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.

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….   

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