Assisted dying: Ex-Archbishop of Canterbury Lord Carey backs bill

Former Archbishop of Canterbury Lord Carey says he will support legislation that would make it legal for terminally ill people in England and Wales to receive help to end their lives.

Lord Carey

 

Lord Carey writes in the Daily Mail that he has dropped his opposition to the Assisted Dying Bill “in the face of the reality of needless suffering”.

But the current Archbishop of Canterbury Justin Welby has called the bill “mistaken and dangerous”.

Peers will debate the bill on Friday.

‘Not anti-Christian’

Tabled by Labour peer Lord Falconer, the legislation would make it legal for adults in England and Wales to be given assistance ending their own life. It would apply to those with less than six months to live.

Two doctors would have to independently confirm the patient was terminally ill and had reached their own, informed decision to die.

Some 110 peers are already listed to speak when the House of Lords debates the private members bill on Friday.

Insisting it would not be “anti-Christian” to change the law, Lord Carey said the current situation risked “undermining the principle of human concern which should lie at the heart of our society”.

He added: “Today we face a central paradox. In strictly observing the sanctity of life, the Church could now actually be promoting anguish and pain, the very opposite of a Christian message of hope.”

Lord Falconer: “Nobody wants people who are properly motivated by compassion to be prosecuted”

When Lord Carey was still the Archbishop of Canterbury he was among the opponents of Lord Joffe’s Assisting Dying for the Terminally Ill Bill, which was successfully blocked in the House of Lords in 2006.

But in his article in Saturday’s Daily Mail Lord Carey said: “The fact is that I have changed my mind. The old philosophical certainties have collapsed in the face of the reality of needless suffering.”

He said it was the case of Tony Nicklinson, who had locked-in syndrome and died after being refused the legal right to die , who had had the “deepest influence” on his decision.

Mr Nicklinson’s widow Jane, said Lord Carey’s switch was “huge”.

“I’m amazed actually and thrilled because the Church has always been one of our greatest opponents,” she told BBC Radio 5 live.

“Someone shouldn’t be forced to stay alive with daily suffering – his life was a living hell.”

Complete Article HERE!

Quebec passes landmark end-of-life-care bill

Act respecting end-of-life care, Bill 52, allows terminally ill patients to choose death

veronique-hivon-dying-with-dignityTerminally ill patients in Quebec now have the right to choose to die.

The non-partisan Bill 52, also known as an act respecting end-of-life care, passed Thursday afternoon in a free vote at the National Assembly in Quebec City.

‘Dying with dignity means dying with the least amount of suffering,’— Véronique Hivon, PQ member of the National Assembly

The bill passed 94-22. There were no abstentions.

“Sometimes when you are suffering in pain, one hour can feel like one week.… The protection of the vulnerable is reflected in every aspect of this bill,” said Parti Québécois member of the National Assembly Véronique Hivon, who drafted the bill when she was minister of social services under the former PQ government.

Bill 52 allows for and outlines under which conditions terminally ill Quebecers can request to receive medical aid in dying.

gaetan-barette-veronique-hivon

Health Minister Gaétan Barrette, right, stood with members of the National Assembly from the three other parties (including Véronique Hivon, who drafted the bill) in late May to affirm the cross-partisan support for Bill 52. (CBC)

The main indicator for requesting medical aid in dying is “an incurable disease, an incurable illness, which is causing unbearable suffering.”

“For me, dying with dignity means dying with the least amount of suffering … and respecting who that person always was during his or her whole life,” Hivon said in the National Assembly before the vote took place.

Her speech was followed by applause and a standing ovation.

Liberal Christine St-Pierre was one of the 22 who voted against Bill 52.

“I don’t believe it’s right to give [anyone] the power to kill somebody,” St-Pierre said.

This legislation is the first of its kind in Canada. Its passage comes at a time when the right to die is being heavily debated in the rest of the country.

The Parti Québécois tabled the bill nearly a year ago after years of work from both the PQ and the Liberal government that came before it.

A committee on dying with dignity was assembled during Jean Charest’stenure as Quebec premier to study the issue and produce a report.

Its massive report, filed in March 2012, provided the foundation for Bill 52.​

However, Liberal Leader Philippe Couillard refused to play ball with the PQ when the party tried to force the bill into passage right before calling an election. Bill 52 died on the order paper as a result.

During the 2014 Quebec election campaign, Couillard promised to reintroduce the bill as it was drafted at the earliest possible moment during the new parliamentary session.

He also got the support from all four parties to reintroduce the bill at the stage it had died, instead of starting from square one.

It was reintroduced in late May by the new Liberal government.

Liberal Health Minister Gaétan Barrette made that announcementwhile standing side by side with MNAs from the three other parties.

