Diane Rehm and her husband John had a pact: When the time came, they would help each other die.
John’s time came last year. He could not use his hands. He could not feed himself or bathe himself or even use the toilet. Parkinson’s had ravaged his body and exhausted his desire to live.
“I am ready to die,” he told his Maryland doctor. “Will you help me?”
The doctor said no, that assisting suicide is illegal in Maryland. Diane remembers him specifically warning her, because she is so well known as an NPR talk show host, not to help. No medication. No pillow over his head. John had only one option, the doctor said: Stop eating, stop drinking.
So that’s what he did. Ten days later, he died.
For Rehm, the inability of the dying to get legal medical help to end their lives has been a recurring topic on her show. But her husband’s slow death was a devastating episode that helped compel her to enter the contentious right-to-die debate. “I feel the way that John had to die was just totally inexcusable,” Rehm said in a long interview in her office. “It was not right.”
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More than 20 years after Jack Kevorkian jolted America with his assisted-suicide machine, Rehm is becoming one of the country’s most prominent figures in the right-to-die debate. And she’s doing so just as proponents are trying to position the issue as the country’s next big social fight, comparing it to abortion and gay marriage. The move puts Rehm in an ethically tricky but influential spot with her 2.6 million devoted and politically active listeners.
Now 78 and pondering how to manage her own death, Rehm is working with Compassion & Choices, an end-of-life organization run by Barbara Coombs Lee, a key figure in Oregon’s passage of an assisted-suicide law and a previous guest on the show. Rehm will appear on the cover of the group’s magazine this month, and she is telling John’s story at a series of small fundraising dinners with wealthy donors financing the right-to-die campaign.
At what point are busy-bodies going to get out of other people’s lives? Has the time come for this very serious discussion in America?
I felt this similar frustration when my mother was gravely ill. She wanted to die. She hated being sick, she was 85 years old, her systems were failing her. She was too old and infirmed to get to Oregon. She did the next best thing. She went into hospice. It’s not the same as the patient or family deciding that final hour. I had just gotten home when my brother called me. My mother had passed on.
Right-to-die discussions are not being had on a national level. For some inexplicable reason, the medical community avoids it like the plague (except for my mother’s wonderful doctor). They avoid it because of the social pressure out of the religious groups. Look what happened to Dr. Kevorkian. I don’t think he was a villan. I think he should have been a national hero!
As the baby boomers age, this issue, the right to death with dignity, will come to the forefront. My generation isn’t too quiet about much of anything and certainly it won’t be quiet about something as important as being able to check yourself out when you feel your time has come–the end of the line, so to speak.
Churches need to back off, mind their own frigging business, and stay out of personal matters. They may speak to their own flock. Period. they must no longer be considered in the national debate as policy setters. When I chose to die is not any church’s business. It’s between me and my God.
I’m guessing that the reason that comments are not flooding in is that end of life is so very, very personal. To me, that means it is not anyone else’s business. Not the government’s, not the church’s, not even my relatives. I accept that I am going to die. It should be a simple biological process like being born… a few minutes or a couple of hours and its’s over.
The most monumental gift of love and care that I can give to my house hold pets is to have them put to sleep when they are in pain without relief or hope. They can’t choose for themselves, so I must and it breaks my heart each time. I feel the same way about humans.
I have discussed this with my wife and we are considering a relocation to Oregon where death with dignity is available. If we choose not to move, I am considering VDD – voluntary death by dehydration. It sounds horrible but do the research and, I think you will find that it is a viable solution.
I feel we treat our pets better than we treat our humans. I have friends right across the rivr from Oregon. When my time comes I think I will move.
I agree, BS, it really isn’t anyone’s business other than those with whom you chose to share.
It’s a very good idea though to put your thoughts down on paper and have it notarized. I guess I have told enough people.
My four year old niece used to wake up every morning, go outside, cross the dirt road, climb the stairs up to grandma’s house, go in the side door and climb into the hammock where grandma was sleeping. If you were in the house, you could hear grandma singing to the little girl as they cuddled. Grandma was like a second mother to her as was her aunt.
