SundayReview  | EDITORIAL 

Offering a Choice to the Terminally Ill 

By 
Last year, the radio host Diane Rehm watched in agony as her husband, John, starved to death over the course of 10 days.
Severely crippled by Parkinson’s disease, his only option for ending the suffering was to stop eating and drinking. Physicians in most states, including Maryland, where he lived, are barred from helping terminally ill patients who want to die in a dignified way.
“He was a brilliant man, just brilliant,” Ms. Rehm said in an interview. “For him to go out that way, not being able to do anything for himself, was an insufferable indignity.”
Ms. Rehm, whose current affairs talk show at WAMU is distributed by NPR, the public radio network, has brought a strong and poignant voice to a debate gaining attention in state legislatures around the country.
Currently, only Oregon, Washington, Vermont, New Mexico and Montana allow health care providers, under strict guidelines, to hasten the death of terminally ill patients who wish to spare themselves and their loved ones from the final, crippling stages of deteriorating health. Lawmakers in 15 other states and the District of Columbia have introduced so-called aid in dying bills in recent months to make such a humane option available to millions of Americans at a time when the nation’s population of older adults is growing.
Maryland lawmakers at a rally this month.Brian Witte/Associated Press 
The impetus for many of the bills was the widely publicized story of Brittany Maynard, a 29-year-old woman from California who moved to Oregon, after learning in the spring of 2014 that she had incurable brain cancer, so she could die on her own terms. The nonprofit organization Compassion & Choices, which has worked closely with Ms. Maynard’s relatives and with Ms. Rehm, has played a leading role in getting state lawmakers to introduce bills.
The right-to-die movement has strong opponents, including the Catholic Church, which opposes any form of suicide. Meanwhile, some medical professionals argue that the practice is at odds with their mission as healers and worry that it could be abused. Unfortunately, many Americans associate the issue with Dr. Jack Kevorkian, a notorious advocate of assisted suicide who was convicted in 1999 of murder and who aided dozens of patients, many of whom were not terminally ill, in ending their lives.
As local lawmakers around the country debate the bills, they should consider how successfully and responsibly the law has been carried out in Oregon. The state’s Death With Dignity Act, which went into effect in 1997, gives doctors the right to prescribe a lethal dose of medication to patients who are terminally ill and who have been advised of their alternatives, such as hospice care. The law provides layers of safeguards to ensure proper diagnosis of the disease, determine a patient’s competency to make the decision, and protect against coercion. Last year, 105 patients in Oregon, a record high, died after receiving a lethal dose of medication.
Health care providers in states where assisted suicide is illegal face wrenching choices when dying patients ask them for help. In one case, prosecutors in Pennsylvania perversely charged Barbara Mancini, a nurse, with assisting a suicide for handing a bottle of morphine in February 2013 to her 93-year-old father, who was in hospice care. A judge dismissed the case the following year.
Some doctors caught in these painful situations end up handing patients lethal doses of painkillers with a wink and a nod, right-to-die activists say. But these unregulated practices put patients and doctors on dangerous terrain. “Making a secret process transparent makes it safer,” Barbara Coombs Lee, the president of Compassion & Choices, said in an interview. Ms. Rehm said she and her husband had long agreed they would help each other die if either was in growing distress from a terminal illness. Her inability to help him die humanely is a situation no spouse should have to face.
“There was no question but that I would support him and honor whatever choice he would make,” she said. “As painful as it was, it was his wish.”