As a retired physician with 50 years of clinical and teaching experience in internal medicine, I wish to respond to an article in the Connecticut Mirror by Joseph Bentivegna MD, opposing an Aid in Dying Bill for the relief of terminally ill patients, recently approved by the Public Health Committee of the state legislature.
He makes a series of assertions, none of which is supported by evidence, about the mass mayhem which might follow the passage of this bill. He presents a scenario in which patients are smothered with pillows, doctors “kill” thousands, people are coerced by their relatives into ending their lives because they are chronically disabled, and he professes that it is impossible to know when someone is terminally ill.
I have to note that as an ophthalmologist who rarely if ever actually deals with end-of-life management, he is not really expected to have expertise in this issue. What he may not do however, is assume that if he is unable to recognize terminal illness, no one else can either.
In the U.S., we have actual peer-reviewed published evidence of the medical and social effects of such legislation. Aid in dying has been practiced in Oregon since 1997. Since its passage, about 1,500 terminally ill patients have availed themselves of this option to shorten their torment. NONE of the horror scenarios envisioned by Dr. Bentivegna has materialized.
It is now the law in 10 states and in Washington, D.C., again without social chaos or an increase in related murder. About one third of those obtaining a lethal dose of a drug to be self-administered at home have opted not to do so, but have been surveyed during their illness. Published studies show that they find solace in the knowledge that they can always end their suffering, should it become unbearable.
The average length of time between obtaining the drug and taking it is six weeks in those who ultimately use it. Thus their action is not rash or impulsive. Many are depressed, something not unusual in dying people. Even in some who might respond to treatment, the treatment will not alter the course of their end stage disease and might well take longer than they have left to live.
I do agree with Dr. Bentivegna that the interposition of a psychiatric evaluation into the process renders it cumbersome. In fact it was rescinded in Oregon without adverse effect.
No one whose religious or ethical stance prevents their participation in this program, either as physician or as patient, need do so. This legislation codifies an inherent human right to shape the last days of life with privacy and in dignity without any trace of harm to society, as evidenced by long term experience. It should become law in Connecticut.
Herbert Ross, MD FACP lives in Lyme.