Today grandma suffers from cirrhosis of the liver. She’s often in pain. She craps in her pants. I just packed up two boxes of adult diapers to ship to her. My niece and El Guapo Jr are still too young to help take care of Grandma, but they certainly lift her spirits. One time my niece put a pair of adult diapers (they were clean; I’m sure they were clean; er mah gerd I hope they were clean) on her head and danced to make Grandma laugh. Even in her old age Grandma has been an integral part of the family. The thought of suicide or offing her prematurely never entered anyone’s mind.
In the U.S., older people lose their usefulness. Grandma and Grandpa almost never live across the street and hardly ever play a role in raising the kids. A lot of old people have pets just to keep them company. When you live in a society where the elderly are not valued and are often shipped off to a retirement home, then, I mean, why not consider ending it early?
It should ultimately be grandma’s decision. She is the one who is suffering.
I don’t think that suffering is next to Godliness. However, if there are those who are uncomfortable with the notion of nudging things along by their own hand, then they shouldn’t do it.
Not one is suggesting that death with dignity should ever be forced or against another’s will.
BS also said:
I expect people are uncomfortable talking about it also. First off, it deals with one’s own mortality. Secondly, its a good way to have people crawl all over them like they are godless hound dogs.
Medical people also really become lock lipped because they don’t want this issue to infuse itself into their practice.
Local politicians have made it miserable to have one’s one opinion on this subject. Remember when Bob Marshall took over the Hugh Finn case?
Well, I haven’t posted anything for a while but feel I must do so here. I spent seven years as a volunteer patient care provider for a local non-profit hospice program. What most people do not know about hospice is that is was started by physician Dame Cicely Saunders, who began her work with the terminally ill in 1948 and eventually went on to create the first modern hospice—St. Christopher’s Hospice—in a residential suburb of London. It wasn’t until 1974 that Florence Wald, Dean of the Yale School of Nursing, along with two pediatricians and a chaplain, founded Connecticut Hospice in Branford, Connecticut. But hospice goes all the way back the 11th century to provide care for sick, injured and dying folks.
What hospice provides is an opportunity to live out your life until you can no longer live. They provide medical support, spiritual support is desired, and emotional support to the patient and the family. They provide medications to relieve pain but at the same time keep the patient cognitive, not in a drugged stupor. They allow patients to remain in the home with their family, where most patients want to be. They also provide respite care for the patient and the family caregivers. The truly do provide an opportunity for “death with dignity”, not death by self-destruction or physician assisted suicide.
Most people avoid hospice until the eleventh hour after a patient/loved one has gone through months of needless suffering. Patients can enter into a hospice program by physician referral, family referral or physician referral. Most insurance and Medicare cover all or most all costs-Medicare covers all costs, particularly if it is a non-profit hospice. Initial enrollment is generally for six months and if the patient has not died, the a physician certification that the patient is terminal can extend the program 90 days at a time. During my seven years, I had several patients who were in the program for 18 months to two years. Patients must agree to not seek curative care but simple palliative care and they must sign a “Do Not Resuscitate” form. If a patient’s health improves, they can drop out of hospice and return at a later date with no prejudice. Many patients find they can live a near normal life and often travel, do things they thought were no longer possible and find time to tie up loose ends.
So before you think you want to run off to Oregon and deny your family the time they and you need to get things in order, think seriously about entering a hospice program. If you have a loved one who is terminally ill, please don’t make them go through needless suffering. Sit down, talk with them, maybe even have the hospice folks come and tell you about what they do and then if you think this is not for you, then you can off yourself and take yourself or your loved one to Oregon or somewhere else and let someone you really don’t know do the job for you.
I disagree with Moon that, “Medical people also really become lock lipped because they don’t want this issue to infuse itself into their practice.” More and more physicians embrace the hospice concept and if they don’t you have the wrong physician. If you are concerned that your physician doesn’t want the “…issue to infuse itself into their practice”, then talk them, ask them how they feel about hospice and if they are against it, then think about changing physicians.
