The Call-In: Physician-Assisted Dying
A MARTÍNEZ, HOST:
And this is The Call-In. Today we're talking about aid in dying. That's when doctors are legally able to prescribe life-ending drugs to terminally ill patients. It's legal now in six states and the District of Columbia. And similar laws are being considered by several others. We asked you to call in and share your experiences with this difficult issue.
JASMINE SOLOMON: Hi, NPR. My name is Jasmine Solomon (ph).
BRIAN NEAT: Hi. This is Brian Neat (ph).
UNIDENTIFIED MAN #1: I live in Riverside, Calif.
UNIDENTIFIED WOMAN #1: Grand Junction, Colo.
UNIDENTIFIED WOMAN #2: I'm calling about physician-assisted suicide.
UNIDENTIFIED WOMAN #3: I've been involved in end-of-life care for 42 years.
UNIDENTIFIED MAN #2: I helped my mom kill herself after a short and intense struggle with pancreatic cancer.
UNIDENTIFIED WOMAN #4: I am seriously considering moving to a state that allows physician-assisted suicide.
UNIDENTIFIED WOMAN #2: Thank you for the opportunity to share my comment.
UNIDENTIFIED MAN #1: Thank you.
UNIDENTIFIED MAN #2: Thank you. Bye.
MARTÍNEZ: JoNel Aleccia is a senior correspondent at Kaiser Health News. Her focus is on end-of-life issues. And she said that we don't have exact numbers on how many people have chosen to take advantage of these laws. But...
JONEL ALECCIA: It looks like, you know, more than a thousand people a year obtain the prescriptions. And maybe a little more than half of them actually use it.
MARTÍNEZ: Now, can you remind listeners exactly what the process is? Who qualifies? What happens? What's the oversight?
ALECCIA: Sure. Patients who are eligible for aid in dying are people who are terminally ill, typically have six months or less to live, who are mentally competent and can administer and ingest the lethal medications themselves. Two doctors typically have to verify that they meet the qualifications.
MARTÍNEZ: Does this process vary from state to state?
ALECCIA: You know it varies some in the states that have opted for it. California, for instance, has a 15-day waiting period between - the people have to have to say they want this verbally twice. And there's - has to be a 15-day waiting period between the first time and the second time. But many of the states have modeled their aid-in-dying laws on Oregon's original law, which, took effect in 1997.
MARTÍNEZ: Is it still taboo, you think? I mean, is this something people feel comfortable or confident to ask about?
ALECCIA: You know, critics of aid in dying say that they would like it to continue to be taboo because they believe it's kind of the first step toward societal euthanasia, if you will. More and more, though - more and more states are considering this. There is potential legislation in as many as two dozen states seeking to do this. So I think, from what I've heard from experts, the issues surrounding it are becoming less taboo. But, still, talking about end of life and death is still pretty uncomfortable in our society.
MARTÍNEZ: JoNel Aleccia is senior correspondent at Kaiser Health News. JoNel, thanks.
ALECCIA: Thank you so much.
LISA CRAWFORD: My brother's name was Ron Crutcher (ph).
MARTÍNEZ: That's Lisa Crawford. She's one of the people who called us. She's a social worker in Roseburg, Ore.
CRAWFORD: He was, I think, somebody that you probably would have liked because everybody always did.
MARTÍNEZ: Ron chose to die with the aid of his doctors in 2015. He was HIV positive and contracted the disease called PML. It's common in people with compromised immune systems. It attacks the white matter of the brain. For Ron, it was a fatal diagnosis.
CRAWFORD: He went from a very vivacious, adventurous, outgoing person to being bedridden and unable to speak or communicate. One of the things that PML does is that it's a progressive disease. So it begins slowly and can very rapidly take somebody from full function to pretty much just being a shell of a person. And that's where Ron was headed. And he coped with it for quite a while. But when it got to the point where he was losing coordination, and he could no longer text messages or write messages, he was almost completely incapable of speech. And it was extremely frustrating for him. He couldn't communicate at all with anybody.
