opinion

A good life deserves a good death

"It is not completely crazy for us to suppose that a good life can be capped by a good death," said professor John Lachs, "or that a good life can be capped by a horrible death over many months."

The evolution of our end-of-life care incorporates those concepts; consider these choices, and what is the difference between them?

A patient who relies on a ventilator to be able to breathe decides she is ready to die. She orders her doctor to remove the ventilator; he does, and she dies soon after.

A patient is close to death and suffering from intractable pain that does not respond to medication and asks that his doctor administer palliative sedation. His doctor puts the patient to sleep, removes his intravenous feeding tubes, and the patient dies without waking several days later.

A terminally ill patient asks his doctor for a prescription for a lethal dose of barbiturates that he may take when he determines that he no longer wishes to bear the pain and loss of control that his disease causes.

Three people who suffer in somewhat similar ways each wish to end that suffering and say good-bye to their life and their families in a dignified manner and on their own terms, with the aid and counsel of their doctor to ensure the efficacy of his or her choice.

In Tennessee, the actions by the physicians for the first two patients to finally relieve his or her suffering is sanctioned and generally appreciated by the patients' families.

The physician in the third case would face a manslaughter charge regardless of how appreciative the patient and his family might be for the aid offered.

On Tuesday, the Senate Health and Welfare Committee heard eloquent testimony in a summer study meeting advocating for, and against, making it legal for a doctor to prescribe a lethal dose of medication to allow certain types of patients to end their life.

While it is often easy to disparage our legislature for the sometimes shallow and overtly political behaviors we see and read about, hearings like the one Tuesday remind us that our political process is also a very human and admirable one.

The hearing was convened to study a bill introduced by Sen. Reginald Tate, D-Memphis, on behalf of Tennessee's champion of civil and constitutional liberty, John Jay Hooker, who has fought for decades to make sure that our government hews to Article 1, Section 1 of the state's constitution:

"That all power is inherent in the people, and all free governments are founded on their authority, and instituted for their peace, safety, and happiness; for the advancement of those ends they have at all times, an unalienable and indefeasible right to alter, reform, or abolish the government in such manner as they may think proper."

Hooker, 84, had been an advocate for "death with dignity" as the "ultimate civil right," but became truly passionate about giving Tennesseans the power to seek assistance from their doctor to die when he was diagnosed with a terminal case of cancer in January.

Hooker was the first to testify Tuesday, and his cognizance of the moment brought poignancy to Room 12 of Legislative Plaza.

Committee chairman Sen. Rusty Crowe, R-Johnson City, warmly welcomed Hooker to the witness table: "John Jay, you are recognized, my friend," Crowe began, and then had to interrupt Hooker to offer Tate, sponsor of the legislation in question, the opportunity to speak first, per protocol.

Tate declined, and Hooker began his testimony by thanking the committee for setting an early date for their hearing so that he could attend.

Hooker recalled his first business before the legislature 58 years ago, in 1957, when he was hired as a special prosecutor in the impeachment of a state judge.

"I was here then," Hooker said, and his sonorous voice began cracking, "on behalf of justice.

"I am here now on behalf of mercy. Not just for me, but for all.

"It is wonderful to have something to live for; it is even better to have something to die for. And I believe that this is the most important thing I have ever done."

The committee heard testimony in support of making death with dignity legal for some patients in Tennessee from Dr. Barton Campbell, a cardiologist and faculty member at the Vanderbilt University Medical Center; John Lachs, Centennial professor of philosophy at Vanderbilt University; and Dr. Peter Reagan, who is a retired family physician from Oregon working for the national death with dignity organization Compassion & Choices. He testified about being the first doctor in Oregon to prescribe medication for a patient to take their life under that state's law in 1998.

The senators questioned the three expert panelists intensely about the "slippery slope" of allowing assisted suicide, about the process for obtaining prescriptions, and about who should qualify.

Testifying against the legislation were Carol Westlake, executive director of Tennessee Disability Coalition, and Josue Rodriguez, representing the organization Not Dead Yet. Their objection is that assisted suicide legislation would devalue the lives of the disabled, who fight for their right to live every day.

Also testifying against the bill were Will Brewer, Tennessee Right to Life, and Dr. David Stevens on behalf of the American Academy of Medical Ethics.

The witnesses gave the committee members a lot to chew on.

It will be interesting to watch whether those senators will trust Tennesseans to make their own choices, or determine that government must protect Tennesseans from themselves.

"I don't expect that I will be here to find out," John Jay told me Wednesday. "But I gave it my best to remind them 'that all power is inherent in the people' and that right is inviolate."

Reach Frank Daniels III: 615-881-7039, or on Twitter @fdanielsiii