How allowing euthanasia and assisted-suicide would save lives

I was visiting a sick friend in a hospital when I noticed a purple plastic band with a couple of plain ones on her wrist. It had not been there the previous day.

“What’s that one for?” I asked, laying my index finger on it.

“It means ‘do not resuscitate,’ ” she said. “A doctor and the nurse asked me about the idea. I said ‘OK, put it on.’ ”

That surprised me. I am 81 years old, and this friend is younger. She’s bright, reads one book after another, can balance your checkbook and pound you down in argument just half trying. She’s the bird watcher who alerted me to take my best wildlife photo ever, of a great blue heron. True, she was ill, but do not resuscitate?

Maybe I’ve watched too many episodes of the TV drama “House” in which doctors intubate a patient to open the airway, inject heart stimulants, force air into the lungs, apply electric shock to restore heart rhythm, compress the chest to pump blood from a stilled heart. But this was not TV. It was my real live friend, just possibly slated to die without intervention should she get into trouble.

So, why do we not resuscitate patients in possibly fatal distress? A major reason is our society’s desire to avoid having patients linger for months or years, perhaps in pain, comatose or in a vegetative state like Nancy Beth Cruzan. Cruzan lived eight years that way after an auto crash. She was the object of a court fight by right-to-life groups who battled to prevent her parents from removing her feeding tube. Then the state of Missouri determined she long before had said she would refuse a feeding tube. She died 12 days after it was removed.

Paul Kalanithi, a neurosurgeon who was himself dying of cancer at the time, wrote in his memoir:

“Learning to judge whose lives could be saved, whose couldn’t be, and whose shouldn’t be requires an unattainable prognostic ability. I made mistakes. Rushing a patient to the OR to save only enough brain that his heart beats but he can never speak … and he is condemned to an existence he would never want.”

Which leads me to a conclusion: We could save some human lives if euthanasia and assisted suicide were legal, as they are in Washington, Oregon, California and Vermont. That way, except in clear end-of-life for the dying, we could attempt to resuscitate most patients in life-threatening situations. It’s true that — unlike on TV — resuscitation doesn’t revive the majority, mostly those already near natural death. But imagine, because of a DNR order, failing to open the airway of a person choking on food.

What often makes it worth trying is the life it just might save. If it doesn’t work, if the patient falls into a persistent vegetative state, then physician-assisted suicide or euthanasia — with the permission of the patient herself or designated relatives — could resolve the dilemma. Something that might be called “passive euthanasia” is widely practiced today. It is the withholding of nutrition, and even water, until the patient dies, usually after little more than two weeks. In fact, do not resuscitate itself is a form of passive euthanasia.

Of course, today’s Kansas and Missouri doctors can be excused. They work in a world where euthanasia and assisted suicide are crimes. Better to take no chances with resuscitation, they might think, and let the death take place “naturally.”

My own Living Will Declaration says that in case of terminal illness or persistent vegetative state, I order my physician to “withhold all life sustaining procedures and that I be permitted to die naturally.” That’s as far as any of us can go in Kansas or Missouri. The crazy thing is that I’ve never put that living will on file at my hospital. Even crazier, if I did, it probably wouldn’t be available to the nurse on my ward some midnight as my life was waning. That document needs to be in a hospital computer file that she could instantly reach.

But I want to go further than that minimal living will and seek physician-assisted suicide when I ask for it, or euthanasia with the concurrence of my family. I recall too well the years-long, painful death of my father by colon cancer in 1974. With terrific luck, I have maybe 10 years of life remaining. So what happens under present Kansas law when my own death approaches?

My former colleague on The Kansas City Star’s city desk is J. Harry Jones Jr. Nearly 50 years ago an editor sent him to an apartment on the Country Club Plaza where a suicide had occurred.

“It was a little old lady, probably younger than I am now,” Harry recalled recently. “Her hair was beautifully arranged, she was beautifully dressed. She had pinned a note to her door that warned her maid not to come in. It said she should notify the building manager.”

Then the little old lady pulled a plastic bag over her head and suffocated. That’s part of a method recommended by “Final Exit — The Practicalities of Self-Deliverance and Assisted Suicide for the Dying” — a book the little lady never saw, since it was published long after her death.

When I am very old, close to death and in pain, I could shoot myself, jump off a tall building, steer my car over a cliff — should I still be able. I could load my overcoat pockets with stones and walk into a deep river — as the great novelist Virginia Woolf did far too early in her life, at age 59 when she thought she was losing her mind. But what a lot of trouble and mess that is for loved ones and others.

How much better than any of those methods would be physician-assisted suicide through a drugstore prescription, or euthanasia supported and observed by the people you love. There would seldom be any need then for do not resuscitate — except when the patient is actually near death.

My friend and I talked about that purple band on her wrist. She took it off, then told the doctor and nurse. They said fine. After three days in the hospital, she went home and soon was back at her old game, volunteering at a food pantry, visiting the Rembrandt-Vermeer exhibit at the Nelson Gallery, bird watching once more and enjoying even in old age that most precious of gifts: Life.

This story was originally published May 24, 2016 at 4:55 PM with the headline "How allowing euthanasia and assisted-suicide would save lives."