RIP Bud Mayer: Psychiatrist, Hero, Loving Husband.

Several years after doctors confirmed he had six months or less to live, Bud Mayer was still alive and well, pipe in hand, dispensing his trademark wisdom along with his ever-present twinkle.

I first met Bud and his lovely wife Heidi in Washington State the fall of 2008. I’d come, film crew in tow, to hear first-hand the story of this extraordinary man and his last great adventure, with the thought that perhaps he could be featured in Coalition Against Assisted Suicide ads showcasing his story and perspective.  I left that day, not with a story, but with two new friends. I’d had the fortune to meet a great man and an amazing woman–and to have been witness to a unique partnership of souls.  It was the first of many treasured conversations with Bud and Heidi over the course of the next year and a half, conversations notable for their lively content, abundant good sense, and, happily, unparalleled hilarity. 

But at that first meeting in the fall of 08, the Coalition, along with thousands of volunteers statewide, were in the throes of fighting Washington’s assisted suicide ballot initiative, Initiative 1000. Though outspent almost 5:1 by suicide proponents with 10 years prep time and loads of out of state cash to drop on advertising, the race was still neck in neck, with the polls virtually tied.

Into this fray appeared the extraordinary Dr Mayer, a psychiatrist and former Assistant US Surgeon General under C. Everett Koop. Bud’s perspective—that the assisted suicide initiative’s safeguards were a sham and that aiding and abetting vulnerable ill people in killing themselves was the opposite of good health care–was cogent, logical, and compelling.

Even more compelling was the fact that Dr. Mayer wasn’t only speaking to the issue as a psychiatrist with decades of clinical experience caring for suicidal patients and developing life-saving policies for suicide prevention and treatment. Nor was he speaking solely from the wealth of public policy experience he’d attained in a decorated career in public service, though both of these perspectives were convincing. Instead, Bud Mayer was speaking as a man–a man diagnosed with not just one, but several life-threatening terminal illnesses, a man who’d already lived well past his six month prognosis, to the tune of several extra years.

Over the next months, and even as late as a month ago, Bud waded into the assisted suicide debate courageously, armed with his trademark diplomacy and an inerrant ability to speak to the truth with kindness. He spoke to documentary crews, local and national news outlets, and newspaper reporters. Convincingly, he narrated his own story, replete with examples of the inexact science of predicting a patient’s death in six months or less. Undiagnosed and untreated depression, too, concerned him about the initiative, as did the horror of treating a suicidal person’s cry for help as a request to be killed, along with the inevitability of abuse in such a law, including the risk for non-voluntary deaths and elder abuse to be dressed up as “choice.”

The Coalition Against Assisted Suicide never did show the add footage shot of Bud—suicide proponent’s despicable trashing of Barbara Wagner (a poor woman who was denied chemotherapy by Oregon and offered assisted suicide instead), and the vicious tone of their campaign made Coalition leaders decide not put to Bud’s fragile health at risk in such a volatile public arena. Tragically, voters misinformed about the dangerous nature of legalized assisted suicide and deceived by a host of misleading ads, voted I-1000 into law in November of 2008.  

With the one year anniversary of I-1000’s implementation set for March 5th, we would do well to remember that Bud was right: the choice proffered by Washington State’s Death with Dignity Act is indeed a lie.  His prescient predictions of abuse actually have come to pass–True Compassion Advocates has recieved calls about  seniors feeling pressured to commit assisted suicide and health care providers torn at being involved in medically sanctioned killings.   

The impact of Bud Mayer’s life and legacy cannot be underestimated. Not only did he live an extraordinary life of public and private service, but in their last great adventure together, he and his beloved Heidi faced his illness and infirmity with dignity, grace, and humor. Heidi and Bud welcomed strangers into their home sanctuary with trademark hospitality and demonstrated genuine compassion to those at risk for suicide, assisted suicide, and elder abuse.

Dr. William E. (Bud) Mayer died February 10, 2010 “in the arms of his beloved wife, Heidi, who was his constant, devoted lover and companion for over forty years, and who has created a home and garden that he believed was a foretaste of Heaven itself.”

Rest in peace Bud. You have given us an authentic example of how to live compassionately, to love well, and to serve generously. It is an honor and a privlege to have known you.  Heidi, you have our heartfelt sympathy and consolation. You are in our thoughts and prayers.

Please see Bud Mayer’s obituary for details of his heroic life and service. To see a video of Bud please see the Media Video section of this site: Facing Life Head On.

The elder abuse of assisted suicide vs. authentic compassion

The pastor was worried.  Ever since Washington’s so-called Death with Dignity Act legalized assisted suicide, he’d noticed an uptick in calls from elderly parishioners wondering if they should stop routine medical treatment for heart disease or diabetes, get “qualified” as terminally ill, and avail themselves of the life-ending suicide drugs marketed as “aid-in-dying” by unprincipled relatives and smooth-talking pro-suicide groups.

Several seniors told the pastor of increased pressure from adult children to “stop taking your medications and die” so the children could have access to funds currently being spent on assisted living apartments and nursing homes.  These victims of elder abuse, faced with a barrage of media information about the costs of elder care, pressure from greedy relatives, and a growing internal sense of “being a burden,” actually considered ending their lives.

Such is the ugly unpublished underbelly of the pro-suicide/assisted suicide movement.  Despite glowing descriptions of compassion and control, the template of manipulative coercion and outright elder abuse described by this pastor and others is all too common.

So, what to do?  How can individuals, families, and communities do a better job at decreasing the lethal market for suicide and assisted suicide?  How do we establish safe harbors in medical and senior care?  What positive resources are available to support at risk populations and prevent elder abuse?