“Between the four of us, we think the bill will pass strongly,” Barrette said at the time.

Complete Article HERE!

Aid In Dying, Part 2

“If you expect heroics from the people who attend you, even if it doesn’t include hastening your death, you’d be well advised to treat your attendants as heroes. Mutual respect and consideration, honor and compassion should be the hallmarks of your relationship with them.”

 

(We pick up our discussion where we left off last time. Part 1 is HERE.)

One of the most predictable questions I get when I present on the topic of aid in dying is; how do I go about finding someone who will be willing to help me? And I always answer the same way; the only way to know is by asking.

AidinDyingphoto_mediumI suggest that anyone looking for help with their end of life choices begin by interviewing those they love, to see who may have psychological, emotional, or moral reservations about assisting them in this fashion. I suggest that you never ask anyone to violate his/her ethical code regardless of how much you need help.

Once you find the person(s) you are looking for, I suggest that you check in with this person regularly to see if their level of commitment remains high, and excuse anyone who may have developed the least reservation about helping you as the time approaches. I suggest that you keep the number of people involved to the smallest number possible. One or two people at the most is my recommendation. Confidentiality and coordination of effort is essential and a large group make that virtually impossible.

At this point in the presentation I share two stories of very different death scenes to make my point. I was invited to consult on both occasions.

Jeffery was dying of AIDS. He and Alex, his lover of nearly twenty years, were preparing for his imminent death. Jeffery had a fear that he was beginning to slide into dementia, which was his worst nightmare. He wanted to short-circuit this final indignity and wanted to know if I would help them plan a strategy for proactively ending his life. I told them that I would be happy to offer them whatever information I had.street drugs

On this first visit with them I tried to assess the situation; to get a feel for the level of commitment that each person was bringing to this endeavor. There was no doubt about it, Jeffery was actively dying, his doctor confirmed the dementia diagnosis, and so time was of the essence.

I asked, “Have you guys done your homework?”

“If you mean, have we squirreled away enough medications to do the trick, the answer is no. We never gave this eventuality a thought until recently and now there’s not enough time to do that.”

“Will your doctor assist you with a prescription for a lethal dose of, let’s say, a barbiturate?”

“Doubt it. We’ve never talked to her about this. I don’t even know where she stands on the issue.”

“Well, then, how were you going to make this happen?”

“We were thinking about using street drugs, you know, coke and heroin. I also have some oral morphine left over from a friend who died last year.”

the_end_life_by_liquifiedsoul-d3fuz2nThat’s it? That’s your plan? What if you mess up on the dosage or something else goes wrong? I’ve seen it happen. You could be in worse shape than you are now and still be alive. Do you have a Plan B?”

Jeffery responded; “Alex and I talked about it some and Alex promised that he wouldn’t let me suffer.”

“But what does that mean? Alex, do you know what it is you are promising?”

The three of us talked for hours about their half-baked scheme. I tried to get them to see how implausible their plan was and how serious the consequences would be if there was a miscalculation. They would have none of it. Their love for each other and Alex’s blind commitment to Jeffery to preserve him from any more suffering was all there was to know. Alex would be as resourceful as necessary, even if it meant he had to suffocate Jeffery in the end.

Ten days later I was invited to their home again. I didn’t realize it at first, but earlier that day they had set their plan in motion. Alex had scored some cocaine, freebased it, and watched as Jeffery shot up. Both of these guys had had a long history with intravenous drug use so all of this was familiar territory. Unfortunately, Jeffery’s history with drug use complicated matters considerably. He had built up a tolerance to the drug and even though he was nothing more than skin and bones, the dose was not lethal. This is the situation as I found it. Jeffery was comatose and appeared near death, and Alex was at his wit’s end.

“He’s been like that for hours. I thought for sure he’d be dead by now. I think we’ve screwed up. What am I gonna do now?”

“I’m afraid I can’t advise you. I can only help you weigh your options.”

As I saw it, Alex had two options. He could call the paramedics and have them try to revive Jeffery with all the trauma that would involve, or he could honor the commitment he made to Jeffery and complete the plan they rehearsed.

Then there was Earl and his wife Christina. Earl was in the final stages of lung cancer. He was a hard, difficult man, plagued angerby many personal demons. Even when he was well, people used to say that he was an acquired taste, and if you ask me, that was being generous. The sicker he got, the more difficult he became. He alienated just about everyone – his sons, his friends, even the people from hospice. No one could tolerate his fury. In the end there was only Christina.

