Right to Die Emerges as Civil Rights Issue

“Kit is dying,” began the e-mail to an Internet cancer chat group.

“She woke from her morphine sleep yesterday afternoon, and told us she wanted to go ahead and die, that she was tired of fighting, that she just didn’t have the strength ‘to go another round’ . . . ,” wrote the Rev. Andrew Short.

In the 16 months since his wife died, the Presbyterian minister has become an advocate for the terminally ill as a member of the Hemlock Society, the nation’s oldest and largest right-to-die organization.

Like other right-to-die groups, the Hemlock Society believes it should be legal for physicians to provide life-ending medication for terminally ill, mentally competent people who want to die.

The movement has formidable opposition from organized medicine, organized religion and even the Clinton administration.

Nonetheless, Hemlock Society members believe that it is an issue whose time has come, and predict that it will be pushed into law before 2000 by a grass-roots organization of volunteers.

“I believe this is the civil rights issue of this decade,” says Peggy Lamm, a society board member who also is an outgoing Democratic state legislator from Boulder.

“People will say, ‘This has nothing to do with the government.’ This is about the people’s choice to be able to decide their own dignity, and that’s what this precisely is about--dignity.”

In two e-mails on the Internet over a four-day span, Short described how bone cancer had eaten away at his wife’s hip, had forced one eye to swell shut and had thinned her bones, causing severe pain with each move.

He told of watching his wife of 35 years falter during a two-month stay at Baylor Hospital in Dallas, and of his vigil at her bedside, sleeping in a chair nearby.

He said she had refused food and water, and asked for guidance on what to expect in the days ahead.

In a third posting three days later, Short related his wife’s final, painful breath, and vowed to push for change in the law so no one would have to suffer as she did.

“If my sons and I have anything to do with it, that will change,” Short says. “The medical community will have other options than simply maintaining a patient, as in Kit’s case, until a bad heart or terminal bleeding or kidneys or infection brings death.”

The right-to-die movement has enjoyed a high profile nationwide since 1990, when the Supreme Court recognized a constitutional right to die, ruling that terminally ill people may refuse life-sustaining medical treatment.

Most states allow physicians to withdraw life-support systems for dying patients under certain circumstances, but they prohibit physicians from aiding in suicides.

The exception is Oregon, which permits doctor-assisted deaths, but its law is on hold until the Supreme Court rules in two right-to-die cases, one from Washington state and the other from New York. The ruling is expected in July.

The movement has gradually gained momentum on the strength of vocal advocates such as Dr. Jack Kevorkian, who has acknowledged assisting in 45 suicides since 1990.

A survey conducted by the University of Pennsylvania this year concluded five intensive-care nurses admitted hastening the deaths of terminally ill patients to end their suffering.

In December, a Florida doctor was charged with first-degree murder for injecting a terminally ill patient with a mixture of drugs. The doctor has said he just wanted to end the man’s unremitting pain.

Kevorkian’s assistant, Janet Good, who is dying of cancer, says her life probably will end in suicide.

As support has grown, so has opposition.

Last spring, U.S. Catholic bishops said doctors at 1,200 Catholic hospitals and medical facilities may give pain medication to terminally ill people, and patients have the right to forgo extraordinary means for extending life.

But they said medically assisted suicide is morally unacceptable.

The American Medical Assn. voted in June to continue its opposition to medically assisted suicide, arguing that the practice contradicts thousands of years of medical tradition.

Even the Clinton administration has expressed opposition in a brief filed in the two pending Supreme Court cases.

Acting Solicitor General Walter Dellinger wrote that people have a significant liberty interest in avoiding pain or suffering, but the state may have an overriding interest in protecting life.

Next year, the 25,000-member Hemlock Society plans to proceed with an aggressive, grass-roots campaign to legalize medically assisted suicide in 20 states.

They believe that their best weapon is the reality of death itself, which they say is not always a peaceful slipping away in a drug-induced coma.

They talk of tortured breathing, seizures or pain-ridden maladies that occur when terminally ill people refuse life-sustaining treatment, the only legal recourse now available.

As more people learn of that reality, more will support medically assisted suicide, contends Faye Girsh, the society’s national executive director.

“We’re talking about hastening the death of somebody who wishes it--who’s already dying,” she says.

“I think the hierarchy of those groups that oppose us are not speaking for their constituents. They’re certainly not speaking for the majority of voters, and I think the legislators who are intimidated by their alleged power are wrong.”

During a recent Hemlock Society conference, a hushed crowd of mostly elderly people listened as Short spoke of his wife, a former first-grade teacher, and the deep love they shared.

In the e-mails describing her August 1995 death, Short said the pain caused by the effects of the cancer became so great that she refused food and water.

“There isn’t anything ugly or sad or suicidal in the sense that one usually associates with the term,” he wrote. “She just decided it’s time to die. . . .

“Anyway, she and I talk about normal things, our sons, their lives, her friends, whether or not the morphine is controlling her pain at any given time, preparing, signing a will and so forth, as well as answering her questions about when she’ll actually die, why she’s still here, is ‘she doing it right.’ ”

Short said the doctors and nurses provided his wife excellent medical care, but did not really explain what death was like.

“So, in the end, we were lulled toward the finish line by matchless medical care which neglected, however, to deal with the bottom line,” he said.

After she died, Short, his family and their friends went through several stages: grief, anger and then commitment to the right-to-die movement.

Their goal, he said, “is that there be change so that Kit need not have died for no purpose.”

Outside the conference, Short said his views toward death changed after the experience.

“This is one issue I would have probably ignored, just like I’ve ignored most of the others in my life, except it made a difference to me,” he said.

“And that’s probably why a lot of us are involved. It needs to change and I need to help it do it.”

With parishioners, Short says he has become “more sensitive to what’s really going on. . . . We’re not talking about constitutional issues, fundamentally.”

“We’re talking about human experience, and that’s the reality of it. The law should not be anecdotal, and we should not make laws perhaps based on the worst of situations.

“Society needs to re-own this issue.”