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Anna KeatingNovember 06, 2016

I am walking in downtown Colorado Springs to pick up a pizza for dinner when a young woman with a clipboard stops me for a signature. Her placard says “Prop 106.” “Do you want to sign here to allow Colorado citizens the right to a peaceful death?” she asks.

I was expecting something different. Maybe a raise in the minimum wage, or a tax increase for roads. When I think of a ballot initiative, I do not think about irreversible life and death decisions. My stomach drops. My heart is racing. I was just going to pick up dinner.

“Do you want to sign here to allow Colorado citizens the right to a peaceful death?” It sounds so benign. How could anyone be against a peaceful death? Why is she speaking euphemistically? I look at her in silence as I come to understand the gravity of the question. “A peaceful death of their own choosing,” she says.

The woman with the clipboard has just asked me to give physicians the right to end their patient’s lives. She has asked me to redefine the practice of medicine, to remove “do no harm” from the Hippocratic Oath, to change the way my children and future grandchildren will die. I shake my head.

“No, I’m on the other side of this issue,” I say quietly, and cross the street.

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Why am I so shaken? All she wanted was a scribble, a couple of letters on a page, and then voters in Colorado could make helping terminally ill people kill themselves part of what physicians routinely do. What difference does it make? They are dying anyway.

And yet I have grave concerns. In Western European countries, like the Netherlands, where physician-assisted suicide has been legalized, the practice has increased by double digits every year for over a decade. “Aid in dying” has been extended to children, the mentally ill, people with autism, even victims of sexual abuse whose suffering was deemed “unbearable.” The Dutch are now in the process of potentially legalizing assisted suicide for those who are not terminal but nevertheless feel they have “completed life.”

And suicide, we know, can be contagious. People who know a suicide victim are twice as likely as the general population to develop suicidal thoughts. Between 2013 and 2015, 29 teenagers in my hometown of Colorado Springs killed themselves; what they had in common was knowing of another teenager who had done the same.

Walking across the street, however, I feel guilty because the organization sponsoring Prop 106 is called “Compassion and Choices.” Who could be against either of those? Such is the power of branding.

For there is a more compassionate way. And there are better choices. My friend Cassie is a hospice nurse. She once helped a woman fulfill her dying wish to marry her boyfriend of 30 years, with a white dress and everything, right there in the hospital. Mostly, she helps people live as comfortably and fully as possible, as nature takes its course. She makes sure patients are not alone or suffering.

If they ask her, Cassie reads aloud to them until they fall asleep. She gives powerful pain medications, as much as her patients want or need. If they do not want to eat or drink, that’s O.K. They are passively dying. If they want off their ventilator, if they want to go home, if they want to never have another round of chemo, that is what hospice is about. Not hastening people’s deaths but supporting them as they are dying. To help patients live as they wish, for as long as they are able. To be present to them and their loved ones, in their joy and in their pain.

Indeed, this kind of palliative care is costly and 24/7. There is no guarantee that in a post-Prop 106 world insurers would continue covering expensive treatments for terminal patients. Under Prop 106, vulnerable patients already worried about burdening their families with the cost of their care would be counseled about their end of life options—by the same doctor who would be in charge of prescribing their fatal and inexpensive cocktail.

It is disheartening that we live in a society that has devalued caring for others and allowing others to care for us. Maybe in a hundred years we will not need hospice or family care anymore. Death will always be self-administered. The stigma will be gone. We will be fully autonomous individuals, even in our last moments. We will take care of it, as we always do, by ourselves. But “a happy death” requires more than a prescription. It requires community and loving kindness.

Whose Life Has Value?

If I went to see my doctor tomorrow and told her that I wanted to kill myself, and insisted that she help me, I am certain that she would say no. She could even have me placed, against my will, in a psychiatric hospital. At the very least she would try to convince me that my life was worth living. Why? Because I am a human being, or because I am a young, healthy, educated, white woman? Because all lives have value, or because I have a husband and children, a career, friends, a lot to look forward to? If my doctor gave me an overdose of sleeping pills and instructed me on how to take them, she would lose her license. People would find it tragic, or disturbing, at best.

