“ ...we have to ask ourselves whether medicine is to remain a humanitarian and respected profession or a new but depersonalized science in the service of prolonging life rather than diminishing human suffering...” Elisabeth Kubler-Ross, M.D. On death and dying. 1969
By Helen Wheeler
Last fall I interviewed Berkeley senior citizens about the election. Most were eager to share their opinions and willing to be quoted.
But when I asked people about the “right-to-die” – assisted suicide, death with dignity, euthanasia, medicide, mercy killing, physician-assisted-dying, self-deliverance, suicide, voluntary euthanasia – people were more hesitant.
A number of seniors responded: “I don’t want to think about that!” Others were willing to express opinions and talk about personal information, but not “to have everyone know.” Ultimately, I learned about some remarkable and admirable people.
Eighty-year old Aiko Yamamoto favors physician-assisted suicide, but she is not confident that physicians can be counted on for
that assistance. Her family has been decimated by cancer. She knows well that physicians “don’t do that,” that is, provide adequate pain relief.
Aiko had been a Hemlock Society member for many years. She joined when she underwent colon cancer surgery. When six months of chemotherapy was recommended, she learned that survival chances might be enhanced by 5 percent. “Forget it!” Aiko, a positive and active person declares: “ I am ready to go any time. To me, the right-to-die means no extraordinary measures.”
J.W. is an 84-year old breast cancer survivor who relies on a hearing aid, and considers herself in good health. She has disaffiliated from her Jewish heritage. She was reluctant to be interviewed until I suggested using initials, rather than her full name. A widow living separately in the same building with a married son, she takes for granted that he will regard her wishes as recorded in “that health thing” stored in a box in her apartment.
What does it provide? Have you gone over it with him? Not sure. No. Have you discussed your wishes with your primary care physician? No.
Occasionally she laughed nervously, “ Whatever you do, I don’t care!” Suddenly serious: “I don’t want to go to a home. What do they call it? No extraordinary measures.” Then, “ I am going to live forever.”
Are you a feminist? I asked Doris Brown Echols, a 67 year-old African American widow. “ No. I’m for whatever is best for the situation.” Doris lives alone with her rottweiler in her own home, which she owns, within walking distance of the senior center where she is an active volunteer Exercise to Music leader and also staffs the telephone one afternoon a week. She received her bachelor’s degree with a psychology major in Texas and was employed as a bookkeeper, secretary and Berkeley junior high school teacher. Raised a Methodist, she is a member of her church choir and serves on its Board of Education.
Doris had a hasty response to all concerns. What does the term, right-to-die, mean to you? “ If I found life boring or not interesting, nobody could tell me what is legal or illegal. I’d just go do it!” Boredom, depression, no pleasure in life would be her personal criteria. Meantime, “I stay here.” Undaunted by the But how would you do it? question, she readily acknowledged she hadn’t a plan, but she is certain she could do it. Shifting gears, I asked about concern for so-called extraordinary measures. She has prepared no plans or documents that would relate to a good death, and has absolute confidence in her daughter’s handling “it.” Doris takes no medications – not even calcium – because she eats right, and indeed her Kaiser physician concurs that she is in great shape.
Well-known as a congenial Strawberry Creek Lodge neighbor and senior center participant, 80-year old Norman Hutchings depends on numerous medications for serious congestive heart and lung problems. “I am more afraid of pain than I am of dying.” Never married, he is alone except for one surviving sibling; a brother suicided in his early forties. They were raised in the Methodist environment of an orphanage. He graduated from Oakland High School and UC Berkeley and worked as an equipment specialist in naval supply. Hutchings is a participant in a UC Davis Alzheimer’s Disease Center controlled study, has taken numerous related tests, and his brain will be autopsied “for research on dementia and normal aging.” He wants no extraordinary measures, but has taken no steps to ensure this.
My conversation with 72-year old Miriam Hawley was unrelated to her role as member of the Berkeley City Council. Mim received a bachelor’s degree from Antioch College, and her master’s in history is from San Francisco State University. She was employed as a transportation analyst. Raised a Methodist, she considers herself a “ nonpracticing Christian.” She has a family, is in good health, and her family health history is one of long life. Like many Kaiser patients, she has completed a “ durable power” document, but has not discussed it nor her desire for “no extraordinary measures” with her physician. She is concerned about the possible association of elder abuse with the right-to-die. Were a physician-assisted dying bill similar to that proposed by California Assemblymember Dion Louise Aroner reintroduced, she said she would support it “with safeguards.”
Edie McDonald Wright is a 71-year old retired public nonprofit director who describes herself as “ a fallen away Catholic.” She rents a one-bedroom apartment in the Redwood Gardens senior housing development, with rents subsidized by HUD. Her daughter lives in Tracy. She was recently elected by her peers to serve on the North Berkeley Senior Center Advisory Council. Chronic fibromyalgia is a problem. She receives her health care at the Over 60 Health Center, where her file contains information provided by her concerning her demise. She has indicated a wish for no extraordinary measures, although she has completed no related legal documents. As our conversation (mainly in English with some Spanish) moved toward the idea of the right-to-die as a civil right, she declared: “ I don’t plan to die that way. When push comes to shove, I just want to not wake up one day.” How are you going to do this? “ I don’t know... I haven’t thought about it. I’m too young.” “ Conflicted” and “ cautious” were the key words.
I drew several conclusions from the interviews:
• Seniors often lack information needed to make informed decisions concerning a good death and the right-to-die;
• Many seniors who consider themselves “ informed” have not taken a proactive approach to ensuring that their wishes are carried out;
• Deficient care at the end of life is due in part to health care providers’ failure to implement the patient’s wishes and to provide adequate palliatives.
Dr. Helen Wheeler is a member of the Alameda County Advisory Commission on Aging, the Berkeley Housing Authority, representing seniors and Section 8 tenants), and the North Berkeley Senior Center Advisory Council. She teaches in the Berkeley Adult School Older Adults Program and can be reached at firstname.lastname@example.org