Episode Transcript
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Speaker 1 (00:01):
The Middle is supported by Journalism Funding Partners, a nonprofit
organization striving to increase the sustainability of local journalism by
building connections between donors and news organizations. More information on
how you can support the Middle at listen to Themiddle
dot com. Welcome to the Middle. I'm Jeremy Hobson along
(00:22):
with our house DJ Tolliver and Tolliver. Some of my
favorite shows that we do are the ones about cultural issues,
not politics, but we may not be able to do
that for a while because of the elections, So you
better enjoyed this show well at last.
Speaker 2 (00:35):
Yeah, man, this is like our moment of zen, you know,
a little yogat treat before things get wet and wild, you.
Speaker 1 (00:40):
Know, yes, a yogurt tree where we talk about death
and dying. That's what's not the most sen topic, but
we'll see. And in fact, next week we're going to
do our show live at a special time on Wednesday
during the day because of the Democratic National Convention. More
details on that later this hour, But right now we're
talking about whether Americans should have a legal right to die,
especially when faced with a terminal illness. It's something called
(01:03):
physician assisted suicide dying with dignity, voluntary euthanasia, or the
term we will use medical aid in dying. As it
stands now, it is legal in ten US states and
is currently being considered in more than a dozen other states.
It first became legal in Oregon back in nineteen ninety seven,
and since then only a very small number of Americans nationwide,
(01:24):
about nine thousand, have chosen to end their lives this
way legally. When you look at the polling, though, most
Americans believe it should be legal. So we want to
know what you think. But first to your calls. On
our healthcare show, we had former Health and Human Services
Secretary Kathleen Sibilius and billionaire businessman Mark Cuban on our show.
(01:45):
He owns a low cost online pharmacy, and we were
talking about why America's health care costs are so high.
Here's what some of you had to say on our voicemail. Hi.
Speaker 3 (01:54):
My name is Karen Jordan. I live in North Carolina.
Speaker 4 (01:58):
At HIME.
Speaker 5 (01:59):
My name is Boos.
Speaker 6 (02:00):
I'm calling from Denver, Colorado.
Speaker 4 (02:03):
Hello.
Speaker 7 (02:04):
My name is Nancy Mathew. I'm calling from Milwaukee, Wisconsin.
Speaker 6 (02:09):
Hey, my name's bradamor retired military and private practice posician
living in Middle Tennessee. There's too much money to be
made in medicine.
Speaker 3 (02:18):
The problem in the medical health system is greed. Doctors
have no longer have the exclusive right to determine what
their patients need.
Speaker 8 (02:29):
I believe the only thing that can be done about
the high cost of healthcare is universal healthcare.
Speaker 7 (02:35):
I am damn mad about this American so called health plan.
We here in America are so be reffed of people
who genuinely care for our health.
Speaker 1 (02:47):
Well, thanks to everyone who called in, and you can
hear that full show anytime because The Middle is available
as a podcast in partnership with iHeart Podcasts on the
iHeart app or wherever you listen to podcasts. So now
to our topic this hour, medical aid in dying. Should
there be a legal right to die in the United States? Tolliver?
What is the number of people to call in?
Speaker 2 (03:05):
It's eight four four four Middle. That's eight four four
four six four three three five three or right to
us that listen to the Middle dot com.
Speaker 1 (03:12):
Let's meet our panel. A Lewa Arthur is a death
doula and founder of Going with Grace and end of
life planning organization. Her new book is called briefly Perfectly
human a Lewa Arthur, Welcome to the middle.
Speaker 9 (03:23):
I'm happy to be here. Thank you for having me.
Speaker 1 (03:25):
It's great to have you. And Rob crib is joining
us as well. A reporter at the Toronto Star. He's
the host of the Ultimate Choice podcast, which explores the
political and ethical stakes behind Canada's debate on this issue. Rob,
great to have you on the show as well.
Speaker 10 (03:39):
Good to be with you. Thanks for having me.
Speaker 1 (03:40):
Well before we get to the phones, Rob, on your podcast,
you follow a man in Canada who is considering how
he wanted to die because of a terminal illness. Is
there a difference in the debate in Canada and the
United States over this issue of medical aid and dying.
Speaker 10 (03:55):
I don't think there's a difference philosophically. I mean the
issues are pretty straightforward. Should we all have the right
to do this or not? And so no, I don't
think there's a big difference that way. I think there
is a difference in terms of the execution of how
you go about doing that. Canada has been remarkably aggressive,
in fact, arguably the most aggressive country on the planet
(04:17):
over the last Since twenty sixteen, twenty seventeen since we
adopted it and expanded it tremendously, So I think in
some ways, I think Canada provides an interesting case study
for Americans looking at this issue around what happens when
you adopt a very liberal policy, around who is ultimately
(04:37):
eligible to apply for it and in fact receive permission.
Speaker 1 (04:43):
And would that include people who are not facing terminal illness.
Speaker 10 (04:48):
That's the big difference. So Canna's legislation initially was very
similar to that in the United States and other countries
where you had to have a terminal illness, you had
to have a foreseeable death. But it changed because in
part because the polling numbers were so tremendously supportive of
it and continue to be on this core question of
should people have the right, and so it was expanded eligibly,
(05:12):
was expanded to those who were in fact not dying
at all, it may not die for a very very
long time, and that's obviously spiked numbers in a way
that is unprecedented on the planet. Right now, there's more
people doing this in Canada than anywhere else in the world.
