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Question 2: Prescribing Medication To End Life

John Kelly, disabilities rights activist and founder of Second Thoughts, and Dr. Marcia Angell, senior lecturer in social medicine at Harvard Medical School and former editor of the New England Journal of Medicine. (Jesse Costa/WBUR)

John Kelly, disabilities rights activist and founder of Second Thoughts, and Dr. Marcia Angell, senior lecturer in social medicine at Harvard Medical School and former editor of the New England Journal of Medicine. (Jesse Costa/WBUR)

With the election just eight weeks away, Radio Boston will be examining the three ballot questions facing Massachusetts voters this November.

First up, we take a look at Question 2, the so-called “Massachusetts Death with Dignity Act,” which would make it legal for an adult resident with a terminal illness to receive a prescription for drugs to end his or her life.

There are many terms that are used to describe this issue, from “death with dignity” to “physician assisted suicide.” It is a controversial and weighty subject that touches on a profound question: What is the value of life and who decides when or if death is ever a better option?

Guests:

  • Marcia Angell, former editor, New England Journal of Medicine; senior lecturer in social medicine at Harvard Medical School
  • John Kelly, disabilities rights activist and founder of Second Thoughts

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  • walnut28

    This is insane.  If MA doesn’t pass the Death with Dignity Act, I will move to Oregon whenever I’m ready to go.  Seems like the very people who oppose ObamaCare oppose Death w/ Dignity, as well as female birth control, food stamps, welfare, abortion, medicaid and medicare.  And now you have Romney accusing those of us who cannot afford pain killers or medical care for terminal, painful or expensive treatments — and don’t want to bankrupt our families — as “victims” who feel “entitled” to gov’t help.  So, Mr. Romney et. al., at the least, give us who are too sick, weak, or down and out to “pay our taxes” the opportunity for another alternative.  Don’t “sentence” us to painful poverty “til death do us part.”

    • swilly

       Has anyone not thought about the fact that this drug like most other drugs will find it’s way to the streets so teens and mentally unstable people can purchase it to end their lives!! It’s bad enough with all the drugs out there but I don’t want my children to be able to get their hands on one that will kill them for sure!!

  • Michaellivia

    I understand the point Mr Kelly is trying to explained has nothing to do with the CHOICE that a patient who is diagnosed and is experiencing an illness, not to compare to someone who is misdiagnosed, if I have the optioned to decide – not the social view of a group of people- I believe there should be the option for an informed and educated choice made by my family, myself and my physicians together.

  • Artemis3

    Every state legislature in the US that has ever considered making assisted suicide legal has rejected it.   The American Medical Association has rejected it, and so have many, many disability rights groups.  Why?  Assisted suicide, upon close examination, is seen to open the door to all kinds of abuse.

     The Oregon reports do not reassure me at all, because the Oregon law, like the one on the Massachusetts ballot, does not require witnesses at the time the poison is ingested.  One of the callers on the program said her relative took comfort in having the poison in the house but never took.  With no witnesses at the time of ingestion, a greedy heir or caregiver could have pressured or coerced that relative to commit suicide, or could even have force fed the lethal dose to him or her.  No one would ever have known.  The Oregon act is based on reporting from doctors who are not present at the time of ingestion or death.  This act literally makes it possible to get away with murder. 

    I also want to point out to the caller whose relative has been living with post-stroke paralysis for 14 months that that relative would not be eligible for assisted suicide, because she is not terminally ill, as long, and only as long, as she receives the care she needs. 

    Marcia Angell insists that the patients who take the poison are suffering terribly, but she is careful not to define that suffering.  Most patients in Oregon, according to the reports, do not take it because they are suffering physical pain.  They take it because they fear being a burden or because they want to die before they are forced to accept care from anyone.  What does this say to a man like John Kelly, who has been forced for years to rely on care from others.  Is he a burden to society?   Like that of the paralyzed woman, his condition would become terminal very quickly if he were denied necessary daily care.  Will governments and insurance companies cut off funds for care of the disabled in the future, while offering to pay the $100 for poison to end their costly lives?  We know that Oregon Medicaid cut off funding for chemotherapy for two cancer patients and offered coverage of assisted suicide.  These two cases, that of Barbara Wagner and Randy Stroup, are very well documented.

    Anyone who wants to commit suicide has the means to do so, without violence.  A bottle of many over the counter drugs would do the trick.  What this act is really about is getting society and the medical profession to assume responsibility that should belong to the individual.  That would be an real exercise of the choice assisted suicide proponents say they want. 

    Society’s role, on the other hand, is to do everything possible to prevent the despair that leads to suicide.  Massachusetts voters should uphold this role by voting NO on Question 2.

