Faye Girsh, senior vice president of End of Life Choices (formerly the Hemlock Society), spoke to Pittsburgh medical student members of the Palliative Care Interest Group (which focuses on treating symptoms without trying to prolong life or cure disease), lawyers and others in late September about living with death in America.
Why the new name? Isn't it kind of awkward?
It is. Hemlock was a name you didn't forget easily, but it had the connotation of suicide and poison and that's not what we do.
How did you get involved in the issue?
Twenty years ago I was on the board of the ACLU of Southern California and I was practicing forensic psychiatry in San Diego and the ACLU got a case of a quadriplegic woman who wanted to die by dehydration. The hospital insisted on feeding her with tubes. I did examine her, and I began to speak out about her case. Many people told me in confidence that they had helped a loved one die. I saw this as an important civil liberties issue.
What's your message for today's med student?
There are many choices at the end of life, and they are going to medical school when three countries and one state in the United States permit legal physician-aid in dying. And there are other bills [pending]. So when a patient of theirs asks for aid in dying, I was just giving them some idea of what to say.
What can you say in Pennsylvania, where there is no such law?
You might make a referral to our organization. We do furnish information and we have a program, the Caring Friends program, and we could possibly provide counseling to a patient who is considering hastening their death.
What would you like to see available for people?
We have been trying to pass a law such as they have in Oregon -- so that if you were terminally ill and wanted to shorten the process of dying you could get help from your physician to do it.
Are there particular groups opposing your efforts?
Yes, there certainly are and have been for a long time. Those groups are primarily religious, although the American Medical Association has a position against physician aid in dying -- but a majority of doctors do [support it].
How can you know how many people want help ending their lives?
We know because the Netherlands has had the practice for 25 years, although it's been legal only for a year -- 25 years ago a woman helped her mother die and she was given a suspended sentence. In the Netherlands, people can choose between asking the doctor for a prescription or asking the doctor for a lethal injection. The rate of people asking for help in dying has remained steadily at 3 percent for 25 years, legal or not legal. In Oregon less than one-eighth of 1 percent of people who have died have chosen to use that law -- 129 people. It's a very small number.
Isn't voluntary death a hard sell?
People don't like to talk about it. But surveys over the last 10 years show the majority of people want the option.