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Westminster, CO 80031

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Right-to-Die Myths

In 1992, Colorado's Gov. Roy Romer signed into law a controversial "right-to-die" bill. The law set up procedures to be used in life-or-death situations by patients, their relatives and friends and also allows a person to refuse resuscitation. Now there are even States that have legalized assisted suicide. In many cases, this right-to-die movement arises from myths and misplaced fear over pain, isolation and finances.

One myth is that dying is inevitably painful and relief is improbable apart from death. The cry for the "right-to-die" and "death with dignity" are based on the assumption that the terminally ill are bound to suffer and their pain can only be relieved by death. This is false. At least one third of all patients dying of a malignant disease suffer no pain at any time and according to specialist Dr. Matthew Connolly, "total pain" is comprised of mental, social, spiritual and physical pain. He says, "Failure to remember this complexity is one of the most common reasons why patients fail to achieve adequate symptomatic relief." 1

"Total Pain" relief can be enhanced by assuring the patient she will never be left alone, helping the patient put her affairs in order, assisting her to make a will and plan for her family's future, encouraging her to seek joy, rest and healing from God, and utilizing appropriate methods to manage physical pain. 2

A second myth is that family members and doctors know what an unconscious patient would want to do in a "life or death" decision. In a study of elderly patients published in the Journal of Gerontology, specific medical scenarios were presented and each participant was asked whether or not she would wish to be resuscitated in a given situation. The patient's spouse and attending doctor were then asked to predict the patient's response. The spouses consistently erred on the side of "over-resuscitation," in which patients who did not wish to be resuscitated would have been. In contrast, physicians' most common error would have been an irrevocable one of "under- resuscitation," in which patients who wanted to be resuscitated would not have been. 3

A similar study showed poor predictions by middle-generation family members (usually daughters and sons) of elderly patients. 4 These findings show how often decisions can be made that do not reflect a patient's desires or values.

A third myth is that laws are needed to protect the dying. As a result of Colorado's legislature jumping into the "life or death" business in 1992, physicians and caregivers can expect more litigation. The rights of those who wish to live have also been infringed upon. One compelling story is that of former Channel 9 helicopter pilot Peter Peelgrane. Peelgrane was unconscious and near death after his helicopter went down in the icy water of Horsetooth Reservoir near Ft. Collins. He later regained consciousness. During testimony against the "Right-to-Die" law in 1992, Peelgrane's wife, Karen Quinn, said, "Had I listened to the medical advice that had been given, I would be grieving today not just for two good friends (killed in the accident) but for my best friend. 5 Quinn also said that many people who had recovered from similar injuries had contacted and encouraged her.

Theologian Richard John Nehaus doesn't see government and laws as the answer. "In these spheres we must rely upon culture and morality -- upon principles being in place, and upon habits and institutions that nurture the conscientious observance of such principles. In short, we must rely upon virtues." 6

The fourth myth is those who exist in a persistent vegetative state only burden their families. Family members of patients in this condition most likely do feel burdened. They struggle to accept their new circumstances and financial concerns. Such feelings call for emotional support and financial assistance, but they do not justify depriving a non-terminally ill person of life.

In a study in the Journal of the American Geriatrics Society, researchers found that family members learned to adapt to life with a patient in a persistent vegetative state. The study surveyed family members of tube-fed patients in nursing homes. The researchers found that while the majority of family members did not expect the patient's condition to improve, most did not want the feeding tube removed unless another method of feeding could be provided. The majority of family members reported that they were able to cope with the situation and did not relate feelings of anger associated with the patient's condition. Many did, however, desire more access to family counseling and psychological assistance. 7

While these results cannot be generalized to everyone who faces a similar situation, they may indicate that with adequate social and spiritual supports, family members can cope emotionally and financially with their situation. The "right-to-die" and "assisted suicide" are not the answer.

Endnotes:

1 Matthew E. Connolly, "Alternative to Euthanasia: Pain Management," Issues in Law and Medicine, 4 (1989), P. 499.

2 "Alternatives to Euthanasia," op. cit., p. 498-504.

3 Richard F. Uhlmann, Robert A. Pearlman, and Kevin C. Cain, "Physicians' and Spouses' Predictions of Elderly Patients' Resuscitation Preferences," Journal of Gerontology, 43 (1988), p. Ml15-Ml2l.

4 Nancy R. Zwiebel and Christine K. Cassel, "Treatment Choices at the End of Life: A Comparison of Decisions by Older Patients and Their Physician-Selected Proxies," The Gerontologist, 29 (1989),     p. 615-621.

5 Jennifer Gavin, "House committee OKs 'Right-to-Die' BiIl" Denver Post, April 17, 1992, P. 5B.

6 Richard John Neuhaus, "The Death Watch," First Things, March 1991, P. 54.

7 Donald D. Tresch, "Patients in a Persistent Vegetative State: Attitudes and Reactions of Family Members," Journal of the American Geriatrics Society, 39 (1991), P. 17-21.

Rocky Mountain Family Council

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Westminster, CO 80031

(303) 292-1800

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