death with dignity

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How Death With Dignity Failed In Mass.

Sometimes it takes an outsider’s perspective to see what’s going on in your own back yard. Here, Paula Span decodes the downfall of the Death With Dignity Act in Massachusetts. Writing in The New York Times today she boils the loss down to a few basics that undermined support for the measure, which was defeated by voters 51 to 49 percent in November.

The winning strategy, Span writes, included exploiting certain language in the measure, and running fear-based ads attacking the act. Span writes:

…early research showed that Massachusetts residents believed in individual choice, and respect for others’ choices, about death and dying, Mr. Baerlein said. So the anti-Question 2 forces didn’t attack on direct moral or ethical grounds; instead, its ads took aim at certain provisions and how they were worded.

For instance, the proposed law — which included multiple safeguards and waiting periods to prevent impulsive requests, coercion or abuse — required a physician to “recommend” that a terminally ill patient notify his next of kin of his intent.

But it didn’t “require” family notification. “How would you feel if you came home and your mother had decided to take her life?” Mr. Baerlein said. “Voters couldn’t get their arms around that.” Continue reading

Marcia Angell: What Went Wrong, What’s Next For Death With Dignity

(stevegarfield/flickr)

Here Dr. Marcia Angell, former editor of The New England Journal of Medicine and lead backer of the doctor-assisted suicide measure that failed this week, talks with WBUR’s Sacha Pfeiffer about what went wrong and how to move forward.

Here’s the full interview:

Marcia Angell: Well, it’s not clear what will happen now. I think we have to regroup and think about that. The bad news is that we lost, but the good news is that the margin was razor-thin. And what this tells us is that people know that we’re ready for this, that this is the decent thing to do. So I don’t think that this is going to go away. But, by law, we can’t do another ballot initiative for another five years, I think.

What I’m looking for is what’s happening nearby. I would suspect that we would see a ballot initiative like this in perhaps Maine, maybe New Jersey, maybe Vermont. And we also can look north to Canada and see what’s happening there. The supreme court of British Columbia overturned a Canadian law against assisted dying, and that’s pending appeal. If the decision in British Columbia stands up to the appeal, then all of Canada will permit assisted dying.

Sacha Pfeiffer: You make me think of a gay marriage parallel here: that the more time passes, the more we see other states approving same-sex marriage. So are you hoping there’s a strategy of acceptance, and if you come back in a few years the state will be more accepting?

MA: Oh yes. I have no doubt about that. Continue reading

What Mass. Can Learn From Oregon About Dying With Dignity

Death is an emotional thing.

And debate over whether to allow terminally ill patients to end their lives by taking a lethal dose of medication — the question facing Massachusetts voters in November — is particularly fraught. Just listen to the charged on-air exchange between supporters and opponents of Question 2 — aka, The Death With Dignity Act, aka, physician-assisted suicide — on Radio Boston earlier this week.

So we thought it might help to start with some cold, hard statistics from the state that knows the issue best.

In 1994, Oregon voters approved the first-in-the-nation right-to-die law allowing terminally ill adults to obtain and use prescriptions from their physicians for self‐administered, lethal doses of medications. After a failed repeal effort, the law was enacted in 1997. Each year, Oregon’s Public Health Division is required to collect certain information and issue annual reports. Here are some of the latest stats from Oregon:

• Since the law was passed in 1997, a total of 935 people have had Death With Dignity Act prescriptions written and 596 patients have died from ingesting medications prescribed under the DWDA.

• Of the 71 DWDA deaths during 2011, most (69.0%) were aged 65 years or older; the median age was 70. As in previous years, most were white (95.6%), well‐educated (48.5% had a least a baccalaureate degree), and had cancer (82.4%).

• Most (94.1%) patients died at home; and most (96.7%) were enrolled in hospice care either at the time the DWDA prescription was written or at the time of death. Most (96.7%) had some form of health care insurance, although the number of patients who had private insurance (50.8%) was lower in 2011 than in previous years (68.0%), and the number of patients who had only Medicare or Medicaid insurance was higher than in previous years (45.9% compared to 30.4%).

• As in previous years, the three most frequently mentioned end‐of‐life concerns were: decreasing ability to participate in activities that made life enjoyable (90.1%), loss of autonomy (88.7%), and loss of dignity (74.6%). Continue reading