Sunday, November 14, 2010

A Good Life Should End Easily

For those of you who have witnessed, experienced (as I have) the unbearable horror of watching a loved-one suffer and die from a painful and incurable disease, who have had to comfort them as they cried out in agony and plead for you to help them die, who have heard the death rattle and witnessed the torment of their last days and hours, you will value, appreciate and understand the
following opinion piece that first appeared in the Atlanta Journal-Constitution back in 2005. The author, Jack Reeves, is a close friend.

By Jack Reeves

From the Atlanta Journal-Constitution Published on: 12/16/05

Marvin died within seconds after the injection. Our veterinarian softly uttered, "There's no charge." My wife, Nancy, cradled our cat as I drove home. He was old, had a terminal illness, and suffered. Once a humane society kitten, we buried him with tears and honor. A stone and daffodils mark his grave.

The life of convicted killer Stanley "Tookie" Williams' ended Tuesday from injections of sodium pentothal, pancuronium bromide, and potassium chloride.

Pentothal induced unconsciousness within 30 seconds. Pancuronium bromide, a muscle relaxant, stopped breathing within a minute. Potassium chloride instantly stopped his heart. It was totally painless.

Nancy died of stage four cancer on Nov. 27. She was 66. Amid bodily anguish and horrid consciousness she pleaded twice: "I wish someone would give me a shot and I could go to sleep."

The hospice nurse came two days before. During her initial visit, she discussed with Nancy her living will, in which Nancy directed that "the application of life-sustaining procedures to [her] body , including nourishment and hydration, be withheld or withdrawn and that [she] be permitted to die."

For Nancy, there was no "shot" — only liquid morphine sulfate. Day and night I put measured doses under her tongue. Twice, though, she suddenly arose in bed, eyes wide staring at me, and screamed.

I'm haunted: What horror slouched through her soul?

She went through the stages of death for three days. Her temperature elevated, then she became colder as blood was being preserved by her failing organs. There is a death rattle: a gurgling sound produced by air passing through mucus in the lungs and air passages. Her breathing became difficult as her courageous heartbeat accelerated.

Some 48 hours after the hospice nurse was satisfied that all was in (legal) order, my beloved Nancy succumbed.

A friend and I were with her to the end. We had nothing to sufficiently palliate our suffering either.

Marvin's death occurred in seconds. Williams' occupied two unconscious minutes. We have mercy on pets and those who cruelly murder. But not for the Nancys.

The love of my life was past president of the Licensed Professional Counselors Association of Georgia, Counselor of the Year in 2005, and elected to the board of directors of the new LPCA Foundation. She was an extraordinary, good person.

I could not help her die without pain and terror. Nancy, even with morphine, experienced the private hell of her death — for days. I know. She screamed its horror to me.

"I wish someone would give me a shot and I could go to sleep."

Why can't we?

Vermont is seeking to be the second state, after Oregon, to legalize physician-assisted death when "it's time." Jack just wrote the following for Patient Choices – "a state-wide organization active in promoting optimum end-of-life care as desired by a majority of Vermonters."


by Jack Reeves

On her deathbed, Nancy twice said, "I wish someone could give me a shot and I could go to sleep."

My wife was suffering from insufficiently palliated pain, including anguish of knowing that she had to experience her death to the bitter end.

She had home hospice oversight, which begs the question: "What exactly is it?"

It conforms to the law that no one facing death has a right to physician-assisted dying, even though being of sound and disposing mind, and not acting under duress, menace, fraud, or undue influence of any person.

If you're terminally ill, you are not allowed to disrupt physiological collapse. In other words, organ failure--regardless of how long--cannot be medicinally short-circuited or advanced.

In Nancy’s case, vital organs had to fail under the stress of dying, especially her heart which couldn't withstand its prolonged, increased beating.

She was medicated, i.e., prescription numbed by morphine--but not to coma. Twice she sat up in bed, eyes wide, and screamed at me.

That haunts. What was she experiencing in the romanticized "valley of the shadow of death"? I suggest dread and demons.

Morbidity--her inevitable death--could not, by her volition, be compressed. The law specifies that dying--mine and yours--has to run an ordained course. And the dying and surviving must accept it under penalty of law.

Fortunately, for Vermont there is Patient Choices, a nonprofit association for people who support choice, compassion, and dignity at the end of life.

It does not advocate suicide--a tragic premature ending of life. Instead, it supports choice for those in the dying process. I repeat: for those in the dying process. It is physician-assisted dying.

Supreme Court Justice Antonia Scalia argues that for a physician to prescribe medication at the request of a mentally competent dying person to speed the process violates law and medical ethics to heal, to cure.

Sometimes, though, we cannot cure cancer, never old age.

Alleviating--to relieve, to lessen, to make (as suffering) more bearable--is a synonym for medical. To alleviate suffering, especially at death, is a legitimate medical objective and value.

Physician-assisted dying is in accord with Ancient Greek medical tradition to "do no harm." Do not perpetuate suffering, distress, torture.

We owe it to our loved ones and ourselves to join the majority of Americans (70 percent, according to a Pugh poll) who believe that our allegiance to liberty cannot be fulfilled unless our laws reflect our wishes for death with compassion and dignity.

1 comment:

mythopolis said...

It becomes more and more of an issue to think about as the baby boomers begin their decline in great numbers. My mother fortunately died quite peacefully. But, going to the nursing home every day was like walking through halls where people were waiting to die in each room. Some were still quite functional and alert, but so many were simply, all but gone. It was quite sad to observe this day after day.