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M. Gabriela Valdez
Allison Fernley
English 1010
April 18, 2016

Letting People Choose When and How to Die

Proponents of the law that will allow terminally ill patients to die call it aid-in-dying,
right to die, self- deliverance and death with dignity. On the other hand opponents
name this practice assisted suicide or euthanasia, some extreme groups may think
it's just another way of murder. The way each group name this procedure actually
reveals the way they think about the practice itself and it says a lot about where
they stand. Whatever the title they give it, this argument has been discussed
publicly for almost 40 years now. Five states in the nation have already approved
right to die laws and more than twenty are currently discussing this issue in state
legislatures. In March of the present year the state of Utah had deferred the "End of
life option act" for another term, which would enable dying patients to end their
lives with lethal drugs prescribed by their physicians.
The most notorious reference of this controversy in the United States was
Brittany Maynard, a young woman from California who in 2014 was diagnosed with
a terminal brain cancer and decided to end her life. To do so she had to move to
Oregon because at that time the state of California didn't have the option available.
Her history resonated to every corner of the nation and opened again the debate
whether or not someone should be granted lethal medication. Through this process
Maynard became an avid advocate for legalization of aid-in-dying law. She finally

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died in November 1, 2014 not before setting a precedent for others like her who
want to end their lives when pain is unbearable.
The director of the Center for Peace and Spirituality at Pacific University, Dr.
Chuck Currie, agrees with Maynard's decision to take her own life. He is also a
minister in the United Church of Christ and through his work witness and blesse
many people at the end of their existence. He sees a lot of suffering from patients
whose pain relief methods were ineffective. Contrary to Dr. Currie's beliefs
Archbishop Alexander Sample of the Roman Catholic Archdiocese of Portland argues
that "assisted suicide offers the illusion that we can control death" and "it's only
God who decides when and how an individual will rest for eternity in heaven."
Other nations such as Switzerland, Netherland and England, have previously
approved various forms of medical assistance at the end of life. Each one has laws
with their own limits, rules and guidelines. These countries also underwent critical
examination from the public that still generates debates. The most common
arguments are presented by Dr. Peter Saunders in an article published on National
News Today. Saunders, a former general surgeon and CEO of Christian Medical
Fellowship, a UK based organization, exposes the practice of euthanasia as "illegal."
His allegations go from the use of organs from the victims to the murder of dozen
of disabled children. He claims that 32% of cases of assisted suicide occurred in the
absence of a written request or consent. Another worrying statement is that many
people who have died were not terminally ill, they were disabled, depressed or frail
and doctors helped them to kill themselves.
Legislators in our country have echoed these public concerns and have specify
strict guidelines on who is eligible, to safeguard individual's integrity. One of those

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legislators is California State Senator Lois Wolk who was one of the representatives
who approved the "End of Life Options Act" last year in that state. She expressed
that she is very proud of this historic moment, and that she has listened to
everyone- patients and family members, health care professionals and those with
experience in other states. On the other hand Los Angeles Archbishop Jos Gomez
wrote a letter to the chairman of the Assembly Committee on Health indicating his
stance in this matter. He wrote, " We cannot allow California to become a place
where we respond to human suffering by simply making easier for people to kill
themselves." The religious man questions that in a for-profit health care system
driven by financial concerns, assisted suicide will be the only option for the poor and
those without health care.
There are others who think that aid-in-dying regulations are a start but not
enough to cope with the unnecessary deathbed suffering. One of those thinkers is
Kathy Butler, a New York Times journalist who in an opinion piece stated how
medical systems support last minute treatment instead of palliative care. She
discusses how Medicare pays so little for palliative care, hospice and nursing homes
but will be willing to spend thousands for an open heart surgery on a patient who
may be too fragile to survive. This helps to explain why a quarter of Medicare
payments go for treatments in the last year of life.
Suicide, assisted or not, has often been consider an evil act. It's taboo in most
parts of the world, it's considered a sin, a crime and something that should be
prevented at all cost. As Margaret Battin declares on a radio interview, suicide has
been vilified and usually associated and treated as a mental illness, especially
depression. Battin is a professor of internal medicine at the University of Utah and