Some weeks before he died, Earl demanded that Christina call me over for a visit. I wasn’t inclined to accept the summons because I hated to see how he treated her, but Christina sounded so defeated on the phone that I relented and made plans to stop by the following day. Nothing had changed in the eight months since my last visit. Despite being a mere shadow of his former self, Earl was as abusive as ever. How had Christina been able to stand it all this time, I wondered.

“I want to die! I want this to be over now. I can’t get decent care. All these fuckin’ doctors and nurses make me sick. They don’t know what they’re doing.”

“He doesn’t mean that, Richard,” Christina interjected. “He gets good care.”

“Pipe down! I’m doing the talking. What do you know about it anyway? She don’t know nothin’ about what it’s like for me. Listen, Richard, I want to die. I want to end it right now, but I need help. I’m sick of this.”

“What kind of help do you need?” I asked.

“I read Final Exit, you know. I know how to do it. I got all these pills I can take.” Earl pointed to the cache of pill bottles in the nightstand drawer. “But I don’t want any slip-ups. I need someone to help me with the plastic bag at the right time, and she won’t help me.” He nodded in the direction of his long-suffering wife.

keep-calm-and-do-your-homework-100It was true. Christina absolutely refused to help. When I asked her why, she could only sheepishly shrug her shoulders. There was clearly much more to this than what was on the surface.

Earl then turned his attention to me. “You got to help me. You’re the only one left.”

“Earl, I won’t and can’t. It’s not that your request is out of line. It’s because I’m a stranger here. In all the years that we’ve known each other, you’ve never once invited even the most casual of friendships to form between us. You’ve always kept me out. You can’t ask me to overlook that now. You’re asking me to participate in one of the most intimate experiences two people can have in life and, I’m afraid, there just isn’t any foundation for that here. I’m sorry.”

“You’re a fuckin’ coward, just like everybody else. So you can just get the hell out and leave me alone. Damn you all!”

I hated to leave Christina alone with him, but I did as he demanded. Christina showed me to the door.

“Why won’t you help him?” I asked, when she and I were alone. “It would be the end of your misery.”

“That’s exactly why I won’t. After all these years, I couldn’t be sure whether helping him die would be an act of compassion, which would end his suffering, or an act of violence, which would end mine.”

These two scenarios provide a blueprint of what not to do if you are seriously considering having someone assist you to die. If you expect heroics from the people who attend you, even if it doesn’t include hastening your death, you’d be well advised to treat your attendants as heroes. Mutual respect and consideration, honor and compassion should be the hallmarks of your relationship with them.

You also have to have a well-thought out plan. And a “Plan B.” There’s no substitute for meticulous attention to detail. Who, what, when, where, and how. Do your homework!

A ‘Code Death’ for Dying Patients

By JESSICA NUTIK ZITTER, M.D.

Sadly, but with conviction, I recently removed breathing tubes from three patients in intensive care.

As an I.C.U. doctor, I am trained to save lives. Yet the reality is that some of my patients are beyond saving. And while I can use the tricks of my trade to keep their bodies going, many will never return to a quality of life that they, or anyone else, would be willing to accept.

Code DeathI was trained to use highly sophisticated tools to rescue those even beyond the brink of death. But I was never trained how to unhook these tools. I never learned how to help my patients die. I committed the protocols of lifesaving to memory and get recertified every two years to handle a Code Blue, which alerts us to the need for immediate resuscitation. Yet a Code Blue is rarely successful. Very few patients ever leave the hospital afterward. Those that do rarely wake up again.

It has become clear to me in my years on this job that we need a Code Death.

Until the early 20th century, death was as natural a part of life as birth. It was expected, accepted and filled with ritual. No surprises, no denial, no panic. When its time came, the steps unfolded in a familiar pattern, everyone playing his part. The patients were kept clean and as comfortable as possible until they drew their last breath.

But in this age of technological wizardry, doctors have been taught that they must do everything possible to stave off death. We refuse to wait passively for a last breath, and instead pump air into dying bodies in our own ritual of life-prolongation. Like a midwife slapping life into a newborn baby, doctors now try to punch death out of a dying patient. There is neither acknowledgement of nor preparation for this vital existential moment, which arrives, often unexpected, always unaccepted, in a flurry of panicked activity and distress.

We physicians need to relearn the ancient art of dying. When planned for, death can be a peaceful, even transcendent experience. Just as a midwife devises a birth plan with her patient, one that prepares for the best and accommodates the worst, so we doctors must learn at least something about midwifing death.

For the modern doctor immersed in a culture of default lifesaving, there are two key elements to this skill. The first is acknowledgment that it is time to shift the course of care. The second is primarily technical.

For my three patients on breathing machines, I told their families the sad truth: their loved one had begun to die. There was the usual disbelief. “Can’t you do a surgery to fix it?” they asked. “Haven’t you seen a case like this where there was a miracle?”

