Aid in dying: Terminally ill Coloradans can choose to live or die under new law
Author: Joey Bunch - June 26, 2017 - Updated: February 4, 2018
A song beckons in Patti James’ steady and dignified voice, a tone both calming and sunny, that encourages a long chat. Almost everyone knows someone like Patti.
The 81-year-old from Littleton who makes others feel better has stage 4 lung cancer, which she’s fought for 11 years, leaving scar tissue that can’t take any more radiation.
“I’ve had a long run with it,” she said with no self-pity on a warm Monday evening.
Her choice to live or die, when the time is right, will be a personal and private one, as it should be for anyone, she said.
During the drive to pass Proposition 106 in Colorado last year, Patti was a “full force” campaigner, as she described it, to give mentally competent, terminally ill adults the option to say their goodbyes, take a overpowering sedative and wait as their brain and nervous system slow to stop.
“We met so many people begging us to get this passed,” Patti said, including her husband, Arlo. “Not just sick people, but people who want to have this option available if they ever needed it.”
Sixty-five percent of Colorado voters supported Proposition 106 on Election Day.
Usually if something is that popular, it never makes it to the ballot. The legislature will address it and hold press conferences afterward to take credit.
But in the two previous legislative sessions, Colorado legislators did not allow a floor debate on any of three bills to legalize aid in dying. Both parties, at least tacitly, avoided a politically tough decision on a controversial issue.
Patti knows her decision is unavoidable now that the law has changed.
“It gives me peace of mind to know it’s my choice,” she said. Her own father’s slow death left an imprint on her. He wanted to die but suffered on.
“He asked me for help, and there was nothing I could do,” she said.
A retired nurse, Patti has watched the devastation of slow deaths more than most. The image of someone saying their goodbyes then dying quietly without pain surrounded by their family in their home is usually a wish, but not a reality.
The terminally ill usually die in a hospital or hospice sustained by machines and morphine.
“I’ve always felt there had to be a kinder, more peaceful way to go,” Patti said.
Strength of faith
Kindness to the Newman family is measured in God’s grace.
It was September 2005 when Pat Newman asked his father to take a look at him.
Tom Newman is a retired internal medicine doctor. He asked his son to hold his arms out rigid. Normally Tom couldn’t budge his son, but Pat’s arms barely resisted.
“This was a kid who could do a hundred push-ups, 20 one-handed, and he was an athlete.” Tom, 81, said, sitting in his motorized chair this week.
He told Pat to take off his shirt. He recognized with dread the tiny muscle twitches in his son’s chest as the neurological disease amyotrophic lateral sclerosis, ALS, “and I knew it was bad.”
His second-oldest of three sons lived only six more months. Pat had gone to college in Oregon, and a close friend who visited urged him to move back there to preserve the option of assisted suicide, if the pain got to be too much.
Tom said it was never a question. His son believed his life was in God’s hands, not his own.
As he spoke, the light green wall behind Tom testified to the family’s devout Catholic faith.
There were original paintings and reproductions depicting a prayerful Christ in a thorny crown, the Blessed Mother Mary, the Lady of Guadalupe and the Lady of Our Tears.
Pat Newman once took a pilgrimage to the Bosnian town of Medjugorje, famous for its apparitions of the Virgin Mary, his father said. A woman there prayed with him and told him accurately how his life had been, but that his faith was not as strong as it once was.
“You’re going to go through a very difficult time, and your life will be shortened,” Tom said, recounting the story.
Pat rededicated his life to the church, and he saw his diagnosis of ALS three years later as a confirmation, his father said.
The retired doctor believes in miracles, but, moreover, he believes God is supposed to decide the hour of death.
In 2000, after two surgeries for a highly maligant from bladder cancer in two lymph nodes, Tom thought his own life expectancy should be measured in months.
“During that time, what I wanted was trust in God,” he recalled. “I wanted the kind of trust a child has for a father … I thought, ‘Whether I live or die, you’ll choose.’ From that moment on I knew what it meant. He was my rock. When I went through these things with my son, I knew He was with us.”
During a prayer for healing with the Benedictine Sisters in Colorado Springs he had an almost instantaneous vision of Jesus placing His hand on Tom’s bladder and saying “No further.” Today he is cancer-free.
Catholics who end their lives still can have a Christian burial, but bishops won’t allow a funeral Mass, because it would suggest the church condones physician-assisted suicide, said the Denver Catholic newsletter last month, in an article called “FAQs on Assisted Suicide.”
“It contradicts the way Jesus Christ accepted death,” the newsletter states.
