Matsushige 1

Emily Matsushige

Mr. Donald

Writing for College

13 April 2018

A Right To Have

To survive is not to live. People are suffering everyday, knowing their lives are soon

going to end. However, with the Physician-assisted Death Act, people with a terminal illness can

end their lives with their loved ones by their sides. Physician-assisted Death and Death with

Dignity are just a couple programs that offer end-of-life options to terminally ill patients. These

programs provide a peaceful and controlled end to a person’s life. Oregon was the first state to

pass this law in 1997. Since then, many countries and states have followed their led in passing

their own law allowing a peaceful means to an end. In 2017, two-hundred-eighteen terminally ill

adults in Oregon received the medication under the Death with Dignity Act and about sixty

percent of the people who got the medication decided to take it (“History”). To qualify for this, a

person must have a terminal illness, make a verbal request, along with a written one, and can not

be clinically depressed. On top of this, the patient must be able to self-administer the medication

(​"How to Access and Use Death with Dignity Laws"). ​People suffering from a disease that

encumbers their lives to the point of misery should have a right to end the suffering peacefully.

Eutheria, another term for assisted suicide, is not a way to end life but to take away

suffering from an ill person with control. With eutheria, a person can avoid suffering by way of

suicide and have the chance of ending their life in a non-violent and peaceful way. Knowing the

exact moment of death empowers people with control over the way they die. To some people
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having a terminal illness means no power, no control over when to bathe or eat. Although care

homes drastically changed since the mid-twentieth century when most of them were shut down

due to harsh environments. Being cared for all the time is not what is valued about life; it is “just

passively treading water until you wear out” (Beir). For many people in care homes, their days

are planned out with loss of freedom and independence. “[For] the first time since childhood,

[patients] lack the ability to direct their own lives” (Beir). Beir points out like children the

elderly lack the capability to direct their own life.

Humans are hardwired to avoid unnecessary pain; pain is a signal that is transported to

the brain by sensory neurons warning us of a potential threat. “[I]t is human nature to avoid pain,

sadness, and suffering. Why as humans, would we want to force others to experience what we

dred?” (Harris). Tony Nicklinson was not suffering from a terminal illness but felt like he no

longer wanted to live. Tony was permanently paralyzed with locked-in syndrome and only could

communicate through the blink of an eye. He challenged people who opposed physician-assisted

death to imagine what life would be if they were in his shoes. He fought hard for his case and

aimed it at the public. His case brought a lot of attention to physician-assisted death through the

TV and media. After losing his case, he was devastated and rejected his regular antibiotics which

might have led to him dying six days after the trial from pneumonia. His wife explained that he

could have died instantly before pneumonia got him and did not deserve to suffer six more days.

Arthur Agnes van der Heide writes, “[l]ife-prolonging treatment does not always serve a patient's

best interest” (Heide). In saying this, Heide points out that merely staying alive is not necessary

what a patient wants it is the pain they want to end.

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Currently, in the United States, there are five states that have Death with Dignity laws:

California, Colorado, Oregon, Vermont, and Washington. The bills of Death with Dignity were

introduced to Hawaii, Ohio, and Rhode Island as of January 2018 (“Death with Dignity”).

Brittany Maynard was one of many who had to move states to receive Death with Dignity.

Numerous people in her situation believe so much in Death with Dignity that they are willing to

move to places like Oregon where this practice is legal. She decided she wanted to take her own

life when she checked off everything on her bucket list. Brittany suffered from brain cancer

causing her to have severe headaches, neck pain, and seizures that would paralyze her speech.

Despite what people said, Brittany believed she was not suicidal; she just wanted control. Having

this choice was important to her because it gave her a sense of peace and control in her life. Her

dream was to have every terminally ill person have this option. She planned to end her life after

her husband's birthday but postponed it because she was feeling well and wanted to spend a little

more time with family and friends. Due to Death with Dignity, she was able to die with her

family and friends by her side.

Suicide can be a happy death saying a person is ready to move on in life and see what

else they have to offer to the unknown they are about to enter. Instead of one trying to conquer

death or a death of a loved one, one should strive to match death with goals and dreams in life

like Gilles Deleuze who already accomplished everything he wanted to. Gilles Deleuze was a

famous French philosopher who had lung cancer. He did not commit suicide because something

went wrong; he committed suicide because he felt like his life already ended. He died peacefully

on his own terms knowing that death was coming and could not be stopped but accepted. He had

a wife and two kids but believed his sickness was a burden for the family and he ended his life
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happily. Deleuze died a death he worked for and with dignity. To have a happy death means to

have already done everything and accept that death as a form of a new beginning (Finn).

A peaceful death is something most individuals want. Pamela Gredicak felt that it is

“important to choose the way [she] die[s] as it is to choose the way [she] [live[d]” (Gredicak).