Speaker 1 (05:26):
HeLa Arthur, You're in California, which is one of the
states where medical aid and dying is legal. Tell us
what it is you do as a death doula.
Speaker 11 (05:35):
So, a death doula is somebody who does all of
the non medical and holistic care and support of the
dying person and their circle of support through the process.
So we're really working with any emotional, practical, logistical, and
sometimes spiritual care of the dying person and the circle.
Speaker 9 (05:51):
Yeah.
Speaker 11 (05:51):
When I say the dying person, I mean anybody who
ask them awareness of their mortality. That means that when
people are healthy, we can help them complete comprehend event
of life plans and work through their fears of or
anxiety around death. When people know what they're going to
be dying of, we can support them and creating the
most ideal death for themselves under the circumstances. And then
after a death, we can help family members wrap up
(06:13):
affairs of their loved one's life. So just full broad
scale support around the issues of death and dying that
are non medical in nature.
Speaker 1 (06:20):
And in your experience, At what point do people actually
come to the decision that they want to end their
lives on their own terms like this?
Speaker 11 (06:27):
It seems to be a rolling answer, you know.
Speaker 3 (06:31):
There.
Speaker 11 (06:31):
I've met many people that have decided that they really
want to do it, have sought medication, got the prescription.
Speaker 9 (06:38):
And then didn't choose it.
Speaker 11 (06:39):
And then others that decide at some point get the medication,
choose it soon, some who wait till the very last minute.
Speaker 9 (06:46):
It's all over. It's all over the map.
Speaker 1 (06:49):
Do you encounter alua opposition to medical aid and dying
in your work? Do you have family members that don't
want this to be something that their loved one does?
Speaker 11 (06:58):
I have met fairy a few family members. I think
it's probably not the right choice. And yet, with most things,
as it relates to how we die, I think, well,
when it's your turn, you can do what it is
that you want to do. But for now, it's this person,
and so let's allow them to continue their agency all
the way into their death.
Speaker 1 (07:15):
A lot of calls coming through. Let's go to Mary,
who's in Philadelphia. Mary, welcome to the middle Go ahead.
What do you think about this?
Speaker 12 (07:22):
I think that we should have a national and dying law.
We should always have had it. It has existed in
the Scandinavian countries for quite some time, and I think
it gives people dignity in their last days or months,
especially if they are in pain. We give the dignity
(07:45):
of a painless death to animals who are suffering. Why
can't we not give that dignity to human beings?
Speaker 1 (07:54):
Mary? Thank you for that call, Rob Crib, is that
something that you have heard before? This is something that
we do with animals when they're dying, dogs, cats, people's
beloved animals. Why can't human beings have the same one
hundred percent?
Speaker 10 (08:11):
Yeah, you hear that argument a lot. I mean, the
counter argument is that we're not dogs and cats, that
there might be a difference there in that argument. There's
no question that there's tremendous populous support for this. It's
very clear. The polling numbers in both our countries are
very clear. But it depends a little bit on the
question too, right, as all polling numbers do. So if
(08:32):
you ask the most basic question, do you support a
legislation that would allow individuals to choose that, I think
you're going to get seventy to eighty percent who will
say yeah, sure. But as with everything, as you know,
it becomes complicated when you start to talk about the details,
and that's where the challenges lie. And so what I
(08:56):
can tell you again is a case study in Canada,
if you asked one hundred Canadians do you support this legislation,
you're going to get seven or eight, seventy to eighty
percent are going to say yes. But when Canada attempted
to further expand eligibility to include, for example, those with
mental health challenges, and this was a very very vigorous
(09:18):
debate here that support womits, you're down to thirty twenty
to thirty percent support for that. And we nearly had
an alteration to our legislation just recently that would have
expanded the government was promising to in fact further expand
to those with mental health. That's one in four people
(09:39):
have some form of mental health challenge, right, Well, he.
Speaker 1 (09:41):
Lout, Arthur, what do you think about that somebody that
may have a mental health issue and decides that they
want to go ahead with medical aid and dying. But
maybe what they need to do is get past their
past their mental health challenge, if that's possible, and maybe
in the long term they won't want to have medical
aid and dying.
Speaker 11 (10:02):
I think part of the difficulty with that conversation is
how we couch mental health challenges. I'm somebody who has
suffered deeply from a clinical depression. I wrote all about it,
and there were times where, you know, I was in
so much pain that I just didn't want to live
like that anymore. I didn't necessarily want to die, but
I didn't want to keep living in pain, and there
(10:22):
felt like there was no hope and there was no
way getting out of it. And when I am with
family members where their loved one has chosen to end
their lives, there's often a lot of guilt or there's
such a stigma around it.
Speaker 9 (10:37):
Yet yet so often.
Speaker 11 (10:40):
What I see are people that perhaps we're in a
tremendous amount of pain before, not in the way that
we quantify it generally, and are no longer you know,
it's a way out of this life, out of pain.
And we say people are no longer suffering anymore when
they die after let's say, a long dance with cancer.
(11:01):
And yet when people have suffered from multiple mental health
challenges long their lives and they die, we don't also
give them the grace to say, hey, they're no longer
in pain, they're no longer suffering anymore.
Speaker 9 (11:09):
And I wish that we would.
Speaker 1 (11:11):
We're getting a lot of messages in online Barbara in
Nashville says, I may be mistaken, but at sixty five,
I still do not believe in the God of the
Bible that decides my final moments. Those who believe may
do as they please. However, this is my life and
I should have the right to die when and how
I see fit Tolliver. One of the central figures in
this debate was doctor Jack Cavorkian, who was actually convicted
of second degree murder in nineteen ninety nine and was
(11:34):
often portrayed by the media as doctor Death.
