Death with dignity

Everyone who is reading this is going to die.

That’s a simple fact, however uncomfortable. No one needs to be in any particular hurry to get there, but it’s the inevitable end point.

And none of us want to suffer unnecessarily when our time comes. Nor do we wish that on our loved ones. The question of what constitutes “unnecessary suffering,” though, is a deeply individual one. It’s certainly not something we have the right to dictate to others.

And that’s precisely why the California Legislature needs to pass Senate Bill 128 this year, which addresses aid-in-dying policy and pain-management options for end-of-life care.

Death with dignity and legislation allowing such isn’t a new idea. Not only has aid-in-dying been broached before in California, it’s been successfully in practice in our neighbor to the north for years.

Oregon’s Death with Dignity Act, in place since 1997, requires that state residents with a terminal illness seek the counsel of two separate physicians, who must agree on the terminal diagnosis. The patient then has the option of using prescription medicine to end his or her own life at a time of personal choosing, before the pain and stress of dying becomes too great.

In addition, the law requires that the Oregon Health Authority gather and publish statistical data about the patients and physicians who participate in aid-in-dying. It’s not done in secret; instead, the public is included in the process.

One of the more interesting facts about Oregon’s Death with Dignity program is that roughly a third of the patients who seek prescriptions to hasten death opt not to use those drugs. More often, they let their illness take its full course.

Just knowing that one has the power to end one’s suffering is often enough to make that suffering bearable.

It’s important that SB 128, which was co-authored by Davis-based state Sen. Lois Wolk, ends up including some broad standards guaranteeing that appropriate pain management for those with terminal illnesses is available. It’s one thing to choose to end one’s life, but it’s not really a choice if the option of pain relief isn’t available. No one should suffer when relief is available.

It’s also worth noting that California already assists people in hastening death. We prescribe powerful narcotics to the dying to alleviate their pain, knowing full well that the drugs will suppress a patients’ ability to breathe. It is a choice to be compassionate, and it is in many cases the right choice.

But death, like life, is not “one size fits all.” No one should ever feel pressured, either by the cost of care or by family members in a rush, to hasten their own death. So this law needs to also include guarantees that insurers will not be able to deny medical care to dying patients in favor of speedier and cheaper prescription aid-in-dying.

But the bottom line is that adequate pain management for the terminally ill will reduce the number of patients who request aid-in-dying in the first place, and the experience of Oregon shows that the number of patients who actually need it is quite small.

This is not a solution for everyone. But it is a solution for some people, and we ought not deny them the ability to take control of their own destiny. SB 128 is a dignified way to show compassion for those about to leave us.