California Senate clears assisted suicide bill

[Judi Lynn]

Source: Reuters

California Senate clears assisted suicide bill
March 27, 2015

SACRAMENTO: Physician-assisted suicide would be legal for terminally ill patients in California under a bill passed on Wednesday by a committee of the state Senate.

The bill, passed by the Senate Health Committee, would Allow patients who are mentally competent and have fewer than six months to live to obtain prescriptions for medication to end their lives.

“This end-of-life decision should remain with the individual, as a matter of personal freedom and liberty without criminalise those who help to honour our wishes,” said state Senator Lois Wolk, a Democrat representing suburbs east of San Francisco and the state’s wine country and one of the bill’s authors.

The California bill is moving through the legislature at a time when the issue of assisted suicide has sparked public attention following the death of brain cancer patient Brittany Maynard last fall.






Read more: http://gulftoday.ae/portal/35307c8f-4016-4aa6-9bc6-9e67f76cbc27.aspx

[Politicalboi]

1. Look for the Slippery Slope People

That some doctors can prescribe death if you want it for no reason. Or doctors tricking you into thinking you're dying, just to kill you.

[bemildred]

2. Good, that solves that problem.

(I am getting up there and have been much preoccupied with end of life options. It seemed wise to think that through while still in sound mind and good health.)

[awoke_in_2003]

10. Too bad it is not an option...

for those diagnosed with Alzheimers. Of all the ways to die, that is the one that scares me the most. I will not put that burden on my family.

[bemildred]

14. Perhaps a bit of deceit will get the job done?

I have some experience. A family that knows what it wants can usually get it. The problems arise when the family cannot agree and the medical staff decides to cover their butts.

I have also considered the possibility of going out looking for a hungry bear in the Spring in that sort of situation. Hungry predators don't want you thrashing around and will make sure you don't get to think it over for long, and it won't leave any messy residue for the family to clean up either. But I like backpacking and I like the "no footprints" approach to life, we are all just passing through and ought to leave things neat for the next bunch.

[sadoldgirl]

3. Good, it is about time.

I hope that it passes and will be signed by Gov. Brown.

[KamaAina]

5. Gov. Brown was once a Jesuit seminarian

I wouldn't be too sure about that.

[CountAllVotes]

9. So what?

He once was a Jesuit yes. Seems his beliefs were not solid enough for him to continue on with being a Jesuit and he decided to go into politics.

>>The governor has long demonstrated an evolved understanding of and compassion for the right of the terminally ill to die with dignity and grace. In 1976, then Gov. Brown signed legislation giving the terminally ill the right to withdraw life-sustaining treatment when death is imminent.

More about this here: http://www.santacruzsentinel.com/opinion/20150214/nathan-benjamin-terminally-ill-have-right-to-die-with-dignity

I too am Catholic and I believe in a person's right to die as well as a person's right to live.

It is not fair to judge Governor Brown by his religious convictions as he does not seem to be mixing his personal thoughts/beliefs with what his job as Governor of the State of California is all about and that job is to carry out the will of the people of the State, not his own personal beliefs/convictions whatever they may or may not be.

Just because he is Catholic does not necessarily mean that he is against the right of a person to die as is the case with other Catholics that I personally know. Throwing the lot of "us" into the same judgmental boat is simply biased and unfair IMO.

[DreamGypsy]

4. Same restrictions as the Oregon Death with Dignity law

Death with Dignity Act Requirements

The Death with Dignity Act (DWDA) allows terminally ill Oregon residents to obtain and use prescriptions from their
physicians for self-administered, lethal medications. Under the Act, ending one's life in accordance with the law does not
constitute suicide. The DWDA specifically prohibits euthanasia, where a physician or other person directly administers a
medication to end another's life.

To request a prescription for lethal medications, the DWDA requires that a patient must be:

• An adult (18 years of age or older),
• A resident of Oregon,
• Capable (defined as able to make and communicate health care decisions), and
• Diagnosed with a terminal illness that will lead to death within six months.

The Oregon Death with Dignity Act requires the Oregon Health Authority to collect information about the patients and physicians who participate in the Act, and publish an annual statistical report.

It's a good law.

[KamaAina]

6. Barbara Wagner would disagree

if she were alive, that is.

http://abcnews.go.com/Health/story?id=5517492&page=1

The news from Barbara Wagner's doctor was bad, but the rejection letter from her insurance company was crushing.

The 64-year-old Oregon woman, whose lung cancer had been in remission, learned the disease had returned and would likely kill her. Her last hope was a $4,000-a-month drug that her doctor prescribed for her, but the insurance company refused to pay.

What the Oregon Health Plan did agree to cover, however, were drugs for a physician-assisted death. Those drugs would cost about $50.

