Editorial: Terminally ill should have control of their final days.
In her final days, dying from pancreatic cancer, Merla Zellerbach eloquently laid out the case for giving terminally ill patients control over how and when they end their lives. “It’s not suicide,” she explained to Chronicle writer Leah Garchik. “For one thing, suicide patients have a choice. They can go on living.” In a situation like hers, however, patients “do not have a choice. They’re going to die. ... And you’re not doing it to yourself. God or whoever she is has made the choice that you can’t go on living.”
Merla, the writer-philanthropist-civic leader whose final months were described by Garchik in a frontpage story last Sunday, had desperately wanted to avoid suffering at the end. But, as Garchik noted, Merla was a “woman who lived by the rules.” And California law does not give physicians the option to prescribe life-ending drugs to dying patients who want them.
As a result, her final days were prolonged and painful.
“I want it to be over with,” Merla said on Dec. 15, 11 days before her death. “I really feel profoundly that it’s ridiculous that I can’t go to my doctor and get a prescription ... and end it when I have every reason, physical and mental, to want to do it.”
Brittany Maynard, a 29-year-old newlywed from the East Bay, had a similar desire for control of her final days after she was diagnosed with terminal brain cancer. She ended up moving to Portland, Ore., where she was able to end her life on her own terms, taking a fatal dose of doctor-prescribed barbiturates when her suffering grew unbearable, under Oregon’s “Death With Dignity Act.”
Brittany’s plight drew global attention and elevated the issue, among the most delicate in medicine.
“For people to argue against this choice for sick people really seems evil to me,” she told People magazine. “They try to mix it up with suicide and that’s really unfair, because there’s not a single part of me that wants to die. But I am dying.”
Terminally ill Californians should not be left with the untenable choice of having to leave the state for a peaceful death surrounded by loved ones (Brittany’s course) or enduring extended suffering as the price of staying home (Merla’s fate).
Their stories should help generate serious discussion on the recently introduced SB128 by state Sens. Lois Wolk, D-Davis, and Bill Monning, D-Carmel. As Monning put it, “Many doctors recognize that existing palliative care doesn't work for everyone.”
Their measure is virtually identical to a past bill (AB654) we supported in 2005. Then, as now, we acknowledge the deeply held religious and moral objections to such a proposal. We also know that such a law must be crafted with great care so that it does not lead to coercion against patients in periods of distress. Oregon, which in 1997 became the first state to allow physicians to prescribe lethal drugs to terminally ill patients who meet certain qualifications, provides a model that addresses such concerns.
Here’s how SB128 (the “End of Life Option Act”) would work:
Two physicians would need to confirm that a patient was mentally competent and had six months or less to live. Participation by doctors, pharmacists and other health care professionals would be voluntary.
The patient’s doctor would be required to discuss alternative treatment options, including palliative care and pain control.
The patient would need to make a written request for aid in dying and two oral requests at least 15 days apart.
It would be a felony to coerce someone to request aid in dying.
The experience in Oregon and four other states that allow patients access to aid in dying has been that not all of the terminally ill people who request the lethal drugs end up taking them. But they had the comfort of knowing they were in control of the final days of their lives. It should be an individual choice, not one for others to judge, and certainly not for the government to make.