Speaker 13 (11:37):
Yeah.
Speaker 2 (11:37):
Here's a clip from a nineteen ninety two interview between
him and Barbara Walters about how he hoped he would
be remembered long after his death.
Speaker 14 (11:45):
What do you say to people who say, doctor Kavorkian,
you are playing God?
Speaker 15 (11:49):
Well, so as a doctor who takes your heart from
one body and puts it in another. Isn't he a
doctor always plays God, even when he gives you a pill,
because he's interfering with a natural process.
Speaker 14 (12:01):
Instead of being called doctor death, which does sound so
very extreme and so very ghoulish, Yes, isn't there something
you would prefer being called?
Speaker 15 (12:11):
Well, I will one day?
Speaker 14 (12:13):
What do you think you will be called that when.
Speaker 15 (12:14):
Society reaches the age of Enlightenment, then they'll call me
and other doctor's doctor Life.
Speaker 1 (12:21):
Jack of Orkian died in twenty eleven and Tolliver. Just
while we have our podcast listeners here, I just want
to say they got to hear you and your band
play in last week's episode. If you missed last week's
episode about Christianity and politics, you better go listening. You'll
get to hear Tolliver and his band. Because you know Tlliver,
they don't get to hear you DJ on the podcast
because we don't have the rights. It's only on the
(12:42):
radio exactly.
Speaker 2 (12:44):
It's not every day you get a funk band with
your news. So you know they get into it.
Speaker 1 (12:47):
So check that out. We'll be right back with more
of the Middle. This is the Middle. I'm Jeremy Hobson.
If you're just tuning in the Middle as a national
call in show, we're focused on elevating voices from the middle, geographically, polite, philosophically,
or maybe you just want to meet in the middle.
This hour, we're asking you should there be a legal
right to die in the United States? Tolliver, what is
(13:08):
the number of people to call.
Speaker 2 (13:09):
In it's eight four four four Middle. That's eight four
four four six four three three five three, or you
can write to us that listen to the Middle dot
com or on social media.
Speaker 1 (13:17):
I'm joined by author and death Doulah Ailua Arthur and
Rob Cribb, host of the Ultimate Choice podcast. And the
phone lines are full. Let's get to Joan, who's in
New Haven, Connecticut. Joan, go ahead, Welcome to the Middle.
Speaker 16 (13:32):
Hi, thank you. I'm just I'm speaking against medical assisted
suicide on behalf of a group called Progressive Against Medical
Assisted Suicide. This is not nearly an issue of personal
individual or individual choice. In the system where healthcare is
biased against the poor, the elderly, the disabled, and other
(13:52):
marginally marginalized people. There is coercion at every level, financial, psychological,
and person. In the states where this is past, they
are also trying to expand the guidelines for who is
eligible to terminally ill people. It's going slowly, but it's
going to happen. And if you look at Canada, which
(14:14):
somebody said is a case study, look at what's happened there.
In a medical system that is geared toward this kind
of discrimination, there is no room for this and I
really really believe that progressive people who are for social
justice need to stand against this and understand that it
is against the common good.
Speaker 1 (14:36):
Joan, let me just ask you a quick follow up question.
What about people who are indeed terminally ill and say
I want to choice in how I die?
Speaker 16 (14:45):
What I just said is unfortunately. I mean, I think
first of all, that people need to the healthcare system
needs to improve palliative and hospice care exponentially. That I said,
believe that would reduce, uh, considerably, the need for people
to feel like they need to take this option. But uh,
(15:06):
the ultimate thing is this is something that impacts everybody,
and it's going to impact people who are marginalized in
the way that I described and by it, and then
for whom the medical system is extremely biased. It is
going to impact them very very seriously, and it's going
to be a co or. It is a coercion. It
(15:27):
is not a choice for those people. This is the
this is an issue of the common good.
Speaker 1 (15:31):
Okay, Joan, thank you very much for that, Rob crib
What about those arguments and the what Joan brought up
at the end there, which is that there is another alternative,
which is I guess hospice. Hospice care many people have
at the end of their lives.
Speaker 10 (15:45):
Yeah, so this, this is one of the big concerns
I think that has been raised in Canada, and it's
part of the counter push against this, and it's just
this and it's and this is let me just say
that there the opposite to this is not strictly coming
from the traditional circles that you'd assume. For sure, there
are sanctity of life arguments from the sort of the
(16:08):
religious right, there's no question about that, but I think
it's naive to suggest that that is the sole source
of the concern. So we spoke with lots of physicians,
and we spoke with lots of researchers on this point.
And there's a lot of division around this, and there's
a lot of doctors who will not do it. And
(16:30):
one of the arguments is that, you know, and this
very thing is happening in Canada, where there has been
a number of examples of people who are living on
the margin. So these are effectively poor people who are
quite openly saying, you know, I'm not dying, but I mean,
if there's a law that can get me out of
the horror that I live in because the healthcare system
(16:52):
is failing me. I can't get a decent place to live.
Social assistance is a joke. My life is meaningless. If
I can get out now legally with assistance, with the
state assistance and my physician offering me this out, I'll
take that. I just don't want to continue on. I'm
not going to I mean, it's not so so that
(17:14):
I think is where there's a tremendous amount of consternation
and the and so the argument is coming, why why
are we so aggressively pursuing this piece of public policy
versus just fixing a healthcare and a social assistance system
that would give meaning, an alternative viewpoint and vantage point
for those who might be seeking it who are living
(17:36):
on the fringes of society.
