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The best palliative care cannot relieve suffering for all

John B. Kelly is correct that Massachusetts should provide better home care and world-class palliative care (“Push for assisted suicide raises questions over disability rights,” Letters, Sept. 7). But even the best hospice and palliative care cannot relieve suffering for every terminally ill patient.

That is why Massachusetts lawmakers should pass the end-of-life options measure that would allow terminally ill adults to have the option of medical aid in dying to gently end intolerable suffering.

The Massachusetts Medical Society in 2017 adopted “the position of neutral engagement, serving as a medical and scientific resource to inform legislative efforts that will support patient and physician shared decision-making regarding medical aid in dying.”

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One of us has a son with spinal cord injury paralysis and the other has Friedreich’s ataxia, a neuromuscular, often life-shortening disease. Our observation over 20 years is that most people in the disability community are strong advocates for autonomy and expanding end-of-life care options.

Medical aid in dying is an end-of-life care option strictly limited to adults with a terminal illness, with full mental capacity, who have unremitting pain and suffering with no hope of survival, confirmed by two physicians.

We urge the Globe to reaffirm its endorsement of the end-of-life options act.

Dr. Eric J. Ruby

Taunton

Michael Martignetti

Lexington

Ruby is the founder of Massachusetts Walks Again and organizer of the yearly Spinal Cord Injury Awareness Day at the State House.


As a person with a disability, she finds push for such measures frightening

As a person with a disability, I support the letter written by John B. Kelly, opposing assisted suicide. So much emphasis is placed on suffering that can usually be modified by a number of treatments. In my opinion, depression is a stronger reason for individuals to choose death. As death nears, we fear loss of control and specific circumstances such as bothering family and friends and requiring embarrassing assistance, and we wonder what the process will be at the end.

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We are all going to die. Palliative care, hospice, and other processes can alleviate most suffering. I do not want my family to be burdened, but I assume that if something happened to them, they may fear being a burden as well.

Death is a reality, but it is frightening to think that people would encourage or legislate assistance in making it happen more quickly. It may not be murder, but how would you define it?

Karen Schneiderman

Jamaica Plain


Retired doctor has seen the agony of dying patients

Re “Push for assisted suicide raises questions over disability rights”: I am a retired internist with incurable, metastatic prostate cancer and a disabling neuromuscular disease. I have cared for many dying patients who suffered terribly.

That is why I am a strong supporter of compassionate legislation in Massachusetts to allow terminally ill adults to have the option of medical aid in dying to end unbearable suffering. The bill is modeled after Oregon’s time-tested, 23-year-old Death with Dignity Act.

Contrary to opponents’ claims, Oregon Health Authority data demonstrate that most terminally ill people don’t take aid-in-dying medication immediately, and one-third of these patients never take the medication but got comfort from knowing they could take it. Data show that the median duration between the first request for aid-in-dying medication and death is 45 days and the longest duration was four years. In addition, 90 percent of these patients are enrolled in hospice.

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National studies show that 65 percent to 85 percent of patients with cancer experience breakthrough pain, 26 percent die with uncontrolled pain, and 20 percent die with uncontrolled shortness of breath. Having seen this nightmare experience repeatedly over three decades of practice as a physician, I definitely do not want to die this way.

Dr. Roger Kligler

Falmouth

The writer is a plaintiff in a lawsuit seeking the right to medical aid in dying.