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Two Sides of the First Assisted Suicide

May 27th, 2009 by Steven Gardner

News that what voters approved had in fact been carried out in the “Death with Dignity” measure struck people on both sides of the debate with some degree of sadness, but for different reasons.

Read the New York Times account of the death of Linda Fleming, and the Seattle Times version, which includes some reporting from the New York Times. One is somewhat clinical, the other a bit more emotional.

Then read the press releases by the two organizations that competed for voter will in the 2008 November general election.

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First Terminally-Ill Washingtonian Uses Death with Dignity Act
Death with Dignity Law Aids in Ending Unbearable Suffering; Provides Comfort and Peace of Mind

SEATTLE, WA – Compassion & Choices of Washington (C&C), a nonprofit organization advocating for better end-of-life care and choices, said that Linda Fleming, age 66, of Sequim, last night became the first terminally ill Washingtonian to die using the state’s Death with Dignity Act. Linda was diagnosed just one month ago with stage 4 pancreatic cancer, and was told she was actively dying.

Linda was stunned when she received her terminal diagnosis, as she had only recently begun feeling discomfort. Linda’s disease progressed rapidly and her pain worsened dramatically. “I had only recently learned how to live in the world as I had always wanted to, and now I will no longer be here. So my fatal disease arrived at a most
inopportune time,” said Linda.

After working with her physician and C&C’s Client Support volunteers to carefully consider her choices and make her end-of-life decisions, Linda took her prescribed medication on Thursday evening at home with her family, her dog and her physician at her bedside. “The pain became unbearable, and it was only going to get worse,” said
Linda in explaining her decision to use the Death with Dignity law. Linda died peacefully knowing that she had a choice in controlling her suffering and time of death from pancreatic cancer. “I am a very spiritual person, and it was very important to me to be conscious, clear-minded and alert at the time of my death. The powerful pain medications were making it difficult to maintain the state of mind I wanted to have at my death. And I knew I would have to increase them. I am grateful that the Death with Dignity law provides me the choice of a death that fits my own personal beliefs.”

“When a cure is no longer possible, the Death With Dignity Act adds another option for patients dying from a terminal illness. The prescribed medication gives patients peace of mind that they can use to take control of their dying if suffering becomes intolerable,” said Dr. Tom Preston, MD, a cardiologist and C&C’s medical director, “Most dying patients experience suffering. The Death With Dignity Act allows a physician to help his patients maintain as much control and dignity as they can at the end of life. Last night, the Death With Dignity Act provided a way to honor this patient’s final decision.”

Dr. Preston said that terminal patients are deriving comfort and peace of mind from prescriptions issued under the new law, and that the law is working as voters and its sponsors intended.

____________________________________
John Peyton dies of ALS on Thursday, May 21st

“In stark contrast, Washington State resident and assisted suicide opponent John Peyton, who was featured in ads and on TV opposing Initiative 1000, died naturally and comfortably at home of ALS the same day Linda Fleming became the first victim of assisted suicide in Washington State,” Eileen Geller, president of True Compassion Advocates, reported today. “Just days before his death, John expressed continued concern about the legalization of assisted suicide in Washington, stating that he ‘felt it victimized people with terminal illnesses and exploited their fears,’” she added.

“Speaking clearly and with passion, even as his life and breath waned, John expressed solidarity with all those experiencing life-limiting illnesses and stated his ‘worry that people with disabilities, those in tough financial circumstances and without adequate caregiving support would feel pressure to take a lethal drug overdose.’”

Just before he passed away John said: “I am blessed with a loving wife and family and wonderful caregivers. I worry that people who don’t have the same support will feel pressure to choose assisted suicide,” Ms. Geller reported, adding “John Peyton was a hero in life and in death. He showed us how to live with real dignity and die naturally and comfortably. He literally gave his last breaths to advocate for those at risk for assisted suicide. John Peyton demonstrates what I have seen in thousands of dying patients over 25 years working as a hospice nurse—that no one needs to die in pain or uncomfortably, and that people with life-limiting illnesses need competent, supportive care, not lethal drugs.”