Speaker 1 (17:38):
Let's go to Craig, who's in Saint Martinville, Louisiana. Craig,
welcome to the MITTA. What do you think?
Speaker 6 (17:45):
Yes, I think what hind's in the balance is that
it should be our choice, and the powers that be
don't want to give us that decision because of all
the money to take and read off of keeping us alive.
(18:13):
So it always comes down to the same.
Speaker 1 (18:16):
Thing money you believe it is, Craig, Thank you for that,
Alua Arthur your thoughts on what Craig had to say there.
Speaker 11 (18:26):
It's complicated, there's you know, there's a lot of different
ways to look at what Craig is sharing. I think
that part of the concern is that there is a
lot of Medicare funding that spent in the last seven
days of life. You know my understanding, and I'm going
to get the figures wrong, so I'm not even going
to try. But there is a very very large amount
of money that spent of Medicare funding in the last
(18:47):
seven days of life for people that are either on
hospice or palliative care. So there is a lot of
money that's been spent there as well. So in some ways,
almost on the counter argument, it makes sense that the
government would want to keep people alive in order in
order for more money to be spent. But similarly, on
the other side, I think that there is a strong
(19:08):
there could be a strong governmental interest in people being
in powered to do to take this medication if they
in fact do not want to keep living. I think
that when it comes down to people that are ill,
it's a there's a bit of a shift because we're
overlooking the existential question at the root of it all,
which is where I believe the focus should really be on,
(19:31):
is the humans who are living in circumstances that they
don't want to be living in, and how has government
supported or not supported those ideas in the past.
Speaker 1 (19:42):
Beth is in Tyra and North Carolina. Hi, Beth, welcome
to the middle Go ahead, thank.
Speaker 17 (19:48):
You, it's try on North Carolina. I think that for
so many of us we get warehoused in what are
you phemistically called retirement communities and assisted living, and for me,
(20:11):
I would rather be put on a plane to Denmark
where I can say goodbye before the last dollar is
sucked out of my wallet by the medical community.
Speaker 1 (20:28):
Is this something that you've given thought to for your
own situation, Beth, Oh, I have.
Speaker 17 (20:35):
Done more than just given thought to it. I have
been very clear and put it into my into my
legal paperwork that I am not to be.
Speaker 8 (20:54):
Kept alive.
Speaker 3 (20:57):
At all, and.
Speaker 17 (20:59):
Hopeful before I lose my mental facility of faculties, that
I can buide the plane ticket and take off with
or without assistance.
Speaker 1 (21:18):
Beth, thank you very much for that. Rob crib. A
couple of things came up there. One is, she's got
it written down. Do a lot of people take the
time to actually think about this well in advance of
any terminal illness and say this is what I want
if I get to that stage.
Speaker 10 (21:33):
Yeah, it's increasing the term living will. I don't know
if that's familiar to you. In America and Canada, it's
a very common thing now. More and more people are
laying out what they wish to happen to them should
they lose faculties. So they're alive but unable to make
decisions about their you know, their healthcare and the kind
(21:54):
of medical assistance or interventions that they wish to receive. So,
I mean, what this has done, for sure is increase awareness.
Like just think about the fact that we're even talking
about this. You know, twenty years ago unthinkable, none of
us talked about death. These were unponderable ideas, and the
very notion of what we're talking about was a criminal
code violation. It was murder, I mean to be clear, right, So, like,
(22:18):
look how far we've come, and so all of these
sort of very taboo unspoken conversations are happening, and so
to something said. What this legislation has done is made
us talk about these things in a very open way.
It's legal in any states the United States and Canada,
across this country, and so, I mean, I think there's
(22:38):
no question that people are now in a position where
they are thinking about what is the answer for them,
They're articulating it to their loved ones, they're putting it
in legal documents, and you know, to that extent, I
think this is all very positive.
Speaker 1 (22:51):
Yeah. Actually, we did a show months ago about legalization
of marijuana in the United States, which started about ten
years ago in I believe Colorado and Washington State, and
now almost half the states have legalized recreational marijuana. And
if you look at back to the nineteen nineties when
(23:11):
it was not legal to have medical aid and dying,
and now we're already talking about ten states Washington, DC
that have legalized it and Ilua, Arthur. There are about
a dozen other states that are thinking about doing right now.
It's moving. The debate is moving very quickly on.
Speaker 11 (23:24):
This, Thank god. I'm really grateful for it. And I
think I just want to echo what Robert was saying earlier,
which is that it's forced the issue it's forced us
to begin talking about our desires at the end of life,
I think gratefully. It's also created opportunities for people to
think about what worked in the deaths that they've seen
(23:44):
their family members, what they want for themselves, what they
wouldn't want for themselves, which allows people to approach the
end of their lives with a lot more grace, a
lot more openness, a lot more vulnerability, which I think
as we die, we teach the people that are around
us how to do it and how not to do it,
thereby helping heal our relationship with death. And so just
(24:04):
opening the conversation so people can talk about what they've seen,
how they felt, what they would want for themselves, and
then creating what would be ideal for them when they're dying,
if that is choosing medical aid and dying or not
if it's legal. That in and of itself has tremendous
value a.
Speaker 1 (24:19):
Lot of people.
Speaker 10 (24:20):
Yeah, go ahead, rob the fact that we have a
job titled death dueler, right, I mean, that's a remarkable thing.