I explained that at this point, the brains of their loved ones were so damaged that they would most likely never talk again, never eat again, never again hug or even recognize their families. I described how, if we continued breathing for them, they would almost definitely be dependent on others to wash, bathe and feed them, how their bodies would develop infection after infection, succumbing eventually while still on life support.

I have yet to meet a family that would choose this existence for their loved one. And so, in each case, the decision was made to take out the tubes.

Now comes the technical part. For each of the three dying patients, I prepped my team for a Code Death. I assigned the resident to manage the airway, and the intern to administer whatever medications might be needed to treat shortness of breath. The medical student collected chairs and Kleenex for the family.

I assigned myself the families. Like a Lamaze coach, I explained what death would look like, preparing them for any possible twist or turn of physiology, any potential movements or sounds from the patient, so that there would be no surprises.

Families were asked to wait outside the room while we prepared to remove the breathing tubes. The nurses cleaned the patients’ faces with warm, wet cloths, removing the I.C.U. soot of the previous days. The patients’ hair was smoothed back, their gowns tucked beneath the sheets, and catheters stowed neatly out of sight.

Then, the respiratory therapist cut the ties that secured the breathing tube around the patients’ neck. As soon as the tubes were removed and airways suctioned, families were invited back into the room. The chairs had been pulled up next to the bed for them and we fell back into an inconspicuous outer circle to provide whatever medical support might be needed.

I stood in the back of the room, using hand motions and quietly mouthing one-word instructions to my team as the scene unfolded — another shot of morphine when breathing worsened, a quick insertion of the suction catheter to clear secretions. We worked like the well-oiled machine of any Code Blue team.

Of those three Code Death patients, one died in the I.C.U. within an hour of the breathing tube’s removal. Another lived for several more days in the hospital, symptoms under watch and carefully managed. The third went home on hospice care and died there peacefully the next week, surrounded by family and friends.

I would argue that a well-run Code Death is no less important than a Code Blue. It should become a protocol, aggressive and efficient. We need to teach it, practice it, and certify doctors every two years for it. Because helping patients die takes as much technique and expertise as saving lives.

Complete Article HERE!

Aid In Dying, Part 1

“I asked my audience to keep that in mind that it’s this social dimension of the dying process that gives us the best context for understanding this delicate issue. I suggested that if we kept our discussion as open-ended as possible we wouldn’t be tempted to reduce the whole affair to the single issue of assisted suicide, because that does nothing but polarize the debate.”

There was a wonderful front-page article in the February 2, 2014 edition of the New York Times titled: ‘Aid in Dying’ Movement Takes Hold in Some States. The most astonishing about the article was that, not too long ago, this sort of even-handed presentation in “the paper of record” would have been unthinkable. I’m so glad this is changing. Because, despite where you stand on the issue, no one benefits from tamping down the discussion.AidinDyingphoto_medium

I talk about assisted dying frequently. Despite being the hot button issue it is, there’s a remarkable amount of common ground amongst the varying positions if one looks for it.

I was conducting a workshop on this very topic recently and before I could really get started, a man stood up and declared: “I need to say upfront that I am diametrically opposed to assisted suicide of any kind, including physician assistance. There’s just too much room for abuse. I can’t help but think about how things would be if we started eliminating the people we think are no longer productive. You could be sure that old and disabled people would be the first to get the ax. I’m afraid the tide of this culture’s prejudice against age and infirmity would overwhelm them. It is such a slippery slope that I don’t think we ought to venture out onto it.”

Not five minutes into the workshop and I already knew it was gonna be a bumpy ride. I asked the fellow for his indulgence and asked him to allow me to continue.

death midwifeI began by saying: “It’s my experience that very few people prefer to die alone. Most dying people express a desire to have company in their dying days. And given the option, most everyone would prefer the company of friends and family to that of strangers. Very few of us have the personal strength to walk this unfamiliar territory alone. We’re social beings, after all, and there’s nothing about dying that changes that.”

I asked my audience to keep in mind that it’s this social dimension of the dying process that gives us the best context for understanding this delicate issue. I suggested that if we kept our discussion as open-ended as possible we wouldn’t be tempted to reduce the whole affair to the single issue of assisted suicide, because that does nothing but polarize the debate.

I turned to address the man who stood up at the beginning of the workshop. “I thought it curious, sir, that you took the time to assert that you are opposed to assisted suicide of any kind, including physician assisted suicide. Is that all you thought we were going talk about?”

“Well, yes, that’s exactly what I thought. Isn’t that what assisted dying means?”