Geller, a long-time leader of opposition to physician-assisted suicide, offered condolences to the families of both Peyton and Fleming. She contrasted Peyton’s death with that of Ms. Fleming’s: “Tragically, on the very same day John Peyton died, Linda Fleming of Sequim became the first person in our state to die from assisted suicide via lethal drug overdose. Ms. Fleming’s death gives witness to Mr. Peyton’s concern for the disabled and the poor being at particular risk for assisted suicide.” (According to the New York Times, 5/23/09, Ms. Fleming was divorced and filed for bankruptcy in 2007. The Times quoted her lawyer, Hugh Haffner, as saying Ms Fleming “had been unable to work because of a disability and lived in subsidized housing on $643 in monthly disability checks.”)

Geller also expressed concern that the extensive media coverage surrounding Ms. Fleming’s death by assisted suicide may have inadvertently sent the wrong message to people with life-limiting illness and their families—the message that assisted suicide, rather than good medical care and improved community support, is the solution to end-stage illness or disability. “Nothing could be further from the truth,” said Geller. “As a caregiver to two close family members who died naturally and comfortably from pancreatic cancer and a hospice nurse to many people with pancreatic or other cancers, I am deeply concerned that vulnerable ill people’s fears not be exploited. Excellent comfort care, pain control, symptom management, and support are available through hospice and palliative care.”

Geller concluded: “Assisted suicide is a tragedy which heightens fear and increases misinformation about living and dying. We need to advocate for truly compassionate care, not false and misleading choices.”

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15 Responses to “Two Sides of the First Assisted Suicide”

  1. Sharon O'Hara Says:

    “Linda took her prescribed medication on Thursday evening at home with her family, her dog and her physician at her bedside. “The pain became unbearable, and it was only going to get worse,” …”died peacefully …spiritual person… important…to be conscious, clear-minded and alert at the time of my death.”

    Contrast that with: “…assisted suicide opponent John Peyton…died naturally and comfortably at home of ALS the same day Linda Fleming became the first victim of assisted suicide in Washington State,…”

    Linda was far from being a ‘victum’. Linda lived her life and made her own choices when the painful end was near. She didn’t have the opportunity to live a long life as John did. Linda also believed each of us should have the right to choose.

    I think John, living until 90, was lucky. He was passionate about not letting folks have the right to choose for themselves, a death with dignity.
    Maybe John’s disease wasn’t painful, I hope not.
    May they both rest in peace… Sharon O’Hara

  2. Theresa Decker Says:

    I am responding to Sharon, above. John Peyton is my father. He would have turned 66 years old this August, had he survived. If the above article is correct, that Linda Fleming (may her soul rest in peace) was 66 at the time of her suicide, then my father was younger than she when he died last week.

    Dad had been diagnosed with ALS in January of 2008. I have been mourning for him for months, as the diagnosis was for me a death sentence for my father, and one of pain and suffering at that. My father did suffer, though he often did not show it. At the end, he suffered unimaginably. It is difficult for me to think about it. Yet he availed himself to the palliative effects of modern medicine, and throughout, was a gracious recipient of the care given him by his family, friends and caregivers.

    Dad showed amazing courage and optimism, despite his debilitating condition. His jokes are legendary….I hope we can complile them!Mom was a trooper. She showed a strength I didn’t know she possessed.

    The idea that we can “control” our deaths is vastly misguided. Those who are really in control of their lives accept reality, and exploit life’s offerings in order to develop their potential, thus realizing their destiny as a human being. Part of life is pain and suffering. This is reality. As human beings, we are called to respond to pain and suffering by alleviating it to the best of our ability, and not by killing the sufferer. That is absurd.

