The Right to Die?
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LEE HOCHBERG: Portland accountant Bill Hancock looks healthy enough, but he knows he’s in his last year of life.
BILL HANCOCK, AIDS Patient: Prognosis-wise, I would say 12 months or less for myself–whichever way you go, the outcome is the same, you know, that I’m going to die.
LEE HOCHBERG: Diagnosed HIV positive 11 years ago, Hancock came down with pneumonia and AIDS-related infections last year. He’s worked hard and gained back 60 pounds of body weight and muscle. But he knows there’s a limit to what his exercycle can do for him.
BILL HANCOCK: You see these people who have no physical or mental abilities and are laying in a bed, you know, racked with pain. And I had big fears about that for myself, I don’t want to be that way–and I’m not going to put my parents through it either. I’m not going to leave them in a position of having to make some kind of decision as to when they’re going to pull the plug. I’m not going to do that to them.
LEE HOCHBERG: Hancock says within a year he’ll ask his Portland doctor to help him end his life. He’s hopeful he can get that help because of a landmark court ruling last month. A Federal Appeals Court overturned a Washington state law that had banned assisted suicide. The justices said the right of a mentally competent, terminally ill person to hasten his own death is a constitutionally-protected personal liberty.
LEE HOCHBERG: (Joanne Scarburry being wheeled to radiation) This first-ever finding of a constitutionally-protected right to die seems to offer a better choice to 64 year old Joanne Scarburry of Portland. Before the ruling, she had tried to get a gun from her son, so she could end her agonizing bout with lung cancer.
JOANNE SCARBURRY, Cancer Patient: Sometimes it gets so bad that you just don’t feel you can go on, so it’s an option you can take.
LEE HOCHBERG: Are you ready to end your life?
JOANNE SCARBURRY: Well, not right this minute I’m not, but yeah, I could do it.
LEE HOCHBERG: Why?
JOANNE SCARBURRY: Why not? Nothing left.
LEE HOCHBERG: It’s a choice Dorothy Hoogstraat’s husband never got to make. A professor and a vocal advocate of the right to die, Emerson Hoogstraat died of bone cancer before that right could ever be written into law.
DOROTHY HOOGSTRAAT, Widow: What do you do? You just suffer, I mean, is really what it amounts to. Every rib he had was broken, and you’d go try to move him when he was in bed and he just would cry out because it hurt him so. There was no place you could touch him that it didn’t hurt him. And his femur and his right leg was broken. There was nothing, I mean, there was nothing anybody could do for him.
LEE HOCHBERG: But there are many who are fighting vigorously against assisted suicide. The State of Washington plans to appeal the rejection of its suicide ban, to the U.S. Supreme Court.
BOB CASTAGNA, Oregon Catholic Conference: This is as shocking a policy development as can be confronted by the Catholic Church in this nation.
LEE HOCHBERG: And the Catholic Church, calling the court ruling “chilling,” is aggressively lobbying judges and state legislatures to reject assisted suicide.
BOB CASTAGNA: What the court has done had been to elevate personal autonomy and the liberty interest of the individual at the expense of the state interest in the preservation of life, prevention of suicide, maintaining the ethical integrity of the medical profession. The potential for abuse of physician assisted suicides, once unleashed in society, is very real.
DOCTOR: (with Bill Hancock) Okay. Just relax for a moment.
LEE HOCHBERG: As advocates and opponents argue, some patients and doctors are taking things into their own hands.
DOCTOR: (with Bill Hancock) Is that tender at all? The liver seems a little enlarged but not dramatic, not real tender.
LEE HOCHBERG: Physicians can be prosecuted for dispensing lethal prescriptions, but a recent Oregon Health Sciences University survey showed 21 percent of Oregon doctors had been asked for lethal prescriptions in the last year. And 7 percent of them wrote such prescriptions. A new study of Washington State doctors reveals similar figures.
