Saturday, May 26, 2012

Death with Dignity

        This is my review of a Documentary called How to Die in Oregon and also the law in Oregon that goes along with the Documentary.

        Dignity, we all want it but must of us are denied just that, dignity. Imagine being told that you only have a few months to live and you will never be the same person you believe you are right now. You will lose your ability to care for your everyday needs. Your daily needs will be placed in the hands of your loving family, or even strangers; but what if you could prevent that, being a burden that most don’t want to be. As of today there only three states in the United State of America, the land of the free and the home of the brave, that allow you to choose Death with Dignity.
            Death with Dignity is also known as physician assisted suicide. This is where a physician aids in a death of a human being. This is not for just anyone; it’s for a person who has a short time left to live. They are also sick and are going to die a long and painful death. They also may choose this because they do want their last memory of them for the love ones to be them vomiting constantly, living in a diaper, unable to eat on their own, or just simply being very ill and unable to act as they did before they became sick. Death with Dignity can be done at home or in a hospital; it is up to the person and the doctor. No one case or choice is the same or preformed in the same way.
            Death with Dignity did not originate here in the United States. The first country was the Netherlands legalized Death with Dignity in 2002. Before it was legalized it was done by a physician prescribing lethal overdose of barbiturates that would be taken by the person themselves (Schoen). Once it was legalized they change their method to lethal injection. Today there are eight countries other than the United State that allow Death with Dignity, but each country has different requirements and ways to do it. Not one follows the same procedure or requirements. For example in Japan there are four requirements and all must be met. They are “the patient is suffering in unbearable physical pain, death is inevitable and imminent, all possible measures have been taken to eliminate the pain with no other treatment left available and the patient has clearly expressed his or her will to approve the shortening of his or her life” (Robinson).
            Reasons that people would choose the Death with Dignity are that they know they will die a long and painful death. They will be unable to care for themselves and become a burden on the family and friends. Some condition that Death with Dignity has been used on in the past are: cancer of the breast, colon, pancreas, lungs, prostate and ovaries, Amyotrophic lateral sclerosis, chronic lower respiratory disease, heart disease and even HIV or AIDs (The Oregon Health Authority, 1). Most of the people who have one of these conditions have been fighting for a very long time and have been given the diagnoses that they only have short time left to live and there nothing left to try or do. The doctor’s main goal from there is to just keep them comfortable for the time they have left (Campbell).
            Oregon was the first state in the United States to adopt the Death with Dignity act, though other states have adopted something very similar. The act was adopted by the voters on November the eighth in 1994. “It was then delay with a legal injunction, but after proceedings that included a petition denied by the United States Supreme Court, the Ninth Circuit Court of Appeals lifted the injunction on October twenty-seventh 1997” (The Oregon Health Authority, 3). To this day there is still a lot of controversy on this act. As of today, the act is still in place. This law does not allow euthanasia, nor does any other state in the United State. What make this act different is that euthanasia is done by the doctors and Death with Dignity act is done only by the person who is able to physically give themselves the lethal dose of medication.
            In order to legal processed the Death with Dignity act the person must be a resident of the state of Oregon. There is no one thing that determents the person residency but the thing that can be accepted are: an Oregon Driver License, a lease agreement or property ownership document showing that the patient rents or owns property in Oregon, an Oregon voter registration card, or a recent Oregon tax return. This part is up to the physician to determine if the person is a resident or not. There is no minimum residency requirement; this part too is up to the physician.
The process of the Death with Dignity act is one with many forms to fill out and talking to many of people. Though these forms are not required by law, the forms are asked to be filled out by the Oregon Health Authority just to have on record. There are five compliance forms: patient request form, attending physician form, consulting physician form, psychiatrist/psychologist form and pharmacy dispensing record form. Each one requires detail information about the illness and present condition of the person. Also there is an evaluation of the person’s mental state of mind. These are submitted to the Oregon Health authority preferable to be informed when Death with Dignity is performed, but if not submitted there is no penalty.
