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While assisted suicide is legal in only three states, the story of 29-year-old Brittany Maynard, who after being diagnosed with terminal brain cancer moved to Oregon so she could legally end her own life, has brought the issue back into the national spotlight. NewsHour Weekend's Stephen Fee reports on how this renewed debate may affect end-of-life care and the momentum for the assisted suicide movement.
Like millions of Americans, Oregonian Pam Wald was riveted by the video of Brittany Maynard, a 29 year old woman suffering from brain cancer who moved here to end her own life.
"I looked at that video. I studied, especially the last time I saw that video, I don't think I left her eyes."
Maynard lived in California but relocated to take advantage of Oregon's Death With Dignity law that permits what's commonly known as physician assisted suicide.
"I will die upstairs in my bedroom that I share with my husband, with my mother and my husband by my side."
She was featured in a media campaign by a group called Compassion and Choices — twenty years earlier, its predecessor group played a key role in advocating for Oregon's first-in-the-nation right-to-die bill.
In 1994, Pam Wald considered herself a supporter of Oregon's Death With Dignity Act.
"So you voted for it, but you never thought, 'This has to do with me.'"
"No, no. It was kind of like out of compassion. The idea that, you know, someone gets in this situation, they deserve a right, you know, to choose. You know, it's important to choose how we live our lives and how we die."
"But then you found yourself in this situation."
"Where you — where it's, now it's the story's about you."
"Yeah. This is my husband."
In 2011, Pam's husband of 43 years, Ben Wald, discovered an earlier bout of cancer had returned — soon after, the disease began taking a lethal toll. Pam and daughter Bonnie watched as the once robust Ben rapidly lost weight. As the cancer spread to his bones, the pain became intolerable.
"Ben woke me up in the middle of the night and he said, 'Pam, we gotta talk. I don't want to keep, you know — I'm dying, Pam. I've had a good life with you and Bonnie. I really don't want to just keep living like this. I want to explore Oregon's Death With Dignity law.'"
Under Oregon's law, a doctor must determine a terminally ill patient has six months or fewer to live. The physician can write a life-ending prescription only after a second doctor signs on and both agree the patient is of sound mind. The patient must request the drug again 15 days after the initial request. But once the patient has it, the doctors' role is over.
Since the law went into effect in 1997, nearly 1,200 people have received life-ending prescriptions — but just 752 have actually taken them and died. Others died sooner and some changed their minds.
As Ben's health deteriorated, he and Pam sought help from Compassion and Choices, the group supporting Brittany Maynard. In 2012, the group connected them with two doctors who signed off on Ben's wishes.
"Monday, Ben got the order for the prescription so it meant we could pick it up on Wednesday. And I thought at that point we would have it and then we would just kind of see. I thought I had more time with him. But he said to me, 'Pam, I want to take it on Friday of that week.'"
Portland physician Bill Toffler has also followed the case of Brittany Maynard — Brittany's story strikes a chord with him, too.
Toffler's wife of 40 years was diagnosed with cancer in 2009.
DR. BILL TOFFLER, PHYSICIANS FOR COMPASSIONATE CARE EDUCATION FOUNDATION:
"We were blessed with five years after the diagnosis was made. And she died just four and a half months ago."
For Dr. Toffler and his wife, assisted suicide was never an option. He leads a group, Physicians for Compassionate Care Education Foundation, that opposes prescribing lethal drugs to terminal patients.
DR. BILL TOFFLER:
"Every day we lived differently because we knew that we had a limited amount of time in a way that I never perceived before I had a wife what that clear diagnosis. And I'd hope patients recognize that I value them as a doctor, regardless of how disabled they are, regardless of how sick they are, that their life still has meaning and value. And I want to reflect that, even when they don't see it themselves."
But what about the fear and the pain that can surround dying? Why not help, I asked Dr. Toffler, if a patient asks?
"It is a very scary time. And at that time, I want to come around the person. I want to walk alongside them. I want to be the best doctor I can be. I'm called to be more of a doctor than ever. I'm not supposed to be the person who helps her to kill herself. That's all too easy."
In a policy opinion, the American Medical Association says "physician assisted suicide is fundamentally incompatible with the physician's role as healer." And some religious groups, most notably the US Conference of Catholic Bishops, have strongly opposed the practice.
According to the Gallup polling organization, a slim majority of Americans supports assisted suicide, but it's only legal in three states — Oregon, of course, along with Washington and Vermont. And court decisions have opened the door for assisted suicide in New Mexico and Montana.
Bioethicist Arthur Caplan — who was an opponent of the practice but now supports it — says the terms of the debate haven't really changed over the past 20 years, even with the publicity surrounding Brittany Maynard's case.
ARTHUR CAPLAN, NYU LANGONE MEDICAL CENTER:
"I think what's different in this debate is that Brittany Maynard is 29, attractive, articulate, almost– passionate about her right to choose here. That's making the debate focus for a group that didn't pay attention, younger people."
Caplan says fears of figures like Dr. Jack Kevorkian helped derail the right-to-die movement in the 1990s — and that improvements in end-of-life care have eased Americans' concerns over suffering at death.
"I can't even tell you the amount of relief it provides me…"
But he says Brittany Maynard's case may provide new momentum for supporters of assisted suicide.
"I think she's shifting the politics in a way that we may see some of the folks who got tied up in say, trying to broaden marriage laws and trying to see homosexuality gain wider acceptance move to say this is a choice I want. This is something I care about because it's her."
On May 4, 2012, Pam and Ben Wald gathered their closest friends in the living room. They sang songs together, and afterward, in the bedroom they shared, Pam handed Ben the medication that would end his life. He took it without hesitating.
"Early on when I got together with my husband and we were first together, we'd be laying in bed together and he was thinking, he'd go like this with his hands. His hands were always moving. It's kind of like, it's when he was thinking kind of thing and everything. But what I've never forgotten is his hands were like this on his chest, and I held my hands on top of his. But his hands never went like that and they just stayed, because he was just at peace. And his last words were, 'Thank you.' And he died in two hours."
Ben Wald was 75 years old.
So what can we learn from Oregon's experience?
Katrina Hedberg of the state health authority — who's neutral on the issue — tracks statistics on Oregon's Death With Dignity law.
KATRINA HEDBERG, OREGON HEALTH AUTHORITY:
"Initially there were a number of concerns that people had around would this be disproportionately used by people who were disenfranchised, so uneducated or people who might have had disabilities or those kinds of things. And we've really found that the people who are participating are people who really want to control the timing and manner surrounding their death."
Still, Dr. Toffler says those final months and days should never be cut short, as he learned from experience with his own wife.
"We were married for 40 years. And in the last five years I think we had the best years of our life — when she actually had a terminal diagnosis. And I wouldn't trade those five years for anything."
As for Pam, she's now volunteering for Compassion and Choices, guiding other families through a process she now knows firsthand.
"Nobody wants to talk about dying and death. But once we get into that, it really becomes an act of love. It really does."
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