Dr. Goitein makes it clear that you don’t come out of a lengthy ICU stay with a life-threatening illness and jump back into tip-top shape. “Among those who required prolonged life support, only a minority go directly home after being discharged from the hospital….More than a third require long-term acute care…For patients who needed more than two days of mechanical ventilation in the ICU, family caregivers typically spend an average of more than five hours a day giving care during the first half-year after hospital discharge … Overcoming ICU-induced physical weakness can take several years, and regaining independence in activities of daily living, like getting dressed and preparing meals, can require fierce determination…”

And of course Dr. Goitein also writes, “It’s also important for families to know when ‘enough is enough.’”  That’s the challenge that so many of us will eventually face.  “For patients who have been on prolonged life support in the ICU, it can be very challenging for families to come to terms with their failure to improve and inability to wean them off the machines keeping them technically alive.”

Check out the book’s info at the publisher’s…

The post Important new book makes clear the realities of the intensive care unit appeared first on FOI.

She describes a case in which a patient’s wishes in an advance directive prepared when she was hale and hearty, turned out not to be what she wanted when in the throes of a critical illness:  “… what has increasingly troubled me working in the intensive are unit is the difficulty of asking people to make decisions about future scenarios.  Humans have an amazing capacity to adapt to illness or disease.  From the vantage point of youth or good health, it is easy for people to say that they would rather die than live with significant limitations, pain or dependence on others.  But people evolve in ways they cannot expect…As a result, what people are willing to go through to extend their life might change depending on the context.  Advance directives written at one point in time about hypothetical scenarios cannot capture what someone actually wants at every point in the future.”

She guides us to a better way.  First, no matter what, find that person to be your health-care proxy, to have your health care power of attorney, make sure they agree, make sure they are someone you trust to make decisions for you if you can’t, have the conversation, and do the paperwork. 

But second, and most important, “we need to shift the focus from talking to healthy people about what would happen should they stop breathing during a routine procedure and toward improving conversations with people are already seriously ill.  All patients for whom these decision are no longer hypothetical should have a documented conversation with their doctor that focuses less on their thoughts about specific medical interventions and more on their understanding of their prognosis, what is important to them and what gives their lives meaning.  When I am standing at a bedside in the intensive care unit, I want to be able to lean on that conversation.  Is my patient someone who would be willing to go through aggressive medical treatments for the possibility of prolonging his life?  Or is this someone who would prioritize comfort given the current medical realities?”

Wow.  That’s profound stuff.  When I’m seriously ill, I hope I’m in the care of a doctor who is as wise as Dr. Lamas, and I hope that doctor has the legal authority to ease me into a gentle final sleep if and when I so direct.  That’s what aid in dying is all about.

The post A Doctor’s Profound Take on End of Life Discussions and Directives appeared first on FOI.

As a fervent supporter of human rights generally, Archbishop Tutu was also a passionate and highly public advocate for aid in dying.  This 2014 op-ed he penned for The Guardian and this 2016 op-ed in the Washington Post are two of his most profound writings on the subject.

“I have been fortunate to spend my life working for dignity for the living. Now I wish to apply my mind to the issue of dignity for the dying,” wrote Mr. Tutu.  “I revere the sanctity of life – but not at any cost. I confirm I don’t want my life prolonged. I can see I would probably incline towards the quality of life argument, whereas others will be more comfortable with palliative care. Yes, I think a lot of people would be upset if I said I wanted assisted dying. I would say I wouldn’t mind actually.”

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That such a prestigious publication would line up solidly in favor of aid in dying augurs well for the continued success of our movement.

Read the article here …

The post The Economist notes the growing acceptance of aid in dying in the West appeared first on FOI.

The article focuses on Sandy Morris, terminally ill with ALS, who plans to use California’s medical aid in dying law.  “She’s fulfilled all the requirements to qualify, and her case embodies the spirit of the law’s aims:  to offer agency and autonomy at the end of life in lieu of suffering, indignity, and shame.”  Without using the law — to “let nature take its course” — would mean a “drawn out death by suffocation she’s desperate to avoid.”

Read the article here … (Bloomberg typically has an introductory rate for subscribers.)

The post Powerful article “A Fight To Die” in Bloomberg Businessweek appeared first on FOI.

The suit was filed on behalf of Dr. Nicholas Gideonse, an Oregon physician who regularly attends to patients from neighboring Vancouver, WA. If successful, eligible out-of-state people would be able to access medical aid in dying in Oregon. May it happen!

Read or listen to an interview with Dr. Gideonse at Oregon Public Broadcasting …

The post C&C lawsuit challenges Oregon’s residency requirement appeared first on FOI.

The state of California has issued an order denying access to the law to the 625 residents of Napa County’s Yountville veterans home and to other facilities across the state, supposedly since about a quarter of the budget for these facilities is provided by the federal government and a federal law prohibits federal money being used for aid in dying.

“Without the same rights afforded other Californians under the act, the veterans’ only option is to leave – or stay and risk misery.  If the veteran leaves, their spouse must leave too and cannot return.”

“‘I’ve watched three of my friends die here who were in apin and suffering.  It’s unacceptable,’ said Jim Thomas, 86, a decorated Vietnam War-era US Air Force officer and pilot.”

The post California vets challenge aid in dying restrictions appeared first on FOI.

We won a big victory in California on October 5, when Governor Gavin Newsom signed SB 380, extending the sunset provision of the California End of Life Option Act for five years; from January 1, 2026 until January 1, 2031. The law also improved access and transparency by reducing the mandatory minimum 15-day waiting period between the two oral requests for aid-in-dying medication to 48 hours for all eligible patients and requiring healthcare systems and hospices to put their medical aid-in-dying policies on their websites.

On the legal advocacy front, on October 28 Compassion & Choices filed a lawsuit challenging the constitutionality of the residency requirement of Oregon’s Death with Dignity Act. The suit was filed on behalf of Dr. Nicholas Gideonse, an Oregon physician who regularly attends to patients from neighboring Vancouver, WA. If successful, eligible out-of-state people would be able to access medical aid in dying in Oregon.

Also in October, the NAACP — the nation’s first, largest and most influential grassroots–based civil rights organization — passed an end-of-life education resolution that recognizes the disparities that African Americans face in end-of-life planning. The resolution states, “The NAACP advocates that families educate themselves on all aspects of end-of-life planning including advance healthcare directives, healthcare proxies, organ donation, wills, trusts, powers of attorney and end-of-life options such as hospice, palliative care and achieving a physician-assisted peaceful transition.” This transformational resolution solidifies the importance of end-of-life education as a civil rights issue.

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Read all it about it in the Dec 5 New York Times …

The post Famed writer Constance Ahrons uses California End of Life Options Act appeared first on FOI.