Although Amanda Villegas’ manual dexterity is hampered by her mild case of cerebral palsy, she is a gifted photographer who documented the last five days of her husband’s life with bladder cancer who died. metastasis. She posted the photos on Google Drive, under “This is Cancer.” Prepare yourself before viewing them. But look at them. They ground the increasingly urgent debate on medical assistance in dying (MAID) in reality.
Chris was 29 when he died at home on June 19, 2019, just a week after doctors belatedly gave him a terminal prognosis. The tragedy of his illness had been compounded by multiple misdiagnoses. The needless horrors of his final days were the result of a hospital’s misinformation — possibly a religiously motivated lie — and a restrictive provision of a California law that was liberalized, effective January 1, 2022.
Speaking recently by phone from California, Amanda said Chris, who was skeletal at the end, was so drenched in pain that “he would cower and scream if anyone touched or moved his bed”. He was told two lies, that MAID is illegal in California, and then it’s only legal in Northern California. When he had the strength, he repeatedly shouted “please let me go”. He died with tubes draining fluids from his stomach, kidneys and chest.
California’s MAID law, as enacted in 2015, allows mentally competent adults with a medical diagnosis less than six months to live the option of receiving prescription drugs that allow them to die in their sleep. . Until it was amended last year, the law’s eligibility process could take weeks or even months. It included a 15-day waiting period between two oral requests for medication – a delay that put a peaceful end beyond Chris’ reach.
A third of those who started the eligibility process died before completing it. From this year, the waiting period has been reduced to 48 hours, and hospitals and hospices will be required to post their MAID policies on their websites. (New Mexico passed similar legislation last year.)
The Economist magazine, true to its classic liberal tradition, recently hailed “the welcome spread of assisted dying” to advance a “fundamental freedom” that is now “legal in one form or another in a dozen countries “.
Around the world, MAID generates useful data. A British study found that doctors tend to overestimate – by 500% – the lifespan of terminally ill patients, often to give those who suffer delusional hope. In Oregon, where MAID has existed since 1997, a third of those who receive end-of-life medications do not take them but derive comfort from having them close at hand. In the 25 years since Oregon became the first state to legalize MAID, only 4,209 people nationwide have used it to assert their self-reliance by ending their lives on their terms. Ninety percent died where most Americans say they want to die: at home, often with loved ones.
Kim Callinan, president and CEO of Compassion & Choices, which advocates for MAID, says it “creates a shift within our end-of-life care system from a paternalistic model to one that is resolutely centered on the patient”. His organization says “over the past six years, 30 national and state medical and professional associations have either endorsed or dropped their opposition to ‘MAID.’
Skeptics warn of a slippery slope: People fearful of becoming a burden on their family may find the MAID option to be an obligation. Thus, a physician who mentions it may inadvertently be experienced as coercive. If MAID is justified by the fear of severe pain ending in death within six months, what about the informed choices of mentally healthy people with progressive dementia? Or the psychological afflictions of, say, people deeply weary of life. Are these people mentally capable?
Basically, MAID is for those who are already dying and want help – to prevent a hideous death, not to truncate an unhappy life. MAID – the medical management of a natural process – should be seen as an adjunct to palliative care (palliative care).
Life is lived on a slippery slope: taxation can become confiscation, the police can become instruments of tyranny, laws can metastasize in suffocating ways. However, taxation, police and laws are essential. The challenge is to minimize the dangers that cannot be entirely eliminated from society.
In percentage terms, Americans 85 and older are the fastest growing age group in the country. Medical wonders prolong and improve the quality of life – up to a point. MAID, wrapped in proper protocols, can and should be a dignity-enhancing response to a particularly harrowing rendezvous with the inevitable.