Friday, January 16, 2009

On the road traveled once

Workshop will discuss terminally ill patients’ rights


By DANA DUGAN
Express Staff Writer

Kathryn Tucker will present a three-part series on end-of-life care at Light on the Mountain Photo by

How and where do you want to die? Are there pain medications your doctor may not know about? Have you given your own demise the thought it is due? Because most people don't long for death, they tend to give it less thought then, say, what to have for dinner when the relatives come over.

Ketchum resident Kathryn Tucker will offer a workshop called "Traveler's Guide to Landmarks, Signposts, Twists and Turns on Life's Last Journey—Approaching Death: Law, Medicine, and Planning" from 6:30-8:30 p.m. Tuesday, Jan. 20, Thursday, Jan. 22, and Tuesday, Jan. 27. Tucker is the legal director for Compassion & Choices, an Oregon-based nonprofit dedicated to protecting and expanding the rights of terminally ill people nationwide.

The workshop will be held at the Light on the Mountain Spiritual Center south of Ketchum. The cost is $150 for the three workshops, but there will be a sliding scale based on need, she said.

"It will be very workshoppy with a lot of discussion," Tucker said. "People can talk about their issues and situations and discuss their scenarios. I thought this was a good opportunity to offer this to the layperson. This is public health issue."

Tucker considers the subject a "road traveled once."

"It's what to expect on the road," she said. "These are junctures and turns that may not be marked. People typically step on the road and it conveys them. It has its own momentum, and it may or may not be what they want."

This particular road starts with an end-of-life diagnosis followed by a drive along the curative treatment road that includes such treatments as surgery, transplant, chemotherapy and radiation.

"That road may lead to an exit which says 'cure' and then you get off the road," Tucker said. "But a lot of times that road isn't available if it's incurable. So what are your choices?"

Among the options that Tucker will discuss are palliative hospice and care, starvation and dehydration (VSED) and other alternative options that are the legal rights of the terminally ill who feel trapped in a circumstance they find unbearable.

"So many patients don't get the information about pain options," she said. "It's a myth that all doctors have all the information. There is an ancient doctrine of "informed consent," which says patients will be informed about all treatment options and empowered about that. We do a lot of things at Compassion & Choices to develop and sponsor promotion for better end-of-life care, including mandating that doctors receive training in pain treatment, and continuing education."

Compassion & Choices was formed in 2005 by combining two nonprofit organizations in Oregon, Compassion in Dying and End-of-Life Choices, the leads in pushing through the Death with Dignity Act in Oregon in 1997. Last year both Washington and Montana also passed Death with Dignity acts. These state that a mentally competent, terminal patient can acquire a prescription for medication to bring about a peaceful death voluntarily.

"This has galvanized the medical community," Tucker said. "It's the tipping point now with the three states. We work with professional organizations that endorse the act, like the American Public Health Association, and found that not only didn't it do any harm but (since the law was enacted) Oregon now has the highest hospice referral in the country. It raised the floor for end-of-life care. There's a lot of momentum."

That momentum couldn't come soon enough. Tucker has been an outspoken and forceful advocate for end-of-life issues in the country for more than two decades. She often speaks to large crowds at national conferences and health-care events. She has appeared as an expert on television and radio discussing end-of-life care, and her work has been profiled in national periodicals including the National Law Journal, The American Lawyer, the Journal of the American Bar Association and Time magazine.

In 2001, she served as co-counsel in the first case in the country to assert that failure to treat pain adequately constitutes elder abuse. The case resulted in a finding of liability and a jury award of $1.5 million to the family of the patient against the involved physician.

Compassion & Choice has been endorsed by the American Women's Health Association, American Medical Students and American College of Legal Medicine, who have each adopted compassionate end-of-life policies,

Tucker is also an adjunct law professor at the University of Washington and Seattle University law schools and the Lewis and Clark School of Law.

For more information on the issues or the workshop, e-mail ktucker@compassionandchoices.org or call 726-0127.




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