Death row

This item set me off when I read it last night.

I voted for initiative 1000 — I also went out of my way to sign the petition to get it on the ballot when it was announced. For obvious reasons, I haven’t given it much thought until recently.

In this day and age, you’d think that this sort of information would be something easily found on the web, but you can actually go looking for this and wind up finding this, instead, just as easily.

But let’s be honest, here — this is not the anti-abortion pro-life position — the arguments for the opposition are more nuanced and have some good examples to back up their claims. There’s just one problem with this.

It’s all an abstraction. The same folks that are pushing to have the Death with Dignity act repealed or blocked aren’t pushing for improved access to hospice or better pain management, nor do they have any direct experience with providing that level of care, for the most part. The first time we attempted to pass this kind of legislation in Washington State, I was working in a nursing home and when it failed, the sense of depression that resulted was palpable. Support was unilateral — there was no opposition to the idea.

Nor did it have anything to do with the burden of providing care; it had to do with the sense that your job was to keep people alive and perpetually miserable. But that’s also the extreme; one of the arguments that the opposition does get right is the notion that it’s not about unendurable pain so much as the loss of dignity.

Both of my grandfathers passed in this fashion before the legislation ever went into effect. In the instance of my maternal grandfather, it was after he’d collapsed in a pool of his own diarrhea and I’d taken him into the ER — he had leukemia and his oncologist was still pushing to have his spleen removed, which we were told would extend his life expectancy by six months. So I phoned him and read him my grandfather’s will.

He was given a self-titrated morphine drip and passed away about 24 hours later. Though I was estranged from my paternal grandfather and had no contact with him prior to his passing, he actually sent everybody letters beforehand, checked himself into a hospice ward and went the very same way.

Thing of it is, my own experience with this goes a lot deeper. In point of fact, if you want to die, there’s very little to prevent you from doing so, outside of a poorly executed method. And that’s where it gets really interesting, because there’s quite a bit that can and does go wrong.

A few years back, I found myself hanging out on alt.suicide.holiday, a Usenet group notorious for providing support for individuals wanting to research different methods of suicide. Contrary to the hype that revolved around a couple of members that actually did eventually kill themselves, after spending some months there I never once saw anyone actually advocate suicide — the point was to be able to discuss the subject openly and to that end, the rule was that you weren’t allowed to tell anyone they shouldn’t. As might be expected, those who did troll the group would eventually flame out and demand that everybody do themselves in for the supposed evil of being part of such an environment.

But what I really discovered was simply that successful suicides pass through the same stages of grieving associated with the terminally ill who pass from natural causes. This distinction is critical, because in the final analysis, it’s also the best safe-guard against the abuse of euthanasia laws.

As it stands, the way it works now? Once you jump through the hoops and complete the paperwork, they give you a handful of Seconal and you take them yourself. Nobody’s actually going to tell you as much, but under ideal circumstances you’d want to do so by mixing it with alcohol and an antihistamine and use an airtight plastic bag. Simple reason being? Takes about five minutes to knock you unconscious, but then you’re relying on your organs to shut down while you’re in a coma, which can last as long as 48 hours and doesn’t necessarily work.

In my instance? I’ve been weighing this as an alternative to my preferred method; shotgun. Besides the obviously unpleasant connotations (the EMTs only remove your body; they don’t clean up the mess), there’s the problem of involuntary motor response; it provokes a very natural tendency to flinch. I spent an evening attempting to dry run this a few years back and at no point could I overcome the tendency completely. Perhaps with sufficient drill, though I presently have no plans to try.

And Seconal would at least give me the opportunity to spend my last few minutes with Tobias.

But to be perfectly blunt, I’m short and getting shorter all the time — much more quickly than I’ve managed to anticipate so far. The last time I gave this much thought, I’d managed to figure out that two and a half years was a pretty accurate projection of life expectancy given my FEV1. I also realized that I’d deteriorated so rapidly that I’d have a lot better idea of what to expect once I’d made it through the winter.

Now? I don’t even want to do that. Today I’m moderately functional; the last couple of weeks left quite a bit to be desired, however. Next week I’m doing a follow-up with infectious diseases to find out what’s going on with the aspergillus in my lungs — I was initially told that it was most likely just something I was picking up from the environment and it was causing an allergic reaction, but the specialist has since refilled my prescription for vfend (the anti-fungal used to treat it) and this has me wondering and semi-hoping that it’s actually the invasive form. This would mean that the mold had actually colonized the lower lobes of my lungs and as such, can actually be knocked back quite a bit, although in extreme cases this requires a hospital stay.

I’m not going to say something like this and claim that I’ve reached the acceptance stage of the grieving process, but I’m damned close. It’s not even so much the idea of being cared for, somehow — it’s that I’m approaching a point where I can’t do anything and don’t want to.

Which is ultimately where the argument for death with dignity really falls out — beyond merely having the determination of terminal illness (which is much tougher to come by than one might imagine), both self-advocacy on the part of the patient and the fact that it’s a patient-directed procedure are what make the difference. What’s at issue is not the potential for abuse but ultimately how carefully the existing legislation is executed. This means that everybody need realize that they, ultimately, are the first and last advocate in favor of the determination of their own care — in a world where most people’s response is to (maybe) take the prescription and wonder why they aren’t getting better if it doesn’t solve the problem, this is an is/ought problem if ever there was one.

But the alternative is not the cost-conscious, coercive “death panels” it’s opponents would have us believe — it’s to revert to a mandate for prolonged suffering has almost never been directly experienced.

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