The “Oregon Model” of End-of-Life Care

November 25th, 2012 · No Comments

by Jane St. Clair

Author of Walk Me to Midnight

 

Sunday, November 25, 2012 – This morning the New York Times’ lead editorial is about how everyone should consult their doctor or nurse and fill out a medical end-of-life form.  Those of us who participate in the movement against assisted suicide generally have no objection to these forms, although we think they are better done when a person is healthy and at a lawyer’s (not doctor’s) office.

We are not against end-of-life forms. We are against assisted suicide as a “medical treatment”.  The Oregon model, which the Times cites in its editorial, has legalized assisted suicide. In the past, Oregon’s medical officials have sent letters to poor people with advanced cancer saying that the state won’t pay for their care because is too expensive and probably will not work — however,  suicide is painless and cheap. And Oregon will happily pay for their suicides. (1)

The New York Times is staffed by those wonderful people who gave us Dr. Jack Kevorkian.  For years the Times defended him as a courageous American hero until his “assisted suicides” of healthy people finally became too bizarre and immoral even for them.  Yet they keep pushing assisted suicide in their editorials and news columns.

The article below is one I wrote a while ago, but it still stands.

1.   Springer, Dan. “Oregon Offers Terminal Patients Doctor-Assisted Suicide Instead of Medical Care,” Fox News, July 28, 2008, see http://www.foxnews.com/story/0,2933,392962,00.html#ixzz2DGV6ksuH

 

The New York Times And End-of-Life Forms

Compassion and Choices is a group that pushes the legalization of assisted suicide. They began as the “Hemlock Society,” a more or less an underground movement in which their members helped people commit suicide. They are still coming from the premise that people have a right to a painless death through suicide.

Many people who agree with Compassion and Choices are well-meaning people like New York Times columnist Jane E. Brody. In a recent Times article, she discusses end-of-life directives and tells people to contact Compassion and Choices, which she describes as “an organization that helps people negotiate end-of-life problems” and one that can provide you with “an excellent free guide and tool kit to help people prepare advanced directives.” Then Ms. Brody tells you how to get their guide.

Her column has a veneer of rational, impartial journalistic advice but yet she never once mentions Choices and Compassion’s mission of legalization of assisted suicide or presents an opposing point of view.

Most of the column is a discussion about why you should plan for end-of-life medical care, and why Obamacare might include having elderly Medicare patients discuss end-of-life care with their doctors before they are terminally ill.

Many Americans have objected to this provision of Obamacare with reasons Ms. Brody and others who present themselves as impartial refuse to discuss.

One reason is that end-of-life directives are not strictly medical documents. If you sign something to the effect that you don’t want antibiotics, you don’t want respirators, you don’t want food and water tubes, and you don’t want surgeries done, you have just signed away your right to certain medical care. Many such forms oppose religious teachings.  For example, the Catholic Church teaches that food and water are not medical treatments and should be available to everyone, regardless of physical condition.

If you sign such a directive in a doctor’s office, and the paper does not designate that you want your husband or wife or other loved one to take charge should you become incapacitated, you just signed away who gets to choose what happens to you. When you sign it with a government doctor, keep in mind that he or she is under pressure to keep your medical costs down.

Traditionally, you sign an end-of-life directive with your lawyer because end-of-life medical forms are legal statements about who you are morally, ethically, religiously, atheistically, or whatever. They should not be initiated by a doctor paid by the government to do so, but rather by you and according to your personal beliefs. My own lawyer told me that when he explains directives to clients and tells them to take them home to think about them, many don’t want to sign them because it takes away choices that they think may be better made hour-by-hour at the time of the occurrence or illness.  For example, if you have cancer and sign into hospice care, you are no longer eligible for certain treatments because you only receive palliative care. This may take away the option of having surgeries to remove tumors, performed not to prolong your life but to relieve pain.

Doctors and other healthcare providers would like to get to the point where everyone has a signed medical form stored in a computerized system so that they can easily assess them in case of life-threatening accidents or other emergencies, and thus protect themselves against lawsuits and performing medical treatments they consider fruitless. But let’s say your college-aged child has one on file. The directive might cut you as a parent out of the decision to “pull the plug”.

Ms. Brody directs you to Compassion and Choices, a group promoting assisted suicide, to find your end-of-life medical forms. You might also want to look at a pro-life directive and contrast the two. She can point to studies that say you’ll have a smoother death if you do end-of-life planning. I can point to studies that show you’ll live longer if your doctor is coming from a religious, pro-life perspective.

“Judging from national studies and people I know (including a 90-year-old aunt),” Ms. Brody writes, “most Americans regardless of age seem reluctant to contemplate the certainty that one day their lives will end, let alone discuss how they want to be treated when the end is near.”

But maybe her 90-year-old aunt has thought about it, and decided on a different course. It’s still her aunt’s right to do that.

Tags: Against assisted suicide · Assisted suicide · Choices and Compassion · Compassion and Choices · Physician ASsisted Suicide · Suicide Prevention · Walk Me to Midnight · walk-me