True Compassion Advocates has created a wealth of resources and information to prevent these elders and others with chronic illnesses and disabilities from being coerced into considering suicide and assisted suicide.

A summary of current TCA’s endeavors follows:   Contact us for more information about how to make a life-saving difference in your family or community.

Neighbor to Neighbor Outreach

What do family members and friends chronic health condition or illnesses have in common with elderly neighbors or co-workers with disabilities?  The answer?  Both are high risk populations who frequently have inadequate access to supportive resources and may feel they are a burden.  Simple outreach and neighborly concern can go a long way towards decreasing the market for suicide and assisted suicide and improving support for those at risk.  A kind word or action, a check-in visit, phone call, or email can make a world of difference.  Lend a helping hand, make a meal, reach out with concern. See TCA’s excellent resources on caregiver resources, including organizations which can help, serious illness support, aging with courage, and suicide prevention.

Education & Information

Ever wonder how to get the vital information you or someone you know needs with regard to medical decision making?   TCA partners with individuals and communities to bring dynamic, up-to-date educational resources presentations, and workshops. We have a broad array of news articles, informational materials, and brochures available for distribution. Our brochure, The Simple Guide for Medical Care and Decision-Making is an excellent brief overview of health care decisions, including what questions to ask and an overview of pain control, hospice care, and assisted suicide. Please contact us to order brochures or to inquire about the presentations and workshop we present in communities nationwide.

Safe Harbors

Each person, family, and community has the right to recieve health care they can trust with their lives. They have a right to know if their hospital, senior living facility, or health care provider offers excellent care to vulnerable ill people or lethal drug overdoses. Before choosing a provider, call or write and ask if they offer safe harbor from assisted suicide or elder abuse. Writing Letters/ Contacting Health Care Providers

Tell us your stories

Many family members have emailed us or called us to tell us their experiences and challenges with caring for ill loved ones, finding health care providers they can trust with their lives, and episodes of assisted suicide, along with concerns of elder abuse, or suicide promotion. Please feel free to contact us if you’d like to tell us your story or receive information or support. Just knowing you aren’t alone can make a world of difference.

Communities for Compassionate Care(CCC)

TCA works collaboratively with organizations and communities such as the newly forming Communities for Compassionate Care which offers life-affirming health care, pastoral support, and community-based services to increase support during aging, disability, illness, and caregiving.  CCC facilitates compassionate connections between people who need help and life-affirming organizations which can assist them.  More info about this exciting new endeavor will be forthcoming.

Supportive Care Gatherings

Peaceful demonstrations of compassion on behalf of those at risk for suicide, assisted suicide, and elder abuse are held at various community locations, including hospitals and senior living facilities. Please call TCA for further news about how you can, literally, walk your talk, save lives, and promote truly compassionate care.

True Compassion & Thanksgiving

It was a day like many others: more than a little busy and quite a bit harried. Between ferrying school-age children, caring for aging parents and working full time, the traffic jam felt like just another delay in a day packed-too-full-to-the-brim. Instead, within the space of a few moments, an overheard conversation reduced me to tears and taught me the true meaning of thanksgiving.

A few months ago, mired in Seattle traffic, I chanced upon a conversation between a radio host and an elderly woman. Her voice was deep, etched gravelly with the accumulation of wisdom and years. Her accent reminded me of my long-departed grandmothers—Ireland’s lilt softened by decades raising a family in America.

“So many people are unhappy these days—they rush from thing to thing (pronounced lovingly in Irish syntax as ‘ting to ting’), all the while forgetting to be thankful. ‘Tis so sad.”

“I’m 85 years old,” she said. “ Some years ago, I decided t’would be my mission to spread a spirit of thankfulness. Now, when someone at the grocery store or the coffee shop asks me ‘How are you?,’ I simply respond, “I’m grateful.”

The host, stunned, responded, “Wow. That’s an amazing response. Then what happens?

“Well,” she said, “it’s almost always the same: they wonder if I’ve won the lottery or some such thing. They blurt out, “What are you thankful for?” And I tell them, I’m thankful to be alive. I’m grateful for faith, family, and friends. I have so much to be grateful for. We all do.” Tears sprang from my eyes even before Ireland’s finest completed her lesson.

I thought of my own family, my husband and children, who I’m so grateful for, but who receive far less appreciation and thanks than they deserve. I thought of my parents and my mother-in-law, who I love so very much. I consider it an honor and a privilege to be with and to care for them through aging and illness—but do they know that?

I thought of my father-in-law Jack, who I’d nursed the previous year as he lived, then died, of pulmonary disease. I remembered how Jack, despite a tough childhood and difficult upbringing during the depression, had been one of the most thankful people I’d ever known. I reflected how, when he was sick and vulnerable, Jack had considered assisted suicide, worried his care imposed too great a burden on his loved ones. Fortunately, before it was too late, we were able to speak to him of the depth of our love and appreciation, the deep honor and privilege of being able to care for him, and our thankfulness he allowed us accompany him in his final days and months. Finally, I remembered how Jack lived AND died with authentic dignity, naturally and comfortably, his family surrounding him as the morning sun rose above his beloved Camelback Mountain on the first hours of the first day of the New Year.

Weeping quietly, I remembered the wisdom I’ve gleaned from the thousands of courageously living dying people in my 25 years as a hospice nurse—the wisdom to be thankful for each day, the strength to both give and receive love, the appreciation of today and yesterday, and the hope to leave a living legacy of love.

I listened to the final words delivered by the Irish sage, her rough speech alive with the cadence of Irish music.

“And do ye know, I feel quite certain of this as well. On the day that I die, I might be strugglin for breath or hurtin. But when they ask me how I’m doing, I’ll tell them as I always have…I’m grateful. I’m so grateful.”