Pamela loved her life and doesn’t want to stop living but in her last hours, days, or weeks, she

does not want to scare her family. She wants her husband to be able to go on living. With her

husband being by her side through the side effects, surgeries, and hospitalizations she doesn't

want him to “have to sit and watch [her] die slowly in agonizing pain” (Gredicak). Personal

stories featured on the Death with Dignity website show the passion people put into making

Death with Dignity legal in other states because of something they feel so strongly about. By

doing this communities can entitle people who have a terminal illness with a power over the way

they die. In doing this, their last moments will be theirs.

While Death with Dignity focuses on giving control to their clients, it is the families who

need support when they are gone. Organizations such as “Compassion and Choices” provide

support to the patients and families in need. This organization, started in 1993, was the first

end-of-life consultancy program which gave patients and families: tools, information, and

emotional support concerning end-of-life options. Compassion and Choices President, Barbara

Coombs Lee, co-authored the Death With Dignity Act which is now the model for

physician-assisted death legislations nationwide. Compassion and Choices also work with

healthcare providers to make sure they honor and enable patients with their choice. This program

works nationwide and helps liberate people with information and options. Their website contains
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many helpful steps for families going through tough times and provides them peace of mind

(“​Compassion & Choices Board of Directors​”).

Compassion and Choices has helped Miguel speak out for what he believed in even in his

last moments before his death. For Miguel Carrasquillo, Death with Dignity was not an option.

Similar to Brittany Maynard, he had brain cancer but could not receive Death with Dignity

because of where he lived--Puerto Rico. He and his family did not have the resources to move.

For more than a year, Miguel followed Brittany’s stories and states that were finally allowing

Death with Dignity. Miguel was delighted to learn that he was the first terminally ill latino that

urged aid in dying. Miguel Carrasquillo became an advocate for Compassion and Choices and

was the first bilingual advocate when he recorded videos in English and Spanish. Even though he

did not get the death he wanted, his mother will not be silenced. Miguel believes she will

continue to advocate for this cause in memory of him with the help of Compassion and Choices.

Compassion and Choices gave him hope and peace that his work will continue to strive for all

people in disregard to where they live (“​Compassion & Choices Board of Directors​”).

All families are different, but when faced with a tough decision one would hope they are

by one’s sides no matter what. Dr. Nicholas Gideonse explains,

the relief from [his] terminally-ill patients and their families is palpable. [He has] helped

families accept their family members’ final wished in the face of terrible illness. Aid in

dying for terminal patients is an essential part of good, compassionate end of life care.

(​FAQs - Physician-Hastened Death​).

Families obtain composure knowing they are no longer on the sidelines powerless of helping,

and don’t have to watch their loved ones die in agony which provides a sense of peace.
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A couple who took advantage of Death with Dignity were Kate and Alan Staple. Kate

and Alan were a divorce and then married couple who came together at the end of a peaceful

death. After getting diagnosed, he knew she was the one he wanted to be with. Alan was

diagnosed with Amyotrophic Lateral Sclerosis (ALS) and was told he had 3-5 years. ALS is a

neurological disease with no cure; it affects the nerve cells responsible for controlling voluntary

muscle movement. (​"Amyotrophic Lateral Sclerosis Fact Sheet National Institute of

Neurological Disorders and Stroke"). ​He had medical appointments four times a week, then was

transferred to a nursing home, and then to hospice. When making deciding to take the medication

Kate told Alan that she needed a three-day notice. On the day of his death, his family gathered

outside. People came to read his poetry and hold his hand and Kate his wife was able to tell him

how much she loved him. After his passing everyone took a cigarette from the pack he got the

day before he died. His death was peaceful and there was nothing that could have been better,

being surrounded by his family moments before death, reading poetry, and getting to hold the

love of his lives hand entering the unknown world of death. Kate explains that “Death with

Dignity is about respecting a person’s ultimate authority over their own path. It’s a

demonstration of over, a way to honor someone is to support them in their death” (Staples). By

putting her story on the Death with Dignity website she has touched so many people with her

wonderful story of integrity and shows how Death with Dignity has helped her family in hope

that it will help others as well (​"Kate Staples: A Demonstration of Love").

Everyone has a life story that will be unique from the next person, and how they die will

be different. Their stories will be special to the people they have touched, hopefully peaceful,

and on an individuals’ terms. James Halsey’s son, inspired by Death with Dignity, created short
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films to share at film festivals to bring awareness of the subject. The film ​Choice: Mother​ has

been accepted into the 2015 Awareness Festival. James Halsey had a thirty-year war with

multiple sclerosis. His lungs continue to fill up with saliva as his limbs and vital organs began to

weaken. He was always worried about the people around him. To make sure everyone was

comfortable, he would mask his own pain with smiles and jokes. By making this decision, he

was refusing to live an unfilling life. As a son, daughter, wife, husband or any kind of caretaker,

one can only do so much to ensure their comfort. Families feel so much gratitude towards Death

With Dignity that they put their stories online hoping they can do something in return on behalf

of their loved one who died and themselves (​"Halsey, Joseph : To Die with Self-Respect").

