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LETTERS

An end-of-life option remains out of reach in Massachusetts

Youssef Cohen underwent cancer treatment as his wife Lindsay Wright looked on, in 2016 in New York. The late Mr. Cohen moved to Oregon that year because of its aid-in-dying law.
Youssef Cohen underwent cancer treatment as his wife Lindsay Wright looked on, in 2016 in New York. The late Mr. Cohen moved to Oregon that year because of its aid-in-dying law.John Moore/Getty Images

We should be able to choose relief from suffering

Re “On their own terms” (Page A1, Nov. 29): COVID-19 has tragically reminded us of modern medicine’s limits to relieve suffering at the end of life. That’s why I urge Massachusetts lawmakers this year to pass the End of Life Options Act. It would give mentally capable terminally ill adults the option of medical aid-in-dying to peacefully end unbearable suffering.

I have a personal stake in this issue. Before my husband died an excruciatingly painful death from pancreatic cancer, I promised I would work to help pass this legislation so that other terminally ill Massachusetts residents would have this option that, unfortunately, he was denied. Even with excellent medical, hospice, and palliative care (including an implantable pump to administer relief), his final weeks were filled with suffering from unrelenting pain.

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It’s a misconception that hospice and palliative care can alleviate pain and suffering in all circumstances. In actuality, 25 percent of dying people have uncontrolled pain.

My husband wanted the option that is available to residents of other states, such as the people Mark Arsenault interviewed for his story. This option would have given him peace of mind in his dying days, ended his intolerable suffering, and allowed him to die in his sleep, surrounded by his family and loved ones.

Janet Simons Folger

Falmouth


Strong support statewide for aid-in-dying

Contrary to the claims of John B. Kelly, director of Second Thoughts Massachusetts, a group opposed to medical aid-in-dying, 64 percent of Black residents of Massachusetts endorse the option, according to a 2019 Boston Globe/Suffolk University poll. Indeed, the poll showed strong support for this end-of-life care option statewide.

However, as COVID-19 has demonstrated, accessing and using end-of-life care options, such as hospice, palliative care, and medical aid-in-dying, is more difficult for communities of color.

According to the Journal of the American Medical Association Network, “research has documented racial differences in hospice use and end-of-life treatment intensity, consistent with a broad range of racial disparities in health care use and health outcomes,” which includes “preferences for more aggressive care, mistrust of the health care system, lack of in-home resources, and miscommunication and misunderstanding of treatment options.”

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The good news is that medical aid-in-dying laws spur doctor-patient conversations about all end-of-life care options. They also benefit each of us by encouraging use of palliative medicine services. That’s why Massachusetts lawmakers should pass the End of Life Options Act in 2020.

Dr. Lewis M. Cohen

Northampton

The writer is a professor emeritus at the University of Massachusetts-Baystate Medical School and Tufts University School of Medicine.


‘Still haunted by the last time I saw her’

Thank you for Mark Arsenault’s extensive article on medical aid-in-dying. In a world where there should be some sense of compassion, there are circumstances in which this option makes sense.

In 2002, my mother, who had been suffering from Alzheimer’s for several years, lost her ability to do something most of us do many hundreds of times a day: Her brain no longer told her to swallow. She would have to live the rest of her life with a tube down her throat or go through each day choking on her own saliva.

My mother had signed a general do-not-resuscitate order, but she was not unconscious, so it did not apply. Assisted dying was not available.

My brother and I were faced with a decision to have her live that way, or have her starve to death.

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I am still haunted by the last time I saw her, looking at me in fear and anguish, not understanding what was happening. She died several days later.

If we call ourselves human beings, then medical aid-in-dying, including the ability to designate in advance the circumstances in which one would want it to apply, is a moral obligation. Moral obligation supersedes religion or politics.

Imposing needless suffering when death is inevitable is immoral.

Robert Gilstein

Franklin


She wants a choice when the time comes

I am 73 years old and have severe chronic obstructive pulmonary disease. I have gone from being a cross-country ski patroller to being able to walk only very slowly. COPD will be what kills me, unless something else gets me first.

I worked as a hospital nurse for more than 40 years and am well aware of what is in store for me: gasping for air at the slightest exertion and being bedridden. I would like to have the option of aid-in-dying in a few years when my life becomes intolerable.

John B. Kelly, director of a group opposed to medical aid-in-dying, believes that if I want to take my own life it is because I am “obsessed with . . . the ability to perform [my] own self care.” Believe me, the fact that my husband has to help me shower is the least of my worries. Kelly insults me and others who suffer with pain and terminal illness.

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The Archdiocese of Boston opposes aid-in-dying and will never be satisfied with having just Catholics follow its rules; it wants to enforce them on everyone of any religion or no religion.

Several years ago we had our elderly dog euthanized. He had masses in his abdomen, and medication couldn’t control his pain anymore. We gave him treats and told him what a good dog he was while the vet gave him a shot to make him sleepy. We continued to talk to him as he got the shot that caused his death. Afterward, my husband and I looked at each other and agreed that we want to go the same way when our time comes.

It should not be so hard for humans to get the same level of compassionate care that is available to animals.

Kathy McDonald

Milton


We are kinder to our pets

The heartbreak of being barred from deciding for yourself when you simply need to stop living is matched only by the excruciating experience of watching a loved one lose their mental faculties and knowing — because they told you, time and again — that they would never want to live in a condition of dementia.

We are kinder to our pets than our parents.

If your religion doesn’t permit this level of mercy, then you don’t have to participate. But please, please, allow me to offer this gift to someone I know would beg me for it.

Iris Sonnenschein

Brookline