I am thankful too, for my own family, for all the families and friends who care for ill loved ones , who reach out to strangers in need, and advocate for those who cannot speak for themselves.  I am grateful indeed.

Pandora’s coffin: ‘How to kill yourself’ workshop in Washington

Pandora’s coffin, once opened, has become predictably difficult to close.  One year after the legalization of assisted suicide in Washington State,  the normalization and expansion of the grim practice continues apace. 

Opponents warned of the dangerous consequences of legalizing lethal drug overdoses for vulnerable ill people.  We also warned that once one class of people has been targeted and made to feel as if they were a burden, another group would follow soon thereafter.  One year later, these warnings have become  an all-too-frightening reality.  Not only are people with life-limiting illnesses in Washington made to feel as if they should ‘put themselves out of our misery’  via assisted suicide, but now it’s open season on the elderly as well.  Phillip Nitschke is coming to town.

Washington State has now become a preferred destination for suicide-promoters and depressed seniors seeking to end their lives.  Phillip Nitschke, the international suicide-promotion pariah, is sponsoring a ‘how to commit suicide’ workshop in Bellingham Washington on November 7th, 2009. His victims?  Not only people with serious illnesses, but also, his ”core audience,” the “well elderly.”

The Australian ‘Dr Death’ has decided to target “the well elderly” with information about how to kill themselves via pills, helium and nitrogen, and other ghoulish forms of suicide, including plastic suicide bags and Mexican animal euthanasia drugs. Having been banned from selling his wares and promoting suicide in Australia and England, he is now turning his lethal gaze towards Washington State, where the recent legalization of assisted suicide gives him all the legal cover he needs to dispense ‘go kill yourself and here’s how’ advice to suicidal seniors and others. Even the public library in Vancouver BC refused to allow him to speak there, fearing that it would be “an indictable offense to counsel or aid or abet any person to commit suicide.”

Nitschke himself makes clear that the reason Washington state is such an ‘attractive’ location for his unsavory suicide-promoting practice, is it’s ‘liberal’ new assisted suicide law.  No doubt he thinks, with good reason, that the glaringly absent safeguards missing from the so-called Death with Dignity Act will protect him (though not his victims)  from prosecution. 

Sadly, unless the state Attorney General’s office or Department of Health do a better job to protect our elders from the abuse of suicide and assisted suicide, the situation does not look good.  Unless a vigorous public and governmental response occurs, Nitschke may well follow through on his plans to set up a permanent ’suicide office’ in Bellingham: that way he can be close to the Canadian border and expand his intended suicidal killing fields there too. 

Fortunately, advocates for truly compassionate care plan to demonstrate their compassion in action by attending a “Protect the Elderly from Suicide/Assisted Suicide Demonstration” on November 7th, from 12 noon to 1:30pm in front of the Sustainable Living Center on 2309 Meridian Street, in Bellingham Washington.  Additionally, many concerned citizens are exhorting the state Department of Health and the Attorney General’s office to do their job and protect seniors and ill people from suicide-promoting exploitation and the thinly veiled elder abuse.  Unless they do, the rot in Pandora’s coffin will continue to spread, victimizing vulnerable people and cheapening life.

Please see the Demonstrate your opposition to assisted suicide section of this web site for further information. 

Assisted Suicide for uncontrolled pain and overwelmed caregivers?

As a hospice RN of 25 years, I’ve helped thousands of people to live with real dignity and die naturally and comfortably.  Not once in all that time have I ever experienced a situation where a patient ‘needed’ medicalized suicide to control pain or managed symptoms. 

1)      But I have seen, and still see frequently, situations where a person is depressed or a family overwhelmed, where gaps in social services or caregiver support have increased the burden of illness and caregiving to the point where the patient and/or the family, are at the breaking point, desperately wondering where they can get the help they need to care for a loved one who is ill or disabled. 

2)      And I have seen, and still see, situations in which well-meaning but insufficiently skilled medical providers ‘don’t know what they don’t know’ about palliative care, resulting in some people living—or dying—with discomfort that is as unnecessary as it is immoral.

3)      Lastly, of late, the creeping (and creepy) rot of utilitarianism has spread, undermining basic human rights of people who are ill and aging, and destroying the rubrics of societal and medical compassion.   

Fortunately, I have also seen great organizations and heroic individuals who have risen to the task of truly advocating for those at risk for assisted suicide and developed programs and assistance needed to forge a truly compassionate response to the problems that create the market for assisted suicide. 

A bit more on each of the above:     

1)      Gaps in Social Services and Caregiver support  In Washington State, since the legalization of assisted suicide, state support for aged, ill,  and disabled people and their caregivers has been decimated by budget cuts and program mismanagement.   The consequences have been lethal, as witness the first six months of suicide and assisted suicide numbers, along with increased phone calls to social services agencies pleading for a return to basic services for those at risk for assisted suicide. 

Organizations who offer life-affirming help:

Fortunately, all is not lost. There are still many valiant organizations providing excellent services  during difficult times.   Please see TCA’s newly updated Caregiver Resource section for details.  Of particular note this month, we are featuring the great resources of the following web sites or organizations:   www.GloriasAngles.org,  www.YourAgingParent.com, www.lovingback.org, www.consolingcommunities.org, and www.consolinggrace.org. 

2)      Pain and Suffering: 

Over the course of the last quarter of a century, the ability of hospice and palliative care to control end of life pain and suffering has improved exponentially, while our capacity to support family members and connect those in need to an infrastructure of truly compassionate support has steadily increased, at least until recently.  (Cuts in social services of late have slashed caregiver support funding, causing family members to scramble to get loved ones access to the care and support they need.)

