Life & Death
Mortality and Morality Collide in a Looming Legislative Clash
The stories handed down from generation to generation can entertain, inform and even change our lives. Frederick artist, writer and activist Geraldine Lloyd says her family often told the story of her great-grandfather, the man who coined the famous marketing phrase, “I’d walk a mile for a Camel,” for tobacco giant R.J. Reynolds. It was a nice detail, an interesting tidbit in a proud family history. But it was also a legacy that turned lethal as Lloyd’s family was ravaged by the effects of smoking.
She watched both of her parents die within four months of being diagnosed with lung and throat cancers in the 1970s and she has persevered through her own major health challenges. And, while she knows she can’t rewrite history, she says she is punctuating the next chapter of her family’s story with hope and choice.
At age 71, she has faced Stage Three throat cancer and lung cancer and is currently engaged in a staring contest with chronic lymphocytic leukemia (CLL). She says most people diagnosed with CLL die “with” it, rather than “from” it, but that is not guaranteed. She has undergone 16 surgeries and she lives with communication, eating and breathing issues, sleep and immune system disorders, carotid artery disease, and chronic pain. These experiences have informed her thinking on matters of life, death and choice.
“What we want is hope and the freedom to change the conditions of our lives. When hope for changing those conditions ends, we should have the freedom to die as we choose—with dignity, not by having to sustain the horrible stigma of suicide by either securing dangerous or ineffective drugs, or by throwing ourselves off a bridge to end our suffering. It’s outrageous that the way we die should be determined by our government, where we have to humiliate ourselves and get permission to die when we know enough is enough. Doctors are not gods. Nor should politicians try to be. We are all governed by a creator of our own determination. If we are allowed religious freedom in our country, then we should be allowed rights to live and die according to our religious or spiritual understanding,” she says.
Lloyd is among the growing number of local residents who are supporting death-with-dignity legislation that has already been passed in three states and is set to make a repeat appearance in the Maryland General Assembly early next year.
State Sen. Ron Young introduced death with-dignity legislation last year that was ultimately tabled for further study; he has pre-filed a slightly amended bill for the 2016 legislative session. Officially named the Richard E. Israel and Roger “Pip” Moyer Death with Dignity Act, the bill’s namesakes are two beloved Maryland politicians. Richard Israel was a former assistant attorney general and retired Annapolis alderman and Pip Moyer was a former mayor of Annapolis. Both men were diagnosed with Parkinson’s disease. Moyer died in January 2015 and Israel died this past July.
Unlike its predecessor, the word “suicide” does not appear in the new legislation. While Young knows there is much work to do to bring the bill to a floor vote, he says his constituents are telling him it is worth the battle. “Legislative bodies always trail the public when it comes to social change,” he says. “Bad bills pass quickly; good ones take a few years.”
He adds, “It’s very much a civil right. It’s the individual’s choice of how they live and how they die if they are terminally ill.”
“A step in the right direction”
Young’s legislation is a replica of Oregon’s law that limits aid in dying to terminal patients who have received a medical prognosis of death within six months. A patient may then request aid in dying by making oral and written requests to an attending physician. No other person can make the request on behalf of the dying patient.
The bill requires that the attending physician refer the patient to a consulting physician. If either the attending or consulting physician believes that the patient suffers from a condition that is causing impaired judgment, he or she is directed to refer the patient to a licensed mental health professional for a competency evaluation. A doctor may prescribe medication for aid in dying only after a patient meets all the criteria. Patients are required to self-administer the medications.
Young’s interest in death with dignity was piqued by conversations with his constituents, as well as the case of Brittany Maynard, the terminally ill California woman who gained national attention when she moved to Oregon to take advantage of its death with dignity law, and a 2014 Atlantic magazine article, “Why I Hope to Die at 75,” by Dr. Ezekiel Emanuel.
Retired Rev. Fred Wenner, 76, formerly of Evangelical Reformed United Church of Christ in Frederick, and his friend, retired Rev. Dr. Cliff Harrison, 87, a United Methodist pastor and Hospice chaplain from the Baltimore area, reside with their wives at Homewood Retirement Center in Frederick. They also read Emmanuel’s Atlantic article and invited Young to speak to their group of 16 retired clergy and other residents this past June. Both men said they liked what they heard.
“As a pastor, I have witnessed many, many deaths and I’ve seen how hard it is for some to deal with it. I think the bill begins to give us more of a say in the process of dying and allows us to take careful leave of our family and friends,” says Wenner.
