On this episode of The Middle we're asking you: Should there be a legal right to die in the United States? We're joined by attorney and death doula Alua Arthur, and journalist Rob Cribb, host of The Ultimate Choice podcast. The Middle's house DJ Tolliver joins as well, plus callers from around the country. #healthcare #medicalaidindying #ultimatechoice #endoflife #righttochoose
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 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.
Yeah, man, this is like our moment of zen, you know, a little yogat treat before things get wet and wild, you.
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 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, 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. 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.
My name is Karen Jordan. I live in North Carolina.
At HIME.
My name is Boos.
I'm calling from Denver, Colorado.
Hello.
My name is Nancy Mathew. I'm calling from Milwaukee, Wisconsin.
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.
The problem in the medical health system is greed. Doctors have no longer have the exclusive right to determine what their patients need.
I believe the only thing that can be done about the high cost of healthcare is universal healthcare.
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.
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?
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.
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.
I'm happy to be here. Thank you for having me.
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.
Good to be with you. Thanks for having me.
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.
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 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 eligible to apply for it and in fact receive permission.
And would that include people who are not facing terminal illness.
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, 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.
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.
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.
Yeah.
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 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.
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?
It seems to be a rolling answer, you know.
There.
I've met many people that have decided that they really want to do it, have sought medication, got the prescription.
And then didn't choose it.
And then others that decide at some point get the medication, choose it soon, some who wait till the very last minute.
It's all over. It's all over the map.
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?
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.
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?
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 of a painless death to animals who are suffering. Why can't we not give that dignity to human beings?
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?
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 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 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 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 have some form of mental health challenge, right, Well, he.
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.
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 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.
Yet yet so often.
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. 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.
And I wish that we would.
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 often portrayed by the media as doctor Death.
Yeah.
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.
What do you say to people who say, doctor Kavorkian, you are playing God?
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.
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?
Well, I will one day?
What do you think you will be called that when.
Society reaches the age of Enlightenment, then they'll call me and other doctor's doctor Life.
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 radio exactly.
It's not every day you get a funk band with your news. So you know they get into it.
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 the number of people to call.
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.
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.
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 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 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.
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?
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, 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 is not a choice for those people. This is the this is an issue of the common good.
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.
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 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 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 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 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 on the fringes of society.
Let's go to Craig, who's in Saint Martinville, Louisiana. Craig, welcome to the MITTA. What do you think?
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. So it always comes down to the same.
Thing money you believe it is, Craig, Thank you for that, Alua Arthur your thoughts on what Craig had to say there.
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 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 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, 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.
Beth is in Tyra and North Carolina. Hi, Beth, welcome to the middle Go ahead, thank.
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, 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.
Is this something that you've given thought to for your own situation, Beth, Oh, I have.
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.
Kept alive.
At all, and.
Hopeful before I lose my mental facility of faculties, that I can buide the plane ticket and take off with or without assistance.
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.
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 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, 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 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.
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 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.
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 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 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.
Lot of people.
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.
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.
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.
Interesting. Yeah, let's go to Claude, who is in Overland Park, Kansas. Claude, welcome to the Middle Go ahead.
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 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 commit suicide while.
She was healthy.
Wow, thank you claud for sharing that with us. Rob Crib have you heard stories like that?
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, 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. 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 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, it becomes a snake's nest.
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?
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 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 facing that should have some.
Control, Dane, Thank you, Alua Arthur. I am imagine that there are very strict guidelines where this happens all over.
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 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 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 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.
It was really beautiful, you know.
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.
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.
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 not to kill them.
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?
Tolliver five stars, just like yelp. You know you're reading a restaurant, Give us five stars.
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, 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.
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 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 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 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 way that we've used medical aid to get us up to that point.
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.
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 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 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 laws around that so that that was still available.
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.
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 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.
Yeah, let's go to Jesse, who's in Rochester, Michigan. Jesse, welcome to the middle. Go ahead.
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 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, 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 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 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. 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?
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.
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 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 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.
Let's use that.
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 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 it's zero point three percent.
Let's go to Fay, who is in Evanston, Illinois.
Fay, I am hi there.
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 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 Illinois when I need it.
Great, Faye, Thank you very much for that call, and I'm going to go to Susan who's in Caldwell, Idaho.
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.
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 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 a starelift for his home and was encouraged to request euthanasia because in Canada wanted to pay for a stairlift.
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?
Well?
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 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 part that keeps getting lost, is I understand the disability rights justice.
The disability justice folks.
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.
And yet I also see how.
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.
Tolliver. More comments coming in on Listen to the Middle dot com.
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.
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.
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 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 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 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 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 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.
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 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.
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. 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 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.
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.
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 try to avoid making judgments about what other people should do with their lives until we're in that situation ourselves, that is death.
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.
Thank you grateful too.
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.
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.
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.