The next sets of forms are for after the Death with Dignity is preformed, and they are titled surveillance forms. The surveillance forms contain the reporting physician interview form and chronology and death certificate extract form. The reporting physician interview is a report about how the process went and if a lethal dose of medication was used or not. It is also asked about the attending physician and whether they were present or not. The chronology and death certificate extract form is an oversight of the dates of when the person ask for Death with Dignity, the dates the first five form were signed on, what the gender, race, marital status, age, county of resident, occupation of the person, if the family was inform of their choices, and what their level of education they had (The Oregon Health Authority, 4). This is just the paper work side of the process for the person and the physician. There are other rules that have to be followed. To find all these form the best website to use is the Oregon Health Authority. There is many of website that you could find information on but many of them have incorrect information on the pages with a one sided take. The Oregon Health Authority also informs the people that there could be other option and insure the people that this is their last resort(The Oregon Health Authority, 6). This page is updated often and will provided the people with the correct information they will need in order to legal proceed Death with Dignity.
            There are some requirements that have to be met in order for the Death with Dignity to be legal. The first being that the person has to be eighteen years of age, capable of making his or her own decision, a resident of Oregon and have an illness that will lead to death in the next six months. These four requirements have to be met in order for the person to request a prescription of lethal dose of medication for fulfill their wish for Death with Dignity, but before this can be done, there are some other rules that has to be met in order for the physician to write the prescription. The five rules are: “the patient must make two oral requests ask for Death with Dignity to his or her physician, and it must be is separated by at least 15 days. The patient must provide a written request to his or her physician, signed in the presence of two witnesses. The prescribing physician and a consulting physician must confirm the diagnosis and prognosis. The prescribing physician and a consulting physician must determine whether the patient is capable making their own decision. If either physician believes the patient's judgment is impaired by a psychiatric or psychological disorder, the patient must be referred for a psychological examination. The prescribing physician must inform the patient of feasible alternatives beside the Death with Dignity act, including comfort care, hospice care, and pain control. The prescribing physician must request, but may not require, the patient to notify his or her next-of-kin of the prescription request. If these form are not fill out and filed with the Oregon Health Authority and something was to happen or go wrong legal action could be taken into place and an investigation that in the long run could result in the doctor losing his or her license to practice medicine.
            Washington and Montana are the only two other states, as of the end of 2011, in the United State that allow Death with Dignity act. Washington passed the act on November 8, 2008 and then went in to effect March 5, 2009. Montana passed the law in November of 2009. There are now six other states that have laws and acts just like Oregon’s Death with Dignity Act. Georgia has a law that it is illegal to knowingly and willingly help someone commit suicide. This law was passed February 21, 2012. This is proof that the laws are ever changing (Barber). Hawaii, Massachusetts, New York, Pennsylvania and Vermont are states that have started the process of allowing Death with Dignity for the people of these states. These five states are all working to what Oregon has for their residents, but they just waiting for the law to be approve because of legal injunction and controversy that comes along with it. Massachusetts and New York are the two states that just passed the Death with Dignity in February of 2012.
            Some controversies that arise with the Death with Dignity act are that the person is playing God, taking nature into one’s own hands or even the fact that it invalidates life itself. Also, people and some doctors believe that this act violates medical ethics (Schoen). Then another one people believe that Death with Dignity gives the physician the power not the patient (Richman). Some reason for the Death with Dignity act could be the financial burden of continuing treatment to keep the person comfortable, loss of dignity, loss of bodily function, and even becoming a burden on the person family (The Oregon Health Authority, 4). Whatever the reason, it all comes down to the person individual beliefs. Most people who are choosing Death with Dignity want control because they know if they go on with this illness they will lose all of their control (Robison, 2).