When did that job title come into existence? This is
all very very new and innovative, and you know, thank God,
because for sure I can see this as being a
rapidly expanding area of professionalism. There's no question about it.
The numbers are certainly pointing that.
Speaker 1 (24:42):
I feel like death DULA is not a job that's
going to be taken over by artificial intelligence anytimes. I
think you need some emotional intelligence to do a job
like that. Tolliver. A lot of people writing in on
Listen to the Middle dot com.
Speaker 2 (24:53):
Yes, so many people. Vicki and Charlotte says the problem
with the right to die is that it will become
a duty to die for many people. I've already seen
folks used to forego potentially life saving treatment because the
copayer costs would break their families' finances. Ronda in Massachusetts
says most of the opposition against the right to die
comes from Christian churches of various denominations. We have freedom
of religion in the US Constitution, but also freedom from religion.
Speaker 1 (25:16):
Interesting. Yeah, let's go to Claude, who is in Overland Park, Kansas. Claude,
welcome to the Middle Go ahead.
Speaker 8 (25:26):
Hi, it's the civil right. In the states that have this,
we haven't been getting complaints from the families because the
families have been able to be together with their loved
one and have closure and assist and be present at
that time and know what their wishes were. We are
losing people. One issue that's not at all recognizes we
are losing people to suicide because we don't have medical
(25:49):
aid and dying. My mother was a Holocaust survivor and
she committed suicide solely for one reason when she was healthy.
It's quite healthy. She committed suicide because she was afraid
something would happen to her and she would lose control
of her choice to end her life. Her state did
not allow medical aid and dying, so she chose to
(26:09):
commit suicide while.
Speaker 4 (26:10):
She was healthy.
Speaker 1 (26:11):
Wow, thank you claud for sharing that with us. Rob
Crib have you heard stories like that?
Speaker 10 (26:21):
Yeah, Listen, the deeper I've gotten into this, the more
fraud and uncertain I am about what I even think.
It's a truly difficult, labyrinthine issue. And if you think
you have a very clear view and understanding of it,
(26:42):
and you know what you think, I'd urge you to
just ponder for a moment the other side, For every
moment where I think I have a glint of clarity
in my own mind about what I think you know,
I'll talk to somebody else, or I'll see another case,
and it's just it's deeply gray and it's impenetrable in
terms of public policy. What the right thing to do is.
(27:07):
So yes, I mean, of course I've heard that, and
I've certainly heard many stories on the other side that
would be just as compelling as what you just heard
arguing the exact opposite way. So I mean, it really
truly is one of the most fascinating contemporary public policy questions.
Like it's hard to think of anything that is more
difficult to navigate, Like I would never want to be
(27:30):
a politician or a lawmaker trying to wrestle with this
because again, at the surface level, yeah, sure, you can
craft something that is going to meet the desires and
wishes of the populace who are answering a basic question.
But once you scratch anywhere past that most basic level,
(27:53):
it becomes a snake's nest.
Speaker 1 (27:55):
Well, and we don't hear politicians talking about it that much.
It certainly hasn't come up in this president campaign as
far as I'm aware, at all the things that they
talk about. Let's go to Dane, who's in Denver, Colorado. Dane,
welcome to the middle. What do you think about medical
aid and dying?
Speaker 18 (28:10):
Thank you. When I'm a home hostice nurse, so I
have a bit of a perspective on death and dying,
and I've had the privilege of one of my patients
to want me to attend when he took the medications,
and I found it to be quite a beautiful experience,
family reminiscing, so forth. And I think it's about control
(28:31):
for people who have terminal conditions to be able to
have some control over their life. Because in Colorado there's
fairly stringent guidelines for this. It's not I can't speak
to the other forms where it's for anyone of any
age for whatever reason. But you know, I see that
there are things worse than death and people who are
(28:53):
facing that should have some.
Speaker 1 (28:55):
Control, Dane, Thank you, Alua Arthur. I am imagine that
there are very strict guidelines where this happens all over.
Speaker 11 (29:04):
The place, incredibly strict guidelines list in California. My understanding
is that you have to make two requests, orly you
have to talk to somebody and make two different requests
for it. I can't remember what the timeframe is between,
and then you get the medications. There's guidelines about when
you can take it, when it can be picked up,
et cetera. And I want to echo what Dane was
(29:26):
saying earlier is that when I've been with folks, with
families with consolations of care, when their person is choosing
medical aid and dying, the amount of agency and the
ability to create an end that honors the life in
front of us is beautiful. We can ritualize that time
between taking the anti naugia medication and the ones that
(29:48):
will eventually slow and stop breathing, where you know, the
person who's dying has a right to control what their
last moments on earth will look like and feel like,
and who's there and music that they're listening to, and
what they're seeing and what they're smelling and what they tasted.
One of my clients wanted his medicine mixed with pistachio
(30:08):
ice cream because he loved it so much, and so
somebody and it was pisassio ice cream from a place
where he had grown up, which was thousands of miles away,
so somebody flew it, flew with it over and we
mixed it up.
Speaker 9 (30:21):
It was really beautiful, you know.
Speaker 1 (30:23):
Tolliver Oregon, as we said, was the first state to
legalize medical aid and dying in the nineties, and the
debate there set the tone for how the issue was
viewed nationally.
Speaker 2 (30:32):
Yeah, and not everyone in Oregon was on board. Here's
prominent Portland psychiatrist Greg Hamilton speaking out against the law
when it finally went into effect in nineteen ninety seven.