P.S. I don’t know if Diane Rehm’s husband was in a hospice program but if not, then shame on her for putting her husband through such misery. Perhaps all of her concern now is trying to salve her guilty conscience.
Some of my patient spent their end days in a renewed and very loving relationship with their families. Some fought death all the way to the end. And what often happened after they were gone, their family would ask me to do their eulogy. Why? Often they would say, “Well, you really got to know (pick a name) and we think you should do this.” I was always honored to help the family when they most needed it. I hope someone will do the same for me.
She honored his wishes. That is the most critical thing. did you read the article?
The point of her mission is that the patient gets to choose his or her own departure without interference from the state.
Hospice is legal.
Very sad story about a very brave man. God bless him.
Welcome, David. I agree that John Rehm was a very brave man.
Just because we can – should we?
There are tremendous costs and procedures that we perform – at the request of the family – to prolong the life of a loved one. As the body is getting worn out due to age or disease we can replace parts and chemicals to keep them going. But what is the quality of life for that individual? If someone of sound mind wants to go – what is wrong with letting them make their own decision to end their life? Were is all this freedom to do what you want talk when it comes to birth and death?
I think the pro-choice people tend to be pro-choice at both ends of the spectrum.
I think its great to get a new hip or liver transplant if the outlook is better quality of life. When people clearly are not going to get getter, why shouldn’t they be able to check out at their own will? We are kinder to our pets.
@Moon-howler
Of course I read the article. John was in an assisted living facility-that’s not hospice. All I’m saying is that hospice is a significant alternative and despite what some wish to call John’s “heroics”, I think he could have departed this vale of tears much more comfortably had he participated in a hospice program. I attended a great number of patients in seven years and as best I know they went peacefully. I’m not opposed to assisted suicide but is there going to be a point where you don’t get to make the decision-the state will make it for you. Think “Soylent Green”.
Hospice can be used in the assisted living where my mother was. We chose to go the hospital route because of the level of care but it was a possibility.
My mother was morphine up. It slows the breathing mechanism until…no more breathing. I mean, lets call it what it was.
I was extremely angry that once she made up her mind she didn’t want to live any longer (end of the line, she said) she couldn’t go out as easily as her beloved pets. I am still angry over it.
@Moon-howler
I’m not sure having someone “assist” you in suicide is any better-no one has come back to tell us if their death was painless. From some of the prison executions of late-assisted suicide may not be as wonderful as we are led to believe. Being “morphined up” may not be so bad. I know of one hospice patient that several of us believed did just that. He was on assisted breathing but took a huge dose of morphine, took off the Bi-Pap and went to sleep and stopped breathing-as best we know-he did leave any note and has not come back to tell us.
I prefer the expression death with dignity. I wasn’t suggesting executing anyone.
Patients should be able to have as much morphine as they want if they are terminally ill, in my opinion.
That is exactly what hospice offers-death with dignity but not suicide. I didn’t say that assisted suicide was an execution, what I said was: “I’m not sure having someone “assist” you in suicide is any better-no one has come back to tell us if their death was painless.” I simply mentioned the executions because some of those have apparently been very painful-although I don’t care since they robbed someone else of their life.
Some of the side effects of morphine overdose include:
Nausea
Spasms of the stomach or intestinal tract
Vomiting
Possible seizures
Difficulty breathing
Slow and labored breathing
and, of course, death.
@George S. Harris
It shouldn’t be one or the other. I have no problem with the concept of hospice. It should not take the place of ending one’s own life if that is the wishes of the individual.
Some people just want to do things on their own terms. I feel that is their right.
George, you obviously would never consider the hemlock solution, as many people call it. That’s ok. It isn’t for everyone. Some folks have religious objections, others object for a variety of different reasons.
However, don’t try to keep the rest of us from having that option if we want it. That’s just a little too right to life for my tastes. Who choses? the person or the government?