Another View: Death with dignity, if you can afford it

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Imagine that you have been diagnosed with advanced cancer, or some other terminal illness, and that you have spent a good amount of time considering your options. You go through some chemo but finally decide to stop all treatments.

Along this road that is unchartered territory for you and your family, you learn about Vermont's Death With Dignity law that allows you to receive a prescription for a lethal dose of medication to end your life. Five other states also allow for the same option.

Using this option is not easy. It requires considerable paperwork, conversations with two physicians and determinations that you have made an unencumbered, clear-headed decision. Once all of the conversations have been completed and you have made the decision to end your life you must wait 15 days before requesting the medication from your doctor.

You then must make a second request for the medication. Now the doctor has to wait another 48 hours before giving you the prescription. You have to be capable of self-administering the medication, secobarbital.

Now imagine that you are bedridden and weak, but feeling a great deal of relief knowing that you have come to terms with your mortality. After a lot of sleepless nights and emotional conversations, you are finally ready to end your life.

This is no easy thing to do and it requires a great deal of resolve. I suspect that most terminally ill people who have considered assisted suicide have rejected it as an option because of the amount of internal strength it takes to commit to such a course.

After all of the required preparation, you finally have the prescription in hand and your spouse takes it to a pharmacy and the pharmacist tells her that your insurance doesn't cover the drug. It costs $3000.

Your spouse returns home and tells you the bad news. Your illness has caused great financial hardship for your family and you thought that the state's Medicaid program could meet all of your needs as you die. They have helped a lot, but not this time. Your family cannot afford to buy the drug to help you end your life.

According to a December 2016 Kaiser Health News story, "As of March, the latest data available, a bottle of 100 capsules of 100-milligram Seconal (secobarbital) had a retail price of $3,082, according to data from Truven Health Analytics. Ten grams is a lethal dose.

When Oregon's law began, the cost was about $150, recalled Dr. David Grube, national medical director for Compassion & Choices and a family doctor who has practiced in the state for nearly 40 years. He calls the price hikes "an almost-evil practice of greed." "I think it's the black side of capitalism," he said. "It really breaks my heart."

In response to the immoral profiteering, doctors are trying to find more creative ways to allow people to afford the medications to end their lives. According to Kaiser News, Dr. Robert Wood, a volunteer medical adviser for End of Life Washington and his colleagues, came up with a new option this summer, a four-drug mixture that includes diazepam, digoxin, morphine and propranolol, known as DDMP. It costs between $300 and $600.

If you are someone who wants to choose to use the Death With Dignity option check with your prescription drug insurance plan to see if you are covered because you might have to abandon any hope for dignity while you try to figure out how to pay to end your life.



Richard Davis is a registered nurse. He writes from Guilford and welcomes comments at rbdav@comcast.net. The opinions expressed by columnists do not necessarily reflect the views of the Brattleboro Reformer.


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