When Patients Choose to End Their Lives


Ms. Rehm said her goal is that no patient should suffer the outrage that her husband experienced at the end of his life. She described his death as “excruciating to bear testimony,” although the lack of food and water is usually quite bearable for the patient after about two days.

Dr. Jessica Nutik Zitter, a palliative care practitioner at Highland Hospital in Oakland, Calif., Said in an interview, “The concept of medical euthanasia is gaining acceptance, but it takes time for people to become familiar with it. Doctors are trained to keep adding technology to patient care regardless of outcome, and technology withdrawal is an abomination for what we are taught. “

As a result, doctors can convince dying patients and their families to accept treatments “that lead to terrible suffering,” said Dr. Zitter, author of the book “Extreme Measures: Finding a Better Way to the End of Life”. In their experience, fear of losing control is the number one reason patients seek medical attention when they die. However, when they have access to good palliative care, this fear often disappears.

Only a third of those eligible for medical help in dying are actually consuming the lifelong medications they are given. Once given the option, they regain a sense of autonomy and are no longer afraid of losing control. In a study of 3,368 lethal drug prescriptions drafted under Oregon and Washington state laws, the most common reasons for seeking medical help in dying were loss of autonomy (87.4 percent). Impairment of quality of life (86.1 percent) and loss of dignity (68.6 percent).

Of course, many doctors view medical assistance in dying as contrary to their education, religious beliefs, or philosophy of life. Dr. Joanne Lynn, a non-supporter geriatrician in Washington, DC, said the focus should be on better care for people who are very sick, disabled, or the elderly.

“We should resist medical assistance in dying until we can offer people who have opted for medically assisted death a real choice of well-supported, meaningful, and comfortable life,” said Dr. Lynn. “There is currently no strong pressure on decency in long-term care. It is not a real choice when a person’s alternative is to live in misery or to impoverish the family. “

Barbara Coombs Lee, president emeritus of Compassion & Choices, a Portland, Oregon nonprofit that seeks to expand options for the end of life, said: “The core principle of medical assistance in dying is empowerment for someone who is terminally ill . “



Robert Dunfee