SOURCE: Allecia. J. (2013).

Doctor-assisted death: A dad's choice sheds light on national

issue. http://www.nbcnews.com/health/doctor-assisted-death-dads-choice-sheds-light-nationalissue-1C9299977.

Doctor-assisted death: A dad's choice sheds light on national issue

Ethan Remmel was only 41 when he died on June 13, 2011, barely a year after being
diagnosed with terminal colon cancer that quickly spread to his bone.
The Bellingham, Wash., psychology professor and father of two young sons took a lethal
dose of crushed prescription sedatives, becoming one of 255 terminally ill people to exercise that
option so far under the states 2009 Death with Dignity Act.
One of the things that Ethan kept saying is he didnt want to deteriorate to the point
where he couldnt interact with his kids, recalls his partner, Grace Wang, 44.
Now, nearly two years later, the hospital program that aided Remmel is offering an inside
look at what it means when a medical center devoted to curing cancer also decides to help people
die.
Dr. Elizabeth Trice Loggers, medical director of the Seattle Cancer Care Alliance's
Supportive and Palliative Care Service, said the report published in this weeks New England
Journal of Medicine is helpful at a time when at least a half dozen U.S. states are considering
right-to-die measures.
There is value in having a structured program and that is why the program is structured
the way it is, she said. If you look at the way most Americans say they want to die, it is in their
home, with their family members present, not in pain, and with their mental faculties intact.
Washington and Oregon are the only states with voter-approved laws allowing what
critics call assisted suicide and what proponents call aid in dying for terminally ill people
with less than six months to live.
Since 1998, 1,050 patients in Oregon have requested lethal medication under the law and
673 have died using it. In Washington, 255 have requested the drugs; 241 have died after
ingesting them.

The Seattle hospital found that overall, the law was rarely used -- only 2.4 percent of
annual deaths at SCCA -- but when it was, it was well-received by all concerned.
Both patients and families frequently express gratitude after the patient receives the
prescription, regardless of whether it is ever filled or ingested, the report said.
Remmel, who obtained the drugs months before he died, wrote that simply having access
to them helped.
So I have the medication now, he wrote, months before his death. It is safely locked
up. I have not decided if or when I will use it, but it gives me great relief to know that I have
some control over my dying process.
Retaining that sense of control was important to nearly all of the SCCA participants,
Loggers study found.
More than 97 percent of patients cited loss of autonomy as reason for participating in the
Seattle hospitals program, while nearly 89 percent pointed to the inability to engage in enjoyable
activities and 75 percent were concerned about losing dignity.
Starting a program aimed at helping people die wasnt easy, Loggers acknowledges.
Heated town hall-style meetings generated intense debate about whether staff would be forced to
participate and how patients would be informed about the process.
At SCCA, our goal is primarily to cure cancer, she said. What we did not want to do
was scare any patient or family member.
A confidential survey in March 2009 found that nearly 36 percent of SCCA doctors who
answered were willing to act as prescribing or consulting physicians, 26 percent were willing to
consult only -- and more than 38 percent were either unwilling or undecided about participating,
the paper showed.
There was a substantial portion of the population who felt this was an appropriate endof-life option, Loggers noted.
You have to find some way to appeal to someones secular brain to say this isnt a good
idea and idea and heres why, he told NBC News.

But from Ethan Remmels point of view, having access to the lethal drugs allowed him to
finish his life on his own terms, said Wang, his partner of five years and mother of their 5-yearold son, Miles.
It was just really hard, she said.
Remmel, an associate professor of psychology at Western Washington University, was
able to finish the school year, teaching until 10 days before he died. He was able to spend time
with his parents, with his friends and with his sons, Seth, then 8, and Miles, then 3, before
becoming too incapacitated by chemotherapy and pain drugs.
Remmel didnt regard taking the lethal drugs as suicide, said Wang, an associate
professor of environmental studies at Western.
We obviously didnt want him to die, she said, but he was dying anyway.