Opinion articles and Letters to the Editor are a great way to consistently hear both sides of an argument, and then form my own opinion after taking in information from others.
After initially reading the Opinion piece from Dr. Dennis O’Hare on Feb. 15 (“Why we doctors oppose legalization of physician-assisted suicide”), I put it aside, re-read it later & pondered what he wrote. I then felt compelled to write my own thoughts based on my experiences that are also relevant to the topic of physician-assisted suicide.
Those who are opposed to this bill the Minnesota Legislature is considering will typically refer to it as physician-assisted suicide, as the word “suicide” has negative connotations. The preferred name, especially for those who support it, is Death with Dignity. The formal name of the bill in the Legislature is the End-of-Life Option Act (HF 1930).
As an ICU registered nurse of well over 35 years, I have witnessed hundreds of patients dying in a variety of manners. In a controlled environment, such as an ICU, I was able, with a physician’s order, to administer narcotics or other medication my patient needed at the end of their life. I always considered it an honor to be present with the patient and their family, and to do my best to ensure that no suffering, whether from pain or shortness of breath, occurred during their final time. As the nurse, I was usually the only medical professional who would stay at the bedside until the final breath was taken.
Before that moment, many of the patients would tell me in private how they didn’t want to pass like this – in a sterile hospital room, having already suffered for weeks or months. They had hoped they could die peacefully in their own home, under the circumstances of their choosing. They asked me why they could make what they considered the humane choice for their beloved pet, but not for themselves. They all knew they were going to die soon from their diagnosis, and they simply wanted some control over the last thing on this Earth that would happen to them.
This is why I remain perplexed over Dr. O’Hare’s writing against this End-of Life Act. He writes that the bill would obligate Minnesota physicians to not only function as healers, but also as the gatekeepers and ultimately decision-makers. Yes, who better than the patient’s physician to make that decision? He himself writes that one day all our hearts will stop beating. I certainly hope that my physician will be willing to help me choose the circumstances under which mine will stop forever.
I hear the concern Dr. O’Hare has about the potential negative aspects of this bill. But if the fear of sliding down a slippery slope is so great, then other important medical decisions would never have been approached, such as allowing hospice patients to have very large amounts of morphine at their homes. That, too, gave the medical community cause for concern and carried with it an obvious risk of abuse. But we are now very comfortable with that and must realize that many patients attempt to use that exact prescription to intentionally end their lives. I have had hospice patients imply to me that they are ready to die and feel at peace with it. Their plan was that they would go home and see how much morphine or other medication was available to them, say good-bye to their family and leave this world on their terms. They would prefer to do it legally, but this state doesn’t give them that option.
The criteria are very clearly stated in this bill, and many patients who may desire it will not qualify. Like other laws, these criteria must be followed to the letter, and we must allow our trusted physicians to carry them out. What Dr. O’Hare wrote about in Canada, the broadening of criteria to include other groups or diagnoses, is certainly not a given in this country and not a fair argument against what is being proposed here. Any changes would have to be made by the legislators.
The National Institutes of Health conducted a random survey of 1,000 U.S. physicians, indicating that 60 percent thought “physician-assisted suicide” should be legal. An informal (and not necessarily representative) poll conducted at our own Minnesota State Fair revealed that 73% of respondents agreed it should be legal.
Here are some examples of the Minnesota End-of-Life Option Act criteria, with the following being just a small portion of what the bill contains:
— It requires two health care providers, meeting specific criteria, to sign off that the patient is terminally ill and has a prognosis of less than six months.
— The patient needs to be found mentally capable.
— There cannot be any coercion for the patient to make this decision.
— No individual would qualify only because of advanced age or disability.
I sincerely applaud Dr. O’Hare’s work as a geriatrician and palliative care physician. It is a specialty that is greatly needed and appreciated. He, like any other provider, would have the choice to practice medical aid in dying. A pharmacist also has the choice to fill a medical-aid-in-dying prescription. A person who does fill their prescription has a choice of whether to use it, and they may indeed choose not to – but the choice is theirs. A choice to have that autonomy, legally, in their final time on Earth.
Registered Nurse Linda Marie Thayer, Lake Elmo, recently retired from United Hospital. She worked there for 40 years, the past 35 in the ICU.
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