Notes on
Bill Moyers, A Death of One's Own
(VC 5256)
From the WNET webste:
"We fear dying in pain, we fear that too much will be done to keep us alive, or we fear that not enough will be done. What are the options? Who makes the choices? When is the right moment for final decisions? "A Death of One's Own" addresses the debate over physician- assisted suicide, where the critical issue is less the right to die, than the way to live when choices are circumscribed by practical realities."
Jim Witcher—Veterinarian—ALS
- Lives on ranch in the country
- Recurrence of feelings at each stage of illness
- Tried any plausible medical alternatives
- Former college athlete
- Clearly understands the details of the progression of the disease
- Spiritual strength of wife Suzie
- Chose no feeding tube or respirator
- Might be unable to swallow to take pills at the end, couldn’t physically commit suicide
- “I’m not suicide-prone.”
- Point of no return: Totally paralyzed up to neck, can’t swallow
- Wife: “I could not myself give him a lethal dose of anything”
- Grown son: struggling to understand his father’s choice
- Daughter-in-law doesn’t believe he should have a choice
- Don’t want to ask too much of grown children
- “I just need to go ahead and finish it/”
Kitty Rail
- Portland, Oregon; 56 years old, cancer, several rounds of chemotherapy
- Difficulty of telling people that time was short
- Was hoping to have five additional years, but just a few months left
- Hospice care
- “I don’t want to become a vegetable…out of control…I want control over my decision to do this…What happens when you can’t get out of bed?”
- Prefers to die at home
- Youngest daughter Jan: organize the family photos
- Both daughters supportive
- “I want every day that I can get. It’s when you reach that point when it’s no longer bearable…and you don’t know when it’s going to be…I want to be able to make that decision.”
Jim Witcher—Veterinarian—ALS
- Probably used up half of his estate already in costs despite good medical insurance
- “He’s sworn that when I have to feed him, he doesn’t want to live any longer”
- Sacrifices of wife, including not being able to go to church; very little help
- Who’s taking care of the caretaker? Wife doesn’t want a stranger to care for him
- Had surgical procedure eight months earlier to avoid clots prolong life
- Role of physician. “I don’t know if I could kill somebody… I like life, but I don’t know if I’d like that kind of life…oath to save people but to make them comfortable. We give people morphine drips [that contribute to death]. I could give him the medication [but not administer it].”
- Jim “Not fair that I’m going to have to do it before I’m ready to do it…while I can still swallow and hold a straw…the law will help me die slowly…it just sticks…not a mature way to look at end-of-life…”
Kitty Rail (cont.)
Dr. Nancy Krumpaker
- Cancer physician
- Can assist Kitty with medication
- Patients more afraid of dying than death itself
- Barbiturate prescription, usually go to sleep within five minutes
- “I am hastening the inevitable death of a patient
Dr. Kevin Olson
- “I can’t participate in the active death of a paitent…I oculdn’t do it and feel good about it…I’ve given an extra amount of morphine…the oath really isn’t the issue…at the end of the day, I wouldn’t feel good about what I’d done.”
- Extra dose of morphine not a problem…if my mission is to make them die, it’s different than to make them comfortable.”
- “I don’t want to sleep all day long…not totally knock myself out”
Ricky. Charlottesberg Virginia, Minister
- Patient terminally ill, meds don’t eliminate suffering, liver failure
- Wants to keep him conscious enough to talk with his wife Rose
- Physician: Dr. Carlos Gomez: “patient is literally out of his mind” can’t control pain and have him be conversant…best I can do is sedate him and let him die…I don’t want this fellow to die…I don’t want to let him sit there and suffer…a line I’m very firm about: I’m not going to do something to directly bring about his death…one of the first principles of medic: do no harm…I can make his dying better.”
- Delirium results from lessening pain medication.
- Wife: “He’s suffered enough…it’s time for him to go home.”
Jim Witcher (cont.)
- One month later: “You can talk big, but doing it’s another thing…I have exactly the drugs I need…I’m going to push the envelope as far as I can…Suzie couldn’t do it, would feel like a murderer forever after”
- Visit of grown daughter Marcy : “I know what he wants to do but I don’t want him to do it…it’s a struggle…”
- “When I can’t wipe my bottom for myself, I don’t want to live…When I can’t feed myself, I don’t want to live.” Still doesn’t want to end his life.
- Wife comments on her own mother’s suffering and death
The fine texture of the moral life is often overlooked by the sweeping expanse of moral theories such an deontology or utilitarianism, yet these theories are often seriously incomplete without the understanding that comes with the details of everyday life. In teaching about end-of-life issues, including active euthanasia, I have found that Bill Moyers’ documentary, On Death and Dying, has been an invaluable resource, especially the episode, “A Death of One’s Own,” for gaining a better understanding of the issues related to the end of life. This essay is intended to provide a bridge between standard philosophical readings, such as Rachels’ “Active and Passive Euthanasia,” and the Moyers video. Each resource illuminates the other, helping us better to understand these complex issues about which well0informed, thoughtful people of good will genuinely differ.
One of the characteristics of Moyers’ video is that he never demeans, he never dismisses opposing views as ignorant or ill willed. Instead, he strives to let each person speak in his or her own voice, bringing us into the conversation without trying to determine our role.
Note how Jim tried every possible cure to fight the ALS.
Witcher’s son is Jay, wife is Pam, live nearby.
Notice how nobody in the community talks about end-of-life decisions, especially physician-assisted dying.
Kitty tried three rounds of chemotherapy
Notice for Kitty how important it is to stay in control. The thing that she fears the most is loosing control.
It’s interesting that Kitty and Jim both want every day that they can get. It’s very difficult to know when to stop.
Question: Why does Jim say the current law is unfair? Explain.
Dr. Peter Blanchard. Jim allowed a surgical procedure eight months earlier to avoid clotting in his lungs.
Explain why Jim says it’s unfair that he will have to do it before he’s ready. Why?
Dr. Kevin Olson. Notice that he feels PAS is inconsistent with his identity—not primarily the oath or religion. No hesitation about aggressive pain medication. It was the disease process that kills the patient, not the morphine. If my mission is to make them die, that’s different from to make them comfortable. Dr. Nancy Krumpacker seeing no difference.
Notice that Moyers suggests to Olson that he wants to remain in control, and he denies this.
Ricky is encephalopathic. He “has a better place to go.”
Ricky’s wife is Rose.
Not that Jim had tried everything to fight