    I realize that the above paragraph may seem heartless and unkind to those who advocate physician-assisted suicide. But I would ask these people to consider whether helping a dying person to deliberately take their own life is really genuine charity. To deliberately deny a person the opportunity to live fully at the end is, I think, the much greater tragedy. Many people who have the diagnosis of a terminal illness have the opportunity to say things they had always wanted to say, to see what is really important in life, to ask the questions that, deep down, had always wanted to surface. Such experiences make us truly human. Suicide says these questions are irrelevant, and that life itself holds no meaning. If promoters of suicide truly believe that life holds no meaning, we should all be extremely wary of the implications of this view. Especially, those of us parents who guide our children to discover the manifold meaning in their young lives must do everything possible to protect them from this dangerous view, that life — and therefore their lives — is meaningless.

    Life is full of lessons, and it is our task to learn from them and develop the potential within us. Some of the best lessons are learned at the end, of this I am fully convinced. To deliberately shorten our lives deprives us of these valuable life-lessons.

    My husband, children and I learned so much these past eighteen months. We learned how to give, we had time to say things to dad that we had not had time to say before. My father himself realized that he was in the enviable position of really preparing himself for death in an authentic way. And he prepared, to my mind, to a heroic degree. Perhaps the outburst of my six-year-old daughter says it well: “But mommy, that was too quick! His death came way too quick! I didn’t know he was going to die so quickly. He never showed it.” And she burst into tears.

    My response was, “Honey, your grandfather set a high example of suffering graciously and without complaint.” This is an example we are all challenged to follow.

    It seems obvious that the promoters of assisted suicide are going to continue their relentless program of changing laws so that some murders do not get penalized. But my challenge to them is: Do you really want to see more people resorting to suicide in the face of pain? Or would it not be more human to try to alleviate pain as well as possible, rather than kill the person? Would it not be more civilized to offer an opportunity to live the last days fully and bravely, with compassionate, trained caregivers and family members supporting the dying person? Would it not be more compassionate to allow the dying person to learn their final lesson, fight their last battle, so to speak, and really come to terms with who they are and their reason for existence? These are questions worth pondering, I believe, and I challenge those on the opposite side to consider them deeply.

  3. Tesira Says:

    My response is to Theresa Decker.

    Dear Theresa,

    To address your challenges:

    Do you really want to see more people resorting to suicide in the face of pain?

    One does not have to endure endless pain and suffering in order to find their path in this life. Not everyone waits until they are at the end of their natural life in order to seek out their path in life; to question why and to then seek the reason for their existence on this earth. How souls decide to exit this world is their business. We do not live in a one belief system fits all society.

    Or would it not be more human to try to alleviate pain as well as possible, rather than kill the person?

    Is it more humane to prolong someone’s physical existence for the sake of others? Is it the responsibility of the terminally ill to live long enough so those they are leaving behind have time to come to terms with it? My step-grandmother, age 96, recently passed. Her life was prolonged by the medical system on her youngest son’s insistence. Her last days were not pleasant and she endured unnecessary suffering. Why? All because her youngest son was not ready to let her go. This was pure selfishness on his part. She had loving family members by her side every day until the end. She had hospice, she was not able to use the toilet and she felt humiliated in her last weeks of life. She did not die a happy person.

    Would it not be more civilized to offer an opportunity to live the last days fully and bravely, with compassionate, trained caregivers and family members supporting the dying person?

    In a perfect world there would be no pain and suffering. However we do not live in a perfect world and not everyone has the same belief system. Just as your father had family members present, so did Ms. Flemming. The only difference between the two is the path they chose to exit this world. Both chose the path they felt fit their belief system. One is not better than the other; they are equally valuable to the person making the choice.

    Would it not be more compassionate to allow the dying person to learn their final lesson, fight their last battle, so to speak, and really come to terms with who they are and their reason for existence?