“Not the way I understand it.” I said. “It’s true, acting to hasten death in the final stages of a terminal illness falls under the general heading of assisted dying, but I don’t think it defines the concept. In fact, I believe that reducing the concept of assisted dying to a single issue would be a mistake for two reasons. First and foremost, it discounts all the other more common modes of assistance regularly being given to dying people across the board. And second, this more extraordinary form of assistance is relatively uncommon. So you can see why I’m so adamant about keeping the discussion inclusive and open ended. It just wouldn’t be balanced otherwise. I believe that the issue of proactive dying can become sensationalized, distorted, and even freakish if this option is not presented as an integral part of the entire spectrum of end of life care.”assisted_dying

I think a good metaphor for what I was talking about is the midwife. Like a birth midwife, a death midwife assists and attends in a myriad of ways. A midwife is the one who is most present and available to the dying person, the one who listens, comforts, and consoles. But a midwife may also bring an array of other basic skills, like expertise in the care of the body such as bathing, waste control, adjusting the person’s position in bed, changing bedclothes, mopping the person’s brow, or keeping the person’s eyes and mouth lubricated. A midwife may also be proficient in holistic pain management and comfort care such as massage, breath work, visualization, aromatherapy, relaxation, and meditation.

A midwife may take responsibility for maintaining a tranquil and pleasing dying environment. Often this means arranging the person’s home or room, not only in terms of the practical considerations, but also in terms of the aesthetic as well. This may include arranging flowers and art, reading aloud or playing music softly. A death midwife, like a birth midwife takes the lead role in the caring for and comforting the one who is dying. Without this kind of compassionate presence, few people would have the opportunity to achieve a good death.

Another guy spoke up: “That’s all fine and good, but I was hoping that we were going to talk about, you know, the more proactive aspects of assisted dying. I mean, I know I’m gonna want help in bringing my life to a close when the time comes and no amount of breathing exercises and adjusting pillows is gonna cut it. Am I making myself clear?”

“I understand what you are saying. You want some practical advice on how to end your life if the need arises.” I responded. “I can assure you that we well get to that. I just wanted to make sure that we all appreciate the context of our discussion.”

physician aid in dyingAn elder woman in the first row raised her hand. “I’m glad that you’re taking the time to help us frame the debate in this way because I’m confused. I have the same reservations as the first gentleman who spoke, but now I’m not sure my concerns are warranted. Maybe I need more time to figure out what it is we’re talking about when you say, ‘proactive dying.’ Is it euthanasia, assisted suicide, self-deliverance, what? And why so many different terms?”

“You make a very good point, ma’am. Unfortunately, there is no agreement, even among experts, about a common vocabulary for this debate. And thus the public discourse often generates a whole lot more heat than light. And the topic of proactive dying will continue to be a hot-button issue until we can come to a consensus about the parameters of the debate, and that seems like a long way off.”

I went on to say that I have trouble with most all the terms commonly used in the debate. I consider euthanasia is much too technical. Curious enough, at one time this word meant an easy, good death. Now, unfortunately, it is defined as mercy killing, a classic example of how language can be corrupted.

I also try to avoid using the term “assisted suicide” when I talk about someone hastening his or her death in the final stages of a terminal illness. The word suicide is inappropriate in this instance, because suicide usually denotes a desperate cry for help, which is rarely if ever the case for those facing the imminent end of life.falling leaf

Finally, I don’t much like the term self-deliverance either. It’s just one of those vague, contemporary euphemisms that does nothing to clear the air. In fact, when polled, most people haven’t a clue what self-deliverance means. I prefer the simpler, more straightforward terms ‘proactive dying’ or ‘aid in dying.’

Another woman spoke up: “I’m having a hard time with this too. I mean, it’s all so confusing and there are so many subtleties to consider. I guess I’d have to say that I’m not particularly comfortable with the notion of assisted suicide or, as you call it, aid in dying. But I wonder if I’d feel differently if I were in unbearable pain. And taking someone off life support; isn’t that technically assisted dying? Where do we draw the line between what is acceptable and what isn’t? And who is going to make that determination?”

I responded: “The simple answer is that doctors and lawyers are generally the ones who make the call. That is unless individuals are granted the right to choose. But even then, medical and legal concerns can and do trump a person’s wishes.”

(We will take up this topic again next time. I’ll discuss how best to approach one’s physician about aid in dying among other things.)

Catholic rebel Kueng, 85, considers assisted suicide

By Tom Heneghan

Hans Kueng, Roman Catholicism’s best known rebel theologian, is considering capping a life of challenges to the Vatican with a final act of dissent – assisted suicide.

KüngKueng, now 85 and suffering from Parkinson’s disease, writes in final volume of his memoirs that people have a right to “surrender” their lives to God voluntarily if illness, pain or dementia make further living unbearable.

