April 05, 2020

Mainers split on assisted death > Bill would allow lethal drug access

AUGUSTA — Laurel Coleman, a young doctor who specializes in care for the elderly, stood before the Judiciary Committee in a crowded hearing room Monday and said, “I help people die.”

The Augusta doctor was not talking about the kind of assisted death that would become legal if Rep. Joseph Brooks’ bill were passed. Called the “Death with Dignity Act,” the bill sponsored by Brooks, D-Winterport, would allow terminally ill people to get a prescription for lethal drugs if a long list of safeguards were satisfied.

Coleman was talking about what she sees as the way to ease a difficult death: listening. By talking to the patient and really listening to what he or she wants at the end of life, Coleman said, the patient has self-determination and can choose to withhold medication or extreme measures like feeding tubes and die sooner.

There were a lot of people at the hearing who wanted more help than that: They wanted to know that when they are dying, a doctor will help them with an easier, quicker way.

Brooks’ bill would require that two doctors certify the patient has fewer than six months to live and is mentally competent. The patient would have to wait 15 days after making the request to get the lethal medication.

There were many doctors testifying against the bill, doctors who said it would be impossible to gauge when a patient had six months left to live, doctors who said that finding better ways to control pain and improve the end of life could obviate the need for the bill, and doctors who said that the very idea of helping a patient die is in direct contradiction to their medical education, experience and ethics.

“From the viewpoint of a physician it’s ghoulish. … It’s hardly a death with dignity,” said Dr. Paul Doolan of Phippsburg, referring to the wording in the bill, “when you vomit half your dose [of lethal medicine], you OD [overdose], and you’re treated for that OD for your next attempt.”

There were no practicing doctors speaking in support of the bill. There were two who are retired, one of whom pointed out that because actively assisting with death is illegal, it is not always easy for practicing physicians to speak out. Doctors can and sometimes do prescribe so much pain reliever that the ultimate result — although not the goal — is death.

The people who spoke in support of the bill were, for the most part, people who had watched a father or brother or wife die an agonizing death, and wished that they had more control. There also were people who were getting older, thinking about their own lives, their own illnesses and what the future might be like.

Emilie van Eeghen of Canaan watched two relatives — her uncle and her father — die of Parkinson’s disease. Her uncle died of starvation. “With Parkinson’s people often die of pneumonia or starvation or something associated with the inability of their muscles to move as directed by the brain,” she said. Her father, who lived his whole life in the Netherlands, had another choice: lethal injection, which is legal there.

She said that although his pain could be controlled, “the morphine could not touch what caused my father’s greatest agony,” the humiliation he felt without control of his physical functions.

After being certified as terminally ill by two doctors and as mentally competent to decide by a psychiatrist, and getting help from hospice workers and a minister, a doctor gave van Eeghen’s father the lethal dose. He fell asleep and died in his wife’s arms, she said.

She also pointed out that “only 2.4 percent of deaths in the Netherlands occur using the physician-assisted dying process.” The same statistic was used by Gordon Smith, the executive vice president of the Maine Medical Association, to warn against the “slippery slope” of the bill. That’s higher than the percentage of people who commit suicide in Maine now, he said.

Doc Des Roches of Farmington, an 81-year-old retired ski resort owner, said he doesn’t like the word suicide. He calls it “management.”

He told the committee he wants more from doctors. “I think they have a responsibility of giving us all the options. If it gets such I can’t stand it,” he said of his prostate and bone cancer and back problems, “if I get to be such a burden on my young wife and kids, I want out.” He hobbled back to his seat with the help of canes, and said, “I know when to quit.”

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