In this day and age though, there is , literally, no reason for anyone to die in uncontrolled pain or to suffer without relief.  http://www.truecompassionadvocates.org/paincontrolinfo.html   Note that uncontrolled pain and mismanaged symptoms are more common than they should be, mostly as a result of medical ignorance, but sometimes as a result of program cuts impacting providers ability to provide the kind of quality care that is possible, but not adequately reimbursed. 

Unfortunately, most people who are initially diagnosed with a life-limiting illness don’t know that no one needs to die in uncontrolled pain. Please see TCA section on the tragedy of needless pain, found under Resources/Serious Illness Support.  http://www.truecompassionadvocates.org/paincontrol.html 

Nor do their family members and friends.  And the voting public most certainly has no idea that advances in end of life care have rendered severe uncontrolled pain and horribly unmanaged symptoms a relic of the past or a sign of mismanaged health care.  Instead, fears of uncontrolled pain and undignified deaths have been fanned, perhaps unwittingly, by radical suicide proponents, resulting  in the bizarre notion that killing vulnerable ill people is somehow a sign of mercy or an indicator of social progress.

Nationally, little noticed amid the health care debate has been the proposed slashing of reimbursement for hospice care, with proposals for rate cuts of up to 14.3%.   These rate reductions are so draconian that, if passed, many of the hospices serving some 1.4 million patients with life-limiting illnesses would go out of business.  Without adequate state or federal support for aging, ill, and disabled people and their families, the ‘choice’ of assisted suicide becomes little more than an ugly mandate, driven by unmet needs, unaddressed suffering  and grossly insufficient funding.

Hospice care is available in most locations nationally and locally.

Note of concern: Quality of care can be variable, depending on the hospice, philosophy of care, whether it is a ‘for profit’ or ‘not for profit’ and other factors.  In locations where assisted suicide is legal, such Oregon and Washington State and in a few other countries such as the Netherlands internationally, great caution should be exercised in choosing health care, hospice, and senior service providers. 

 Organizations who offer life-affirming help:

Please see TCA’s information under Resources/Serious Illness Support/ Resources to help with challenges.  http://www.truecompassionadvocates.org/endoflife.html  

Faith-based health care organizations which eschew participation in assisted suicide and advocate care excellence are obviously safer bets for a vulnerable ill and aging population than those who prescribe lethal drug overdoses .  The Christian Medical and Dental Association is an excellent resource,  http://www.cmda.org  as is physicians for compassionate care.  www.pccef.org

In Western States of the US, such as Oregon and Washington, the following health care providers have opted out of assisted suicide and opted in to excellence in senior services, health and hospice care:  www.peacehealth.org ,  www.providence.org,  and www.fhshealth.org 

These are just a few of many helpful organizations who offer life-affirming choices.  Feel free to let us know your favorites:  we’ll pass them on.  

3)      Creeping Utilitarianism:  Please see the article in our news section from the Hastings Center Report re the mother who journals how her disabled daughter was not afforded either life-saving or comfort enhancing medical care.   Many people remain concerned they will be over-treated in medicine when in fact, the risk in this age of cost-conscious medicine is quite the opposite. 

The notion that we are human doings vs human beings, has become prevalent, leading many in medicine and in society, as well as in the health care debate, to conclude that some lives or more—or less—worthy of being lived than others and that, inexplicably, those who are aged or disabled, should ‘qualify’ for less or the health care resources, than, say, a younger or more ‘functional’ person.

More on the dangers inherent in this twisted philosophy in later blogs….   

Assisted Suicide in Washington: Tragic, unsafe, and unnecessary

Compassion & Choices, formerly The Hemlock Society, says that the assisted suicide numbers for the first 6 months in Washington State show that physician-assisted suicide is “safe, legal, and rare.” One wonders:

Safe? For whom? 100% of the patients receiving the state-sanctioned lethal drug overdoses die prematurely and unnaturally. And, it turns, out, some of them die uncomfortably as well. According to the Oregon’s Department of Health Services, some patients regurgitate the lethal prescription and take up to 3 and a half days to die. In the latest year for which data are available, seven percent of those dying from lethal prescription in Oregon experienced “complications” relating to regurgitation. Furthermore, a British Medical Journal study published last June documents that the majority of Oregonians requesting assisted suicide met criteria for clinical depression. Giving suicidal depressed people lethal drug overdoses surely can’t be accounted as safe.

Also, in Washington and elsewhere, giving lethal barbiturate doses to death row prisoners is called ‘cruel and unusual punishment’ by some, and even Washington State’s chief prison physician resigned rather than participate in the gruesome process. And lethal barbiturate overdosing is what we’re advocating as ‘safe’ for our vulnerable ill friends and relatives? Besides, since most assisted suicides in both Washington and Oregon are presided over by the Compassion & Choices, how would one know if the reported deaths were, in fact, safe? Self-reporting by the self-same radical suicide advocacy organization which wrote the law and has vowed to replicate and export it to other locales?

Rare? We can’t actually be sure. The Washington Death With Dignity Act (DWDA) requires physicians to lie on the death certificate—that is, to pretend and to certify that the patient died from the underlying disease rather than from a lethal prescription. Then they’re supposed to separately send in a form to the Department of Health which documents the lethal procedure. But how will DOH know if the physician doesn’t send in the form? Not from the death certificate—it actually masks the fact that the lethal procedure was administered to the patient. Not from the patient’s family—they’re not required to be notified, and they may not even know how their relative died. Not from the doctor who chooses not to send in the form. (Oregon statistics show that most of the physicians writing lethal drug prescriptions are a small group of pro-suicide doctors affiliated with Compassion & Choices.)

