For Edward Silverman, Wednesday's federal court ruling in favor of physician-assisted suicide comes too late, but is no less welcome for its tardiness.
The morally charged issue of assisted suicide is painfully real to the Santa Paula dentist. In October 1993, Silverman sat by the bedside of his wife Carla and watched as she took a lethal dose of Darvon.
She was dying of breast cancer that had spread through her whole body: bones, brain, liver, lungs and glands. For a few anxious weeks after she died, Silverman faced the possibility of prosecution before the Ventura County district attorney's office decided against pressing charges.
"Carla had thought that she had covered all her bases," Silverman said. "She had written a note; for years, she had told anyone that would listen that she planned to kill herself. Still, it backfired temporarily."
Coping with the grief of losing the wife he loved while dealing with an investigation by the district attorney's office was hard on his family. "We needed that like a hole in the head," Silverman recalled.
Silverman calls physician-assisted suicide "death with dignity," but not everyone in Ventura County agrees with him.
Local reaction to the ruling by the U. S. 9th Circuit Court of Appeals in San Francisco was mixed. Some doctors and religious leaders expressed moral opposition to the decision, saying it could lead to abuses. Private attorneys and senior citizens applauded it, saying choosing to die should be a constitutional right.
At the Ventura County district attorney's office, prosecutor Pete Kossoris said he believes that the ruling will be swiftly overturned.
But even without the law, Kossoris said the district attorney's office is disinclined to prosecute assisted-suicide cases because it is difficult to find a jury willing to convict. This belief led prosecutors to decide against charging Silverman.
"I think in a situation where someone assisted in a suicide and it was a loved one dying of a painful, terminal illness . . . it would be extremely difficult to get a jury to follow that law," he said.
Kossoris said he has strong personal feelings about assisted suicide.
"I think there are certainly situations where it is the moral thing to do to assist someone in dying when they can make the informed decision to do that," he said. "I would do it for my wife, and I would expect her to do it for me."
Wednesday's ruling won approval from the president of the Ventura County Bar Assn., David Shain.
"I really concur with what I think is the central premise of the ruling, that a right to terminate one's life is central to the Constitution," he said.
For local leaders in the Catholic Church, where suicide of any sort is a mortal sin, the appellate court's decision was a deep disappointment.
"We are dismayed with the ruling," said Msgr. Patrick O'Brien of Mission San Buenaventura. "We are very concerned about its implications."
Of utmost concern to O'Brien and others opposed to the ruling is the fear that legalized assisted suicide will lead to abuses.
"Who is going to be next in this society where everything is managed?" O'Brien said. "We won't be able to afford our handicapped people, our old people, our disabled people, and maybe someone will decide their life is not worth living and put them away."
The chairman of the ethics committee of the Ventura County Medical Society, Dr. James Hornstein, agreed.
"How many grandparents will feel a burden to their families now?" he said. "People may feel a duty to die in order to avoid feeling useless or a financial burden."
Hospice workers shared similar concerns.
"I worry about preemies, premature babies, and what is going to happen with disabled and mentally retarded people," said Pat McDonough, director of Livingston Memorial Visiting Nurse Assn., which served 450 people in Ventura County last year as a hospice. "Are we going to begin to extend this? It can happen."
Joe Ellenbogen, 78, a resident of Leisure Village in Camarillo who has lobbied the California Legislature on behalf of physician-assisted suicide, said the slippery slope phenomena is also of concern to aided suicide proponents.
"You have to be careful about how doctors and citizens utilize this right," he said. "It can't be abused."
Ellenbogen said guidelines would be needed to prevent abuse if the ruling is upheld. The best safety net would come from opponents of the issue acting as watchdogs, he said. But those people should accept Wednesday's ruling, he added.
"For those who are opposed, they don't have to participate," he said. "I believe people should have the right to determine their own destiny at life's end."
Many of Hornstein's concerns with physician-assisted suicide are tied to the changing climate in medicine today.
"Should we be giving people this right while at the same time we are taking away their rights to health care?" the medical ethicist said, pointing out that health care is in constant fluctuation and that many Americans are without medical coverage. "That bothers me a lot."
Hornstein said the ruling is unlikely to have an immediate effect in Ventura County, noting that physicians will not be rushing to hand out sleeping pills or other drugs as a result.
"I don't think this means that the practice of medicine is going to change tomorrow," Hornstein said.
For foes like hospice worker McDonough, there are alternatives to suicide for the terminally ill, namely medications to ease pain as well as loving care from friends and family.
But for those who favor assisted suicide, like 83-year-old Leon Kaplan, a resident of Leisure Village who serves on the state's Commission on Aging, it can ease pain and offer dignity.
"I think the intelligent view of any senior would be, look, I've served my time, I have done my thing on Earth and I want to go out with honor; I don't want to end up being a vegetable," he said. "Who wants to end up doing nothing, vegetating and costing a lot of money to your children?"
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