|
Getting your Trinity Audio player ready...
|
By Kate Daly | Special to the Almanac
“I barely knew him,” said Nancy Meyer of Portola Valley, who was there when her client took prescribed drugs to exit life peacefully, just as he wished.
Ms. Meyer is one of a dozen volunteers who works in Northern California for Compassion & Choices, a national nonprofit focused on end-of-life care.
The organization advocated for the passage of the End of Life Option Act in California, which became law in June 2016. Right-to-die laws also exist in Oregon, Washington, Vermont, Colorado and Montana.
In November the group’s California medical outreach manager, Stefanie Elkins, met with more than a dozen people at Ms. Meyer’s home to talk about the law. At the time, Ms. Elkins noted, there were “50 anecdotal cases statewide” of patients having gone through the process to end their lives.
Ms. Meyer has volunteered for seven years to sit at bedsides, help clients make choices, and write advance directives to provide instructions on end-of-life health care. “All of our roles have changed a bit with the new law in place,” she said.
Referring to her recent client, she said she met him on a Friday. On Monday they had a follow-up conversation about scheduling and logistics.
On Tuesday with Ms. Meyer, another volunteer, and a nursing aide present, “he took the medicine, and it took 15 minutes” for him to die, she said.
He chose not to have a family member there.
In another situation a client had his family there and decided not to take the drugs.
“They called us in that day needing help to take the meds,” Ms. Meyer said. After going over the choices, “we had a conversation with his family, he changed his mind, and sent everyone away.”
The law was written to give California residents 18 and over who are mentally competent and diagnosed with a terminal illness and a prognosis of six months or less to live, the choice to die by a self-administered drug.
The law requires two oral requests made to doctors at least 15 days apart and a written request, plus multiple forms involving two physicians and two witnesses, only one of whom can be family.
A question persists about implementing the law, namely how difficult is it to find local doctors willing to practice physician-assisted-death.
“It’s early days,” said Dr. Vyjeyanthi Periyakoil, director of palliative care education and training at Stanford University School of Medicine. “It’s a very sensitive topic.”
Some people object to physician-assisted death for religious or spiritual reasons.
“It’s too new,” she said. “I think many feel uncomfortable and worried about viable options,” such as pain management, hospice care, and voluntary stopping of eating and drinking.
She said she believes in “early engagement of palliative care, as soon as diagnosis (occurs), because suffering is something that builds up over time.”
Usually, a doctor who knows the patient best, such as a primary care physician or oncologist, gets a request from a patient for physician-assisted death.
Under Stanford’s policy, after such a request is made, the ethics department of the School of Medicine gets involved, and the second required physician must be a palliative care specialist.
A doctor may opt out of helping a patient and another physician can be found.
Stanford will not accept new patients solely for physician-assisted death, and does not allow for the procedure to take place on Stanford Health Care premises.
At Kaiser, according to Dr. Michelle Caughey of Woodside, associate executive director of the Permanente Medical Group, physician-assisted death “is such a rare thing, an unusual option.”
“Doctors have no obligation” to comply, she said. “In our organization, we’ve had to make it available to members.”
“We have about the same participation rate as in Oregon; it’s unusual, but people are opting for it. Some just want to have that as an option, but don’t necessarily follow through,” Dr. Caughey said.
Oregon Health Authority reports in 2016, 204 people received prescriptions under the state’s Death with Dignity Act. As of Jan. 23, a total of 133 people died from ingesting them, including 19 who received their prescriptions in prior years. Most of the people were cancer patients 65 years and older.
“The law is very detailed and requires a lot of reporting which is very good,” she said. “You really need that string of custody. These drugs shouldn’t be out and about.”
Kaiser pharmacies deliver the drugs, usually a barbiturate such as Seconal, in capsule form.
The drugs reportedly cost anywhere from hundreds to thousands of dollars and often aren’t covered by medical insurance. Physician-assisted death is not considered suicide and therefore doesn’t affect life insurance.
Compassion & Choices has observed that in states where physician-assisted death is legal, patients use hospice care more.
Here on the Peninsula, Ms. Elkins said, Mission Hospice & Home Care is “super supportive” of the new law.
She described her job as reaching out to medical providers and educating them about physician-assisted death, to “normalize this addition, expand the care and choices at end of life.”
On the website, endoflifeoption.org, doctors, pharmacists and patients can find more information.
—
Now the nursing homes and other “medical providers” of California are trying to get the right to simply declare a patient incompetent so that they can get guardianship and kill a patient at will now that assisted suicide is legal. (SB 481 Pan) The bill intentionally avoids the input of existing state programs that are supposed to protect patients like the Long Term Care Ombudsman or Adult Protective Services. Effectively, the vulnerable like the disabled and elderly will be euthanized as costly objects based on Darwinian mathematics rather than respected as members of our human family. (Remember Hitler went after the disabled first using Darwin’s natural selection as justification for getting rid of the “defective” people in his day.)
No, that won’t happen you say? Think again. This is just one example of many in CA today. In October, 2016, a 93-year-old woman was being deprived of nutrition and hydration in a Northern California hospital. She did not have a terminal illness. She was able to breathe on her own. Neither she nor her family wanted her to be dehydrated to death. Yet the hospital believed it was within its rights to end her life without her consent or the consent of her family simply because she was elderly. Luckily, the daughter contacted a lawyer and got a restraining order to stop the hospital from dehydrating the woman to death. Oh… What would have happened if the hospital got guardianship? Let’s turn to VA now to see how that works.
Presently, a nursing home in VA is trying to starve a disabled woman of 49 to death despite her communicating she wants to live (she was conscious) and despite serious injuries she has suffered at the nursing home. The family disputed with a hospital that refused care to the woman for a blood clot, and the family would not take the woman home insisting that proper care be provided. The hospital went to court, got guardianship and blocked the family from seeing the patient. The hospital then put her in the nursing home under “hospice” and is now trying to dehydrate and starve her to death. (Hospice lowers medical malpractice liability because no matter what injuries occur, the patient was slated to die, but Medicare still pays a ton. It’s a gooooood business.) Also, good way to cover up your patient abuse and malpractice issues as well as opening up more beds for higher paying patients who don’t qualify for Medi-Cal.
If you remember anything from this post, never leave a patient in a facility that is denying him or her proper care. Get him or her out of there as soon as you can while you look for healthcare professionals that actually want to heal people. Research, research and keep researching medical options. Try to get the best insurance you can for you and your family, preferably at least a nationwide plan and international coverage is not a bad idea.
John, seriously: When GOP leaders like Chaffetz and others are running away because of Trump, is this a good time to step in?
As Trump said yesterday:
“I don’t stand by anything”