            People may say we are playing the role of God, meaning we are taking Gods will in our own hands. Many people believe that this effect or goes against the religion. The way I see it that if you believe it goes against then your beliefs then you do not have to choose Death with Dignity, but this reasoning doesn’t have to control someone else’s life or even their own personal choice. Another controversy is that we nature into our own hands, but how is this any different from what we do with our animals when they are suffering. We say we are putting them out their misery when they in pain and are suffering. As human we don’t allow our animals to suffer or be in pain. So how is this any different? They both, a person and animal, will be in pain, unable to care for themselves, to walk or even communicate. Yes I know there is a difference between animals in human but how different? We are both God’s creation. How can this be any different? Yes we have a choice, and animals well the choice is made for them with the best intentions in mind but in the end there peace for both humans and animals. People also bring up the argument of the second commandment, Thou shall not kill, but Death with Dignity is not murder. There is no one who administers the medicine to the person, the person taken willingly by them.
            Some say that the Death with Dignity violates the medical ethics. Physicians take an oath and part of that oath is to do no harm; but to some physician have different meaning of what do no harm is. It is also different for person at the same time. So some people see that seen the physicians writing the prescription for the lethal dose of medication that that is doing harm to the person. Even though the person will most likely die within the next few month the physicians is assisting them to die prematurely and not allowing nature to take its course (Schoen, 3). Other seem to think that allowing the Death with Dignity act to be in place it give the physician power over others’ live, because they are the one prescribing the medication. The physician also has the right to deny the person of the prescription. This argument could be for or against it just all how you see it. This also could be seen as limiting a person freedom, rights that we are given at birth. It is all in the hands of the doctors (Richman, 5). Richman state in the article “Why empower the doctors? Suicide isn’t a medical issue. It’s a moral issue.” I don’t believe it could be put any better. Everyone has a different set of morals and we don’t force others to abide by our moral that just not how it works. We are all individuals we are not going to all one hundred percent agree on one thing. Not every physician has to abide by the Death with Dignity act; neither does a hospital or a hospice center.
            There are many reasons why I see Death with Dignity to be expectable on multiple levels. If someone is going to die a long and painful death, why should they have to suffer? When they probably already suffer years of pain and having to rely on others helping them with their daily needs? Death with Dignity is not an easy way out of the person life. I know what it like living with pain, I have chronic daily migraines, sometime the pain can just be too much to handle. Thank goodness I was able to gain control on my pain levels. But who am I to tell someone that they cannot be pain free, to allow themselves not to be a burden on their family or to have to loss all of their dignity. If a person is at peace with it and ready to leave this earth then who am I to say they can’t do that.
            Recently in 2011 there was a documentary release to tell the story on how real people make their choice for Death with Dignity. The title is an ironic one, How to die in Oregon. The title is ironic because not only does it show you physically how to die, but on an emotional level as well. Besides telling the stories of people who are suffering from a terminal illness but it also share the story of how one woman is trying to fulfill her husband last wish. That wish was to change the laws in Washington State where a person who is suffering from a terminal illness can choose Death with Dignity like the people in Oregon. The documentary is one that makes you think not only on a moral level, but about the world we live in. For the people who have not seen someone suffer a painful illness; it is hard to watch, but this documentary was main to get everyday people thinking. There is a lady in the documentary named Cody, who is suffering from liver cancer. She says in the documentary that she doesn’t want to have to die; she wants to live and be present in her children lives. Another statement in documentary is that the law is not about death but about having that choice, to choose when your life is over (Peter).
            I believe that more states should allow Death with Dignity act to be part of the state consultation. If more states allows this we would see less people suffering a long and painful death. I don’t see how Death with Dignity is any different from the death penalty. How can a state sentence people to death because of something they did but we don’t allow people who are suffering the choice to end their own life. As of right now thirty-four state have the death penalty law but yet only three allows Death with Dignity (Peterson). I do not see how this is right or even fair.
