We all have empathy for dying people. And as a physician, I am relieved to know that terminally ill, mentally capable adults will soon have the option to request a doctor to prescribe aid-in-dying medication so they can die gently in their sleep.
When the quality of life gets so low and there is no chance of getting better, most of my patients are ready to go. Often it is hard for healthy people to understand the thoughts of a dying patient. Therefore it’s important to listen and to honor the patient’s thinking.
But as doctors prepare to implement the state’s new End of Life Option Act that takes effect June 9, we must clearly understand its benefits and requirements. Physicians must assess the patient’s mental capacity to make an informed request, review previous treatment and offer alternatives, including hospice and palliative care.
As physicians, we should be more prepared to have conversations about death. But most medical school curricula don’t adequately teach doctors how to address end-of-life care. Because of physicians’ discomfort with their own thoughts about dying, they often don’t discuss it with the very people facing this reality.
Health care providers can now call a free hotline offered by Compassion & Choices to talk to doctors with years of experience in end-of-life care. The hotline also offers similar consultation to pharmacists.
I have asked my cancer patients to talk about the possibility of dying. When they see the end coming, they focus on quality of life. They don’t want to be a burden to their family. They don’t want dying to be a dehumanizing process. They want to finish unfinished projects and discard what cannot be finished. They want to make amends where needed. They want to say goodbye and give their parental philosophy to those they leave behind. They want to be remembered in a positive way.
If we allow them to talk freely, they become role models for the rest of us. Good palliative care and hospice are wanted and essential. Attention to all this makes for a “beautiful” death. That may sound odd, but it’s what patients tell me they want and families appreciate.
Implementing the law properly is just as important as passing it. Now the real work begins to provide terminally ill Californians with care that addresses all the issues.
I hope that other physicians throughout the state join me in honoring their terminally ill patients’ decisions by allowing them the full range of end-of-life care options: palliative care, hospice and assisted dying as needed and chosen by the patient.
C. Ronald Koons is a retired oncologist at the University of California, Irvine, and a member of its ethics committee. He can be contacted at firstname.lastname@example.org.