MARTÍNEZ: What was the breaking point? When did he decide, OK, I want to end my life?
CRAWFORD: Well, one of the upsides about talking about physician-assisted suicide - it was always on the table. We live in Oregon. It's a law here. And it's legal for people to exercise that right. And so long before he had deteriorated, he had made a decision that when he could no longer take care of himself - that that was his line. And so when he reached that point, we were all aware of it. And it happened much sooner than anybody was ready for. But we were at least aware and knew it was coming.
MARTÍNEZ: As his sister, I would imagine that maybe that your reaction might be different than maybe his mom or his dad. What was your reaction like? What was - what were other family members' reactions like?
CRAWFORD: I'm a social worker, so I tend to be very much an advocate for people. For me, physician-assisted suicide is something that I have long supported. And that's only been more deeply affirmed through my brother's death with physician-assisted suicide. I know that my mom struggled with it a lot more than I did. But as a whole, our family was maybe uniquely supportive of this.
MARTÍNEZ: What was your mom's biggest struggle with this?
CRAWFORD: I think her biggest struggle was getting to a point where she felt like he would not have any regrets. You know, you read articles about new research coming out for HIV. Or, you know, you come across something and think, you know, what if we were just six months away from a potential cure? The reality is that Ron didn't have six more months. He was suffering, and he was miserable, and he was lonely. And everything that made him who he was was being taken away from him. But as a mother, to sit there and walk that path with your child, that's a hard road. And she struggled with that.
MARTÍNEZ: Lisa, if you can, if it's OK, can you tell me about the day he died?
CRAWFORD: It was actually one of the most powerful moments that I have ever experienced in my life. And I know that I'm not alone in that. My brother was a very, very outgoing man. And he had tons of friends and wonderful friendships. And the day that he died, he was - he and his partner lived in a house right on the river in Portland.
And, of course, to my brother's style, he had to have his king bed drug all the way downstairs and set up so that he could look out his living room window and look at the river and watch the boats pass and have a nice scenery during the day. And that's where he decided that he wanted to die, as well. And so the day that it happened was December 14, 2015.
And we truly celebrated his life the night before. We made all of his favorite foods and had great wine and conversation and lots of tears and a lot more laughter and more tears. And the following morning on the day he actually died was much of the same. We surrounded his bed. My mom crawled into bed, laid next to him. And my sister and my stepdad and I all kind of piled around - and the friends back around us. And we had stories that everybody shared and favorite memories of him and really surrounded him in the love and support.
And the most difficult part out of the day was just simply the logistics of him drinking the medication. It's a pretty nasty-tasting concoction. And at this point, he was having trouble swallowing. So he had some difficulty getting it down. And that was a little scary for him because, obviously, you're dealing with a medication that's lethal. And you want to make sure that the dosing is right. And he had choked on some and kind of coughed some up. And so, you know, at that point it's a little scary about - has he taken enough? You know, is it going to work out OK? And it was fine. But that was really the only hiccup in the entire process.
Eventually, he faded off to sleep. And his breathing slowed down and eventually got a little ragged. And he had a couple moments where he took some really jerky, deep breaths. And he died. His heart stopped, and he passed away. But he did so with so much love around him. And I think that's really one of the key differences with a traditional death by a terminal illness, as opposed to choosing physician-assisted suicide - is that the person is in an uncontrollable environment. But yet this gives them some control. And we all die. We all have to die. And if you go out surrounded by friends and laughter and love and tears, I think that's not a bad way to go. I mean, there's certainly much worse ways to die.
MARTÍNEZ: Lisa Crawford is a social worker in Roseburg, Ore. Lisa, thank you very much for sharing your story.
CRAWFORD: Thank you so much. I've enjoyed sharing Ron with you.
MARTÍNEZ: And next week on The Call-In, we're returning to the summer of 1967. Fifty years ago, riots devastated Newark and Detroit, and the aftermath continues to this day. What do you remember from that time? We want to hear your stories? Call in at 202-216-9217. Be sure to include your full name, contact info and where you're from. That number again - 202-216-9217. And we may use your story on the air.
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