In the California State Assembly in 2000, Hannabeth Jackson and Dion Aroner grabbed me in the hallway outside of the committee hearing where I had just voted against the “Death with Dignity” bill to allow doctor-assisted suicide on the Oregon model. They demanded that I change my vote for the sake of their mothers. As we have no contact, I do not know whether their mothers are still living. The bill, with all of its “protections” for the will of the suicidal patient, went down due to the discovery that California physicians did not have adequate training in pain management. Patients who are not in pain due to or associated with depression, we concluded, will not want to end their own lives.
Later my own mother suffered a massive stroke in 2005. Within a few hours, as I sat with her in the emergency room, I received a call from the manager of her Oakland home, a luxurious “Life Care” facility, stating that she could not return to her apartment as she was no longer ambulatory, and I should immediately advise what to do with her and her possessions. A clear message: “Pull the plug.”
My reply was that many people recover partially or fully from strokes and I wanted to give her a chance. I had followed the Terry Schiavo case and developed a skeptical attitude toward family members and medical establishments with a financial or emotional interest in dispatching an ailing person. California Life Care facilities after a million-dollar entrance fee provide all medical care to residents to the end of their lives for a flat monthly fee included in their rent. They are told to cancel all their private health insurance and sign the facility’s own DNR (Do Not Resuscitate) form. This form, like many hospital forms, is interpreted by management to require no interference, including CPR, if a resident is found unconscious. Most people who sign these DNRs are not aware that a house nurse has instructions to simply watch and verify their time of death if they pass out after pulling the emergency cord. All elders who choose these facilities do so in order not to be a burden on their loved ones at the end of their lives. They do not know about this "natural death" practice that frees up their apartments for a new entrance fee. I always vowed that if I ever returned to the legislature I would write a bill to remove the apartment-turnover financial incentive for Life Care facilities.
My parents’ own Advance Health Care Directives, recorded in 1987, specified that they were to receive No Heroic Measures only if they were in an irreversible coma or brain dead, to be verified by three unaffiliated specialist physicians. Very clear and not at all the same as hospital DNRs.
My mother was released from the hospital after her rehabilitation was botched in transporting her, resulting in another stroke. She was assigned hospice care and given 6 weeks to live. During this time I fought her Life Care facility to keep her in her own apartment where there was room for me and her private caregivers. Because she still needed a wheelchair, state licensing did not allow her to stay in Independent Living. I quickly left my small apartment and bought a house where the floor plan was like her apartment. Transport by private ambulance was successful. Three weeks later Hospice canceled her as a patient because she was improving. She lived seven more years in my unexpected new home.
My brother and sister sued to remove Mom from my care, arguing that her preference was to have my brother, who lived in another state, take care of her finances. My sister, a heavy smoker and small apartment resident with no car, was to take care of her person. They claimed that Mom was in a vegetative state and would rather be dead than cared for by me and the professionals who had also cared for Dad.
The alarmed court judge assigned a guardian ad litem to determine if Mom was receiving adequate care. When my brother and sister had visited, about once a year, she had not responded to them, but she was always animated with our Oakland pastor when he drove the hours to see her once a month. She also had a clear conversation with the guardian ad litem, assuring him that she was comfortable.
Two and a half years and great legal expense later my brother and sister dropped their case when they heard they were to be deposed on the evidence for their claims. I had cared for my parents with professional help I hired for over ten years. Dad passed at 93, Mom at 95, both in their own beds, not hospitals or nursing homes, as they had requested once they had seen Life Care policies in action.
My siblings and the Life Care facility were not the only ones who pressured for euthanasia. The doctors in the hospital and the rehab center, many friends and other family did as well. My cousins, one of whom is a doctor and made the request, even had Hospice dispatch their father, my father’s younger brother, because they felt he was too ill to continue to live. They had sent the lady-friend doctor who was caring for him away in order to kill him quickly. I visited him and called her back from Florida. They had his last 24 hours together.
I believe that no human being has the right to determine what another’s “quality of life” is. This standard, frequently applied to animals we are no longer willing or financially able to care for, exists only in the eye of the beholder. Doctors and even the most devoted loved ones do not know how much better than death a “poor quality” life may be. The patient him/herself cannot know. But a person who is disappointed in their own condition--be it illness, disability or just loneliness—can easily be persuaded by the abstract idea that their poor “quality of life” requires them to give up life. I am very sorry for the woman who moved to Oregon to die. Most of my friends facing old age say they will kill themselves rather than become in any way dependent on their children. Some have even made detailed plans.
Call me selfish, call me Christian, I don’t care. After having been a spoiled prodigal daughter studying and working all over the world in my early adulthood, serving the public in the state legislature and local government and raising my own child as a single mother, I discovered lasting joy in caring for my parents and honoring their wishes. I cannot decide that anyone else’s life is not worth living, so I fear a society that is already determining that people who are not “contributing” are not worth curing of illnesses. In all government-funded medical systems, the definition of non-contributors includes all the old no longer working and all the not-yet-self-supporting young. Individuals who request doctor-assisted suicide will always be those who believe that they are a burden rather than an asset. Soon that is all of us.
Regardless of the moves of six other states to provide doctor-assisted suicide, I believe that your own personal background-- and forgive me for citing it--with a Jesuit education and service with Mother Theresa, tells you that even with all the safeguards in doctor-assisted suicide, it is still wrong. Please veto this new attempt to take life.
Audie Bock 9/14/15