The Politics of Dying

The Politics of Dying

Dying in DC?  Don’t get your hopes up just yet.

Many are not aware that the citizens of Washington DC do not enjoy the same representation in local and federal government that the 50 states enjoy. Because of that, these guys (who are not affected by the law and who do not have a relationship to the people of Washington DC) are able to exert their personal opinions and beliefs over the desires and due process of the city council and local government.

Presently, six states enjoy an end-of-life freedom having the option to obtain medical aid-in-dying if they qualify and their physicians are willing to support them.  Colorado recently enacted a Death with Dignity law by the choice of the people through referendum.  That measure passed by a 65% vote, reflecting what most polls see: about two-thirds of the voting population believe a qualified, dying patient should have the option to obtain medical-aid-in-dying from their physician if the doc is willing to support their request.

The attempt by federal government to intervene in Washington DC’s case may have farther-reaching implications.

Spoiler Alert:

One of the federal representatives attempting to block the law in Washington DC happens to be a physician whose personal beliefs are in opposition.  So he thinks he can exert that influence over the folks in Washington DC, even if their Washington DC physician has no problem supporting them.  Go figure.

Read more here: As Promised, Republicans On Capitol Hill Submit Resolutions To Block D.C. Death With Dignity

Palliative Medicine and Death with Dignity

Palliative Medicine and Death with Dignity Co-Mingle

I have a lot of sadness around writing this. I’ve decided to officially resign from the volunteer rolls of the hospice organization I’ve served with in my community.  This does not come as an easy decision. Truthfully, I’ve not been in a position to volunteer for some time now anyway.  More importantly, I’m often reminded and all too aware of how my name and my points of view are considered by some in palliative and hospice medicine to be too controversial.

I know that some in the hospice community believe I am “anti-hospice.” Thankfully, those who actually know me and my work also know that I am a strong proponent of palliative care, of which hospice is an integral part.

I find the highest value in palliative and hospice care.

In fact, some of the richest experiences I’ve ever had in my life have come from interacting with the dying and those who care for them. I don’t want to sound cliché, but some of my best friends are hospice nurses.

What troubles me is this: some hospice folks are unwilling to discuss certain dying matters.  And others want to but can’t, for fear of losing their jobs.  It seems to me that folks who work in hospice should feel fully informed on Death with Dignity laws, so they will know how to respond to patients who have questions.  Believe me, even in states where there is no law permitting end-of-life prescriptions, patients still ask about that.

The fact that over 90% of the patients who choose to pursue an end-of-life prescription are also enrolled in and receiving palliative care and hospice services up to the time of their deaths is clear evidence to me that all end of life options are important.

Not “either-or, but “both-and.”

I know these tools and the people who provide them can live and serve in harmony.  The average length of stay in Oregon hospice is over 40 days. Here in Maine, it’s about 18.  The Oregon statistic speaks to me of a vital, viable service being offered that does support quality of life and give needed time to people to feel as complete as possible in their lives before they die.  In my mind and my heart, the end objective is to meet the needs of the one who is dying in a purposeful, compassionate, and open-minded way that honors who they are and what has meant the most to them.

I believe in dialogue when there is controversy.

I’ve dearly enjoyed my time as a hospice volunteer and I will continue to promote hospice and palliative medicine as a means to achieve quality of life as long as possible.

I will also continue to devote my time and energy to bringing visibility and awareness to how Death with Dignity laws work and how they are in complete harmony with the compassionate efforts of all end-of-life workers and caregivers to support peace, comfort, and respect to patient choice.  I believe in discussing studied research on this issue.  And I believe this education is important.

Valerie Lovelace, Executive Director, It’s My Death

Little Sister, 1959 – 2009

Little Sister, 1959 – 2009

Letting go of the ones we love is probably one of the most difficult things we humans have to endure. It’s never easy, and the way is fraught with doubt, fear, and hopeful wishes. The challenge for each of us is recognizing that no matter how badly we want something else to be happening, what really is happening is that our loved one is dying.  And they will die with or without us.

We feel powerless.  We want to put on a cheery face and a gird ourselves with a brave demeanor – stiff upper lip, and all that.  Maybe we think that helps.  Truthfully, it doesn’t.  Being is what helps.  Just being.

Rather than thinking of something brave, chipper, or clever to say, why not just say,

“Shit.  I don’t even know what to say.  I’m sorry.”

Being that honest and that vulnerable is what helps, and there’s nothing else like it in the world that will support being with your loved one every step of the way.  Even to the final breath.

Yes, it hurts like hell.

But it’s worth it.

A couple of weeks before she died, Dee was dealing with anger, regret, and other difficult emotions and unresolved feelings.  I remember a moment of awful clarity during which I realized that as I struggled with losing her, she struggled with losing everything.  That moment was a turning point for me in being able to hold space for everything she needed to express.

This poem, written the day after she died, describes my last few hours with her.

Little Sister, 1959 – 2009

“The Man in the Moon is really a Woman,” I said,

And she smiled knowingly, sharing my secret.

Then she read to me from her Magic Book:

“There’s a blue fish.”
“And there’s a red fish.”

And I wept them into the river – she always did love Dr. Seuss.

I marveled with her through that last day as she reviewed her life and memories –

“It’s coming in bits and pieces, but I need more time; I’m not ready.”
“I’m not afraid to die, just afraid of the journey to get there.”

“Don’t be afraid, Baby Duck,” I whispered, kissing her head.
“You’ll know when you’re ready, just in time and not too soon.”

“Okay, thank you.” Nodding, a little girl again, believing me.

Then in little bits and pieces she shared her precious life with me again.
Emotions flickering over her face on fast forward – too fast for me.
Whispers, insights, sorting, shaking out, cleansing one by one.
I watched her check off each; an internal list, the final pages of her Magic Book.

“Okay, sissie, it’s time. Can you put my jeans on me?” Breathy, gasping.

I asked her if she was going to travel and she nodded again,
Wiggling her feet, whispering, “I want to wear my jeans.”

I pulled magic jeans over her frail legs, asking if she liked them.

And she smiled. The world is a great place when you wear magic jeans.

They must be like Superman underwear – they make you stronger, more able.

Holding her, reassuring, encouraging her to fly away,

I blew purple butterflies into her heart and then she was gone.

Valerie Lovelace, January 2009