"It was horrible," Wagner told ABCNews.com. "I got a letter in the mail that basically said if you want to take the pills, we will help you get that from the doctor and we will stand there and watch you die. But we won't give you the medication to live."

[DreamGypsy]

12. Sensationalizing a sad case cheats the public of sound debate...

...from The Oregonian, November 29, 2008:

In the crucial period leading up to Washington State's vote on an Oregon-style Death with Dignity law, this newspaper published a story featuring Barbara Wagner. A sensational story, an easy media "gotcha" on Oregon's Medicaid program, it completely missed the deeper questions crucial to public understanding of end-of-life care and our national healthcare debate.

Readers will recall Wagner as a 64-year-old Springfield resident with end stage lung cancer, a life-long smoker enrolled in the Oregon Health Plan (OHP). Over several years the OHP had paid for extensive cancer treatment and it continued to pay for Wagner's healthcare until her death.

When it became clear that first and second-line therapies had failed and her prognosis was grim, Ms. Wagner's oncologist recommended a costly, third-line cancer drug called Tarceva. Research indicates that 8 percent of advanced lung cancers respond to Tarceva, with a chance to extend life from an average of 4 months to 6 months. The likelihood of no response to the drug is 92 percent, yet 19 percent of patients develop toxic side effects like diarrhea and rash. Based on the low indicators of effectiveness, Oregon Health Plan denied coverage.

The irresistible ingredients of sensationalism included a distraught patient, a doctor deeply opposed to Death with Dignity and an insensitive letter of payment denial. The media was called in and the rest is history.

As a publicly funded service, Oregon Health Plan aims to do the greatest good it can. It assigns a high priority to preventive care, health maintenance, and treatments that offer a near-certain cure. Elective, cosmetic or ineffective, "futile" care is not covered. Futile care is defined as any treatment without at least a 5 percent chance of 5 year survival. "We can't cover everything for everyone," said the medical director of OHP. "Taxpayer dollars are limited for publicly funded programs. We try to come up with policies that provide the most good for the most people."

<more at the link>

Oregon's Death with Dignity Act and the Oregon Health Plan are distinct entities.

The Death with Dignity Act is a good law, it is not a great law. It does not solve all problems and it does not answer all questions.

[KamaAina]

15. Ah yes, the Oregonian

which my Portlandian friends tell me is the Left Coast equivalent of the NY Post, minus the sensationalism.

[Larry Engels]

16. There is still a danger here.

Will assisted suicide increasingly become the alternative to expensive medical treatment?

Disclaimer: I am not opposed to assisted suicide. But there are risks involved that need to be addressed.

[DreamGypsy]

17. Here are the results of 16 years of Death with Dignity in Oregon...

...from https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year17.pdf

You can judge for yourself.

The Oregon Public Health Division is required by the DWDA to collect compliance information and to issue an annual report. The key findings from 2014 are presented below. The number of people for whom DWDA prescriptions were written (DWDA prescription recipients) and the resulting deaths from the ingestion of prescribed DWDA medications (DWDA deaths) reported in this summary are based on paperwork and death certificates received by the Oregon Public Health Division as of February 2, 2015. For more detail, please view the figures and tables on our web site: http://www.healthoregon.org/dwd.

<snip>

As of February 2, 2015, prescriptions for lethal medications were written for 155 people during 2014under the provisions of the DWDA, compared to 121 during 2013 (Figure 1). At the time of this report, 105 people had died from ingesting the medications prescribed during 2014 under DWDA. This corresponds to 31.0 DWDA deaths per 10,000 total deaths.

•Since the law was passed in 1997, a total of 1,327 people have had DWDA prescriptions written and 859 patients have died from ingesting medications prescribed under the DWDA.

• Of the 155 patients for whom DWDA prescriptions were written during 2014, 94 (60.6%) ingested the medication; all 94 patients died from ingesting the medication. No patients that ingested the medication regained consciousness.

• Eleven patients with prescriptions written during the previous years (2012 and 2013) died after ingesting the medication during 2014.

• Thirty-seven of the 155 patients who received DWDA prescriptions during 2014 did not take the medications and subsequently died of other causes.

• Ingestion status is unknown for 24 patients who were prescribed DWDA medications in 2014. For all of the 24 patients, both death and ingestion status are pending (Figure 2).

• Of the 105 DWDA deaths during 2014, most (67.6%) were aged 65 years or older. The median age at death was 72 years. As in previous years, decedents were commonly white (95.2%) and well-educated (47.6% had a least a baccalaureate degree).

• While most patients had cancer, the percent of patients with cancer in 2014 (68.6%) was lower than in previous years (79.4%), and the percent with amyotrophic lateral sclerosis (ALS) was higher (16.2% in 2014, compared to 7.2% in previous years).