    I am not terminally ill and I do not anticipate passing from this earth anytime soon, however that being said, I could get in my car tomorrow, someone who was drunk could slam their car into my driver’s side door, causing irreparable damages to this physical body and even to the mind. I have a DNR and do not place on life support order. I am not afraid to die. If I have the power, my death will be on my terms and not on the terms of others who do not know me nor do they truly care about me as a spiritual being. I have not waited until my last days to seek my place in this world. I know my place in this world.

    So to answer your question, yes and no. It really depends on the individual and how they have lived their life up to that point. If they have not found their path and need that extra time, then it is their choice to prolong their life in the hopes that it is not too late for them to find whatever it is they are seeking.

    However I challenge you and others like you to have an open mind and to not place your belief system on others. That is not to say that your opinion is not true as that is your perception and as such it is true for you. However to say that another valuable soul’s perception is flawed is inappropriate. As human beings we have the right to make a choice that impacts our lives and that includes how much suffering we are willing to endure. If an individual who is terminally ill wishes to shed themselves of their earthly body then that is their choice to make. How they accomplish that is likely to be based on their personal belief system. Society does not have all the answers, and to make everyone succumb to a single way of thinking takes away our natural rights. That is not to say that your perception is wrong. However that does not mean that your perception is right for everyone. Please do not condemn others for having a different perspective, just because it does not fit in line with your belief system.

  4. Jake Metcalf Says:

    I watched my grandfather die of an uncurable long painfull illness that tourtured him for years.

    I hope we never have to use them but I am glad they are on the books for the people that need them.

  5. Sharon O'Hara Says:

    “All because her youngest son was not ready to let her go.”

    Yes.
    I’ve had three dogs die of cancer. I couldn’t let them go either and did all I could to keep each one alive.

    One had the fast acting cancer. The day came when I looked at him and was surprised to see a bony ridge across his head and his skin hung in folds across his bones – I was shocked.

    He never failed to follow me wherever I went…and I watched him stagger to his feet time after time….but he would recover, I knew it.

    But the cancer ate him up, in spite of the pred and all the food he could eat – even his favorite treats…. and I didn’t see what I’d let happen until I saw and felt the ridge on his skull.

    I looked and really saw him as he was and he wasn’t getting better. His brown eyes were so sad but they never questioned or doubted my ability to do the right thing. I let him suffer because I couldn’t let him go.

    I called our vet. We were in the driveway waiting for him when he came and Mr Green was resting on a blanket surrounded by the empty sackful of the pigs ears he so loved and rarely got in his healthy days.

    Some of you speak of murder and suicide. Oh please. Let each person decide for his or herself if and when the time comes.
    Death with Dignity is exactly right…not murder or suicide.

    Grow up… the only opinion that matters is the opinion and wishes of the terminal person – not their family. I respect their wishes.

    Sharon O’Hara

  6. Sharon O'Hara Says:

    “Do you really want to see more people resorting to suicide in the face of pain? Or would it not be more human to try to alleviate pain as well as possible, rather than kill the person?”

    You clearly don’t know what pain pills do to the respiratory system. What do you suggest if the person in pain happens to also have lung disease?
    Sharon O’Hara

  7. Registered Voter Says:

    I have a very close friend who insisted that DWD was humane and the right thing to do. She and her surviving family were asked to assist when her offspring had had enough suffering from a devastating disease.

    Her words after having done so? “It is one thing to discuss and debate it, and another to actually face it. Honouring X’s request was the most difficult thing I ever had to do in my life. I will never do it again for a loved one and pray I am never asked to participate again. More importantly, I will never subject anyone I love to such a decision where my demise is concerned.”

    One person, one experience. But certainly not a situation where the only opinion which matters is that of the terminal person.

  8. Mary Colborn Says:

    That’s an interesting point, DK, I listened to a NPR This American Life program that dealt with the same sort of situation, in which a young man was asked to aid his mother in carrying out such a wish. She was very much alive, but did not want to have her body nor mind deteriorate. She also wanted to be able to choose her own time of death.

