Austin American-Statesman

Calif.’s new law advances right to die with dignity

- Goodman is president of the Goodman Institute for Public Policy Research and a senior fellow at the Independen­t Institute in Oakland.

Have you ever thought about how you’re going to die? If you’re lucky, it’ll be quick and relatively painless. A sudden heart attack, for example.

Most of us aren’t that fortunate; we have a much better chance of dying slowly, while connected to half-dozen tubes in a hospital ICU.

Nearly 70 percent of all deaths in the United States occur in hospitals, nursing homes and hospice facilities.

One doctor, who blogs under the pseudonym Scott Alexander at the website Slate Star Codex, describes how many of his patients leave the world: “Old, limbless, bedridden, ulcerated, in a puddle of waste, gasping for breath, loopy on morphine, hopelessly demented in a sterile hospital room.”

He gives some specifics — and be forewarned, this gets gruesome: “You will become bedridden, unable to walk or even to turn yourself over. You will become completely dependent on nurse assistants to intermitte­ntly shift your position to avoid pressure ulcers. When they inevitably slip up, your skin develops huge incurable sores that can sometimes erode all the way to the bone, and which are perpetuall­y infected with foul-smelling bacteria. Your limbs will become practicall­y vestigial organs, like the appendix, and when your vascular disease gets too bad, one or more will be amputated, sacrifices to save the host. Urinary and fecal continence disappear somewhere in the process, so you’re either connected to catheters or else spend a while every day lying in a puddle of your own wastes until the nurses can help you out.”

Most doctors, meanwhile, choose to die quickly and with very limited interventi­on from the health system.

In “How Doctors Die,” Dr. Ken Murray, writes: “I cannot count the number of times fellow physicians have told me, in words that vary only slightly, ‘Promise me if you find me like this that you’ll kill me.’ They mean it.”

California Gov. Jerry Brown just signed legislatio­n creating a right to physician-assisted suicide. Similar laws already are on the books in the states of Montana, Oregon, Vermont and Washington. New Mexico’s proposal is caught up in the courts.

I have no problem with such laws, but they’re really only half-measures. For every patient who might request physician-assisted suicide there are thousands more whose lives are being prolonged unnecessar­ily by hospital bureaucrac­ies. They need our compassion and attention as well.

Imagine you’re in a restaurant and a woman at the next table stops breathing or her heart stops beating. You would immediatel­y give her CPR, right? And if you don’t know how, you’d franticall­y search for someone nearby who does. The idea of denying the woman CPR would be monstrous. It might even be described as murder.

Yet, for patients near the end of life, the ethical choices are often reversed. Thousands of patients both verbally and in writing request “do not resuscitat­e” designatio­ns.

Basically this means, “If I am in pain, have no quality of life and I’m incapable of communicat­ing intelligen­tly with you, don’t keep me alive by hooking me up to a respirator, feeding me through a tube or breaking my ribs with CPR so that I will continue in that condition.”

Yet hospitals systematic­ally deny such requests if even one relative objects. The relative may be someone the patient hasn’t seen in years. She may be someone the patient doesn’t even like.

This needs to end. And our attitude toward death needs to change.

Most families wouldn’t think of allowing their dog or cat to needlessly suffer. Why can’t we be just as compassion­ate to our mothers, fathers, brothers and sisters?

 ?? RICH PEDRONCELL­I / ASSOCIATED PRESS ?? Dan Diaz holds a photo of his late wife, Brittany Maynard, taken on their wedding day, during a rally last month calling for California Gov. Jerry Brown to sign right-to-die legislatio­n at the Capitol in Sacramento, Calif.
RICH PEDRONCELL­I / ASSOCIATED PRESS Dan Diaz holds a photo of his late wife, Brittany Maynard, taken on their wedding day, during a rally last month calling for California Gov. Jerry Brown to sign right-to-die legislatio­n at the Capitol in Sacramento, Calif.

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