But look at the news reports themselves. The Department of Health (DOH) says 16 people have died from lethal prescriptions so far this year. Compassion & Choices says 11. That’s something like a 30% discrepancy, and we’re only half way through the first year of the law. In addition, it’s been only 6 months since the law took effect. It’s too soon to say whether physician-assisted suicide is rare in Washington. In Oregon, the per-year rate of physician-assisted suicide actually tripled over the first ten years and is continuing to trend upward. And in Oregon, the suicide rate for seniors is anything but rare. In fact, since the legalization of assisted suicide, the senior suicide rate has increased steadily, until now, Oregon has one of the highest rates of senior suicides in the country.

More importantly, back when it was still called The Hemlock Society, Compassion & Choices did not consider the rarity of physician-assisted suicide a good thing. Its founder, Derek Humphrey, is famous for saying that legalized assisted suicide will ultimately prevail everywhere because it makes economic sense—and he’s not talking about limiting it to terminally ill people. And, indeed, under the logic of the Compassion & Choices position, and in the context of health care rationing, why should physician-assisted suicide be rare? Under that logic, why would it be good for it to be rare? Shouldn’t a good thing that can save expensive private insurance and Medicare dollars be more widespread? Wasn’t Derek Humphrey right after all, about it making economic sense once you accept the assumptions underlying physician-assisted suicide?

Legal? Well, at least Compassion & Choices got that part right. Unfortunately.

VA’s recommended death book tells vets: “hurry up and die.”

The health care debate has certainly heated up of late, with talk of rationed care for the elderly, death panels, and now,  a ‘death book’ for veterans, written by an advocate of both assisted suicide and health care rationing. 

Amid the health care reform controversy, most Americans agree that elements within our health care system are broken and in need of improvement.  But the discussion of health care reform and end of life wishes should be separated from the kind of bare-bones manipulation and seedy coercion practiced by radical suicide promotion groups.  The advancing of assisted suicide as ‘just another end of life choice’ should not, under any circumstances, be slipped into health care reform unnoticed and unremarked upon, hiding amid nice sounding words or innocuous seeming advance directives. The debate should be vociferous and open, detailed and honest. The last few weeks have been quite a start. 

The most recent installment of health care/end of life controversy was stirred up by a Wall Street Journal article and Fox News, The Washington Post, and CNN reports about comments made by Mr. Jim Towey, former director of the White House Office of Faith-Based Initiatives and founder of Aging with Dignity.  http://fns.blogs.foxnews.com/2009/08/23/the-death-book/  Towey, who worked with Mother Teresa of Calcutta for 10 years, spilled the beans on The Department of Veteran Affairs, which recently instructed participating hospitals, nursing homes, and physicians to use a 53 page manual “Your Life, Your Choices” as the preferred and recommended advance directive for 24 million veterans, even those who are not ill or disabled. 

According to Mr. Towey, the booklet, which sends a “hurry up and die” message to ill veterans, is “fundamentally flawed” and may facilitate government bureaucrats in ”greasing the slippery slope that can start with cost containment but quickly become a systematic denial of care.” Tellingly, the lead author of  the workbook ‘Your Life, Your Choices’ is Dr. Robert Pearlman, who has advocated for physician-assisted suicide before the U.S. Supreme Court and is known for his support of health-care rationing.    

Mr Towey’s article, published in the Wall Street Journal on August 19th and entitled “The Death Book for Veterans,” reports that “Your Life, Your Choices” presents end-of-life choices “in a way aimed at steering users toward predetermined conclusions, much like a political “push poll.”  For example, various scenarios are listed and users asked to decide whether their own life would be “not worth living.”  (http://online.wsj.com/article/SB10001424052970204683204574358590107981718.html) 

 “The circumstances listed include ones common among the elderly and disabled: living in a nursing home, being in a wheelchair and not being able to “shake the blues.” There is a section which provocatively asks, “Have you ever heard anyone say, ‘If I’m a vegetable, pull the plug’?” There also are guilt-inducing scenarios such as “I can no longer contribute to my family’s well being,” “I am a severe financial burden on my family” and that the vet’s situation “causes severe emotional burden for my family.”” 

Towey asks, “When the government can steer vulnerable individuals to conclude for themselves that life is not worth living, who needs a death panel?” and goes one to wonder: “One can only imagine a soldier surviving the war in Iraq and returning without all of his limbs only to encounter a veteran’s health-care system that seems intent on his surrender.” Indeed, per Towey, when the VA sought to update “Your Life, Your Choices” between 2007-2008, it not only did not include any faith-based groups or disability rights advocates, but in fact listed only one organization as a resource on advance directives: the Hemlock Society (now euphemistically known as “Compassion and Choices“). 

Why does all this matter?

 Because, the twisted agenda of suicide advocates is seen more clearly through the lens of the seductive marketing of manipulative advance directives such as ”Your Life, Your Choices” (which could be aptly re-named, ‘Your Life, My Choices”), through intentional age-based health care discrimination, and through systematized dehumanization of people with disabilities and serious or terminal illnesses.  The core of this debate has very little to do with health care reform as such–and much more to do with preventing a small number of radical suicide promoters from hijacking actual health care reform and replacing it with incentivized victimization of vulnerable ill people. 

Good-hearted, intelligent, and well-intended people across the country may disagree about the need for and extent of proposed reforms to our health care system–but most of us want to ensure competent, compassionate, and supportive care for ourselves, our elders, people with disabilities, and the poor.  And we know, instinctively, that manipulative tools such as “Your Life, Your Choices” only cheapen the debate and victimize the vulnerable.    

True compassion advocates everywhere would do well to join the fray, speaking out against deceptive advance directives such as “Your Life, Your Choices” and the assisted-suicide-light as it appears in some versions of health care reform.  We, each of us, must more aggressively advocate for improved education, health care, and support for veterans, seniors, the disabled, and the seriously ill.  And we must not allow the public forum to be dominated by those who would victimize vulnerable people to advance their own chilling death-promoting agendas. 