Speaker 19 (30:40):
The people of Oregon have unleashed a terrible tragedy not
only on this state, but on other states in America,
across America and the world. It's entirely appropriate for the
DEA to enforce federal laws requiring that Oregonians, as well
as other America Americans, use drugs to heal people and
(31:03):
not to kill them.
Speaker 1 (31:05):
Well, that was in the nineties, and as we've said,
a lot has changed since then across the entire country.
Tolliver just briefly for people who are listening to this
right now and they wonder what can I do to
help the middle You can rate us? What can you
rate us on the podcast platforms?
Speaker 2 (31:18):
Tolliver five stars, just like yelp. You know you're reading
a restaurant, Give us five stars.
Speaker 1 (31:23):
Starry every where you can. Okay, we'll be right back
with more of the Middle. This is the Middle. I'm
Jeremy Hobson. This hour we're asking you should there be
a legal right to die in the United States. You
can call us at eight four four four Middle. That's
eight four four four six four three three five three.
I'm joined by Rob crib hosted The Ultimate Choice podcast,
(31:43):
and author and death doula Alua Arthur. Let's get right
back to the phones because a lot of calls are
coming in. Bill is in Saddlebrook, Arizona. Bill, Welcome to
the Middle.
Speaker 5 (31:54):
What do you think, Well, I'm an advocate for maden dying.
I'm familiar with the need for it. My wife passed
away and a half ago wanting reading it, which of
course was impossible in errors. She was Some of the
arguments say out the care and hospice is sufficient. She
(32:14):
was on both, and in the last three months hospice
was wonderful, except in the last week they were unable
to keep her comfortable, or they chose not to be
able to keep her comfortable. Three days before the past
I called hospice nurses to my house four times twenty
four hours and still didn't get relief. She passed away
(32:36):
two days later, the argument I'm hearing that this is
a highly scripted law. You have to you have to
you have to have two doctors, you have to ask twice,
you have to be able to do it yourself. There
are so many, so many safeguards, and there's no state
that is doing anything to any of the ten states
(32:59):
trying to expand beyond the law that we have to
resemble what they do in Canada. We just want to tight,
carefully constricted law that applies to a small number of
people who really want need the option to pass away
carefully using medical aids in their passing in the same
(33:19):
way that we've used medical aid to get us up
to that point.
Speaker 1 (33:23):
Yeah, Bill, thank you very much for sharing that. Thank
you for sharing that with us. Alwa Arthur, I just
think about, you know, somebody like Bill who's there with
his wife as she is in such pain and trying
to help in that way in a state where it's
not legal right now in forty states, it's not legal
in the United States.
Speaker 11 (33:45):
Heartbreaking, it's absolutely heartbreaking. And these cases really are the book,
are the reasons why they make the real strong case
about why it should be legalized, because not everybody's going
to choose it, but for those that could use it,
for those that would want to, we're denying them, and
then they're suffering needlessly. It seems inhumane to me that
(34:05):
we would not allow humans to choose off of this
ride when it gets too much for them, for whatever
that means for them. I also want to point out
the fantastic point that he made about the capacities to
be able to take the medication yourself. And one of
the challenges with the laws, at least here in California,
and I think in quite a few other places, which
(34:25):
is that for people with diseases like als or Alzheimer's
and dementshall where the capacity to take the medication themselves,
any degenerative diseases also, once they lose the capacity to
swallow the medicine or to push the plunger or something
of the sort, then the law is not applicable anymore.
And I wish that there were ways to write the
(34:48):
laws around that so that that was still available.
Speaker 1 (34:51):
Yeah, how do you handle a situation where somebody has
Alzheimer's or dementia and wants this either of you, Alua
or Rob if you know I mean, is is there
a way that that is handled, because that's very difficult
to know whether they are able to think clearly when
they make a decision like that.
Speaker 11 (35:12):
Well, my understanding is that you have to be of
sound mind and you mean using air quotes around that
term in or to make the request anyway, and you
have to make it clearly and consistently. And depending on
the amount of cognitive function somebody still has, they may
not be capable of making that request of sound mind
when the time when the when it's time to make
the request. Additionally, when folks still do have the capacity
(35:36):
generally to speak very clearly and are still of sound
mind to make that request, they don't meet the requirements
of the law, and that they're not in that six
month window.
Speaker 1 (35:46):
Yeah, let's go to Jesse, who's in Rochester, Michigan. Jesse,
welcome to the middle. Go ahead.
Speaker 20 (35:53):
Yes, I have a daughter who's fifteen that has significant
physical and mental disability, and to be honest, as somebody
in the disability community and knows a lot of families,
I find this frightening. I mean, we have been with doctors.
They do have the power over life and death, even
now in the hospital, and a lot of it for
(36:13):
the disabled comes from lethal neglect or like we went
to for heart surgery, they decided her type of chromosome abnormality,
they wouldn't do it. They want to send us to
an ethicsport. We tried to get a BYPAP, which tons
of people have a CPAP or BYPAP, and they said,
no one does that for kids like yours. And what
I'm saying, I guess when I hear all this, I go, well,
(36:36):
doctors are already doing this, and it's just applied to
the disabled. So like when I go into a doctor,
the first thing I say, new doctor with my fifteen
year old daughter, and myself, I tell them starvation is
not a medical treatment. Overdosing my daughter is not a
medical treatment, and death is not a cure. And what
(36:57):
we're already fighting are doctors that are not good with
complex care because they are just letting people go Already,
this I think is terribly frightening, and I think it
puts vulnerable people that are disabled, that cannot, that are
just in positions of complex care into the position where
you have the heavy hand of medicine and even if
(37:19):
you're continually asked, you know, even if it's just not
a even if it's like, well, don't you want to
do this? I mean a lot of people equate suffering
with disability. And so now we have doctors that are
thinking they're doing you a favor by getting rid of
your life and maybe convincing you that your life isn't
worth living. I mean, we get that all the time.