The Catholic Church rejects assisted suicide, which is allowed in Kueng’s native Switzerland as well as Belgium, the Netherlands, Luxembourg and four states in the United States.

“I do not want to live on as a shadow of myself,” the Swiss-born priest explained in the book published this week. “I also don’t want to be sent off to a nursing home … If I have to decide myself, please abide by my wish.”

Kueng has championed reform of the Catholic Church since its 1962-1965 Second Vatican Council, where he was a young adviser arguing for a decentralized church, married priests and artificial birth control. The Council did not adopt these ideas.

A professor at the German university of Tuebingen since 1960, Kueng was stripped by the Vatican of his license to teach Catholic theology in 1979 after he questioned the doctrine of papal infallibility and ignored Vatican pressure to recant.

The university responded by making him a professor of ecumenical theology, securing him a post from which he wrote dozens of books, some of them best-sellers, and many articles.

NOT LIKE JOHN PAUL OR MUHAMMAD ALI

In the third and final volume of his German-language memoirs, Erlebte Menschlichkeit (Experienced Humanity), Kueng wrote that a sudden death would suit him, since he would not have to decide to take his life.

But if he does have to decide, he said, he does not want to go to a “sad and bleak” assisted suicide center but rather be surrounded by his closest colleagues at his house in Tuebingen or in his Swiss home town of Sursee.

“No person is obligated to suffer the unbearable as something sent from God,” he wrote. “People can decide this for themselves and no priest, doctor or judge can stop them.”

Such a freely chosen death is not a murder, he argued, but a “surrendering of life” or a “return of life to the hands of the Creator.”

Kueng, who writes openly about his Parkinson’s and other medical problems in old age, said this death was compatible with his Christian faith because he believed it led to the eternal life promised by Jesus.

He cited the late Pope John Paul’s public struggle with Parkinson’s and the silent suffering of boxer Muhammed Ali, also afflicted with the disease, as models he did not want to follow.

“How much longer will my life be liveable in dignity?” asked Kueng, who said he still swims daily but is losing his eyesight and his ability to write his books by hand as usual. “A scholar who can no longer read and write – what’s next?”

Kueng, who repeatedly criticized the now retired Pope Benedict during his papacy, described Pope Francis as “a ray of hope”. He disclosed that the new pontiff had sent him a hand-written note thanking him for books that Kueng sent to Francis after his election in March.

It seems highly unlikely the new pope will include support for assisted suicide among possible Church reforms he was discussing with eight cardinals in Rome on Wednesday.

Speaking in Sardinia in late September, Francis denounced a “throwaway culture” that committed “hidden euthanasia” by neglecting and sidelining old people instead of caring for them.

A spokesman for Rottenburg-Stuttgart diocese, where Tuebingen is located, said Kueng’s views on assisted suicide were not Catholic teaching. “Mr Kueng speaks for himself, not for the Church,” Uwe Renz told Stuttgart radio SWR.

Complete Article HERE!

Deaths With Dignity

Rear Adm. Chester Nimitz Jr. and Joan Nimitz planned their suicides with military precision.

By Lewis M. Cohen

NimitzLast month, following a decade of bitter political combat, Vermont Gov. Peter Shumlin signed the Patient Choice and Control at End of Life Act. Passage of the bill was a bittersweet triumph for the governor, who had made it part of his election platform and then encountered fierce opposition from a coalition of leaders from the Roman Catholic hierarchy and from representatives from the disability community and socially conservative organizations that also dispute the legitimacy of same-sex marriage, abortion, and contraception. Vermont is now the fourth state to make it legal for a physician to prescribe lethal medication to a terminally ill, mentally competent patient who wants to end his life and to offer immunity from criminal prosecution to doctors, family members, and friends who wish to participate. Vermont has also become the first state from New England to officially accept this treatment option, which has been available in Oregon, Washington, and Montana. The new law is an important step forward for the death with dignity movement.

When I mention this movement, people often look mystified. Explaining that it is the same phenomenon as “aid in dying” merely results in additional perplexity. It’s only when I say, “physician-assisted suicide” that the coin drops and they recall Jack Kevorkian—the original Dr. Death—or perhaps Derek Humphry, author of Final Exit and founder of the Hemlock Society. At this point in the conversation, many enthusiastically identify themselves as staunch advocates while others just as vociferously announce they are fervent opponents. And then there are the few individuals who suddenly break eye contact and start inching away. The latter are a reminder this is not only an extremely private and sensitive subject but that the act of hastening death is a cardinal sin if you’re Catholic and a potent taboo regardless of one’s religious affiliation or lack thereof.