What else can we do?

Write letters to the editor, post on related blogs and web sites, share this info with those on your email contact lists, reach out to neighbors and friends in need.  Let your local physicians, hospitals, and nursing homes know how you feel.  Support organizations such as True Compassion Advocates monetarily and with your volunteer hours.  In sum, demonstrate your compassion in action. 

For more information about how to protect you and those you love and how to make moral medical decisions, please refer to True Compassion Advocates newly composed brochure and articles on medical decision-making, which can be found in the Resources section, of our web site, under Health Care Choices.  

For more information on Mr. Towey’s organization, Aging with Dignity and the Five Wishes (the advance directive he recommends, which honors the inherent dignity of all life), please refer to www.agingwithdignity.org . The full text “Your Life, Your Choices” booklet can be found at  http://www.agingwithdignity.org/forms/YLYC_First_edition.pdf

Twisted Compassion: Assisted suicide as health care reform

Death panels, euthanasia, and assisted suicide discussions have electrified the health care reform debate. Blogosphere and the press have been atwitter (a Twitter?) for weeks at the “end-of-life counseling” provisions in health care reform. And now it appears the controversial section has been erased from at least one version of the bill (though it may well continue in other versions or be added before a vote), the vigorous debate continues.

But with all the polemics, misrepresented facts, and downright fiction being written, it’s difficult to find out the truth of the matter. What are the real risks of the end-of-life counseling provisions?

What of end of life counseling? Is it ever OK or always ethically troublesome? What about the death panels and the ‘kill your grandma’ rules? Are they lurking beneath health care reform? Or not? Will assisted suicide counseling be reimbursed? Encouraged? Mandated?

Is end of life counseling ever ethically acceptable?

Discussing end-of-life issues is not only a part of good medical care but an essential conversation for spouses, families, anyone who is ill, and most of us who are not. This end-of-life counseling, which already occurs in doctors offices and hospitals across the country, is already reimbursed in the context of providing quality patient care.  What is not now reimbursed, and should never be reimbursed, is pro-suicide counseling dressed up as a new and improved end-of-life care option.

Counseling of any sort is neither good nor bad in and of itself—it’s the content and context of the counseling that can be either helpful or problematic.  Clearly any sort of “end-of-life counseling” which pushes patients into rationed care and offers or incentivizes assisted suicide and euthanasia is very bad indeed.

At the same time, it is smart to be prepared in advance so that your own wishes for life-affirming health care can be protected and respected. That’s why True Compassion Advocates has prepared our Simple Guide for Medical Care and Decision-making brochure and will soon be posting several new features answering your questions about advance care planning, including living wills, durable power of attorneys, POST forms, DNR, nutrition and hydration, and moral guidelines for making ethical end of life decisions.

But please take note: executing advance directives can be a tricky business. Sometimes, even the best of intentions become muddled when an advance directive like a Living Will intersects with a specific medical situation for which it was not intended to apply. One of the biggest problems with Living Wills is that not a one of us has a crystal ball—and therefore it is nearly impossible to anticipate what one’s health status might be and what one might want in such a hypothetical circumstance.

Bottom line? Many people choose to skip the Living Will and get a health care proxy they can trust instead. Your chosen health care representative (aka your Durable Power of Attorney for Health Care ), and physician can then apply your wishes to particular medical circumstances—and advocate for you when you are unable to advocate for yourself.

What about the ‘death panels’ and the ‘kill your grandma’ rules?

The danger of health care rationing lurking in some versions of health care reform is clear and present—though the existence of formal ‘death panels for grandma-killing’ may be somewhat exaggerated, at least for the moment. Nevertheless, rationing by ‘comparative effectiveness’ is not only possible, but likely.

Since a large portion (27.5%) of Medicare funding is spent in the last six months of life, incentive to save money by preventing such expenditures exists now and will only grow with time. In England, where they use a formula called Quality Adjusted Life Years (QALY’s), to rationed care, health care expenditures for the elderly and terminally ill are severely limited. The QALY concept encodes a dangerous and elemental discrimination whereby some lives are deemed more worthy of medical expenditures than others.  The Wall Street Journal has an excellent article entitled Why the Elderly are right to worry when the government rations medical care, explaining how ‘once health care is nationalized, or mostly nationalized, rationing care is inevitable, and those who have lived the longest will find their care the most restricted.’

Even The Daily Beast, which thrives at a journalistic continuum far to the left of the Wall Street Journal, featured an eye-opening article entitled Obama’s Euthanasia Mistake by Lee Siegel on ‘why the plans Obama is endorsing are dangerously sympathetic to “cost-effective” end-of-life treatments.’ According to the Beast, “one of the key ideas under consideration—which can be read as expressing sympathy for limitations on end-of-life care—is morally revolting. And it’s helping to kill the plan itself.”

Perhaps the most disturbing news of all is reported by Siegel further into his article. It turns out that President Obama’s nominee for regulatory czar, Cass Sustein, has been mentored by Judge Richard Posner of the University of Chicago, “an enthusiastic advocate of euthanasia and an energetic eugenicist. He once wrote of Oliver Wendell Holmes’ ideas about eugenics—Holmes believed that a just society “prevents continuance of the unfit”—that “we may yet find [Holmes’] enthusiasms prescient rather than depraved.”

Perhaps, with a regulatory czar’s like Sustein, Grandma may be in a heap of danger after all. And not only Grandma…

Will assisted suicide counseling be reimbursed, encouraged, or mandated in health care reform?

