Ballot Question 2: Dying With Dignity or Doctors of Death

Until he died a couple of decades ago, Princeton and Harvard-educated surgeon Dr. Frederick Phelps was an old school doc based in the central Massachusetts city, Fitchburg. Old school doc means he made house calls. He accepted firewood and handmade gifts as payment from patients without money or insurance, and, when people asked for it and had zero chance of recovery, he “put them to sleep.” His usual technique was to set up an I.V. packed with morphine to leave their fatal pain in peace. Dr. Phelps had so much respect for easing the undeniable and inevitable, he ‘hitched-to-the-drip’ his beloved wife of 4 decades to let her leave the cancer that had kept her bed-bound for two years and had no plan to stop its pillage.

The first time he ‘put people to sleep’ was while a medic in World War II. “In a split second you have to choose who’s likely to live and who isn’t. There are the obvious medical facts it’s fatal when spouting blood is unstoppable, organs are spilled, and skulls are smashed, but even more, the decision is from men begging, “Please, please let me die.”

Dr. Phelps’ description simplifies the essence and evolution of Ballot Question 2: Dying with Dignity. If passed, the initiative will allow people diagnosed with no more than 6 months to live to request a lethal drug. The request has to come twice verbally, and once in writing, only when physicians deem the person has enough ‘mental competency’ to make a rash decision. Two doctors must determine the illness is, in fact, terminal and also present alternatives to pain and death. If the patient passes the tests, and doesn’t back down, at home and with no doctor present, they are legally allowed to self-administer a potent barbiturate.

Among the obvious supporters Question 2 are the AIDS Action Committee, The Civil Liberties Union, and a whole lot of physicians, who believe individuals should have the right-to-die. Marcia Angell, a senior lecturer at Harvard Medical School and the former editor of the New England Journal of Medicine says, “Assisted dying is specifically limited to patients to whom healing is no longer possible because of an incurable illness. The focus of the debate should be on the patient’s needs, not a physician’s self-image.”

The term ‘assisted-suicide’, created in the decade of Dr. Jack Kevorkian, who ended up doing 8 years for the last of the 130 deaths he ‘assisted’, is being replaced with ‘assisted dying’. Because of the punitive consequences and very bad press that came to the now deceased Kevorkian—whose nickname was ‘Dr. Death’—many doctors refuse to ‘sign-off’ on someone’s request to die. Ironically, Oregon, the state where Dr. Kevorkian conducted his first ‘assisted suicide’ made it legal 15 years ago. If passed, Massachusetts will be the 4th state to have ‘assisted dying’ on the books, joining Washington and Montana; and the European countries of The Netherlands, Columbia, Spain, Luxemburg, and Switzerland.

The vocal opponents to Question 2, like the American Medical Association, Massachusetts Against Doctor Prescribed Suicide, and the Roman Catholic Diocese, claim that the process of determining a person’s mental capacity is too vague and potentially biased, and evidence shows doctors are never truly accurate on how much time someone will live and if their illness is truly terminal and incurable. In a recent article, Archbishop Sean O’Malley wrote: ‘Even proponents to PAS (physician-assisted suicide) readily acknowledge that modern medicine can manage the pain in every case. Very few Oregon residents that request PAS indicate unbearable pain as the reason.”

While Oregon is viewed as the country’s test-pilot of what is called, ‘Compassion in Dying’, the controversy persists. Only 34% of the state’s doctors are willing participants; only 1 out of every 6 who request death receive it, and of those, the drugs given in the law’s first 5 years only succeeded in death 65% of the time, leading lots of people to believe doctors don’t know what it takes to kill each individual and why certain people’s bodies refuse to give up. Successful deaths take anywhere from 5 minutes to 24 hours; and many people who can’t ingest pills have been fed their fatal dose in ice cream or drinks by a friend or family member. To avoid Kevorkian-style prosecution, they aren’t ‘helping’, they’re simply ‘feeding’.

One of the few surgeons still practicing medicine in the ‘old school’ style is Nantucket Dr. Timothy Lepore. He has ‘hitched to the drip’ numerous people in pain and illness he sees as insurmountable. He thinks imposing formal rules and regulations is a ‘slippery slope’ that runs the risk of the depressed and mentally ill being cleared to kill themselves. “It interferes with the Sub Rosa of the Hippocratic Oath,” he says. That fancy doc-talk refers to a part of the oath doctors take: ‘There is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh a surgeon’s knife or the chemist’s drug’. Assisted-dying allows doctors to make safe, patient and family-supported decisions in a manner Dr. Lepore compares to the military’s ‘don’t ask don’t tell’ rule concerning homosexuality. “Any experienced doctor knows when the pain and the illness are unstoppable, we should let the person living in that body decide.”

-Pippin Ross



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