But if I were poor, old, disabled and terminally ill, or otherwise perceived to be of little value, and I told my doctor that I wanted to kill myself, under Prop 106, she would be able to “assist” me. She would not even need to know me or have treated me in the past in order to meet with another doctor and then prescribe me a lethal injection and teach me how to take it at home. It is no wonder that disability activists, the poor and racial minorities are the most vocal opponents of physician-assisted suicide. They will be offered this “option” first. Then again, we will never know how equally or unequally Prop 106 is administered because the law does not require the keeping of detailed statistics about who is using it and why.

We live in a culture that values productivity and success and makes the weak feel that their lives have no purpose. If Prop 106 is passed, it will irreversibly change the way we think and live in Colorado. If suicide is now referred to as “death with dignity,” has the person in the wheelchair with the feeding tube who stubbornly refuses to die, somehow forfeited their own? Can there be no dignity in suffering? Is there no dignity in a natural death if our “useful” years have passed? Are people who do not make money of no value?

I pick up the pizza and walk to my car. If the woman with the clipboard had wanted to ensure that every Coloradoan was better informed about their end of life options I would have signed on the dotted line. We do need to change the way people die in the United States. Most of us would rather die at home than in a hospital, receiving painful, costly and ultimately ineffective care. We do need to better support Coloradoans with terminal illnesses so that they can make informed choices. We do need to educate patients about the difference between life-prolonging care, limited medical care and comfort care—well before the end of their life. If the woman with the clipboard had wanted to ensure access to hospice or psychological or spiritual support for terminal patients, I would have thanked her for her work and joined her in the cause.

But Prop 106 in Colorado is not about any of that. It is about the continued marginalization of the most vulnerable.

Anna Keating is the co-author of The Catholic Catalogue: A Field Guide to the Daily Acts That Make Up a Catholic Life (Penguin Random House). She and her husband own Keating Woodworks, a handmade furniture studio in Colorado Springs. She blogs at thecatholiccatalogue.com.

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Crystal Watson
7 years 1 month ago
*** The woman with the clipboard has just asked me to give physicians the right to end their patient’s lives. **** Doctors already end their patient's lives n a number of ways. They take them off respirators, they deny them a chance to part of drug studies because they are too old and will skew the results, they kill them by denying them food and water, etc. You drag in scary circumstances that have nothing to do with the actual issue .... this law, like the one in California where I live, is not about getting rid of disabled people, not about getting rid of poor people, not about letting people who are depressed commit suicide, not about saving money, not about devaluing patient care. It lets people who are terminally ill and have only a short time left to live, people who are suffering, decide for themselves what they want to do. I think the reason people who are against assisted death for the terminally ill bring up all these non-issues is because they don't want to state the real reason they are against it .... they believe God is the only one who can decide when you get to die.
Willam Nat
7 years 1 month ago
There's a world of difference between taking a patient off a respirator and intentionally killing them by giving them poison!
Willam Nat
7 years 1 month ago
California has only had the law for a few months, how can you state what its results are?
Willam Nat
7 years 1 month ago
No, the real reason people are against it is because it gives one person (in this case a doctor) the "right" to intentionally take the life of an innocent person. There are no other laws that do that. You don't need to believe in God to understand that this is dangerous for the vulnerable people of society.
Christopher Dawson
7 years 1 month ago
In the end, the only thing that is yours is your own soul. And if you are at the point where medical science is useless and you are tired of constant pain and the indignity of being unable to feed yourself or wash yourself or even get yourself to the toilet and you decide you are ready to die, you should be able to ask a doctor to prescribe you a lethal dose of medicine so you can have one least measure of control over your own life. Your soul does not belong to the church or to the state. Likewise, the right to choose when you die under the circumstances of terminal illness does not belong to the church or the state. It belongs to you. http://c-dawson.blogspot.com/2016/05/all-that-you-have-is-your-soul.html
Willam Nat
7 years 1 month ago
How is it that most pro-suicide people ridicule and belittle religious opponents of assisted suicide, but you come along with this odd "soul" argument FOR it?
Travis Wakeman
7 years 1 month ago
@Christopher Dawson Would you be opposed to legalizing consensual dueling to the death? What about turning Yankee stadium into a gladiatorial arena where consenting fighters duel to the death for cash prizes and fame? I'm sure that we could find enough crazy people who would be willing to sign up. If people should have complete freedom on the ends of their lives, why could anyone oppose either of those things? @Crystal Watson I think it has more to do with the sanctity of human life. Does one need to be religious in order to believe in that?
Willam Nat
7 years 1 month ago
Excellent article! You show compassion for the vulnerable people in our society --- which is something that is often lacking in this debate.

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