    Her son described what it was like to have a vibrant mother make such a decision. His job was to make the necessary phone calls, etc. Indeed, what a position to put someone you love into.

  9. Sharon O'Hara Says:

    Why wouldn’t the decision by the terminal person, meeting all the requirements for a Death With Dignity choice, be singular?

    It never occured to me that one’s family would be involved personally. The patient makes the choice and the arrangements, why would they drag their family members into it? The choice is not about the family and it isn’t and shouldn’t be, their choice.

    I cannot imagine asking assistance from a family member to involve them as co-assistants, that would be cruel.
    As Mary said, “..what a position to put someone you love into.”

  10. Registered Voter Says:

    If the decision by the terminal person was truly singular, no one else would be involved. In reality, someone is needed to prescribe the drug, and if the person is unable to do so themselves, someone must administer it and monitor the process. Also, loved ones will be present if they want to bid a final farewell. Again, another side of a complex issue which extends well beyond the person making such a choice.

  11. Sharon O'Hara Says:

    When all the criteria is met, including medical assistance, the decision for Death with Dignity can only be made by the terminal patient.
    The arrangements include other people…not, I would hope, having the loved ones involved with something they disapprove.
    Loved ones would be present if the terminal patient wants them there. If the patient wants them there, the loved ones can make their decision to be in attendance or not.
    The process should be simple and straightforward and leave good feelings and memories behind, not strife and upset to anyone.
    Sharon O’Hara

  12. Registered Voter Says:

    This isn’t about who can make the decision; it’s about who that decision ultimately involves. The former is a question of law; the latter, of life and love.

    Clearly, one can decide whether or not to attend. But beyond theoreticals, many will opt to do so because they cannot imagine not being present, particularly if asked.

    In a perfect world the process should be simple, straightforward and absent strife and upset. In reality, it can be more complicated.

  13. Kathryn Simpson Says:

    Such a situation would be amongst my worst nightmares. Yet, who would or could say “no” to being there with a loved one or close friend who asked you to be there? Frankly, I’d have a very difficult time saying “no” to a stranger who made that request, let alone a loved one.

    I’m trying very hard to avoid judgment because I know that perspective sometimes changes when one is, by circumstance, faced with a situation that seems so clear-cut from afar, but is so much more complicated when you are in the midst it.

    Thus, my post tonight isn’t to provide some great wisdom on the issue. It is simply an observation that judging anyone either way on this issue is no one’s role but God’s.

    My pregnancy with my first child was complicated and required medical attention from the get go. At six weeks gestation, we had our first ultrasound and at that moment… in that moment… I fell in love with her. Until that moment, I had a position on abortion. But from that moment forward, it was as if God spoke directly to my heart and settled any question of what was right and wrong for me on the abortion issue.

    I pray that God grants me the grace to never have to face a “death with dignity” situation with my family. And yet, should that ever happen, all I can hope for is that God speaks to my heart to know what to do, just as He spoke to my heart the day I first laid eyes on that little embryo… who is going to be a senior in high school in 4 days….

    There are many things in this world that I take a strong position about. But there are some things that we will only understand when God, in our moment of need, speaks to our heart and settles the question.

    Regards,
    Kathryn Simpson

  14. Registered Voter Says:

    My religious beliefs aren’t relevant, but suffice to say many wonderful, highly evolved people in the world don’t believe in god and still receive messages/guidance in the heartspace.

    I’m trying very hard to avoid judgment because I know that perspective sometimes changes when one is, by circumstance, faced with a situation that seems so clear-cut from afar, but is so much more complicated when you are in the midst it.

    Indeed; well said…and my only point in this thread.

  15. Physician-assisted-suicides in WA, OR, and MT « What Sorts of People Says:

    [...] http://pugetsoundblogs.com/kitsap-caucus/2009/05/27/two-sides-of-the-first-assisted-suicide/ [...]

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