Academic journal article The Hastings Center Report

Strange Deathbedfellows

Academic journal article The Hastings Center Report

Strange Deathbedfellows

Article excerpt

In 1998 I was hired by a local health care system to evaluate the mental health of enrolled patients who requested lethal prescriptions under Oregon's newly implemented Death with Dignity Act. I drove to the trailer home of my first patient, a man in his sixties tethered to an oxygen tank for his chronic pulmonary disease who was recently diagnosed with advanced lung cancer. He told me about his abusive, alcoholic stepfather and how he left his family and church at age sixteen, determined never again to be subjugated in any relationship. But in a life marked by an avoidance of intimate relationships, he corresponded regularly with his nephew and was proud to leave him a small inheritance. He shared with me his delight at the morning's newspaper comics, particularly those focused on family life.

A hospice intake nurse had come to his home a few days earlier. She had upbraided him for smoking while using supplemental oxygen. He judged her bossy and domineering. Thirty minutes into the intake, he fired her, then notified hospice that he did not need their services. He wanted to die in his trailer, alone. To be observed in such a dependent state during his final moments was anathema to him. All of his providers were very uncomfortable with this plan. "Surely he's depressed?" I was repeatedly asked. But after careful negotiations, he agreed for his physician to be present when he ingested a barbiturate, provided the doctor left as soon as he became unconscious. His final words to the physician were "Turn out the lights and lock the door."

Since then, I have been privileged to interview more than fifty Oregonians who requested legalized, physician-assisted death, as well as their family members, physicians, and hospice providers. These people prize independence, autonomy, self-sufficiency, and control. They want to leave this world in the driver's seat, and they anticipate a dying process that is incompatible with this goal.

When talking to a variety of audiences about my experience around Oregon's law, I am often asked, "How and why do hospices allow physician-assisted death to happen?" I respond, "How can they prevent it?" Even among hospices that "prohibit" participation, patients live at home and receive lethal prescriptions from their physicians, who may not be affiliated with the hospice. Some patients never tell their hospice providers of their plans. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.