Friday, February 12, 2010


My sister died from cancer this last December, at home. Four decades earlier we’d seen our mother die slowly and painfully from wide spread metastatic disease. Maybe that’s why she signed the papers that would allow her to legally end her life.

In November 2008 the voters of Washington State passed Initiative 1000 – the Death with Dignity Act modeled closely on a decade-old Oregon law. It allows physicians to prescribe lethal doses of medication to terminally ill patients who have been diagnosed as having less than six months to live. The law went into effect in March 2009. I voted for it.

The intent is humane; to allow a person the option to die quickly and peacefully instead of slowly and painfully.

As the law went into effect, hospitals and clinics scrambled to make institutional policies as to whether to op in or out. About a third of the hospitals are participating, meaning they're letting each individual doctor, pharmacist, and caregiver decide whether to participate. About a third of the state's hospitals have opted out. That means caregivers operating in their facilities or on their behalf are forbidden from helping a patient die, and their pharmacies may not dispense the medications. Another third seem to be somewhere in the middle. That could mean a hospital might forbid doctors and pharmacists from prescribing and dispensing lethal medications on its premises. But the hospital could let its doctors prescribe a lethal dose to an outpatient.

But here’s the rub. If you’re you meet requirements for a prescription (usually Seconal, a potent barbiturate), you must find a pharmacy that will fill it and you must show up in person to collect it. In my sister’s case, by the time she was sent home for terminal hospice care she was too sick and frail to get out of bed and move further than a bedside commode. The law that allowed her to exercise her right to end her life paradoxically denied her the option.

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