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has an extensive knowledge in philosophical issues in suicide. It seems that what
matters about suicidal people is the mechanism they use to end their lives instead
of the intention, which would be ending suffering. Taking a pill to kill oneself is not
acceptable even if that person's heath cannot be restore it. On the other hand if a
person fasts to die he will be called a martyr, or if someone else loses his life saving
others he is called a hero and so on. Socially, if we die is not as important as how
we do it.
I am fortunately enough to have never experienced any friend or relative one in
a decisive moment like this. People die every day, everywhere and sometimes
death hits home, that's inevitable. Neither societies nor religions have taught us
how to properly deal with it. All we know is that the person we love is gone forever.
We must to understand that death is universal, permanent and inevitable. For some
people it happens quickly, while for others it may take a very long time. And when
this last instance is the actual situation we may encounter also many different
paths, been some of them highly traumatic.
Today's advances in medical technology and an overall better way of life allow
people to live longer although not always better. As Kathy Butler put it in her" Aidin-dying laws are just a start" report, about seven out of ten of us now live enough
to die from chronic conditions such as heart disease, dementia, diabetes and
cancer. Many of them will spend years on medical treatments which are usually
worth trying and others will attempt different therapies in an effort to restore
health, like implant defibrillators, dialysis, and feeding tubes. Some of this
procedures will bring temporary relief to the patient but in certain types of illness
and at a determined age not even that will be enough repair for a damaged health

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condition. At this point a sick person might opt to seek help in dying instead of
lingering to a weak and agonizing life.
Critics of the right to die laws, such as Marilyn Golden, a senior policy analyst at
the Disability Rights Education and Defense Funds are against this practice,
claiming that it's to dangerous particularly for the elderly and disabled. She makes a
fair point and is concerned about wrong medical predictions. Others remark that this
laws doesn't help dying patients because suicide will be always the cheapest
treatment. They worry that low income and uninsured patients will choose death
instead of piling up debts. They consider that this time is a bonding time between
patients and family and a great opportunity for them to be compassionate and
caring for loved ones. In addition to these issues opponents argue that assisted
suicide practices could lead to epidemic unnecessary deaths. Although there is no
proven evidence that legalizing aid in dying will cause more deaths, this group is
skeptical of the data sources and prefer not to have this option available. According
to the Oregon Health Authority, people using Death with Dignity Act increased a
mere 0.21 % of all deaths after the state enacted the law. Also states that 30% to
50% of patients who are prescribed end-of-life medicine never take it.
Whether they should be allowed or not to end their lives with a fatal dose of
prescribed medication is a divisive issue that have people pulling from both sides
for decades now . It's certainly traumatic to experience the loss of a loved one, and
even more devastated if their departure from life is slowly and painful.
This issue reminds me of the last years of my grandmother. Culturally, in
Argentina it's not well regarded to help elderly members die when they stop being
productive for the family and there are no laws that approve such practices either.

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Dying people will spend their rest of their lives with some relative. Palliative care is
a right that every citizen has, but only ten percent of them receives it, in part
because those treatment are very expensive. There are several hospital and clinics
but only ten hospices in the country and most of them are used mostly by well-off
citizens. My grandmother suffered a multitude of illnesses that kept her in a
wheelchair for more than twenty years. Despite all her ailments and suffering she
was full of life and always grateful to be alive. It seems that she wanted to be
around forever and we were ok with that. That attitude changed when she was
eighty six years old, she became tired of fighting and aching for everything even
breathing was a hard task for her at the end. In our country there is a law that allow
patients to reject therapies and medical procedures for them if they are facing
irreversibles pathologies. They also can reject to be submitted to surgeries and ask
to take away life supports. My grandmother decided it was the end for her, and
asked my family to stop all the medical treatments. She died peacefully in her
sleep, surrounded by the people she care the most. She suffered for many years, I
don't have a memory when she was completed out of pain, there was always
something that bother her, but I'm grateful that she was around that long. She
helped my parents in raising me and my siblings, she taught us many important
life's lessons like how to be strong despite the circumstances.
Through my grandmother I also learned that there is a difference between pain
and suffering. Pain is more related to the aches in the body and suffering is
associated with sorrow, grief, distress, sadness, heartbreaks of the mind and soul.
She had discomfort in her body most of her adult life but I now think she wasn't
suffering in equal proportion because she was grateful, pleased, lighthearted and
most of all fortunate that she was taken care of with patience and love.

