June 11, 2002 9:14 p.m. EDT
By YASMIN SATI, United Press International
Barbara Coombs Lee's friend "Penny" is extremely ill and is getting worse. She can't tolerate it anymore. She says if it becomes too difficult for her to handle, she wants to die. She feels she is no longer living, but simply existing.
Should Penny be allowed to take medication and end her life?
Some people believe she should.
"We need to improve the care of individuals at the end of life and expand their choices to improve some aspect of autonomy and self-determination," said Lee, president of the Compassion in Dying Federation.
The federation, which encourages physician-assisted dying, says terminally ill, mentally competent adults should be able to ask their personal physician for medication they might need to end their life when they want to, Lee said.
Some people say otherwise.
"Barbara Coombs Lee tends to call the chemicals that kill people medication. They are not. It is poison and physicians are not supposed to subscribe poison to kill people intentionally," said Ira Byock, hospice and palliative doctor and author of "Dying Well."
Byock said American society needs to focus on the essentials of social responsibility by making sure doctors can treat a patient's pain and that hospital and palliative care are available.
"We are not reaching many Americans with even basic health care. There are 41 million Americans without health insurance and so I look at that (physician-assisted suicide) as an apology for failed social responsibility," Byock said.
In 1994, Oregon became the first state to have a physician-assisted suicide statute, which voters have approved twice since 1994, Lee said. According to the law, the patient must be a mentally competent, terminally ill adult who is verified to be such by two physicians, various witnesses and a psychiatrist or psychologist.
The patient must make one written and two oral requests to the physician who is responsible for treating their illness, with a 15-day waiting period.
The physician must council the patient and offer alternatives that are recommended and available. The patient also has to consult with a pharmacist.
Over the past fours years, the law has allowed 91 patients to obtain prescription to end their lives, Lee said. The practice was legally approved by the Clinton administration but the Bush administration wants to reverse it the law.
"I think the law in Oregon was passed in a state that values personal autonomy above almost any other value," Byock said. "It's interesting that already there have been significant problems with the implementation of that law."
In November, U.S. Attorney General John Ashcroft attempted to stop Oregon doctors from prescribing federally controlled drugs but the state wants federal intervention to be limited. The federation is putting much of its effort on protecting the law "that we have carefully stewarded for four years," Lee said.
The federation conducted a number of studies to find out what patients' concerns are when they approach the end of their life. The studies concluded many patients do not want to prolong their dying process. They would like to have a sense of control and they do not want to be a burden on their family, Lee said.
"If you ask people where they would like to die, I don't know people who say 'I'd like to be in a really sterile intensive care unit with lots of machines and I'd like to have my family denied access to me. That's my idea of a perfect death.' No one says that. People say I want to be at home, to be among the people whom I love," Lee said.
"If you have a person who is seriously ill, in pain, they are worried
about being a burden to their family and to society. We are not treating
their pain. We are not teaching our doctors how to keep them comfortable,"
Byock said. "We are financially devastating the patient and then their
family, simply because they are serious ill and not dying quickly enough."
Copyright © 2002 United Press International