DOCTOR: (with Bill Hancock) You continue to astound me in that you’re doing so much better than you were six months ago.
LEE HOCHBERG: Bill Hancock’s doctor says the new court ruling identifying a right to die will make it easier for him to write Hancock a lethal prescription.
DR. MICHAEL MacVEIGH: I personally would not just be concerned about the legal aspects, any repercussions of assisting a patient with suicide, where previously obviously that would have been a concern.
BILL HANCOCK: It makes me feel better as far as being able to talk to him about it, and it’s kind of a relief. You know that there’s a potential for that assistance not only from my doctor but also legally.
LEE HOCHBERG: Other doctors say the recent acquittal of so-called “Suicide Doctor” Jack Kevorkian is making it easier for them to respond to their patients’ wishes for assisted suicide, as are last month’s appeals court ruling that Washington State cannot ban assisted suicide, and the latest ruling that new York State cannot ban assisted suicide. But Dr. Peter Goodwin cautions that until the U.S. Supreme Court upholds the right to die, and state legislators draw up standards to regulate it, many doctors will avoid dealing with it.
DR. PETER GOODWIN, Oregon Right to Die Committee: Oh, there’s still a huge barrier because I don’t think any physician sort of is secure that, in fact, there has been a law change in his or her state, because there are no safeguards, there are no professional standards established.
LEE HOCHBERG: Goodwin and seven other Oregon doctors wrote Oregon Measure 16, the nation’s first law permitting assisted suicide. It requires two physicians determine the patient is terminal, competent, and acting voluntarily in requesting lethal medication. Oregon voters passed it in 1994, but a judge ruled it unconstitutional. That case is also headed for the Court of Appeals.
NURSE: Wow! You’re kind of drowsy.
SOCIAL WORKER: On the pain scale zero to ten, where is your pain now?
SOCIAL WORKER: Really wonderful!
NURSE: Boy, we did good!
LEE HOCHBERG: As the battle plays out, critics of assisted suicide are pressing hospitals to establish comfort care teams to deal with the special needs of the dying. This team at Portland’s Providence Hospital hopes attention to pain relief and spiritual needs will leave patients less inclined to seek suicide.
BOB CASTAGNA: We don’t need to resort to killing the terminally ill to solve the problem of pain at the end of life. Between modern means of pain control, hospice care, community involvement in the dying process, we can provide the support that people need as the antidote to asking for the prescription of the lethal overdose.
LEE HOCHBERG: An Oregon Health Sciences University study found doctors have become fare more attentive to end-of-life care after being stunned by the Measure 16 vote.
DR. SUSAN TOLLE, Oregon Health Sciences University: In the media campaign, Oregon patients and families got a lot more sophisticated, they learned that pain is usually treatable, but we don’t always do it, and they got more aggressive in saying, give him more, he is suffering, and that made a big difference.
LEE HOCHBERG: Study co-author Susan Tolle says physician referrals to hospices have increased as much as 20 percent and several hospitals have developed comfort care teams. She estimates all but 2 percent of Oregon’s dying can now have their discomfort dealt with to their satisfaction.
DR. SUSAN TOLLE: The majority of those who are dying in Oregon will have the kind of care they wanted, and will have a reasonable death, and a much huger number of people are affected by what we’re doing in improving comfort care than the number of people who would ever utilize assisted suicide.
LEE HOCHBERG: But Dorothy Hoogstraat doesn’t think comfort care would have been the answer for her husband.
DOROTHY HOOGSTRAAT: I don’t know what comfort care is. I don’t know how you give comfort care to people who have what he had. I mean, perhaps for some things there is comfort care, but for what he had, no, there was not, there was no comfort to it.
LEE HOCHBERG: Bill Hancock says what would make him a little more comfortable in his last two months is a swift legal resolution of his right to die.
BILL HANCOCK: There’s no time when you have, when you’re looking at 12 months, you don’t have a lot of space for a waiting game.