Harrison pointed out that there is an effort to find more effective drugs to use in executing prisoners who have been sentenced to death and wonders why the same idea would not be applied to those with terminal illness. “Not everyone would use it,” he says. “But it would be a step in the right direction.”
Kaili van Waveren, of Compassion and Choices, a nonprofit organization working on choice and end-of-life issues is hoping that more of Young’s constituents embrace the bill. As the organization’s volunteer coordinator for Frederick County, she has planned rallies and screened the film How To Die In Oregon at Area 31, a Downtown Frederick gallery. She speaks about the many facets of the issue, including the emotional and financial burdens terminal illness can have on patients and their families. “Simply put, death-with-dignity legislation is humane, and though using the act may not be the right decision for everyone, it is a choice that everyone should have.”
“Nothing more than assisted suicide”
But not everyone is a fan of death-with-dignity legislation, citing philosophical, professional and spiritual differences of opinion. State and local Republicans, Hospice of Frederick County and the Catholic Church, among other organizations, are lining up in opposition.
“The Republican party’s position on death with dignity is that the party believes in protecting life from conception until natural death,” says JoeyLynn Hough, chairwoman of the Frederick County Republican Central Committee. “In 1999, Maryland made assisted suicide a felony. Sixteen years later, Del. Pendergrass and Sen. Ron Young are trying to give the death-with-dignity act a new name when it is nothing more than assisted suicide. One of the concerns I have with the assisted suicide act is that it is a slippery slope for devaluing human life. There are several alternatives to assisted suicide such as advanced directives or living wills, medical power of attorney, and Hospice to assist patients with a terminal illness.” She adds, “This is not a partisan issue, it is an issue of protecting life and valuing life at all stages, from conception to natural death.”
(The bill’s supporters counter Hough’s argument by saying “assisted suicide” is not the correct term to use to characterize the legislation, since patients are required to self-administer—by mouth, not injection—prescribed medications.)
Dr. Eric Bush, medical director of Hospice of Frederick County, explains: “Our position is we do not hasten death or prolong life. By all means we support symptom management pharmacologically or holistically. We provide palliative care and comfort.” When asked if death with dignity was a civil right, as Young and other supporters claim, Bush quoted the popularized version of the Hippocratic Oath, “First do no harm,” and then turned the question around: “Is it a violation of my civil rights to make me prescribe something that would hasten the end of life?”
While individual doctors have a range of opinions on the matter, the Maryland State Medical Society (MedChi) has not endorsed the bill, either. Dr. Tyler Cymet, president of the organization, says: “It is an extremely difficult topic and it’s very hard to come up with one policy. I still have questions because I don’t want people to go doctor shopping, and it sounds as though that’s an option.”
The Catholic Church takes a no-holds-barred approach. In fact, Sean Cain, communications director for the Archdiocese of Baltimore, won’t even call the bill by its name. “This is assisted suicide. There is no other way to put it,” he says. According to Cain, the church’s opposition to this bill falls in line with its opposition to abortion and capital punishment. “The Catholic perspective is that all life is sacred, from conception until natural death.”
Father Kevin Farmer, pastor at St. John the Evangelist Roman Catholic Church in Downtown Frederick added, “For us, it’s a moral issue, but we also have compassion. When we look at the Agony in the Garden, we recognize that even Jesus had fear,” he says. “But we also recognize that you can’t get to the resurrection without the suffering.” He also pointed to Pope John Paul II, who died in 2005. “We all watched him suffer for decades and teach us how to suffer and how to die. He saw it through to the end. It was a powerful image.”
“I’m grateful I know what’s real”
As for Lloyd, who has written for local newspapers and is currently writing a column about death and dying, she backs Young’s efforts, despite believing the legislation does not go far enough in affording people the ability to make end-of-life choices soon enough. The six-month diagnosis requirement is too limiting, she says. “But, when I imagine what lies ahead, and I’m realistic to know my current condition will bring greater challenges, I’m more than eager to support legislation that will advance our societal views on death and spare unnecessary suffering, if and when, we so choose.”
As for her own situation, she remains philosophical.
“I’ve been fortunate that I faced my mortality and personal issues at an early age, and have spiritually made friends with it,” she said. “Death seems to be shaking his keys by the limousine some days, but he’s a handsome thing. I just tell him to stay on his side of the room while I maintain space on the other. He’s crossed over sometimes. So, we’ll either dance or fight, depending upon the fear. But so far, we’ve been able to go back to our respective corners. Death is just that, illusion. I’m grateful I know what’s real—life, choice—and it never ends.”