many times, death of old age is a rarity.all of my 1st cousins, that stayed there,have died of cancer.

During WWII, my fathers brother and uncle moved to Cancer Alley along the gulf coast, to work in the oil refineries that were being built to service the needs of ships, airplanes and vehicles in WWII. They all stayed, except my father who was a Marine, and again every cousins family, down to four generations, that have stayed in the area have suffered cancer.

And no one moves, Men would rather die of black lung disease, than consider moving away from the mine and finding some other work. The same in Florida and other states where the quasi fascists have power and inflict their fears and laws on the rest of us.

Apparently having a source of income, is the impediment to escaping a harsh and unforgiving

environment.

The post WWII great migration of people, especially American Descendants of Slaves, from Mississippi and Alabama to the Great Lakes was possible because of the lack of income producing jobs in the south.

Today there is a reverse migration of citizens from the Clintonian rust belt, Great Lakes region,to the south, where tech, the defense, auto and airplane industries have built facilities, but this time it is mostly white.

I consider myself fortunate to live in a state that permits death with dignity and other human rights, Washington State, and not it's neighboring quasi fascist Idaho. But I worry how much longer that feeling of safety will last, when the theocratic fascists finally take full and total control of Congress and the Executive, they already own the Supreme Court and the House.

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I feel like being angry and cynical and adding this to list of how the Christianists and the death cult GOP screw us over. And so I will. I also am sending funds to my state chapter of Death With Dignity and will find a way to serve that cause. Please consider doing the same.

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I feel so lucky to live in Canada, which has saner Dying with Dignity laws, but they still involve a lot of forethought and paperwork. The few doctors who are willing to provide a good death are overwhelmed with so many requests that their own mental health is at risk.

By contrast, in European nations that have had these laws for decades, the average doctor will face only five such cases during an entire career. S/he then takes the next day off with pay for emotional recuperation. Unlike our own system, which still delegates the sad task to a stranger, s/he has usually been the dying person's family doctor for years, knows their history, and has developed a personal relationship.

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Thanks Thom. My heart and prayers go out to Ellen. This is so wrong. How sad.

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While I agree with your cogent essay on suicide as

an option for the terminally ill, a recent article in the New Atlantis demonstrates how the notion of death with dignity might go wrong. Canada roughly has a population the same size as California. California had about 400 medically assisted deaths in 2021. Canada had over 10,000. Apparently a "quality of life," is allowed on a check list so that ostensibly, poor people with depression and uncomfortable but not life threatening conditions can qualify. Canada's safety net is not the economic freedom some imagine. A number admit "they don't want to die" but have no choice as bills pile up after illness and reduced income while economic aid is a lengthy bureaucratic process (as it is here) and they face homelessness. It may also be an avenue to put pressure on the disabled for this final alternative treatment. cf . "No other option." NEW ATLANTIS 01/23

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I'm depressed and one of the Medically Bankrupt people. BUT suicide is also something that is inflicted upon not just yourself, but to your whole tribe, whoever the members are - friends, family, even FB friends. Our pets die with dignity intact. I've had to do that 3 times - and each time I'm devastated just to lose each individual pet. Besides, I'm a big chicken! And feel undying gratitude to all the people and doctors, surgeons who helped me get my health back. It was costly in more ways than just the money. I have medical PTSD now and there's no cure for PTSD, ask any traumatized soldier. I just live day to day, read a lot to enrich and entertain my mind.

To Thom - I am so sorry this couple were friends of yours. What anguish for you and for the wife who "helped" her husband have his wish. Sending you much care.

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There is presently an intensive lobby campaign being waged by church leaders who have privately admitted that NOTHING - no policy changes, no income, housing or disability supplements - could change their opposition to Dying With Dignity. It's a religious issue. They also have people convinced that taking money from one program would shift that funding to help the poor. But that funding comes from entirely different budgets, and government doesn't work that way.

My Significant Other and I are both low-income, but lucky enough to have affordable rent, so instead of suffering, we are able to donate to causes like Dying with Dignity and UNICEF. He fits the profile of Undesirables in several ways: poor, elderly, gay, disabled, with several chronic medical conditions requiring expensive drugs and regular checkups. He just spent a week in the hospital for a sudden pain attack that struck at 3:00 a.m. on a Friday night, as these things tend to do! When he mentioned on admission that he'd be tempted to suicide if that level of pain continued, far from shepherding him toward the grave, the intake worker fell silent and then changed the subject!

After discharge, we were swarmed with free home care workers and assistive devices. Luckily, his health and strength is improving rapidly with home care. I know life is a lot harder for many people than for us, especially disabled people living alone - and I know some of these people. But economic inequality has *nothing* to do with assisted dying, except that the poor are less able to access the legal assistance required for it! Many of those lurid headlines ("They're trying to kill us all") are based on complaints about ONE rogue VA employee, who inappropriately offered the option to veterans who had not asked for it.

IMO, such information *should* routinely be included in the list of other assistance that the patient qualifies for. However, some folks are still offended by the very mention of it.

Many people do need more financial assistance, and the ones who need it most are least able to jump through the legal hoops to access it. I am a strong proponent of a Guaranteed Liveable Income, which could be easily administered via the existing income tax structure. People who don't need it would be free to decline, but I have yet to hear of anyone turning down a tax rebate! Every dollar in the hands of a low-income person tends to circulate over 10 times within the local economy. Then people could stay in their home towns without sacrificing their health to Black Lung Disease or similar maladies. Buckminster Fuller spoke wisely when he said that we need to distinguish between wealth, which contributes to well-being, and "illth," which ratchets up the GDP every time we have a natural disaster or oil spill.