What almost all of these people have in common is a lack of facts or experience upon which to base their opinions. Whether they love or hate the idea of physician-assisted suicide or are simply creeped out, it is unlikely that they have encountered anyone or even heard a narrative of someone who has resorted to using it as an option at the end of life; they are similarly unfamiliar with doctors or loved ones who have helped a patient to die. Because physician-assisted suicide has been illegal, complex, and intensely private, the stories have remained in the shadows. Even when they are recounted, the subject of suicide is so morbidly powerful that most people psychologically protect themselves by promptly forgetting the narrative or quickly switching the mental channel.OLYMPUS DIGITAL CAMERA

Last year, during the time of the Massachusetts Death with Dignity ballot initiative, I learned about Rear Adm. Chester W. Nimitz Jr. and his wife, Joan, from a brief article written by their daughter Betsy Nimitz Van Dorn that appeared in the Cape Cod Times. The couple died on Jan. 2, 2002, and after a fleeting spate of publicity, the story disappeared from public attention. I was able to speak with Van Dorn for a more intimate perspective of her parents and their decision.
Joan Nimitz was born in England, trained as a dentist, and came to America for specialty training in orthodontia. Like many women of her generation, after meeting and falling in love with her future husband, she had little opportunity to practice her profession and instead devoted herself to raising their three daughters and furthering her husband’s career.

As a Navy wife, she led a peripatetic existence, moving the family every year to a new base in a strange city often located in a foreign country. She oversaw her children’s upbringing single-handedly during the extended periods in which her husband was at sea. By age 89, Nimitz suffered severe osteoporosis, bone fractures, and the constant pain of peripheral neuropathy. Although she and her husband loved golf, this pursuit was no longer possible, and because she was becoming blind with macular degeneration, she was unable to indulge her passion for reading.

Chester Nimitz Jr., at age 86, was a bonafide military hero and the son of the legendary World War II Pacific fleet admiral—Chester Nimitz Sr.—who was responsible for defeating the Japanese navy in the Battle of the Coral Sea, the critical Battle of Midway, and in the Solomon Islands campaign. Chester Nimitz Jr. graduated from the Naval Academy and served on a submarine, the USS Sturgeon, during World War II. He was awarded the Silver Star, which was presented by his father at Pearl Harbor. Nimitz was transferred to command of another submarine, the USS Haddo, and was awarded the Navy Cross and a Letter of Commendation with Ribbon. The Navy Cross citation reads in part, “For outstanding heroism in action during her Seventh War Patrol in restricted enemy waters off the West Coast of Luzon and Mindoro in the Philippines from 8 August to 3 October 1944.” The citation goes on to say, “Valiantly defiant of the enemy’s over powering strength during this period just prior to our invasion of the Philippines, the USS Haddo skillfully pierced the strongest hostile escort screens and launched her devastating attacks to send two valuable freighters and a transport to the bottom. … The Haddo out-maneuvered and out-fought the enemy at every turn launching her torpedoes with deadly accuracy despite the fury of battle and sending to the bottom two destroyers and a patrol vessel with another destroyer lying crippled in the water.”

An interview recorded two months before his death was conducted at the Naval War College, and it reveals a man with no interest whatsoever in rehashing any brave exploits that took place in the war. When asked about his awards, he simply replied, “Yes, the patrols were all deemed successful. We got a combat star. In other words, we sank something all the time.”

Of greater concern to him in the interview was conveying his indignation over the penurious salary that he received during his time in the military that would not properly cover family expenses. After completing service in the Korean War and against Chester Nimitz Sr.’s express wishes, he left the Navy. He was recruited by Texas Instruments and later became the president of the Perkin-Elmer Corporation. According to his daughter, the first year he worked at Texas Instruments in Dallas he paid more in income taxes than he had cumulatively earned during 23 years in the Navy. Her parents did not lead especially lavish or self-indulgent lives but were extraordinarily generous to all of their progeny. Their mantra, Van Dorn says, was:

Chester Nimitz“We are not the kind of people that would ever want to leave any of our children a trust fund. We have given you decent educations, and you are fine on your own. We want the pleasure of watching our grandchildren go to great schools and summer camps and take trips and have adventures. That is the pleasure money can bring—not stockpiling it so some spoiled offspring can have it when he or she turns 21.”

Chester and Joan Nimitz were longtime members of the Hemlock Society, a national right-to-die organization that was organized in 1980. Hemlock’s philosophy—that people should be in charge of their deaths as well as their lives—appealed to them as meticulous managers. The Nimitzes freely discussed these beliefs with their children, and Van Dorn explained, “They always proclaimed that when they got sick and tired of feeling sick and tired, that they would do themselves in.”