  • Guest

    I oppose Assisted Suicide, for so many reasons, but I’ll address one here.  With skyrocketing teen suicide numbers nationwide, what message does it send teenagers to legalize assisted suicide?  It sends the message that suicide is an acceptable way to deal with your problems.

    • Rick McCall

      No it is not!!!! suicide is not the same thing as death with dignity.

  • Clara

    Artemis3 said it all.  There’s no need for me to add anything.  Just go back and read the post by Artemis3.  I am 65, own my home with my husband, and have 6 children, four of whom are adults who agree with PAS and don’t own homes.  I have never been one to have tattoos or body piercings, but I’m starting to believe I should have I WANT TO LIVE tattooed across my chest and back, just in case.

  • Miranda

    The folks at Second Thoughts are right on.  Creating public policy around physician assisted suicide is bad public policy.

  • Dawn

    I became disabled with a head injury in 2004.  None of the members in my disabled community consider suicide a legitimate medical treatment, which is what proponents of Death With Dignity want the public to accept.  None of us wish to end our lives.  Our lives are now different and we certainly have struggles.  None of us consider ourselves to have been deprived of quality of life.  We live our lives to the fullest as we support each other and show compassion and understanding to others.  When one loses compassion for others, one has lost his/her humanity.  This law would contradict suicide prevention laws already in place.  The whole motivation for this bill is to cut medical care costs, and the bill as written, permits abuse, as artemis3 stated.  This bill is wrong.  If anyone does wish to end their life, they already have means at their disposal.  This bill takes the choice away from the individual and gives it to the doctor, caregivers, insurance companies, or heirs.  As a faithful believer, if I commit suicide, I forfeit my eternal life in Heaven and go to hell.  Do not permit this to become law in Massachusetts.  Vote NO on Question 2.  

    • Agogue

       With all due respect to your opinion and beliefs, you should read the bill more thoroughly. To suggest that the bill “takes the choice away from the individual and gives it to the doctor…” is ridiculous. Any action taken by an individual is VOLUNTARY. If none of the member of your disabled community wish to end their lives, or believe in Hell, great for them. The bill requires an individual to be within six months of dying and meet all kinds of requirements in order to be issued a script for life-ending medication. The fact that your disability dates back eight years, and apparently is not life-threatening, indicates you are not someone the bill refers to in the first place. With that being the case, my question is why are you being so adamant about not letting unfortunate people who the bill DOES apply to make their own decision?  

    • Joseph Waldbaum

      Dawn, 

      No doctor or caregiver is empowered to request the medication– only the patient. Here is the law:

      (1) An adult resident of Massachusetts who is capable and has been determined by his or her attending physician and
      consulting physician to be suffering from a terminal disease, and who has voluntarily expressed his or her wish to
      die, may make a written request for medication that the patient may self-administer to end his or her life in a humane
      and dignified manner in accordance with this chapter.
      (2) A person does not qualify under this chapter solely because of age or disability.  An essentially identical law has been in place in other states for a total of 18 years with not a single incident of abuse. No one  can force you to do this. Why would you deny this choice to others?JW

    • Rick McCall

      Dawn I feel you are misinformed. The Dr. doesn’t say “we can’t do anything for you , so go kill yourself ” 

        The patient has to request the pills. If you have ever seen a person screaming in pain .. in so much pain that their eyeballs are popping out of their scull due to the pressure from brain tumors pushing on them, or seen a person with spinal cancer that can’t control their arms or legs  or bowel movements at all.

      Thank god if you have not . However if you have, you may change your way of thinking . It isn’t suicide if a loved one administers the medication . Nor is it murder if it’s legal to administer them  
      Vote  Yes  on Question 2.   It’s a no brainer

  • lokicat3

    I am a recently retired hospice chaplain and favor Ballot Question #2 and Death with Dignity.  Hospice doesn’t make any stand pro or con such initiatives but as an individual and a minister I can.  Second Thoughts makes many misleading statements. (they may be fronting for religious conservatives).  In reality, pain cannot always be treated effectively.  People suffer great agony sometime even with a pain pump and hospice staff go to the 9th to care for people.   We know from studies that pain remediation is often neglected. 
    I never had any patient choose death with dignity as an option.  People linger for days, weeks, years.  They should have the choice of assisted suicide.  Anything else is cruel.  Once you’ve worked with patients and families as I have, you’d see that having the choice is important to patients.  They may never act on it.  But they feel empowered by the fact of the choice, that if worse comes to worse, they can choose to end it.  This is very freeing. In Oregon few people who sign up for medications for assisted suicide ever use it.  Once people have the decision on their own hands and get on hospice and get decent pain relief and support, they will opt not to use the medication.  Get the straight facts. also check out http://www.compassionandchoices.org

  • Ethel

    I know this will sound cliche, but if this “Massachusetts Death with Dignity” bill is passed, it will be just another slippery slope.  We are HUMANS, not animals. 