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When doctors have nothing left to do to cure a patient, the focus should shifts to
care instead. The point is that the person leaves this world, as far as possible, in
peace, without pain neither in the body nor the mind. That's the reason why
palliative care are so important, not only physical aspects, but emotional and social
as well. When a patient faces a terminal disease every member in the family is also
affected. To provide a better service for those patients, palliative care must be
provided by an interdisciplinary team, such as doctors, nurses, psychologists, social
workers, therapists, kinesiologist, nutritionists, among others. The whole purpose is
to provide physical and emotional support for the patient, but there are going to be
circumstances when even the best intentions won't be enough to mitigate the pain
and suffering. What is the option available for that person? Only five states in this
country guarantee them the right to choose to terminate their life when they
consider convenient. That option should be available everywhere. If a person has a
terminally illness, is extensively suffering and knows there is no possible treatment,
that patient should have the right to request medical assistance in ending his/her
life.
We are going to need a massive public education campaign to teach people
about living wills and when and how people get to decide. We must define why so
many are in favor of death penalties but against the right to die. We need laws that
support people's individual decisions and make people aware that sometimes death
is not the worst thing a person undergoes, and let them go when the time is right is
not only the right approach but necessary for the patient and the family.

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Work Cited

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Blanco, Abigail. " Individual liberties and the right to die". Independent Institute. Jan
14, 2015. Web.
Butler, Kathy" Aid-in-dying laws are just a start " New York Times. Jul 11, 2015. Web.
Childress, Sara." The evolution of America's right to die movement". Frontline. Nov
13, 2012. Web.
Cunzolo, Florencia" El trabajo de los que ayudan a morir en paz y sin dolor". Clarin.
Nov 23, 2012. Web.
Currie, Chuck. "Brittany Maynard made a moral decision". Huffington Post. Nov. 3,
2014. Web.
Firth, Shannon. "Is there a right to die?". Us News. March 24, 2014. Web.
Lazo, Alejandro. " California Senate passes right to die legislation" The Wall Street
Journal. Sep 11, 2015. Web.
Saunders, Peter. " Right to life". National News Today. July 5, 2013. Web.
"The history of the ethics of suicide". KUER News with Doug Fabrizio. KUER. Mar 30,
2016. Radio.

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Position synthesis Paper. Reflection

1. After my presentation, first in a small group then in front of the whole class, I
concluded that almost everyone agrees with my personal point of view I presented
in this topic. It was interesting to see how most students would accept the idea that
a person has a right to decide when and how to die in case of a slow and painful
terminally ill. Some wanted to know where the state of Utah stands in this matter,
others witness their own stories. From the teacher I received more specific feedback
for my paper such a grammar mistakes, where to explain my point of view, cite
sources where are needed and particular format for this work.
2. I've read my paper over and over trying to find grammatical errors and correct
them as much as I could. I've made my best writing this issue and trying to make
sense of it. I've tried to organize my own thoughts and sources to create a synthesis
that both inform and persuade readers to consider and support laws that assist
patients. I believe I've learn the basics on English writing and I'm ready to move on
more academic approach.
3. In the introduction I presented the topic, the importance of it in the present time (
kairos), the "they say/I say" of the argument and I also cited and specific case that
happened less than two years ago and was all over the news.
In the body I mixed all sources in favor and against the issue, I cited them and I
provide some data that proved my point and was important for the topic. I went
back and forth explaining both sides, giving them credits for their specific reasoning
without leaving my own stance in the matter. I used a personal experience,

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although it wasn't exactly the case I thought it was useful for the purpose of the
paper.
In the conclusion I addressed how we could change people's minds about this
practice and I finished with a reflection for the reader ("who cares") because
eventually we are all going to die and it's important we let our family knows what
we have decided for our future.