Death With Dignity Advocate Sparks New Discussion

November 11, 2014

With the passing of Brittany Maynard, the California woman who became the public face of the controversial right-to-die movement over the last few weeks, focus has been renewed about end-of-life choice, palliative care, caregiving, and hospice. Brittany Maynard died after taking a lethal dose of medication prescribed by a physician. This option, which does not exist in California, is legal under Oregon’s Death With Dignity Act.

That law allows competent adult Oregonians with a life expectancy of six months or less to ask their physician for a prescription of life-ending medication. The Act requires a second opinion, two oral and one written requests, and a 15-day waiting period. It requires that the person be fully informed about “feasible alternatives, including, but not limited to, comfort care, hospice, and pain control”, as well as diagnosis, prognosis, risks, and results.

Although the law has sparked controversy, its supporters point to some unanticipated benefits. Oregonians are more aware of their end-of-life choices than many other citizens. Oregon ranks No. 6 among the top states that access hospice.

For people nearing the end of their life, “aid in dying” is not so much about death. It’s about control and their last chance to decide their own destiny. The majority of Death with Dignity proponents cite loss of autonomy as their greatest end-of-life concern. Most who have prescriptions for life-ending medications never use them.

” Typically the prescription is never used but serves to give the patient peace of mind,” Hospice of the Foothills interim executive director, Carolynn Peterson said. “It serves to let them know they have control.”

Oregon law requires that the patient be on hospice and once on hospice the focus is on symptom management and quality of life. Hospice does not hasten death but rather supports the patient and family being in control.

Hospices are uniquely qualified to address the needs of the dying. Hospice of the Foothills encourages all individuals who have received a terminal diagnosis to enroll in hospice. Hospice can help patients remain in control and die at home. The goal of hospice is to improve quality of life in the patient’s last months, focusing on comfort care, control of pain, and symptom management, as opposed to continuing curative treatments.

“Hospice isn’t about giving up,” said Peterson, “It’s about a better quality of life.”

In addition to caring for the patient, hospice also provides instruction, assistance, and support for the family. Seeking a prescription for life-ending medication should not be the option of first choice for relieving their fears, pain, or symptoms of a terminal illness.

According to Peterson, one of the most frequent comments heard from patients and families at Hospice of the Foothills is “If only I’d known about you sooner.” Now is the best time to learn more about hospice and ask questions about what to expect so you can make an informed choice about what you want to happen at the end of your life.

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