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Healthcare Consumers Drive Peace at Life’s End Campaign

Last week Compassion & Choices and our friend, Neil Rudolph, held a press conference in Denver to launch a national public education campaign, “Peace at Life’s End — Anywhere.” We hope to inform people in every state of safe, legal and peaceful means to end life when physical decline and suffering become pointless and unbearable. Neil’s parents, Dorothy and Armond Rudolph, were in their 90s when they tallied their escalating discomforts, infirmities and limitations, thought through their options, and decided to pursue a chosen death.

Media outlets throughout the nation picked up the Rudolph story and broadcast our campaign via newspapers, blogs, TV networks and talk radio. Reader and viewer response is overwhelmingly supportive of the Rudolphs’ careful planning and rational decision to achieve a planned death by voluntarily stopping eating and drinking (VSED). Most Americans believe Dorothy and Armond, after a long, hard-working and fruitful life together, had earned the right to die on their own terms.

Knowledge and planning are key. We’re thrilled so many people are calling and writing for information on VSED and other peaceful, legal end-of-life options. We’re sending packets throughout the nation and hosting community forums across Colorado. We do this without charge and hope additional funding will enable Neil to make community presentations in as many states as possible. We’re especially focused on residents, and prospective residents, of assisted-living facilities because the Rudolph family was evicted from their senior community when administrators knew their plan. We have tools to help prevent that pitfall and others.

It’s dreadful to read of an elderly individual or couple who acted alone and in secret when they saw their lives narrowing and diminishing by the day. They might have seen calamity approach in the form of imminent dementia or increasingly invasive and ultimately useless medical interventions. They probably contemplated their options without input from healthcare professionals. With alarming frequency they turn to a gun or other violence, their loved ones left confused, grief-stricken, guilt-ridden and ashamed of the family tragedy.

Grief is unavoidable when a loved one dies. But comprehensive information and careful planning can prevent the bitterness, confusion, recrimination and emotional scarring that so often follow a violent death. We all need to hear how the elderly and ailing feel about losing the things that give their lives meaning and purpose. Families must put their own needs aside and listen when someone says they are ready to die.

Medical professionals should hold alarm and judgment in check when an elderly patient, spiraling downward in deteriorating health, hints that ending life now might be preferable to continued decline, and likely suffering and dying under intensive hospital care. Labeling such patients “suicidal” and locking them in a psychiatric ward is not an appropriate response. Doctors should be willing to engage in an intimate and rational discussion of how they might manage medical care with peaceful death as the desired outcome. Is there a pacemaker or implanted cardiac device they could deactivate? Could they discontinue critical medication or treatments and mitigate distressing symptoms? Would they provide supportive comfort care to ease the symptoms of dehydration that follow refusal of food and fluids?

Our “Peace at Life’s End — Anywhere” campaign includes important information for doctors, but it’s really aimed at healthcare consumers. Compassion & Choices offers individual consultation to anyone rationally seeking a peaceful death. But ultimately we can’t serve everyone in need of such intensive inquiry and consultation. We hope to awaken and empower people with the knowledge that their own doctor has the ability and legal authority to manage a peaceful death. Unfortunately, it’s a responsibility too many doctors have shirked for far too long. Armed with knowledge, patients will change their expectations of the medical profession. Gradually, we anticipate people will feel comfortable openly asking for their doctors’ expertise to help them safely navigate their final mortal journey.

When those conversations happen routinely, we’ll see fewer self-inflicted gun deaths among the elderly and infirm. Then families will be able to sit beside their loved ones as they leave this earth in a way that reflects and honors the values they lived by. And like Neil Rudolph, they will grieve loss of the beloved, but rejoice in the peace and dignity with which they left.

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Barbara Coombs Lee is President of Compassion & Choices, a non-profit organization dedicated to expanding and protecting the rights of the terminally ill. She practiced as a nurse and physician assistant for 25 years before beginning a career in law and health

Since then she has devoted her professional life to individual choice and empowerment in health care. As a private attorney, as counsel to the Oregon State Senate, as a managed care executive and finally as Chief Petitioner for Oregon’s Death with Dignity Act, she has championed initiatives that enable individuals to consider a full range of choices and be full participants in their health care decisions.

Ms. Lee took her undergraduate education at Vassar College and Cornell University and obtained advanced degrees in law and medicine from the University of Washington and Lewis & Clark College. She holds an adjunct position at the University of Washington School of Public Health and Preventative Medicine and is a member of the Oregon State Bar.

She has been interviewed by NBC News, CNN Crossfire, 60 Minutes, McNeil Lehrer News Hour, NPR, The Today Show, and Bill Moyers’ “On Death and Dying” among others. She has also testified before the US Congress on end-of-life issues.

She has been recognized with a national health Policy Fellowship, Boeringer Ingeheim Foundation, an American Jurisprudence Award for outstanding performance in the study of medical law and a National Health Lawyers Association scholarship for outstanding student achievement.

Ms. Coombs Lee has been a presenter at programs sponsored by American Bar Association, Older Women’s League, American Pain Society, Oregon State Bar, Americans for Better Care of The Dying, American Associations for the Advancement of Science, End of Life Concerns, and the American Pain Society. She spoke at the World Federation Right to Die conference in Zurich, Boston and Brussels.
Her audiences have included the Oregon Gerontological Association: the California Nurse Assembly & Education Conference. Her debate “Doctor Assisted Suicide: Compassionate Alternative or Murder” with James Bopp, Jr., was produced by “Justice Talking” a project of the University of Pennsylvania’s Annenberg Public Policy Center
for Public Radio.

Since Gonzales v. Oregon, the lawsuit defending the Oregon assisted-dying law, Ms. Coombs Lee has been interviewed by many of the nation’s newspapers. She has been quoted in the New York Times, The Washington Post, The Chicago Tribune, and on NPR’s All Things Considered. Recently, The Harvey M. Meyerhoff Lectures on Ethics at the End of Life hosted her presentation “Local Medical Practice and the Federal Threat” at Johns Hopkins University.