(37:39):
They're talking about quality of life. And let me just
say something that I say to the doctors. I do
know as a profession doctors have a pretty high suicide rate,
depression rate, substance abuse, right, But we don't push this
on them because they suffer in life to do their job.
And so I was saying that why are we offering help?
Speaker 1 (38:01):
We've got it, We've got it. It's okay, I know,
it's it's it's a it's a big important topic. Thank
you so much for that call. And Rob crib Uh,
what do you say to or or what have you
heard from people who are in favor of medical aid
and dying when brought up? When when the issue of
people who with disabilities like Jesse's daughter, are brought.
Speaker 10 (38:21):
Up, it's another constituency that argues very vigorously against the
widespread adoption certainly the liberal adoption of this for sure,
and they're and the argument is very clear, and I
think we just heard it is it is that whether
openly or tacitly, it will be used as a pressure
point for families or against families to move towards a
(38:43):
you know, a speedy death. So there's no real body
of evidence on that because all of this is is
far too new and there there isn't any data. There's certainly,
you know, whispers about it, but there's no I was
unable to find any true evidence of that. But it
is without question of fear. And there again it gets
(39:05):
to the execution of how this is done. Right, So
let me just very briefly give you a very clear
illustration of this. A louse in California.
Speaker 9 (39:15):
Let's use that.
Speaker 10 (39:16):
So California has about the same population as Canada. They
both jurisdictions imposed their legislation respectively the same exact year.
California is very restrictive, as we just talked about, so
you have to ask twice. It's formal, there's a weight period,
et cetera. And you have to be terminal, right, there
(39:37):
has to be a foreseeable death. Canada's law the way
it's evolved. You don't have to be terminal, it does
not have to be a last resort. Okay. So it's
a far more liberal application in Canada today. So legislations
came in the same time. Four percent of deaths in
Canada are now medical aid and dying deaths. In California
(39:58):
it's zero point three percent.
Speaker 1 (40:02):
Let's go to Fay, who is in Evanston, Illinois.
Speaker 8 (40:06):
Fay, I am hi there.
Speaker 13 (40:09):
Yes, I'm in Evanston, Illinois, where we have a bill
called the Illinois End of Life Options Act pending in
our legislature, Senate Bill thirty four ninety nine. Like the
one in California and also Colorado, art is very moderate
and very balanced form of medical late and dying, unlike
the Canada law, which is much broader and allows a
(40:33):
lot more people to use it. Like ten other states
in the United States and the District of Columbia, the
Illinois End of Life Options Act would make this option
available only to terminally ill adults who are mentally capable
of making this choice. And as a woman in my
late seventies, I certainly hope this option is available in
(40:55):
Illinois when I need it.
Speaker 1 (40:58):
Great, Faye, Thank you very much for that call, and
I'm going to go to Susan who's in Caldwell, Idaho.
Speaker 21 (41:04):
Susan, go ahead, hello, emphatic no from a forty year
career RN who after twenty years in ICU trauma care,
transitioned into the warehousing end of our healthcare system, the
nursing home situations.
Speaker 22 (41:21):
There, you have the mercy of bureaucrats you'd want to
take the last amount of effort to take care of people.
They have managed to take a DNR declaration do not
resuscitate me if my heart stops declaration into a dohing,
do nothing request, which is not what that is at all.
So if you give these people the ammunition that somebody
(41:42):
can be euthanized, it will be taken. It will be
the poor people, that disabled people, because I've been watching
it for over twenty years and it's discussed me and
anybody who with these loss come through is very naive.
And I've heard of some horrible cases up there in camp,
like a veteran who is a paraplegic who just requested
(42:05):
a starelift for his home and was encouraged to request
euthanasia because in Canada wanted to pay for a stairlift.
Speaker 1 (42:13):
Susan, thank you for that, Alua Arthur. We've now heard
from a number of callers who have either said there's
a monetary incentive for people to want to push people
into medical aid and dying. This is Susan such as
a registered nurse and says that there's an INCENTI different doctors.
What about that argument? What do you say to that?
Speaker 4 (42:36):
Well?
Speaker 11 (42:36):
I think as a black person living in America, I
also carry a healthy distrust of our government and of
our medical care system point blank. And being in this
work as long as I have been at this time
it's been almost a decade. The amount of pain and
Mila's sufferings that I see, and how much of an
(42:59):
individual agency is stripped away nearing the end of their
lives encourages me to stay open to the possibilities and
to keep coming back to compassion. Not understanding what somebody's
particular situation may be, but wanting to hold them and
their ability to make the choices for themselves when they
are making their choices for themselves. I think that's the
(43:20):
part that keeps getting lost, is I understand the disability
rights justice.
Speaker 9 (43:25):
The disability justice folks.
Speaker 11 (43:27):
Their argument about quality of life and people misunderstanding or
abusing that notion to push and amusing air quotes around
that push this law on people.
Speaker 9 (43:37):
And yet I also see how.
Speaker 11 (43:41):
A lot of people sometimes suffer in ways that they
don't have to because of religious, disability rights, the theories
around medical aid and dying that can be destructive.
