Framingham resident; hospice volunteer
I have been a hospice volunteer for four years, visiting hospice patients and sitting with actively dying veterans. I believe in hospice care but even excellent hospice care cannot ensure a peaceful death.
One of the veterans I met went to Vietnam when he was 17 and served three years. At age 69, he was diagnosed with ALS and later admitted to our hospice. He was on high doses of narcotics but still suffered unremitting pain. Often he would sob uncontrollably. His death was prolonged and agonizing.
In Massachusetts it would have been illegal for him to avoid suffering at the end of life with prescription medication. This is not so for residents of Oregon, six other states, and Washington, D.C. (and shortly in two other states). Medical aid in dying has been an option there for a combined 40 years without a single documented case of it being used for any reason other than allowing terminally ill people to choose a peaceful, pain-free death.
Proposed medical aid-in-dying legislation in Massachusetts, the End of Life Options Act, requires two physicians to agree the requesting patient has less than six months to live, and a mental health professional to confirm the patient has sound judgment.
An oral request has to be followed by a 15-day waiting period and a written request witnessed by two people. The patient must be able to take the medications on their own. These safeguards would ensure the dying patient chooses medical aid in dying voluntarily to avoid an agonizing death. This legislation should meet with wide support; 70 percent of Massachusetts residents favor medical aid in dying, according to a 2014 survey.
Many would not wish to use this option, but our laws should not deny it to those who would find comfort in knowing we could opt for a peaceful end when death is near. The veteran I cared for had already faced death as a teenager; he deserved a choice over how he faced death as an old man. I want the same choice — the option of dying quickly and peacefully, surrounded by my family and friends — for myself. I pray our legislators enact this law.
Malden resident; certified peer specialist; longtime disability rights activist; board president of M-power, a mental health advocacy organization
At first I thought I supported assisted suicide. As a member of a peer community of people with lived experience of mental health diagnosis, trauma, and addiction, I passionately believe in self-determination regarding treatment for our physical and mental health. But when I looked more closely, I found that assisted suicide prevents choice as it threatens everyone with premature death.
We have learned a “terminal diagnosis” of six months or less to live is guesswork; 12 to 15 perrcent of people admitted to hospices survive six months or longer. A significant few will live years, even decades longer. Their lives would be lost by way of excessive trust in their doctors’ diagnoses. People can become “terminally ill,” meanwhile, if denied potentially curative and life-extending treatment by health insurance companies.
Last year, 54 percent of those taking their lives through Oregon’s medically assisted suicide program felt they were a burden. Feeling one’s very existence is burdensome to others ruins the possibility of individual choice.
Under the Massachusetts legalization bill, a mental health professional must determine “the patient is not suffering from a psychiatric or psychological disorder or depression causing impaired judgment.” Many in the peer community have received harmful psychiatric care, so we have a healthy mistrust that our best interests will be upheld.
Moreover, well-meaning counselors may miss clear signs of distress. Even severely depressed people can usually present as “unimpaired” for a single meeting with an unknown psychologist or psychiatrist.
My community knows that depression is insidious. We know depression does impair judgment. Absolute hopelessness and seeing no way out are common feelings for those of us who have experienced severe depression. Personally, as someone who has been suicidal in the past, I can relate to the desire for “a painless and easy way out.” However, depression is treatable and reversible. Suicide is not.
Assisted suicide programs send the message to people in emotional distress — old, young, physically ill or not — that suicide is a reasonable answer to life’s problems. It isn’t.
The reasonable approach is to provide people the supports and health care they need and deserve so that they will experience real options, not a push toward suicide.
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