By reading all these wonderful stories one would feel happy for the families and patients

who got their wish and the death they wanted. However, after the death of a loved one the

surviving family member may experience grief in many different ways. Compared to a

non-physician-assisted suicide families will see the death as justifiable and will unlikely to be

angry or depressed. Other options a patients has if their states does not allow physical aid in

dying is to voluntarily stop eating and drinking, stop treatment, or not start, or the use of

palliative sedation (“​FAQs - Physician-Hastened Death”​).

When making this decision patients often turn to their families for advice. On the other

hand, advocates for physician-assisted suicide would disagree to giving family members a

disagreeing vote over the patients first choice. How one is physically feeling and ones will to live

is one's choice. Telling family and friends is important in this process and what makes it unique

knowing the exact moment of death (“​Physician-Assisted Suicide: Family Issues”).

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Money has always got in the way of what one has, versus what one wants. Financial

trouble can be hard on many families. Spending money on food, clothing, medication, and other

necessities can be expensive. For many families, spending money on their loved one who is

dying doesn’t make any sense if they lack the will to carry on. Having a terminally ill family

member can also be difficult for families who have to take off from work to care for them. Many

families, especially ones without health insurance, are struggling to pay for terminal care. Poor

dying patients are likely to be Medicaid beneficiaries which helps them pay for the costly

frequent treatments.

In times of need, many patients turn to health care providers for advice. There are many

different third-party resources such as medical organizations, nonprofits, and membership

organizations. In 2009, Medicare covered fifty-five billion dollars for doctor and hospital bills

for terminally ill patients during the last two months of their life. “Hospital inpatient charges

exceed $6,200 per day, and costs to maintain someone in ICU can reach up to $10,000 per day

("Hospice and End-of-Life Options and Costs”). Choosing to put your loved one in a facility

where they are comfortable can be very expensive and hard to keep up.

By choosing to die a month earlier with Death with Dignity, a family can save

ten-thousand dollars in health care costs with the exception of intensive medical services with

higher health care costs. If not insured and not part of hospice, a patient with cancer with six

months before death--which is the earliest point permitted--can save on average twenty-thousand

dollars. Even though the final savings from physician-assisted suicide may be small, for others

not insured the savings can be valuable. While saving money might not be on everyone's mind
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when dealing with death, it is something to talk about and take into consideration (Emanuel et

al.).

Medications for Death with Dignity can vary depending on the medication type,

availability, and form. Pentobarbital, a liquid medication that speeds up the death process cost

five-hundred dollars up until 2012; the price rose dramatically to fifteen-thousand dollars, then

later, twenty-five thousand dollars. This was due to the European Union’s ban on exports to the

US because it was being used as capital punishment. This is why many international

pharmaceutical companies do not export the drug to the US. When this happened, many users

switched to the powdered form which costs four-hundred to five-hundred dollars. Due to the

high cost, alternate mixtures of medication have been developed by physicians in Washington

state costing four-hundred-fifty to five-hundred dollars (“​FAQs - Physician-Hastened Death”).

People believe this movement will lead to underground practices where people have

uncontrolled ethical and medical standards. One would say the opposite, meaning if our states

don’t legalize physician-assisted death then people may feel an obligation to have underground

practices in places where it is illegal. (​"Doctor-assisted Dying: What Difference Does

Legalisation Make?”)

One suffering miserably due to a terminal illness should have the choice of dying with

dignity. A person should have control over his or her death, a family should be able to remember

their loved ones when they were not in pain but in their last moments where everything was

under their control. Families should be able to get back on their feet and live out the rest of their

life without feeling guilty about all the pain they saw their loved one go through. Families or
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patients should not have to choose whether to spend thousands of dollars living a life they don’t

want to live or dying an agonizing death without food, water, or treatments.

To advocate for Death with Dignity, individuals should stand up for people who have or

are in the process of moving across the country to receive physician-assisted death to give them a

sense of control. To witness or to have a terminal illness is dreadful, having Death with Dignity

will give patients families a sense of closure knowing there loved one is no longer suffering.

People with a terminal illness that are suffering should be able to put it to an end. Where state

laws do not allow physician-assisted death communities need to band together to raise

awareness, whether it be contacting legislators for support, contacting local news stations, or just

supporting families that are going through this process. By visiting the Death with Dignity

website a person could sign up to join the Death with Dignity movement and read the many

stories posted on their website. By doing this, states can pass a law that has helped so many

people in the past and will continue to help more people if allowed in more states.
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Works Cited

"About Us." ​Death With Dignity​, Death with Dignity. www.deathwithdignity.org/about/.

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www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Amyotrophic-Lat

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Bier, Daniel. "Life Before Death." ​Freeman: Ideas on Liberty​, vol. 66, no. 2, Summer 2016, p.

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andchoices.org/stories/miguels-story/. Accessed 5 Feb. 2018.

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"FAQs - Physician-Hastened Death" ​Death With Dignity​, ​www.deathwithdignity.org/faqs/​.

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