We surely hope not. But versions in the House and Senate, as currently written, might indeed encourage and reimburse for pro-assisted suicide counseling. Despite all the media hype and patently false information to the contrary, assisted suicide as a component of the current health care reform plan remains a very real danger.

Compassion and Choices, the nation’s foremost radical pro-assisted suicide organization, is aggressively promoting the widely-discussed “end-of-life counseling” provisions found in section 1233 of H.R. 3200 and paraphrased in other, still active, House and Senate versions. Compassion and Choices even claims responsibility for getting these provisions included in the bill–while at the same time denying assisted suicide will be a component of end of life counseling.  C and C’s spokesperson, Steve Hopcraft, had the gall to say “It’s a myth that C and C or any organization would be the counselor. The bill specifically says MD or nurse practitioner.”  Fascinating word usage in that denial–the organization won’t be the counselor.  My, but that’s comforting.  One wonders about the pro-suicide MD’s and nurses who work with or for the organization counseling vulnerable ill people toward a premature death by lethal drug overdose.        

In Washington and Oregon, where assisted suicide is legal and considered by the state to be just another end-of-life care option, the Department’s of Health already refer vulnerable ill people to the pro-assisted suicide group Compassion and Choices to provide end of life ‘counseling’ in favor of assisted suicide.  And in Oregon, health care rationing similar to that which is contained in the federal governments’ health care reform bill, led the state health plan to refuse Medicaid patient Barbara Wagner’s chemo while offering to pay for her (significantly cheaper) assisted suicide pills instead. During Washington’s assisted suicide battle last fall, ads featuring the courageous Mrs. Wagner were pilloried by suicide proponents, including one despicable video showing the ad of Mrs. Wagner, who was very recently deceased, being flushed down a toilet. Mrs. Wagner, and others like her, have received little real compassion and even fewer choices.  Their experiences don’t bode well for all those ill, elderly, and disabled people whose Quality Adjusted Life Years aren’t up to snuff.   

Pro-suicide organizations, which far haven’t been able to bill for suicide counseling services, have a heap of incentive to sneak reimbursement of the dirty deed into national health care reform. It surely isn’t but a hop, skip, and a jump from there to taxpayer-paid end-of-life counseling, including assisted suicide as one of the available options. Pro-suicide organizations could then bring an equal protection lawsuit against the federal government claiming that patients in states where assisted suicide is not legal are being deprived of information about a “benefit” provided to patients in states where it is legal.

There we have it: our worst nightmare—elder and disability abuse rolled together with health care rationing, discrimination during serious illness, assisted suicide, and eugenics—all packaged neatly as federally reimbursable “end-of-life counseling.”  

Assisted suicide media love fest continues even as body count increases

Five assisted suicides in Washington State thus far. And counting.

Tragically, we can expect the body count to continue. That’s because pro-suicide advocates have ramped up their PR campaign to normalize assisted suicide as just another ‘end of life care choice’ and sell the lethal practice to an ever growing number of vulnerable ill people and families through subterfuge, clever media marketing, and raw exploitation of end of life fears. Gone is the limited number of carefully selected ‘white wealthy men with above average control needs ’ policy we saw in Oregon. Now, it’s a full-press ‘everybody and their mother needs assisted suicide;’ and ‘it’s the best thing since sliced bread’ kind of engagement, complete with tailored human interest news stories and misinformation about pain control, natural death, and real end of life dignity.

In the last few weeks alone, local, national, and international media have picked up (or been offered) several stories sympathetically featuring victims and family members and sugar-coating the ugly reality of assisted suicide.

Just last week I was interviewed by KOMO TV in Seattle, who was doing a feature on Linda Fleming’s family’s response to her assisted suicide. (Linda Fleming, a disabled and low-income woman with pancreatic cancer, was Washington’s first assisted suicide victim. See previous blog entry.) The segment, which aired on local TV news, featured many tragic minutes of Linda Fleming’s daughter speaking about what a good thing her mother’s assisted suicide was, still more time interviewing the doctors who assisted in her suicide and also thought it was a good thing, a statement from Rob Miller from Compassion and Choices speaking still more positive words on Linda’s unnatural death by unnatural means, and several old photos of Linda and her daughter, accompanied by a moving musical soundtrack, totaling, for the TV segment, perhaps 10 minutes (for the internet version of say six minutes).

And, then, as a stark reminder of continuing media imbalance on the issue, about 30 seconds were extracted from a 45 minute interview of me discussing the adverse effects of the media attention glorifying Flemings death by assisted suicide and how the wrong message is being sent to vulnerable ill people and their families, causing many to believe they ‘should’ commit assisted suicide. Hmm. Let’s see. Four people in favor, plus a moving photo tribute, and some really nice music. Opposed? One voice. Less than a minute. And a few truncated quotes.

In another media story, KING TV in Seattle is following a man by the name of Tory Plaisance, who wants to sign up and receive a lethal overdose under Washington’s so-called Death with Dignity Act. Just one unexpected problem turned up in the glowing feature: Tory Plaisance isn’t actually terminally ill after all (at least right now). Turns out that perhaps Tory used to qualify for the Act but doesn’t any longer. Apparently a recent CT scan shows his tumor decreased and his condition improving. Tory’s situation showcases one of the law’s major problems: the unreliability of terminal diagnoses for determining who qualifies to receive a lethal prescription. According to KING 5, “his plans” (for a death by assisted suicide) “have been complicated by a recent positive diagnosis.” Tory’s response to this news: “That’s just how I’m kind of torn right now, like ‘Yay I could live’ and ‘Damn I could live.”

Let’s review this: even with all the nifty-stricty safeguards in the Act, Tory could’ve already received and taken a lethal drug overdose, in which case he’d be way dead—without even being terminally ill. And yet he’s alive, working five days a week, watching his softball team, taking care of his cat, and living life, albeit with serious illness and some limitations.