• While similar to previous years that most patients had cancer (68.6%), this percent was lower than the average for previous years (79.4%); in contrast, the percent of patients with ALS was higher in 2014 (16.2%) than in previous years (7.2%).

• Most (89.5%) patients died at home, and most (93.0%) were enrolled in hospice care either at the time the DWDA prescription was written or at the time of death. Excluding unknown cases, all (100.0%) had some form of health care insurance, although the number of patients who had private insurance (39.8%) was lower in 2014 than in previous years (62.9%). The number of patients who had only Medicare or Medicaid insurance was higher than in previous years (60.2% compared to 35.5%).

• As in previous years, the three most frequently mentioned end-of-life concerns were: loss of autonomy (91.4%), decreasing ability to participate in activities that made life enjoyable (86.7%), and loss of dignity (71.4%).

• Three of the 105 DWDA patients who died during 2014 were referred for formal psychiatric or psychological evaluation. Prescribing physicians were present at the time of death for 14 patients (13.9%) during 2014 compared to 15.9% in previous years.

• A procedure revision was made in 2010 to standardize reporting on the follow-up questionnaire. The new procedure accepts information about the time of death and circumstances surrounding death only when the physician or another health care provider was present at the time of death. Due to this change, data on time from ingestion to death is available for 20 of the 105 DWDA deaths during 2014. Among those 20 patients, time from ingestion until death ranged from eleven minutes to one hour.

• Eighty-three physicians wrote 155 prescriptions during 2014 (1-12 prescriptions per physician).

• During 2014, no referrals were made to the Oregon Medical Board for failure to comply with DWDA requirements.

Personally, if I had to choose between extraordinary expenditure of my family's financial and emotional resources in order gain a few extra weeks of severely compromised life or a dignified death with my loved ones around me, I have no doubt of my choice.

I have the journal (~40 handwritten pages) that my Mother kept during the last 8 months of my Fathers life suffering from dementia. The last two journal entries are these:

21st October - Spent over 4 hours by his bedside. He kept having little seizures. Couldn't swallow water or meds. Gaunt and must be down to 100 lbs. Looked terrible. I left at 2pm.

Call came at 7:10. He died at 7:05. Peace at last. Thanks be to God!!

There were no states with Death with Dignity Acts when my father died. The Oregon and California acts would not have applied to his case since, by the time a physician would have estimated his death within 6 months, his ability to make and
communicate health care decisions was gone.

[Larry Engels]

18. Thanks, but that doesn't really answer the "slippery slope" concern.

As the population ages, there will be more and more financial pressure on the government and on families to use the suicide option. That's the concern. Once again, I am not endorsing this idea, just mentioning it.

[DreamGypsy]

19. The "slippery slope" concern is yours...

...and the data provided by the Oregon, and soon, California DWD laws provides evidence.

Oregon has been running an 'experiment' on physician assisted suicide for 16 years. The fact that the most recent data reports:

As in previous years, the three most frequently mentioned end-of-life concerns were: loss of autonomy (91.4%), decreasing ability to participate in activities that made life enjoyable (86.7%), and loss of dignity (71.4%).

suggests to me that the "slippery slope" of health care cost is not a major motive. I didn't look through all the data.

All 16 years of Oregon DWD data is available on line. If you want to validate your concern/conjecture, the data awaits you.

[project_bluebook]

7. Death with dignity should be everyones right

After watching 2 parents die a slow, miserable death from cancer because right wing religious nut job laws don't allow people to choose for themselves.

[awoke_in_2003]

11. Hopefully this is a good starting point...

that will expand.

[Ruby the Liberal]

8. Excellent news

As a cancer survivor, I can honestly say that quality of life trumps quantity of life. Something I never thought about before I was diagnosed and began surgeries/treatment. With all honesty - if I am ever Dx with an illness that is terminal and my state is still in denial about human dignity, I will relocate somewhere that does treat people as well as we are allowed to treat a suffering animal.

[nirvana555]

13. I have been in contact with the group Compassionate Choices who, I believe, is the

main organization affiliated with this issue. I've already signed up to volunteer in any capacity in which they may need me. My understanding is that we need to get 350,000 signatures in support and then we'll be able to get it on the ballot for the voters in 2016. It would be wonderful if ithe legislators could get it through without us having to get signatures and then the votes. It was horrible that Brittany Maynard had to leave the only home (CA) she's ever known and move to another state to die with dignity. Her story is what motivated me to help if need be.

[smirkymonkey]

20. I hope more states follow suit.

I wish they would do away with the 6 months left to live part and just make it "terminally ill". Many people lose their independence and endure great pain and suffering well before the 6 month cutoff mark. Some people can linger on for years, long after all the joy and meaning has gone out of their life. I would want the option to end it as soon as the suffering and lack of independence started to outweigh my desire to live.