Marcos Bretón

Marcos Breton: Dying isn’t the right to fight for – care is

Sometimes you find yourself supporting a lost cause and fighting against friends from the wrong side of public opinion.

That’s me on the issue of assisted suicide in California, which is a pen stroke away from being signed into law by Gov. Jerry Brown after being approved by both houses of the state Legislature.

You never know what Brown is going to do in the coming days on this issue, but even if he vetoes the End of Life Option Act, right-to-die supporters are certain to try again. As the Los Angeles Times editorial board recently wrote, “Polls consistently show that 70 percent of Californians – and Americans generally – support right-to-die laws for the terminally ill.”

I would wager that 90 percent of my friends, colleagues and acquaintances support the right to die. “It’s all about choice,” said one friend on Facebook. That’s the way this issue has been expertly framed by people on the other side.

They used the death of a beautiful young woman who had to leave her California home and relocate to Oregon amid the physical and emotional anguish of her dying days. Brittany Maynard became the perfect symbol for the right to die: a cancer victim who tragically died just shy of her 30th birthday, away from her home, because she wanted to avoid the ravages of her disease but couldn’t in her own home state.

So a narrative grew over a choice between death with dignity and prolonged, avoidable agony. Right-to-die supporters were aided by our sick health care system where doctors prescribe treatments that prolong lives, even when all hope is gone and patients are in agonizing pain.

I’ve lived this myself.

I couldn’t understand why my dying father was not moved into hospice care sooner. His doctors kept treating his vascular and respiratory ailments as if the treatments would cure him when we knew they wouldn’t. There I was with my younger brother in the fall of 2008, powerless to do anything and confused by the entire process.

The worst part was a session with a young woman whose job it was to explain our benefits options. She stared blankly at me as if I were a lifeless object and rattled a litany of figures and health care jargon that made my head spin. I’m college educated and work in the media and I felt brutalized by the process.

When they finally moved my dad into hospice care, he was gone in a couple of days while I wondered why he – and I – were made to suffer so badly for so many months.

These experiences are what right-to-die supporters are supposedly fighting against. God knows I was angry with my dad’s doctors and insulted by the benefits expert whose cold manner and rapid-fire doublespeak carried an unmistakable message: We had no good options. We were screwed.

So why not support right to die? I would be lying if I suggested that my Catholic faith didn’t play a role. It has. Life is precious and should be protected. But just as there are opponents of right to die beyond the Catholic Church, there are also good reasons to oppose it that have nothing to do with religion.

The choice as defined by the California campaign to enact a right to die is a false one. Instead of empowering doctors to prescribe death, why not expand palliative and hospice care for all?

“Even today, people with advanced cancer, heart disease or neurological disorders in Montana, Oregon, Vermont and Washington may qualify for physician-assisted suicide, but be deemed ineligible for hospice under Medicare and Medicaid, either because they are too healthy or still want treatment for their terminal condition,” said Ira Byock, a professor at Dartmouth’s Geisel School of Medicine, in The New York Times.

“Legalizing assisted suicide fixes nothing,” he said. “The principle that doctors must not kill patients stands. Two moral wrongs don’t make a right.”

In a 2014 study, “Dying in America,” the Institute of Medicine cited the “pressing need to improve end of life care.”

The study spoke of barriers to access for too many people who would benefit from expanded hospice or palliative care. The study also recommended creating incentives that “decrease the need for emergency room and acute care services.” It called on the federal government to create public reporting on the quality of end of life care.

Most importantly, the study revealed the greatest concern to those of us opposed to the right to die: “Most people nearing the end of life are not physically, mentally or cognitively able to make their own decisions about care,” the study said.

I can certainly attest to this. I was in no position to suggest to my dad that he empower his doctor to take his own life. And as sick as he was, he wanted to live. Until he died, he thought we would wheel him out of that hospital and back to his apartment.

The most dangerous aspect of the right to die legislation in California is that people who support it are under the assumption that a one-size-fits-all law will protect everyone. But what about people like my dad who want to live but who don’t have the family support my father had?

“People who are poor, or old and frail, or simply have long-standing disabilities, may worry that when they become acutely ill; doctors might see their lives as not worth living and compassionately act to end their supposed misery,” said Byock in The New York Times.

Why put doctors in the position to be prescribing medicine that ends lives? Why not put doctors in the position to ease suffering instead? Gov. Brown is nothing if not a man who understands the big picture. He sees high-speed rail, climate change and water infrastructure as legacy projects designed to solve problems for the long haul.

Why not view the end of life the same way? Why not pursue medical reforms that will encourage doctors and hospitals to ease the suffering of patients – instead of prescribing drugs that kill them?

We already know Brown is uncomfortable with the way right to die was slipped into a special legislative session. He could veto the End of Life Option Act as a way of creating the right choice for doctors and patients, one that empowers doctors to exercise compassion without prescribing death drugs.

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