Help establish a compassionate end-of-life option for the terminally ill in Arizona

“Just give me the pill so I can end it all.” This request has been repeated often among dying patients in the last stages of a terminal illness.

A common misconception is that the medical aid in dying medication is a pill that a patient easily swallows and drifts off to sleep to their death. There is no magic pill, however, but rather a combination of medications which when ingested, are potent enough to bring about a person’s death. As states have legalized Medical Aid in Dying, doctors and pharmacists have collaborated on the optimum medications that are easily obtained, reliable, well-tolerated and as comfortable and rapid as possible, and still affordable. Recently the American Clinician’s Academy on Medical Aid in Dying (ACAMAID.org) was established and has conducted research on this and has published its protocols.  When Death with Dignity was first legalized in Oregon and then in 2009 when Washington state passed their law, barbiturate medications like pentobarbital and later secobarbital was used with success but the price was raised to over $4000.  Then European manufacturers withdrew the drugs from the American markets because they were used in capital punishment, which the Europeans objected to.

The next generation of MAID medications started with Chloral Hydrate, a toxic-tasting medication that elongated the death to over 200 minutes on average with some very long times to death. Carol Parrot MD in Washington and her colleague Lonny Shavelson MD in California began to research alternatives using medications that were generally available and settled on a combination of diazepam, digoxin, propranolol, morphine, amitriptyline, and recently phenobarbital was added. This combination reduced the average time to death to under 2 hours and the time to sleep to under 10 minutes, was well tolerated and highly effective and affordable (about $800), with bitterness being the major issue. Death is peaceful and quiet.  Besides warning patients about this, volunteers who help mix the powder medication with about a ¼ cup of liquid have also suggested juice or sorbet. An hour prior to taking the compound, patients also take anti-nausea medications --Zofran and Reglan,  

Thanks to Drs Shavelson and Parrot and the Academy for their work to provide a humane way to exit this life and to educate physicians and health providers.

Know When to Fold ‘em.  Disappointment in the Silver State

We were excited to report the progress of a MAID bill and the passionate voice of Assemblymember Edgar Flores in Nevada in our newsletter of April 15, 2021.

Unfortunately, the 2021 legislative session ended and SB105 did not advance out of the Ways and Means Committee and the sister bill in the assembly, AB351, died in the Health and Human Services committee.

Having a MAID bill die in committee is an all-too-familiar scenario when lawmakers feel the timing is just not right for a variety of reasons:  maybe there are not enough votes on the floor, the fear of a governor’s veto, or lack of support from the general public.   This is frustrating for the two national groups that lobby for MAID: Compassion & Choices Action Network and Death with Dignity National Center, both of which also fully support the work we are doing at Arizona End of Life Options.

“We are deeply disappointed that legislators ran out of time to try to pass the End of Life Options Act,” said Sam DeWitt, Nevada Campaign Manager for Compassion & Choices. “We are thankful to Assemblymember Edgar Flores for introducing this compassionate legislation. This temporary setback will not deter us from passing this bill in the near future for the 73% of Nevadans whose last wish is to die peacefully.”

An article in the Nevada Independent described the bill as deeply divisive and a contentious piece of legislation, yet it looks like the majority of Nevadans support MAID.  Also, many groups endorsed MAID including the ACLU of Nevada, Nevada Association of Health Plans, National Association of Social Workers, and the Nevada Libertarian Party.  Groups that maintained neutrality included the Nevada Medical Society, Nevada Psychiatric Association, and Nevada State Board of Pharmacy.  Even Dolores Huerta’s passionate voice couldn’t move the lawmakers this session.

Will Nevadans continue this fight?  Absolutely.  You can bet on it.
 

Spotlight on Maudene Fruehwirth

In 1988 My husband and I retired and moved to Merida, Yucatan – after 5 years we built a villa on a private beach 60 KM south of Cancun – in 2001 it was time to return to the good ole USA as we needed health care and conveniences -  we chose Tucson and have been so happy with our decision.

After getting settled in I began volunteering – for the UofA college of medicine, Humane Society of SA, and President of the HOA for 13 years.  About two years ago I retired from my volunteering to take care of my husband.

Lots of ups and downs with my caregiving experience.   A feeling of achievement when I found something or some procedure that worked to make Michael’s life easier.  But the personal reward of volunteering is not the same and I missed it.

A while ago I read an op-ed in our local Daily Star written by Mary Ganapol about Medical Aid in Dying and Arizona End of Life Options working to pass a bill for Arizona folks to be able to end their life with dignity.  I went to the website and then joined Kem’s drop-in zoom – where I actually met Mary.

After e-mailing Mary we finally met and I found her to be extremely knowledgeable about MAID and dedicated to the cause in Arizona. I took her advice and signed up for the webinar, watched the 3 part series at Death with Dignity, and am slowly getting through the 2011 Documentary "How to Die in Oregon". So many stories. 

MAID is a cause I can support and I clicked the volunteer button.  I can do plenty from home while caring for Michael.  I was told that for now the best thing I could do is educate the public.  So I tried it out early in the morning while talking with the other dog walkers, brought it up while attending a caregiver support group on zoom, and even engaged a physician friend – and everyone I have spoken to is in favor of this passing in AZ!

Passing a bill won’t be easy – but  I will do what I can to help the cause.  

I hope that you will consider joining the Arizona End of Life team as well. Together we can make a difference!

                ~~~

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