Monday, July 29, 2019

Death With Dignity: One Of The Problems of Lifetime

Image result for circle of lifeEnvironmental & Science Education
Edward Hessler

I've referred, perhaps too often, to a paper by Rodger Bybee in which he discussed science education for an ecological society. The paper, one of two focusing on the this topic, was republished in Reforming Science Education (Teachers College Press 1993). 

There is a sentence in one of Bybee's papers that has stuck with me, one that I still find useful. "We are clearly concerned with problems of lifetime (conception, abortion, birth control, death with dignity), lifespace (pollution, crowding, urban decay), and lifestyle (affluence, poverty, consumption, conservation)." (Emphasis added)

I was reminded of Bybee's essay when I read an essay by Colorado thoracic oncologist D. Ross Camidge (Huffington Post) titled "Why I Wrote The Rx That Helped My Cancer Patient Die."  Colorado is one of seven states and the District of Columbia that have death with dignity acts.

Camidge writes about his experiences with three patients. Two of them never used the prescription. One told Camidge when asked on whether she had taken the pills, "No. Not yet. I just like to have them sitting in the bathroom cabinet, to be honest. It makes me feel calmer. More ... in control." She died on her own, pills still in the cabinet. His second case, a patient with small cell lung cancer, was unable to self-administer the prescription and died on his own in a coma.

Camidge struggled following these two deaths, losing "sleep over both of them," because the process of Medical Aid in Dying (MAID) seemed "to be 'giving in' instead of fighting for every good day."  He found the experience "different and unsettling" from his regular practice, training and commitments as a physician. (Doctors are trained to extend life with little regard to other factors--financial cost and the informed wishes of patients. In addition, there are the advances in technology designed to extend life.) And then, several months later, a patient, Bobbie, "a tiny, talkative Italian American woman" brought up the option of MAID, "and this time everything was different." 

Image result for sunsetIn the essay, Camidge describes treating Bobbie for three years--their arguments, their honeymoon periods, their "last dance" (Bobbie's attention to details, her penchant for circular discussions), his work with a team (and how one of them helped Bobbie decide but especially Camidge "to get it."), the options (including cost and how the drugs work), and the setting of the date (Camidge asks an interesting question: "What do you do on your last day on earth?" and expresses some of his hopes for how she spent that day.).

This essay is a sensitive, respectful and personal story about death with dignity. Camidge closes by writing, "Bobbie, on behalf of your team, I want you to know how much you are missed, despite all the endless conversations in busy clinics. How much you were loved, for you laughter, your attention to detail and your style. And above all, how grateful we are for your courage in showing us if not the way for everyone, at least one way that was, in the end, the right way for you."

A death with dignity.

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