End of Life Decisions


End of life planning can be daunting for patients and loved ones, especially when considering the right to die. But as controversial as the topic may be, the issue is being discussed more, with many ideas and changes being introduced. To encourage health care providers to discuss advanced care planning with their patients, many insurance companies are considering creating incentives for health care providers to do so. The World Federation of Right to Die Societies Convention was held in Chicago last week. While illegal in Illinois, physician assisted death is legal in Oregon, Montana, Vermont, and Washington, and it is being considered elsewhere in the United States. The landscape of end of life decisions can be controversial and seems to be changing. Joining us to discuss the changes and controversies are University of Chicago's Dr. Peter Angelos, associate director of the MacLean Center for Clinical Medical Ethics, and Ed Gogol, president of Hemlock of Illinois.


 

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--Graphic by Travis Cornejo

 

Compassion and Choices of Chicago and Hemlock of Illinois are pushing for Illinois to join the list of states that have passed “Right to Die” legislation.

The proposed law is drafted similarly to successful legislation in Oregon, Montana, Washington, and Vermont. There’s no set date for introducing the bill in the Illinois legislature.

“The Act is essentially the same as the bills and laws that are legal in four states,” Hemlock of Illinois President Ed Gogol said.  “Which is a terminally, mentally competent person, can be prescribed a medication that will induce death.”

The process comes with certain conditions, he said. Two separate doctors have to agree a patient is terminally ill, with less than six months to live. A patient must be proven mentally competent. When a doctor does write a prescription, he or she must explain the process and give the patient every option to decline. Patients must administer the prescription on their own.

“Morally, this is very different than a mentally ill person who kills themselves,” Gogol said. “This is for people for whom the end is near, and they are choosing not to suffer through the final time of the dying process.”

When going through the legal process, the cause of death is listed as the underlying condition, not suicide, according to Gogol.

Currently in Illinois, a person has the legal right to decline life-saving treatment. According to Dr. Peter Angelos, associate director of the MacLean Center for Clinical Medical Ethics, patients have a tremendous amount of control, but they cannot require physicians to hasten their deaths.

“For someone who is in tremendous pain, it is sometimes needed to give them drugs that may reduce their ability to breathe [or] slow their heart,” Angelos said.  “That is acceptable. But again, it is the intent. The doctor is intending to ease the pain, not intending to speed their death.”

 To those that oppose his position, Gogol wants to stress that the right to die is everyone’s individual choice.

“If this is something you would never do, that is your choice,” he said. “If you are a doctor that does not want to participate, that is OK, you do not have to be involved.”

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