Compassion in Dying.

Compassion: a deep feeling of sharing the suffering of another, together with the inclination to give aid or support or to show mercy.

--American Heritage Dictionary

Second College Edition

As humanists, much of our dedication to the well-being and freedom of others originates in our experience of compassion. By applying our empathetic response to our principles of self-determination and individual liberty, we construct the foundation for ethical conduct regarding the issues of our day.

Our commitment to the right to choose the time and manner of one's own death is a natural conclusion of this process. Indeed, self-determination in dying is the ultimate human right--the final civil liberty of truly free people.

Among those in the right-to-die movement who share this conviction are many humanists who have worked and continue to work for legal reform. Unfortunately, in late 1991, Washington state's Initiative 119 for physician aid-in-dying was defeated. A similar proposal was recently defeated in California.

Unable to deny the moral imperative to respond to constant and repeated pleas for help, some death-with-dignity activists began to explore new strategies. As long as our fellow human beings are dying protracted and agonizing deaths, often alone, denied the most basic control over their own lives, how can we not be actively engaged in doing something to help them? Should citizens be forced to behave in cruel and inhumane ways toward one another? The terminally in who seek to end their suffering should not have to die alone because others feel they cannot be present for fear of criminal prosecution.

Humanists know that dying is a natural part of the human experience. Most agree that no one should be forced to endure a prolonged death marked by physical pain and emotional anguish. Enabling the terminally ill to make their own choices according to their personal beliefs and convictions is an act of love.

Hospice programs try to keep patients comfortable while awaiting a natural death and refrain from the employment of intensive efforts to prolong life. However, hospice will not permit action which might directly facilitate death. For many patients, this is entirely satisfactory. But for those who prefer an earlier death to further deterioration or experience intractable pain despite the best painkilling medications, hospice services are inadequate.

In response to repeated pleas for help, Compassion in Dying has been created in Washington state to support terminally ill persons in choosing to die without pain, without suffering, and with personal assistance if necessary.

Compassion will provide counseling, emotional support, and personal help to terminally ill patients. This assistance may include encouraging the patient's physician to prescribe the drugs needed to end suffering and the provision of specific details about preparation for dying. Compassion will provide whatever information is desired about alternatives for bringing life to a close with dignity and self-respect.

In addition to providing emotional support to the patient and his or her family, if requested, we will be personally present with the patient and the family as the dying person succumbs. We will provide ongoing support for the survivors if they request it. Information will also be provided about grief and bereavement resources available in the community.

The Compassion board of directors has spent months in intensive discussion and consultations with mental health, medical, and legal professionals. Some procedures are still being developed as of this writing, but the detailed guidelines and safeguards developed by Compassion will include: * The patient's condition must be considered

terminal in the judgment of

the patient's primary-care physician--that

is, the patient suffers from an incurable 

condition which, according to

reasonable medical judgment, will result

in death within a reasonable

period of time regardless of continued

treatment. * The patient understands the condition,

prognosis, and types of comfort

care that are available. * The patient's condition and prognosis

must be confirmed by one or more

physicians who review the patient's

records. * It must be clear that the patient's suffering

is not due to inadequate hospice

or comfort care. * It must be clear that the patient's

decision is not based upon lack of adequate

health insurance or other economic

concerns. * The patient will be counseled on how

to obtain the necessary medications

from his or her primary-care physician. * Any indication of indecision or uncertainty

on the part of the patient

will cancel the process. * The patient must request help at

least three times over a specified

period of time. * Evaluation by a mental-health professional

will be obtained if there is any

indication of impairment of judgment. * If Compassion's presence is requested,

two representatives will be

present at the time of death. * Volunteer health-care personnel and

others will develop a relationship

with the patient to be assured that a

hastened death is the most appropriate

outcome for a particular patient. * The patient will undertake the action

resulting in death, which may not include

the injection of drugs or the use

of any violent means. We will hold

confidential all information about the

patients and families we assist.

Are these activities illegal? Washington state law reads: "A person is guilty of promoting a suicide attempt when he knowingly causes or aids another person to attempt suicide" There has never been a prosecution under this statute, and no definition of "causes or aids" is provided. Compassion will not promote, cause, encourage, or urge suicide. We do not believe we will violate this law, and it is not our intention to do so.

Our mission is not without risk. Many in the death-with-dignity movement will not be able to lend their support. But on the wall above my computer screen, I read again a favorite quote from Margaret Mead: "Never doubt that a small group of thoughtful, committed citizens can change the world: indeed, it's the only thing that ever has."

Compassion's activities will be limited to Washington state residents. There will be no charge for Compassion's work with patients and families, nor is Compassion an individual membership organization. We rely upon donations from those who support our efforts. Readers may send (tax-deductible and confidential) contributions to: Compassion in Dying, P.O. Box 16483, Seattle, WA 98116.

We know we can alleviate human suffering and help relieve mental and emotional anguish. It is our hope that, during this process, we can also further the cause of death-with-dignity and make a contribution in the struggle for human rights. Compassion in Dying responds to a moral imperative which can no longer be denied by humanists and other compassionate people.

(Note: Compassion in Dying is an independent organization and has no official connection to the Hemlock Society.)

Barbara Dority is the president of Compassion in Dying. She is also president of Humanists of Washington, the executive director of the Washington Coalition Against Censorship, and cochair of the Northwest Feminist Anti-Censorship Taskforce.