Dozens of Colorado hospitals have said they won’t participate in ending someone’s life. About one-third of Colorado’s hospitals are Catholic-affiliated.
But the Colorado law says hospitals can only block patients and doctors from engaging in end-of-life medicine on the hospital’s property.
Doctors can still choose to write prescriptions in their office and allow the patients to die at home.
Doctors, hospitals and pharmacists face no legal liability if they choose to or not to participate.
A decision to die
Melissa Hollis Brenkert said her younger sister, Leslie Hollis, chose to die in 2014.
Her sister was so full of life. Only 21 months apart in age, they grew up in Fort Collins best friends and constant companions still midway into their 30s.
Melissa laughed and cried remembering Leslie, who would make up words, like “significational,” and continue to use them. Her initials were LAH, and she and her friends said it stood for “Live Always Happy,” because that reflected her radiant personality.
“She walked in a room and, bam, there was sunshine,” Melissa said.
The brain cancer robbed the sisters of that.
A few weeks before her death, as the tumors swelled in her brain, Leslie looked up to her sister from her hospital bed and whispered, “I’m done.”
Melissa held her hand and said, “I know.”
The first relief for the family was the relief that came over Leslie’s face when she was offered the opportunity to take heavy doses of morphine while the hospice legally withheld food and water until she died. She eagerly accepted.
Nearly five days followed. Her body withered and darkened. Because the steroids no longer controlled the swelling in her brain, she had violent seizures, screamed out from her sleep and sometimes stared with bugged eyes at her older sister through her drugged stupor.
“We would hold her hand and tell her it’s OK to let go,” Melissa said.
Melissa has no doubt her sister would have chosen a different ending to her life.
Compassion & Choices, the national organization that helped pass the Colorado ballot initiative in November, knows of about 10 prescriptions that have been written since the law took effect, but there’s no way to know for sure how many have followed through.
That’s in keeping with the 16 people who chose to die in Oregon the year after it became the first state to allow medical aid in dying in 1997. The Los Angeles Times, however, reported last week that 111 Californians had taken their lives in the first six months after the new law took effect there. California is a state of nearly 30 million, to Colorado’s 5.6 million and Oregon’s 4 million people.
About 1 in 3 people who receive the prescription never exercise the option of ending their own life.
The Colorado Department of Public Health and Environment won’t have any report until the end of the year. The report will tell how many doctors and pharmacists handled prescriptions, but it won’t say how many people followed through, said spokesman Mark Salley. Death certificates will still note the terminal illness as the cause of death in Colorado.
Oregon’s law includes provisions for death certificates and other reporting.
The politics of dying
During the legislative session that ended in May, lawmakers were able to tuck $44,000 into the state budget to help better inform doctors who have patients who might ask about the new law and pursue the option.
Sen. Kevin Lundberg, a Republican from Berthoud, argued that taxpayers shouldn’t support the practice.
He personally opposes assisted suicide. Doctors took an oath to do no harm, he said, and he takes a philosophical oath to keep tax money out of where he doesn’t think it belongs.
“This is not the job of a doctor, and it’s certainly not the job of the government,” Lundberg said last week.
State Sen. Lois Court, a Democrat from Denver, fought to get the money.
She worked in vain for two sessions to pass an end-of-life options law.
But it wasn’t the politics she was used to, not left or right, Republican or Democrat.
“I wouldn’t even say it was politics,” Court said. “It was emotional. This wasn’t a head issue. This was a heart issue. We were talking about life and death, and that’s very personal.”
Between the first failed bill and the second her neighbor of 25 years died from esophageal cancer.
“That was important,” Court said. “It reminded me who we were doing this for.”
When Court admonished the state House, where she served in 2016, for refusing to consider her bill, practically calling them cowards, there was clear emotion in Court’s usually stern voice.
Harold Celva, owner of Three Crowns Imports in Cherry Creek who fought for the first business improvement district there, was an unaffiliated voter with conservative leanings.
He delighted in trying to get Court’s liberal goat, but Court gave as good as she got, Beth Celva recalled.
“He always enjoyed Lois,” Beth Celva. “They enjoyed each other.”
She reminisced on Tuesday, the couple’s wedding anniversary. They were married for 45 years until his death in 2015.
The day before he died, he asked Beth to make a list of things he wanted done after he was gone.
The last thing on the list, he told his wife, was, “Tell Lois to get that bill passed.”
He was a proud, dignified man who showered, shaved and dressed himself every morning until the last days when the pain and suffering were too much.
She learned that the best doctors and medical equipment can prolong life, but not the will to live.
“I’m not sure that’s what God intended,” Beth said of an artificially extended life.