Filling out my Living Will

Which lines would you initial?

"If in the judgement of my physician, I am suffering with a terminal condition from which I am expected to die within six months, even with available life-sustaining treatment provided in accordance with prevailing standards of medical care:

__I request that all treatments other than those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible;

OR

__I request that I be kept alive in this terminal condition using available life-sustaining treatment (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.)"

For me, it's pretty easy here. I initialed the first option. If I knew I was terminal, I would only want comfort care. The next question gets into more gray areas for me though.

"If, in the judgment of my physician, I am suffering with an irreversible condition so that I cannot care for myself or make decisions for myself and am expected to die without life-sustaining treatment provided in accordance with prevailing standards of care:

__I request that all treatments other than those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible;

OR

__I request that I be kept alive in this irreversible condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.)"

I want to initial the first line, but I also really want to know what the condition would be. Doesn't everyone? I'm lucky; I have a great medical advocate as my medical power of attorney. I'm wondering how other people have worked through these topics though. 

Another Harvest Moon

I was alerted to this film in the comments section of a recent post. 

And I just have to say, it's about freakin' time someone made a movie about life in a retirement home/assisted-living facility. 

Also, it looks like the movie deals with quality-of-life issues, withholding treatment, and the right to die. I'm very curious to see it, and I hope others go to the movie and have lots of conversation afterwards. 

Five Wishes

Just found out about this website, Aging with Dignity. 

They offer a living will written in everyday language, and they call it Five Wishes—because it helps you lay out your five wishes about end-of-life care.

*Who you want to make healthcare decisions for you when you can't make them

*The kind of medical treatment you want or don't want

*How comfortable you want to be

*How you want people to treat you

*What you want your loved ones to know

If you're looking to fill out your own living will, this is a very accessible resource. Please note, it meets the legal requirements in 40 states. But, the site also has a handy little map to show which states accept this form. Link to it here. 

Update on Death with Dignity in Washington State

Just a short piece in the Seattle Times giving some stats on what has happened under the first six months of Washington state's Death with Dignity Act. 

Twenty two people have received prescriptions for life-ending drugs, and it seems 16 of them have since died. The article cites sources that claim 11 are known to have died from using the medication, as opposed to natural causes. (The state will not release information on how exactly specific people have died because of patient confidentiality laws.)

That's about all the article says, except for a couple of quotes from groups on either side. But it's only a few quick paragraphs if you want to check it out. 

Is Assisted Suicide a Constitutional Right?

That's the question Montana's State Supreme Court will take up on Wednesday. 

It stems from the case of Robert Baxter, a 76-year-old retired trucker who died of lymphocytic leukemia. Baxter, while still alive, sought the right to die, and took his battle to the Montana court system. A lower court ruled in his favor, on the very day he died. The State of Montana appealed the decision and it has now reached the state's Supreme Court. 

According to the New York Times:

"The legal foundation for both sides is a free-spirited, libertarian-tinctured State Constitution written in 1972 at the height of a privacy-rights movement that swept through this part of the West in the aftermath of the 1960s. Echoes of a righteous era are reflected in language about keeping government at bay and maintaining individual autonomy and dignity."

It seems now, not only is the right to die being advocated for from some of the more liberally minded states (Washington and Oregon), but now we're seeing a movement come out of a more conservative, individualistic state. 

And we're seeing some different arguments because of the unique nature of Montana. For one, since so many people live in near isolation, opponents worry that the sick will be pushed into the law out of a lack of access to proper healthcare. Montana also already has one of the highest suicide rates in the nation, and some worry about enacting such a law in an area that already has problems with suicide. 

On the flip side, proponents state the need for individualism and autonomy in decision making—the rights of the individual to direct his or her own fate. 

This will be interesting to watch. And if the court does approve the assisted suicide, it will be interesting to see what type of law they come up with, since this move has not stemmed from a carefully drawn out initiative, the way Washington's and Oregon's laws did. Will they essentially copy Oregon's law, like Washington state did, or will they do entirely their own thing, which seems more in the character of Montana. 

Ted Kennedy Wanted a Good Death

A great NY Times piece about the way Ted Kennedy handled planning for his death—from his cancer treatment, to getting his advance directives in order, to spending his last nights eating ice cream and watching James Bond movies with his wife Vicki. 

I'm happy Kennedy had the time and the foresight to plan his last days like this, and I hope others will think a little about doing the same when their time comes when they read this story. 

A High-Profile Bioethicist!?!

What did these parents feed their children? One is White House Chief of Staff, one inspired an HBO show about Hollywood agents, and the another has become maybe the first ever famous bioethicist. 

The insanity of all of that aside, this NY Times piece on Dr. Ezekiel J. Emanuel and his role in advising President Obama's on healthcare legislation is a great read. If for no other reason, it is yet another example of how issues that need to be carefully, reasonably discussed get spun out into crazy, maddening, thoughtless rhetoric in the political arena.