Next month, Washington voters will decide Initiative 1000. It would allow terminally ill patients to request a lethal dose of medication from their doctor. The measure is modeled after Oregon’s “Death with D8ignity Act.” Recently, we reported on two widows who are on opposite sides of this debate. Now we hear from doctors – including one who is struggling to decide how to vote on I-1000. Olympia Correspondent Austin Jenkins reports.
Dr. Kevin Martin is a family practice physician in Auburn, Washington. He sits in his living room – his cat in his lap – and describes the moment he decided to become a doctor
Martin: “I made that decision in an Intensive Care Unit at my grandmother’s bedside as she passed.”
Then five years ago, Martin watched his mother die of cancer. As a son, grandson, and a doctor - he says he understands the desire of patients to have some control over their final days. Especially when pain is involved.
Martin: “It is pompous of me to look somebody in the eye and say I understand that you have pain and you understand there there’s nothing I can do about it and you have to live with it. I can understand somebody saying I want this pain to end, I want this suffering to end and on a compassionate basis that is a very compelling argument for me.”
But Martin says he’s decidedly undecided about how to vote on Initiative 1000. As a doctor, he struggles with the notion that physicians should play a role in speeding up the dying process.
Martin: “Most of the doctors I know don’t want to play God, they don’t want to give the appearance of playing God and I think that a lot of the discomfort I feel is that in a very real sense this initiative puts physicians in that position.”
Martin’s conflicted feelings mirror surveys in Washington State and nationally – physicians are generally divided on the issue. One doctor firmly opposed is Linda Seaman, a former hospice director and end of life care expert in Yakima, Washington.
Seaman: “I believe Initiative 1000 gives doctors basically power that we don’t want and is contrary to good medical practice.”
Seaman says she believes assisted suicide is unnecessary because modern medicine can make dying patients comfortable.
Seaman: “I know as a palliative care person that pain is treatable and there’s only rare circumstances where it’s not and when it’s not the number one reason is existential suffering – suffering for unresolved issues in people’s life.”
O’Donnell: “People who have that attitude are people who don’t want to give a patient their choice.”
Paul O’Donnell is a bone marrow transplant physician at Seattle’s Fred Hutchison Cancer Research Center. Part of the reason he supports I-1000 is he lost his first wife to cancer. But more than that he says the patients he’s known want options.
O’Donnell: “Allowing a physician to give a patient a prescription with which they could hasten their death well then that could be considered a kind of palliative care. I’m not going to go and administer it to anybody, but that’s an option for that patient.”
One sign of the split among doctors: the Washington Academy of Family Physicians is so divided on the issue it couldn’t agree on a position to take. But other medical organizations including The Washington State Medical Association and the State Hospice and Palliative Care Organization are opposed to legalizing physician aid in dying. Kevin Martin, the undecided doctor, says in the end he may not vote either way on the initiative.
Martin: “Out of respect for the suffering of the people that are pushing this I don’t know that I can come out and say I oppose it, I’m pretty sure I can say I don’t support it and I may wind up sitting on the sidelines and supporting my patients anyway I can.”
If I-1000 passes and one of Martin’s patients asks for a lethal prescription, he says he doesn’t know how he’ll respond. Where doctors seem to agree is that end of life care has improved in the last ten to fifteen years. And that there is no excuse for people to die without being made comfortable. I’m Austin Jenkins in Olympia.