Stories about end of life situations I encountered during a 32 year practice in Pulmonary/Critical Care Medicine. I try to point out the ethical issues, stresses, successes and failures. There are literature citations but this is a personal, hopefully educational exercise. Please comment!
Wednesday, February 24, 2016
Diane Rehm - an advocate for us all
I was fortunate to hear Diane Rehm speak at Seattle's Town Hall last evening. She had credibility with this packed audience, many who had followed her during her 37 years on NPR’s The Diane Rehm Show. As a 79 year old woman she spoke of the death of her beloved husband. In assisted care with advanced Parkinson’s Disease, he ended his life by voluntarily stopping eating and drinking (VSED). Her book, My Own Way, reveals the difficult path of finding support for his choice (laws prohibit physician assistance in dying in Maryland) and promotes her strong advocacy for death with dignity (DWD). This has sparked some controversy at NPR, however Diane is on a mission to reach out to us all. She might smile a bit finding that the Seattle Times labels her as a “rebel.”
As this point, she states she’s “stepping away from the microphone”, but will continue to advocate for choice by speaking and writing. She pleaded with the audience to have the “the conversation” with their loved ones as most important way to have choices their respected. “You can sign all those papers, but they won’t mean much unless your loved ones understand and agree about your choices.”
I wish she had emphasized the durable power of attorney for health care (DPOA-HC), which is the most important document. It truly helped me, as doctor, to know who had the legitimate right to make decisions when the patient could no longer speak for themselves. But that wasn’t her focus in this presentation.
Although I strongly support the DWD movement, only about one in five hundred deaths in Washington and Oregon are from this mode. Good hospice and palliative care are a much more common way of exiting this life – and are still underutilized. So my plea with Diane is to show that there can also be control in the mode of dying in many situations without having to invoke physician assisted death (DWD). But as she said, “Choice is the key.”
Often we don’t understand the choices. After all, we get no practice in that we hopefully only die once. The choices are often nuanced to the particular situation. It’s hardly ever black and white. Good communication, listening, caring, and focusing on my wishes – that’s what I pray for at my own life’s end. May we all have an advocate like Diane Rehm.