from our blog: living with dying |
Listen Up, Montana!
posted by Peg Sandeen, MSW on July 27, 2010
My Thoughts
Montana Death with Dignity
It appears an ugly battle over Death with Dignity legislation may be brewing in Montana. In a complicated 2009 ruling, the Montana Supreme Court determined physician hastened death is not prohibited under current Montana law. In the text of the ruling, the Court did not lay down procedures for implementing Death with Dignity which leaves potential dangers for physicians, patients, and family members that require some sort of statutory or regulatory solution.
Most likely as a result of the murky procedural status, there has been virtually no change in medical practice in the state. Few or no physicians, pharmacists, and/or terminally ill individuals have outwardly discussed their experience under the ruling. Of course, they are not required to do so. Unlike in Oregon and Washington, there is neither state monitoring nor data collection in Montana.
This undefined policy has led state legislators with opinions on both sides of the issue to step in and propose legislation to regulate the practice. A proposed ban, LC0041, by Greg Hinkle and a forthcoming law, LC0177, proposed by Dick Barrett defining the parameters for Death with Dignity in Montana are in the hopper. But, legislation is not the only route to a policy solution. Regulatory bodies in Montana, such as the Board of Medical Examiners and the Board of Pharmacy, could issue regulatory standards to provide guidance to physicians and pharmacists.
With the proposed legislative battle, outside interests are ramping up their presence in the state. Visible opponents include the Montana Family Foundation which is affiliated with Focus on the Family and Not Dead Yet, a group focused on people with disabilities. Invisible opponents include the Catholic Church (which funded the recent campaign against Death with Dignity in the state of Washington to the tune of $800,000, 70% of which came from Catholic churches and institutions outside of the state). Certainly, when the legislative battle becomes more intense, the Catholic money will roll into the state as it did in Washington and Oregon.
As Executive Director of the organization that wrote the original Death with Dignity Act in 1994, I say this to the policy makers in Montana, "ignore the outside interests, and look to the data." Ann Jackson who headed the Oregon Hospice Association for over 20 years recently published a piece in the Billings Gazette about how the Oregon Death with Dignity Act works with adequate pain management in palliative care rather than against it as was once feared.
You do not have to listen to Ann Jackson's interpretations of the data or mine or anybody else's. The states of Oregon and Washington publish annual reports. They are short, concise, and accessible, and you do not need a degree in statistics to read them. If you want more in-depth information Susan Tolle, MD, one of Oregon's most respected medical ethicists, has published extensively on the topic, as have members of a research team from Oregon Health & Science University led by Linda Ganzini, MD.
Read the work of scientific experts, read what the Department of Human Services in Oregon has to say: Oregon's law is a rarely used final option for a small number of terminally ill adults. There are complications involved in all levels of medical practice; with Death with Dignity, complications are exceedingly rare. People with disabilities are treated equally under Oregon's law — they may use the law only if they meet all criteria. There are no cases of coercion.
The safeguards work. This is the only conclusion that may be drawn from an examination of 12 years worth of data.
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The greatest human freedom is to live, and die, according to one's own desires and beliefs. From advance directives to physician-assisted dying, death with dignity is a movement to provide options for the dying to control their own end-of-life care.
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