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60 to 70 years ago there was a radical psychiatrist named Thomas Szasz who wrote a series of books that outlined and exalted the extremes of personal liberty, with an absolute right to commit suicide premier among them. Szasz was seen as right wing and would have qualified as Libertarian. It's ironic that the unholy conglomeration of factions that now comprises the right wing now stands in the way of assisted suicide and so many other very personal liberties. Of course it's a function of the huge electoral power of the Christian Dominionists. The Christianists and the Capitalists (for want of a better rubric) are a match made in Hell. The Capitalists, read oligarchs, could care less about suicide, reproductive rights, criminal justice reform, or any issue the Christianists might pursue, so long as their voters elect right wing politicians who further serve the aims of a malignant oligarchy.

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Once again, the questions we find being asked are, how far should government be able to go in regulating our lives; which people will be deciding what government’s role and approach will be, and to what extent is religious belief influencing the process. That “government which governs least” is a concept with great appeal. But if government is in place to advance the interests of the nation as a whole, to protect the vulnerable and the commons, and to defend against discrimination and the excesses of wealth and power, it must have power commensurate with its responsibilities.

Thou shall not kill is closely associated with religion and has been appropriated as a decree from above. But preserving lives is a more fundamental social and practical human imperative. With the issue of assisted suicide, the most careful scrutiny and analysis should be offered to the public for debate and for a collective decision, without the undue influence of sentimentality, religious belief, or the profit motive. It cannot be decided based on doctrine from a storybook or revered set of texts or on revelations presumed to be delivered from a deity. I wrote a paper pointing out my objections to making assisted suicide too easy, however I believe it must be an option in selected cases where a strong case has been made for mercy.

Just as with abortion, experienced and qualified medical experts should evaluate each situation in consultation with patients and family members and there should be no criminal prosecution without evidence of criminal intent and clear violations of established laws and a disregard for life or civil rights. There must be laws which account for exceptional situations and which deny government or law enforcement the ability to control or punish conscious and well-considered choices by individuals. Government that meddles nanny-style and is inclined to become intrusive or that is oriented toward intimidation and threats of punitive actions for personal decisions affecting citizens and not harming other (viable) citizens has overstepped its bounds.

This is the same essential principle I harp about daily with regard to education. It’s fine for government to put a splendid brand new school on every corner with the best of everything, and we should demand that government support schools and protect students from discrimination, abuse, neglect, or exploitation. However, the second there is a law which threatens to punish anyone inappropriately or without due process and solely based on arbitrary social or community standards imposed from above we are in very dangerous territory. Prosecuting citizens for refusing to avail themselves of a government service or for not accepting the prevailing conception of what education is or what schools provide can only lead to degradation of the very benefit or good that is sought. As soon as there is even a hint of coercion in the equation, a line has been crossed.

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Is there a legal defense fund for people in Ellen’s predicament?

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Thank you for addressing this incredibly important issue, Thom. It broke my heart to hear my Mom on her hospital deathbed in Alabama, begging to be put out of her misery, while staff refused to increase her dose of painkillers because "they might shorten her life." Her suffering lasted only for a few weeks, but it must have felt like an eternity to her at the time. It certainly did for the people who loved her.

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There is another legally protected way to commit suicide, and it's a nightmare for the family members. It's called VSED---Voluntary Stop Eating and Drinking. This is what passes as compassion in this screwed-up country!

I've been through this with my mom and sister under hospice conditions. It is a HORROR. It is an alternative when you cannot and should not have to take the pain anymore. From a group called Compassion and Choices:

"The Supreme Court of the United States has affirmed the right of a decisionally-capable person (meaning a person not suffering from an illness that would prevent informed decision making) to refuse any unwanted treatment including food or fluids, even if that refusal will result in death. This includes individuals who do not have a terminal illness."

Their website honestly describes the whole process, it just cannot describe the anguish of a long drawn out dying that took both my loved ones a full week, when it could have happened in an hour with less suffering. It is inhumane to sanction this and not some fentanyl, heroin, or barbiturates. As you said we are kinder to our pets. It's a shot and it's hard, but you know they didn't suffer.

Thom, Compassion and Choices is located in Portland. You might think about an interview with them. Our state changed the law (March 2022) to cover out of state people to use the physician system in place in Oregon.

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What passes for Palliative Care often ends with giving the patient large doses of morphine and withholding food and water. We recently spoke with a man who was still livid with rage that his partner of 30 years, who had been nonverbal with Alzheimer's for over a decade, was forced to end her life in this degrading fashion. Some of the people involved with the program are sincerely convinced that the dying don't feel hunger or thirst. (People used to believe the same about animals, slaves and newborn infants!) But I don't believe this myth, unless they have put the patient in a medical coma (and some coma patients are more conscious than others think). When my mother was at death's door and genuinely unable to take food or water by mouth, she would still greedily bite the stick and suck on the sponge whenever I would swab her dry mouth.

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Bless you Geneva for your care-giving. I didn't want to get too lengthy, but I knew all about the morphine aspect. And speaking of that, when my guy came home from 'Nam he became a nurse. He discovered the truth about morphine relief that just keeps increasing till the dying is finally allowed the ultimate relief. The docs and nurses had to do everything on the down low; the records had to look right or they'd end-up in jail.

My Mom was a Baptist, but on this subject she would say "You can't kill a a dying person". If one of my siblings had refused to let her go, there would have been problems with this method. They were in different states and the doc actually called all 4 of them. My Sister was well enough at the time to decide along with her doctor.

Such good, kind people deserve better.

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