Tory’s tragic story—one in which the good news of not being terminally ill is described as a complication impeding his wish to receive assisted suicide—should alert us the horrific abuses involved marketing assisted suicide as the only ‘peaceful’ death alternative to people who are ill, vulnerable, and alone. People who are ill experience depression and discouragement at times. As do the rest of us. Life, after all, is not easy or without struggles. Ambivalence, fear, and loneliness are also a part of life—including the lives of people who are ill and their caregivers—which is exactly why people who are ill and their loved ones are so vulnerable to the exploitation and subtle coercion of this lethal new law and to the media marketing campaign surrounding it’s use.

Glorifying death by intentional barbiturate overdose while setting up natural death as the ‘straw man’ of horror and agony is as manipulative as it is just plain wrong. And Washingtonians—and people everywhere deserve ‘the rest of the story.’ But we aren’t getting it—not in the least.

What else aren’t we seeing in the media?

Well, there sure aren’t a plethora of features on ill people and their families who are choosing natural death, news crews ‘following’ those who choose not to participate in assisted suicide or those who give or receive excellent end of life care and community and hospice support. Nor are they interviewing poor and disabled people who feel they have ever fewer care options aside from assisted suicide, especially with Washington State’s draconian cuts to basic health care and caregiving assistance. They are not interviewing those unfortunate ill persons who feel they might be a burden to their families and thus should ‘get out of the way’ via a sacrificial suicide or those who may be coerced by people who’d rather they die than live. In short, the real story of assisted suicide in Washington State and elsewhere has yet to be told.

And people continue to die as a result.

The legalization of assisted suicide is both a tragedy and a travesty, not only for Linda Fleming and Tory Plaisance, but for all those in Washington State and elsewhere who are, or who will be, victimized by the marketing of assisted suicide as compassion and choice, rather than what it really is, exploitation and coercion. I feel abiding sorrow that Linda Fleming was a victim of this merciless and lethal  law.  And I offer my condolences and sincere regret for all those in Washington, Oregon, and elsewhere who have thus far died unnaturally, prematurely, and unnecessarily by assisted suicide violence masquerading as choice.

Don’t ask/Don’t tell who’s committing assisted suicide

From Bellingham, Washington:  Don’t ask/Don’t tell which doctors are committing assisted suicide.

Hmm.  Let’s see if we have this straight… 

 Whatcom County Medical Society President David Lynch said at a recent panel held at the Bellingham Club,  “It’s a question of don’t ask, don’t tell,”apparently a reference to physicians assisting suicides under Washington State’s new so-called Death with Dignity Act.  According to Lynch, the Whatcom County Medical Society has asked opposing physicians– those who will continue to provide excellence in end of life care but will not help their patients kill themselves — to identify themselves on a list. “Many have done that,” he said.  But at the same time, the Medical Society is intentionally not keeping a list of those willing to prescribe lethal barbiturate overdoses.   

One wonders: in this brave new world of legalized assisted suicide, are some doctors more equal than others?   Strange as it may seem, the Whatcom County Medical Association asks physicians who advocate caring for their patients, rather than killing them, to be listed publically. Yet those MD’s who are actually committing assisted suicide will continue to overdose patients under a veil of medical and state- sanctioned secrecy. 

And how about patients?  Do some deserve clear information and above-board reporting with regard to physician care practices, while others are kept in the dark, unaware and uninformed that a trusted family physician is prescribing lethal medications to loved ones rather than compassionate and competent end of life care?   

Besides, why the shroud of secrecy? If providing lethal barbiturate overdoses is such a groovy new (albeit lethal) medical service, what’s there to be ashamed of?  If, as Compassion and Choices spokesperson Arlene Hinkley said, the new law is “a fact of life and we have to live with it,” then why can’t patients and family members in Whatcom County and elsewhere know which physicians, facilities, and providers do and don’t participate in assisted suicide, which ones are compatible or incompatible with their own philosophies of care?  (I can’t help but issue a distorted language alert at the preceeding vernacular:  The new law isn’t ‘a fact of life’, but rather a direct cause of death.  And the whole problem is that we can’t live with it–it’s killing us.)  

After all, most of Whatcom County knows that Peace Health and St Josephs Hospital are improving and enhancing end of life care, building a new hospice center, and opting out of involvement with assisted suicide. In other words, according to Nancy Stiger, former cancer nurse and St Josephs CEO, the hospital is “living our mission, which is relieving pain and suffering.” Amen to that. 

Certainly it’s well and good—even essential—for patients and families to know which doctors, hospitals, and facilities they can trust with their lives.  True Compassion Advocates, and all those who oppose assisted suicide and advocate for improved end of life care, strongly favor making such information available and accessible everywhere.  But it’s also important for people to be able to freely choose not to go to a provider who commits assisted suicide on vulnerable ill people. 

I mean, it’s all about choice, isn’t it?  At least that’s how the slick I-1000 bill of goods sold last November was marketed.  Suicide proponents trumpeted enhanced choices and marketed assisted suicide as a valid health care choice,  all the while whipping up voters into a end of life fear frenzy.  (Twisted language alert:  this ‘health care choice’ is more than a little weird–it’s designed soley to ensure a prematurely and unnaturally dead patient. And there still aren’t any safeguards ensuring that it’s actually the patient and not someone else making the lethal choice.)  Now it looks like suicide promoters don’t even want people be able to choose an assisted suicide free physician to provide their medical care.  

‘Choice, choice, and more choice’ seems to have morphed into: not my choice, not your choice, not our choice.  Turns out the so-called ‘choice’ of assisted suicide is nothing but a rent-a-wreck careening down a dark and slippery slope, detouring into a Dead End.