Speaker 1 (43:56):
Tolliver. More comments coming in on Listen to the Middle
dot com.
Speaker 2 (44:00):
Absolutely, Cindy in Texas says death is inevitable, suffering should
be optional. Joanna in Kansas City says, my grandmother was
in a nursing home with dementia for over It's so
difficult to watch her suffer listening to her say that
she wanted to die. She should have been granted her
wishes to die when she wanted to do so. So interesting.
Speaker 1 (44:19):
Interesting. You can weigh in at Listen to the Middle
dot com or eight four four four Middle. Let's get
to another call and Roger, who is in Foalnmouth, Massachusetts. Roger,
welcome to the middle, Go.
Speaker 4 (44:32):
Ahead, Oh thank you. I'm a retired doctor. I've been
retired for ten years and because of my experiences working
with end of life care, taking care of people on
hospice giving pale elucidation to those that we couldn't get
their pain under control. Having watched my mother die a
(44:57):
horrible death from a pancratic cancer while she was on
hospice and being a member of the disability community, I've
been working for medical aid and dying and you're really
talking about two separate issues here. You're talking about Canada,
which has one set of rules and regulations, as Rob
(45:19):
has said, in the United States, where things are much stricter.
And so when you talk about people being encouraged to
use medical aid and dying, that doesn't happen in this
country because it's illegal. You cannot legally do that. And
you have groups like Disability Rights organ Disability Rights New
(45:42):
Mexico who monitor people who in the disability community, and
they've written letters saying that they give legal help to
people with mental and physical disabilities and they have not
gotten any complaints of coercion in over twenty five years
that medical aid and dying has been around. So there
(46:04):
are people who are afraid of it. I understand their fear,
but the reality is what is happening is not equal
to the fears. It's that you can look at it,
you can take care of it. And I counsel people
at the end of life in Massachusetts, and I've helped
some people go to states where medical aid and dying
(46:28):
is authorized, you know, and counsel them and how to
do it. And it's really one of those things that
people are suffering and it's an individual To my mind,
it's an individual right to be able to make that
decision at this personal time at our death.
Speaker 1 (46:46):
Great Roger, thank you very much for that. Rob Crib
As you reported out the Ultimate Choice podcast and as
you've been following this issue, I am sure that you've
heard so many personal stories just like that one there,
and people talking about relatives who have had a very
painful time at the end of their life. What is
(47:08):
How is the politics split on this in Canada? Does
it end up being one party is in favor of
it and the other party is against it? Or is
it really more complicated than that.
Speaker 10 (47:20):
Yeah, it's more complicated than that. This is one of
those interesting straddle issues. I would say there's there was
division within parties in Canada on this issue. In other words,
you know, our Liberal Party, which would be sort of
similar to your Democratic Party, is the party in power
that has been aggressively pursuing an increasingly liberal approach on this.
(47:46):
But even within that party, interestingly enough, there was such
strong feeling that there were those speaking out against it,
and alternatively, in the other party that was largely against it,
there there were those who were So it's it's sowed
an interesting division because it is such a deeply held
personal issue that goes to the deep core of all
(48:10):
of us. Who should the state allow us to or
should the state play a role in our deaths? And so,
you know, it's intractable. It's been a very very interesting
political exercise.
Speaker 1 (48:24):
I'm going to amazingly, the hour has almost come to
a close, but a lua, let me go back to
you just finally. If there are people listening to this
and saying themselves, you know, I've never really thought about this,
but should I be thinking about this? Should I be
having a conversation about this? Just briefly, what would you
tell them they should be doing in terms of a
conversation about medical aid and dying.
Speaker 11 (48:40):
At this point, start talking to the people in your
life that you care about about your decisions at the
end of life. Start talking about your desires for life
support or lack thereof, who you want to make your
decisions for you if you can't what your views are,
what your values are, mostly because that will uncover some
of the roots of the issue, and then it could
create some clarity too. And also secondarily, I'd say, let's
(49:02):
try to avoid making judgments about what other people should
do with their lives until we're in that situation ourselves,
that is death.
Speaker 1 (49:09):
Doula and founder of Going with Grace a Lua Arthur.
Her book is called Briefly Perfectly Human. We've also been
speaking with Rob Cribb, a host of The Ultimate Choice podcast.
Thank you so much to both of you for joining us.
Speaker 9 (49:21):
Thank you grateful too.
Speaker 1 (49:22):
Thanks and Tolliver. Next week we're going to be bringing
you a special edition of The Middle on Wednesday instead
of Thursday, during the Democratic Convention and during the day
on many stations. We'll have former CNN political correspondent Candy
Crowley and Charlie Sykes, the former editor in chief of
The Bulwark, on the panel, and we'll be asking you
how you feel about your choices this election.
Speaker 2 (49:41):
Yeah, man, we'll see how my late night musical Vampire
Vibes play. During the day, We'll see you can call
in at eight four four four Middle that's eight four
four four six four three three five three or reach
out at Listen to the Middle dot com.
Speaker 1 (49:53):
The Middle is brought to you by Longnok Media, distributed
by Illinois Public Media and or Bana, Illinois, and produced
by Johann Jennings, Harrison Patino, Danny Alexand and John barth.
Our intern is on A Kdesslar. Our technical director is
Jason Kraft. Thanks to the more than four hundred and
ten public radio stations making it possible for people across
the country to Listen to the Middle, I'm Jeremy Hobson.
Talk to you next week.