            My great-grandmother was blind, had Alzheimer’s, and had a tumor on her brain. The tumor made her unable to walk and that care of her daily needs along with the Alzheimer’s. She was always in pain towards the end. She hated the fact that she was in diapers and that her grandchildren had to take over her daily needs. I called her Gee-Gee and she cared for me as if I was her own daughter. My great grandmother was a nurse who worked in a nursing home and saw what it was like for people to lose their dignity. She would tell me that she never want that to happen to her. As my great grandmother declined she was ask to sign her legal rights over to my mother. We then knew that is our responsibly to just keep as comfortable as possible. When she started to decline and was un responsive we began to see that it was soon her time. As a family we decided not to resituate or use any means to prolong her life like intubate her or force a feeding tube in her. We did this because it was her wishes before she became ill with Alzheimer’s and we did not want to go against those wishes. My great grandmother stopped eating and drinking about two days before she passed away because she knew by doing so she would not live long. If my great grandmother would have been of sound mind and in a different state she could of choose the Death with Dignity act. The act state that the person must be of sound mind and able to take the medication on their own, my great grandmother was unable to do either. In my great grandmother own way she did choose Death with Dignity by not eating and drinking because without those two important things she knew she would not last long.
            I wish that all state would adopt something similar to the Death with Dignity act but I know that would take a lot change on multiple levels. I know this change will not happen overnight but hopefully the more people who see the documentary and realize what it like to see someone suffer from a terminal illness their minds may change.

Work Cited
Barber, M. "Death with Dignity Around the U.S.." Death with Dignity national center. Mandate Media, 2011. Web. 16 Apr 2012. <>.
Byock, Ira. "Dying with dignity." The Hastings Center Report Mar.-Apr. 2010: 49. Gale Opposing Viewpoints In Context. Web. 28 Feb. 2012
Campbell, Courtney S., and Jessica C. Cox. "Hospice and physician-assisted death: collaboration, compliance, and complicity." The Hastings Center Report Sept.-Oct. 2010: 26+. Gale Opposing Viewpoints In Context. Web. 28 Feb. 2012
"FAQ For the Death with Dignity Act - WA State Dept. of Health." Death with Dignity Act. N.p., 2010. Web. 16 Apr 2012. <>
How to Die in Oregon. Dir. Richardson, Peter, Clearcut Productions, and HBO Documentary Films. New York, NY : Docudrama : Distributed by New Video, 2010. 1 videodisc (107 min.) : sd., col. ; 4 3/4 in.
"Individuals Should Have a Legal Right to Choose Death" by Thomas A. Bowden. Assisted Suicide. Sylvia Engdahl, Ed. Current Controversies Series. Greenhaven Press, 2009. Thomas A. Bowden, "After Ten Years, States Still Resist Assisted Suicide," Ayn Rand Institute, October 30, 2007. Copyright © 2007 Ayn Rand® Institute. (ARI) All rights reserved. Reproduced by permission.
"Legalized Physician-Assisted Suicide Empowers Doctors, Not Patients" by Sheldon Richman. Assisted Suicide. Sylvia Engdahl, Ed. Current Controversies Series. Greenhaven Press, 2009. Sheldon Richman, "The Fraud of Physician-Assisted Suicide," Future of Freedom Foundation, June 24, 2004. Copyright © 2004 The Future of Freedom Foundation. All rights reserved. Reproduced by permission.
The Oregon Health Authority, . "Death with Dignity Act." State of Oregon, 2010. Web. 16 Apr 2012. <;.
Peterson, K.. "Death Penalty: 34 States Permit." The Pew Charitable Trusts, 2005. Web. 16 Apr 2012. <>.
"Physician-Assisted Suicide Violates Medical Ethics" by Physicians for Compassionate Care Educational Foundation. Problems with Death. David A. Becker and Cynthia S. Becker, Eds. Opposing Viewpoints® Series. Greenhaven Press, 2006. Physicians for Compassionate Care Educational Foundation, "Amicus Brief for Physicians for Compassionate Care Educational Foundation in Support of Petioners," Gonzales v. Oregon, Supreme Court of the United States.
Schoen, E. K.. A brief history of physician-assisted suicide and euthanasia in europe and the united states. n.p., 2008. Web. 16 Apr 2012
Robinson, B. A.. "Physician Assisted Suicide (PAS)." Religious tolerance. n.p., 2009. Web. 16 Apr 2012. <>.

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