Thursday, February 12, 2015

Just Ask Ed Horn's Widow

If Canada needs a model for our assisted suicide legislation, we could learn a lot from Oregon.  The state's Death with Dignity Act has been in effect since 1994 and it's been observed, studied and analyzed thoroughly over the years.  Even in a state with a lot of Christian fundamentalism, Oregonians support for the law comes in at a powerful 80%.

The Toronto Star looks at the 2013 death of 76-year old geologist, Ed Horn, who was in the late stages of ALS, Lou Gherig disease.

Ed Horn, a 76-year-old geologist, was dying of ALS. A doctor asked him if he had any religious qualms about his decision to end his life by giving himself a lethal medication. He said no.

“I’m a scientist,” Nancy Horn, his wife of 54 years, remembers him responding. “I believe in the earth.”

Ed Horn got to die in nature. Someone from Compassion & Choices, the group that supports patients who have opted for “death with dignity,” let the Horns borrow a little house in the Oregon hills with a fireplace and a picture window.

“It was just lovely,” Nancy Horn, 75, said Friday when contacted at her home in Sherwood, Ore. “It had a view over Mount Hood, the fir trees. It was just the nicest gesture that anyone has ever made for us.”

Nancy has flashbacks to Ed’s death in 2013. She does not have regrets. Had he waited even one more day, she said, he would have been too weak to fulfil the law’s requirement that he administer the deadly dose himself — “and then he would have had to go on living.”

“My husband and our family were all greatly relieved that he didn’t have to suffer on,” she said.

“After Ed died and people would come up to me and say they were sorry, I would say, ‘I don’t know your opinion of this, but Ed had chosen death with dignity.’ And they all said, ‘Oh, isn’t that the greatest? Wasn’t he lucky?’ Every single person I spoke to said the same thing.”

What makes Oregon's end of life regime special is that while it's enormously popular with the public and open to so many terminally ill patients, it's rarely used to end life.

Despite its popularity in principle, doctor-assisted suicide is rarely chosen by dying patients. Through 2013, 752 people had taken lethal doses. Another 421 people had prescriptions written but did not make use of them. The government said 71 people died under the law in 2013 — 0.2 per cent of all people who died in Oregon that year.

What Oregon's law does is allow the terminally ill to die without the terror of having to go through unbearable suffering at the end.  It's an option.  There's no booking an appointment, no travel to a clinic where medical staff wait to put you down.  There's no death on some strangers' terms and timetable, nothing resembling Death Row.  You have a prescription.  You fill that prescription or you don't.  If you do, you receive a medication to painlessly end your life.  You take it or you don't and, if you do take it, you choose when and where and how. It's the patient's life and their life to end as they see fit.  

What Oregon has found is that most people are able to go through the dying process without taking the Death with Dignity option.  There are many reasons a person would choose a normal death.  Yet even those who don't take life-ending drugs have the comfort of knowing they have the option.  Anything less is inhumane.


Lorne said...

Although not explicitly stated in the article, Mound, I wonder if Oregon's right-to-die law has prompted better end-of-life care. For far too long the suffering that could be alleviated by pain reduction through liberal administration of drugs has been only tepidly embraced, if at all. It is my hope that the Supreme Court decision here will ultimately lead to improvements in that aspect of dying.

BTW, Margaret Wente wrote a surprisingly good (for her) piece on this topic recently:

The Mound of Sound said...

Thanks for the link, Lorne. I agree that we have enormous room for improvement in palliative care. I don't know what the situation has been in Oregon but with privatized medical care I doubt it was very good. Insurers aren't sympathetic to those who won't be paying premiums next year.

Purple library guy said...

"Had he waited even one more day, she said, he would have been too weak to fulfil the law’s requirement that he administer the deadly dose himself"

Hmmm . . . hopefully there's an angel in the details, but does that mean people who are, say, quadroplegic are less equal than other dying people? Surely a requirement that the decision-maker "pull the trigger" themselves can be handled in ways that don't require strength or manual dexterity--a tube to blow into, say.

The Mound of Sound said...

I wondered about that too, PLG. I can understand why they wouldn't want the kids offing great aunt Tilly for her sterling tea service. Perhaps they thought they needed to draw a line somewhere even knowing that it could mean tragic consequences for a small percentage.