End-of-life care discussion
I read with great interest the Feb. 20 op-eds “Assisted suicide is not health care” by Dr. Errol Baptist and “Our sons’ agony taught us the importance of medical aid in dying” by Nilsa Centeno and Suzy Flack. This is a difficult discussion. The authors do not share a term while discussing the process but rather use terms designed to be emotive — “suicide” versus “aid.”
I understand the issue. I am a retired medical oncologist and bioethicist and spent hours in homes and at bedsides with patients receiving supportive hospice care, making sure I was available to them 24/7. I also have metastatic cancer, have experienced failure with five treatments including experimental therapy, had brain cancer removed and have complications from therapy. I will die from this disease, sooner rather than later.
What is needed in the discussion of the proposed End-of-Life Options for Terminally Ill Patients Act for Illinois is compassion and a comprehensive approach. It is well documented that quality hospice care is not as widely available as it should be. Too often, diagnoses are made at advanced stages of disease due to lack of medical care, leading to few or no options and feelings of desertion and abandonment. Availability of aid in dying/assisted suicide is not uniform in the states that have approved it, and there is nothing new in the proposed legislation to change that for Illinois.
While we may not agree on the appropriate term for the process and the need for the specific legislation, we should agree that we can and should do better with patients who have diseases leading soon to an inevitable death. Expanding and improving hospice coverage throughout the state, eliminating barriers to medications needed to control symptoms and having thoughtful discussions about the wishes and fears of the patient are needed.
Caregivers, both professional and family, need the support this intensive effort would require. Providing medications to end life early is not for everyone; providing quality end-of-life care is.
Greater resources than the proposed legislation would likely be required — but would be the way to make a difference. We all should want this for Illinois.