This did not mean they wouldn’t take advantage of medical advances, and when the admiral developed coronary artery disease, he promptly underwent quadruple cardiac bypass surgery. However, after several years, his health began to noticeably deteriorate; he had frequent bouts of congestive heart failure, suffered gastrointestinal problems, lost 30 pounds, became incontinent, experienced chronic back pain, and began to fall at home. Like his wife, his vision became impaired, and he could no longer safely drive. Extensive evaluations and treatment at the best Boston teaching hospitals proved ineffective for this proud warrior.

Nurses were employed at their home to attend to Joan Nimitz’s worsening health problems, but the couple did not want to squander all of their money on such care. They were both appalled at the vast sums spent at the end of life to sustain people who were frail and sick and not likely to get better. They could clearly envision—and they rejected—the idea of spending their remaining years in a nursing facility.

The admiral particularly worried his heart condition might suddenly worsen and his wife would be unable to commit suicide by herself. Joan Nimitz confided to the children that she, too, feared that without her husband’s help, she would not be in a position to ingest the barbiturate pills they had been stockpiling.

The admiral told his daughter, “That’s the one last thing I have to do for your mother.”

According to Van Dorn, her father had a large file box labeled with a 3-by-5 note card upon which he had written with a magic marker, “When C.W.N. [Chester Williams Nimitz] Dies.” In it were his insurance policies, documents concerning his Navy pension, and so forth. This was intended to save the family from the frustrating task of scrambling around in search of these papers. He was a commander, and he wanted his death and its aftermath to be conducted with the precision of a military operation.

Throughout the fall and winter, the Nimitz couple explicitly discussed with the children their plan. It followed the suggestions in the book Final Exit. When ready, they would begin with an anti-nausea suppository, followed by the sleeping pills, chased with a little of their beloved Mount Gay Rum with a squeeze of lime and soda, and maybe a little peanut butter to settle their stomachs. The last step involved securing a plastic bag over their heads as a precaution in case the medication was not sufficiently lethal. The admiral was going to let his wife take the pills first and make sure she was dead before he followed her example. Van Dorn concluded, “None of it was particularly pretty. But they were just so determined and upbeat about all of it.”

On New Year’s Day in 2002, the Nimitz clan, including some grandchildren, assembled for lunch. They discussed the football games, embraced, and quietly praised the patriarch and matriarch. Everyone was relatively subdued; the admiral and his wife were emotionally reserved individuals. The family members did not try to persuade them to change their minds, because they knew that this would be fruitless. They were confident that neither parent was depressed and their decision was entirely consistent with long-held beliefs.

The admiral had wanted one more chance to write tax-deductible checks for his children, their husbands, and grandchildren, and these were dated Jan. 2, 2002, and left in the apartment. He had seen a lot of deaths in World War II. Joan Nimitz had experienced the deaths of siblings, including one of her brothers, a British Royal Air Force pilot shot down in combat. Death was no stranger to this devoted couple and held no fear. After their family went home, Chester and Joan Nimitz wrote a suicide note that read in part, “Our decision was made over a considerable period of time and was not carried out in acute desperation. Nor is it the expression of a mental illness. We have consciously, rationally, deliberately, and of our own free will taken measures to end our lives today because of the physical limitations on our quality of life.”

After the police officially notified Van Dorn of the deaths, she brought out her father’s comprehensive list of people and telephone numbers. She divvied up the list with one of her sisters, and they called all of her parents’ closest friends to tell them what had happened before any word got into the newspapers. Almost universally the response was, “Yup, that’s your parents!”

In the spring when the ground thawed, the family convened in Cape Cod, Mass. It was a place filled with memories of summer barbecues and sailing expeditions. The ashes of the couple were interred; the younger children placed small keepsakes into the grave, such as a particular piece of Lego that reminded them of their grandparents; and family members spoke lovingly and respectfully of their progenitors.

In the ensuing years, Van Dorn has supported a number of nonprofit organizations, including Compassion & Choices, which along with the Death with Dignity National Center evolved from the original Hemlock Society. The efforts of these groups led to passage of the Vermont bill. Van Dorn appreciates that the law would not have directly helped her parents, as neither had a “terminal” disease. She understands that a civil rights movement, such as death with dignity, takes politically expedient and incremental steps. She anticipates that in the future the infirmities and suffering of advanced age may also qualify people to request this option (as is presently true in Belgium, Switzerland, and the Netherlands). Meanwhile, one more American state will allow its citizens further control at the end of life. And Van Dorn is looking forward to the day “when kids and their parents will regularly sit around the dining room table and talk about end-of-life issues the way you talk about college planning. Because, after all it is just another kind of planning.”

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