    • Metootall1

       We are animals and often inhumane at that. It pisses me off that I can choose to help my pet die gracefully, without pain, yet my husband who suffers from Parkinson’s Disease will have to endure his pain, alzheimers etc until the end because he doesn’t have a choice. It amazes me how many clueless people there are, religious or not, say let God handle it. Well if that is true then we should “let God handle it” and NOT give meds and life prolonging procedures in the first place. If someone can choose to have a new lung, heart, cancer treatment etc. then they should also have the right to die with peace and dignity when that time comes.

    • Agogue

      The slippery slope has already started, lest you forget the panel of judges to be set up to determine who gets what care under Obamacare. If you want to stress our humanity, the best thing to do is make sure Obama is defeated in November, since both Romney and Ryan are committed to the repeal of at least the majority of Obamacare. 

    • prochoice

      and as a HUMAN you should have a right to choose: nobody will deny you to have “everything done”. But if you chose to end the suffering, you, as a HUMAN, should have that right.

      • April1940

        I so agree with your comment. Having worked in nursing for over fourty years I have heard many people plead to end their suffering and have seen uncountable patients die finally after suffering  severe pain .  As patients chose to end their suffering with the Death with Dignity bill (if passed) they are able to change their mind anytime so therefore there IS NO SLIPPER:Y SLOP and I vote for the Mass. Death with Dignity bill to be passed.

    • Rick McCall

      So when a person can no longer be treated under  Obama’s new  health care laws  they should just be sent home to suffer quietly? There are fates worst than dying you know!!! People are going to do it either way this is just a lot cleaner and peaceful way to go ..Allow it !! It’s really that simple.

  • Pat

    The “right to die” will so quickly become the “obligation to die” with money being the sole determinant of “health treatment” administered to a person.  Death is a mystery that a person experiences and it can are and not be reduced to the saving of money.  In the mystery of death, vital attention must be given to the spiritual dimension of both the life and death of the person who is dying. 

  • castorag

    As a nurse I believe that everyone should have the opportunity to have what they want and need in healthcare, and that they have the opportunity to refuse any care they don’t want. I also see a lot of people who say they “want everything done” who have never seen what “everything” really means. Also, death becomes more feared for its unfamiliarity. Your great-grandmother probably saw her grandparents, aunts, uncles, and siblings die at home. How many of you have seen a relative at the time of death? When people die in sequestered environments like hospitals or nursing homes, rather in the downstairs bedroom as our forefathers used to do, no one sees the noise and suffering that often attend these deaths; no one knows what death can look like.
    Give people the choice to end their lives the way they lived them: in their own way. Who dares to order otherwise?

  • Elfpix

    I really resent a religion dictating to me when I may die.  The only reason humans cling so to the idea that we are something so special that all other creatures are for our use is religion.  Religion dictates way too many of our customs – the role of women, the tax code, how we give birth, how we die, how our children understand their gender roles, how flagrantly we exploit the earth, who we enslave.  For some their religion even dictates what they eat and off of which plates, for crissake.  Give me a break.  Let me and all of us decide when it’s time to go.  And if some young person makes a decision we think is ill conceived, who are we to say?

  • swilly

      Has anyone not thought about the fact that this drug like most other
    drugs will find it’s way to the streets so teens and mentally unstable
    people can purchase it to end their lives!! It’s bad enough with all the
    drugs out there but I don’t want my children to be able to get their
    hands on one that will kill them for sure!!

    • Rick McCall

      Swilly thats a cop out Pal. There isn’t  just “one” pill as you think!!  Your kid would need to get his hands on like 150 pills in order to achieve this method of demise .

      It  is a combination of  several different pills  & they would have to be prescribed by a DR. the pills are already available,  it’s the combination of meds that makes them deadly in a” humane fashion” 

       Besides if a kid is dead set on offing him or her self,  I highly doubt they would go to the difficulty of obtaining the combination of pills needed to formulate this concoction.  When an overdose of heroin is much easier and cheaper to get   Id imagine .

      As a matter of fact  if this was the  only way to commit suicide  it would save lives because all the time needed to procure these  pills all together  would give said  person enough time to re evaluate their situation and get over the depression bump that most people do if given the time  and perhaps forget it all together.

      There is a documentary called…”How to die in Oregon”  it is about these  pills ands a liquid concoction they also formulate to do the same thing  it is a very informative Documentary that educates folks as to how and why some people do it. Here is a link to the HBO documentary I’m talking about 
      http://www.movie2k.to/How-to-Die-in-Oregon-watch-movie-685905.html

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