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….   

True grit + lived compassion = caregiving

Are you a caregiver? Have you ever been one?

If so, you’ll know all too well the unique combination of exhaustion and self-transcendent love involved in caring for an ill spouse, parent, or friend. In the last few days, I’ve been inspired anew by the selfless courage, lived commitment, and true caregiving grit evidenced by three extraordinarily women I know. These women, in very different caregiving circumstances, are walking the talk of lived compassion. They, and so many other unsung heroes like them, are choosing live daily for the good beyond themselves and to embody care for the vulnerable ill.

In the midst of this death-denying/disposable/assisted suicide legalizing society of ours, care such as theirs is notable and salutary. And, thank heavens, it is not rare—though one would not know it to read the newspapers.

The job description of caregiver as ‘the best, most heart-wrenching, yet achingly necessary job you’ll ever do’ seems to fit the bill—yet doesn’t even begin to describe the honor and the privilege, the frustration and the gut ache, the constant worry and the all-too-common sleep deprivation, that, among other things, typifies the experience of lived caregiving love. And that’s when the person one is caring for is beloved and appreciative. The other sort of caregiving, which involves caring for someone (perhaps a relative, perhaps a friend), who, shall we say, is appreciation-challenged and behaving abominably. That sort of caregiving is the grit-your-teeth-and-choose-to-live-love-no-matter-what kind of caregiving. And it is, if possible, even more challenging. And exhausting. And even more heroic.

No matter the sort, any kind of caregiving really must be accompanied by a healthy measure of societal, community, and familial support. And yet, all too often, it is not.

True Compassion Advocates is committed to building community-based support for caregivers and to connecting caregivers in need of help with the information, resources, and assist they need to ease at least some of the burdens of caregiving. Our caregiver resource section is a good start, but in the weeks and months ahead we’ll be adding to, updating, and improving that as well. In the meantime, www.youragingparents.com has wonderful practical caregiving tips and know-how, along with a wealth of supportive information. It really is one of my favorite sites. Check out topics for great checklists and immensely helpful articles. (Some of the articles are written specifically for Catholic audiences—but all are applicable to general audiences as well. ) And a fairly new organization in California, Loving Back, also has an on line support community in addition to extremely helpful information. Check it out.

Truly, my hat is off to my dear friend caring for her beloved spouse as he lives out his final days and weeks, my wonderful friend for providing loving care in tough circumstances to her father, and my new friend who cared so faithfully for her husband as he died and is now going the extra mile for her very ill childhood friend. To each of these, and so many more who advocate for true compassion with their lives, I say thank you. To those of us who can pitch in and help ease the burden (the burden, of course, is the situation, not the ill person), I say: ‘Let’s have at it!”

Today is a good day to start. Call that friend, family member, or neighbor right now. Offer dinner, a ride, respite, help. Walk the talk. Help a hero. Become a compassion advocate.

Needless suffering drives market for assisted suicide

Q: My mother and father both passed away in the past eight months.
Each had terminal illnesses, and each died in the hospital under
excruciating, painful circumstances despite being on hospice care.
While I was mostly pleased with the hospice program, the final days
were nothing less than barbaric. My father had to be tethered to the
bed; my mother could not breathe, causing her also to be tethered to
the bed to keep her from pulling out her IV lines. Each had a living
will stating that neither wanted life support if they were terminally
ill, but they got it anyway. After they died, their contorted faces
showed the agony each suffered. Neither had eaten for days, so they
were fed despite their living wills.

While I certainly know the difference between the two situations, when
my 14-year-old family dog got to the point he could no longer walk or
eat, I took him to the vet, who put him down in a fast, humane manner
without our pet suffering. Why are we so barbaric with terminally ill
family members while beloved pets get the easy way out?

The above question and origninal blog authors answers, can be found at:
Next Steps: Debate continues over end-of-life rights, By Jan Warner and Jan Collins
Tuesday, April 14, 2009 (http://www.post-gazette.com/pg/09104/962562-51.stm)

First, I would like to offer the questioner my sincere condolences at the tragic loss of her parents. The death of one’s parents in such a way is devestating.

In addition to sorrow at her loss and heart-felt condolences, the story of parents dying so uncomfortabley evokes in the rest of us the unspoken fears lurking within each of us—the unnamed fears dwelling in the dark center of the debate surrounding assisted suicide, the fears that radical suicide proponents exploit at every turn to pass initiatives, influence judges, and promote lethal legislation.

Far too many of us are well on our way to swallowing hook, line, and sinker, the well-marketed ‘kill me quick’ product promoted by radical suicide enthusiasts, having come to believe that the only way to prevent an ignominious death is to choke down a passel of lethal pills—to hurry quick and beat the grim reaper before he beats us.

So what creates the market for assisted suicide?
Why do people want to have the option of lethal drug overdoses?

All too often, the reason the ‘market’ for assisted suicide is successful is because of poorly provided end of life care and people who suffer needlessly.  All the rational opposing arguments in the world are utterly ineffective if people considering assisted suicide are afraid of dying in the way this woman’s parents did.  If true, the sad story above is a series of unlikely and unfortunate events, which could, perhaps should, have been handled much, much differently.

So, let’s take a look: As with most circumstances, ‘the devil is in the details.’ Read more »

Help wanted: Caregiver support

Amid talk of assisted suicide and slippery slopes, the silent and heroic work of caregiving goes on, often unnoticed, sometimes unappreciated, many times under-supported.

When was the last time you noticed–and thanked–a family member, co-worker, or neighbor who is toiling silently, caring for a loved one, trying to live in action the challenge of saying ‘yes’ to true compassion? When was the last time you offered to help? Concretely and specifically?

In the last few weeks I have been inspired by the real-life heroism of several women I know who are caring for elderly or very ill relatives. These women, and others like them, who juggle work and family, caregiving and community, form the bulwark of defense against the slippery slope. They are, by their actions, living the commitment to caregiving, saying ‘yes’ to ‘being with’ those who are at risk for assisted suicide. But they, and all those who help with the care of an ill or aging loved one, are often tired and under duress. They need our help and loving support.

Caregiving can be difficult and heart-wrenching. It can be exhausting and stressful. But it can also be rewarding and fulfilling, joy-filled and meaning-saturated, especially if the weight of the care is distributed beyond a single person or family.

The architecture of support necessary to care well is not unlike the flying buttresses of the magnificent cathedrals of Europe–they distribute the load, hold up the roof, and in the process offer a vision of lofty transcendence, a concrete image of timeless wisdom. Preventing the spread of assisted suicide necessitates that we build community support during illness and grief, that we support, in our lives and with our daily actions, those on whom the weight of illness or caregivng falls too heavily.

Supporting those who need our care–and to those who are providing that care–is just as important, perhaps more important, than simply saying ‘no’ to assisted suicide. We certainly can’t do one without the other.

Is there someone you need to call now to check in with? Someone who could use respite from the demands of caregiving or for whom you can make and deliver a meal? Someone whose strength needs to be buttressed by your own?

The ‘market’ for assisted suicide, after all, is composed of the very real fears people have of dying in pain and unattended, of being a burden to family and friends, a worry of the ‘cost’ of caregiving both financially and emotionally. These fears, these needs, these worries, must to be addressed honestly and with true compassion. And not only with words.