All of us know that our healthcare options are limited by the boundaries set by a for-profit healthcare industry. I’m justifiably skeptical of proposed assisted suicide legislation that was written and supported by the healthcare industry. Particularly when they are marketing it as a civil right that just happens to be the $300 alternative to more costly options.

Assisted suicide legislation, modeled on Oregon’s law, is once again up for a vote in the state where I live. I look at assisted suicide legislation as a public health issue that will affect thousands of people in the state of California alone. Consider just three factors in combination:

1) California’s fastest growing demographic is people age 60 and up.

2) Elder abuse is on the rise while investigating agencies such as Adult Protective Services (APS) caseworkers are already dealing with unmanageable caseloads.

3) A physician is not required to be present when assisted suicide drugs are taken but an heir may be present and help administer them. (“Self-administer” is a term that does, in fact, allow for assistance in taking the drugs.)

This is the real-world context where proposed assisted suicide legislation would be implemented. All of us know that our healthcare options are limited by the boundaries set by a for-profit healthcare industry. I’m justifiably skeptical of proposed assisted suicide legislation that was written and supported by the healthcare industry. Particularly when they are marketing it as a civil right that just happens to be the $300 alternative to more costly options. Even where there appear to be safeguards, people are not protected. In Oregon, for example, a woman who had cancer was denied coverage for chemotherapy but offered assisted suicide.

I’ve been through frustrating and sometimes debilitating denials and/or capitations of coverage, including coverage for my BiPap machine that keeps me safe from carbon dioxide narcosis while I sleep. But I lived to fight through denials and mistakes. Assisted suicide mistakes can’t be undone because people are dead.

I have about 50 years experience in as a healthcare consumer with complex needs, and more to come because of a degenerative neuromuscular disease. Part of living with a progressive disability since birth has been the constant practice of thinking strategically about my future and planning for what might be down the road. This is why taking control now about the very end of my life seems natural, empowering, and comforting. It’s how I choose to live with dignity so that my dying can be about the process of letting go and relying on others. Safely.

I feel safer knowing the legal rights I already have — and using them:

1) Signing an advanced care directive that reflects my own choices, as best as I can foresee them, about the level of intervention I want.

2) Knowing I can withdraw from and end treatment, and discussing those choices with my family so that we have as much time as possible to reconcile conflicting hopes and points of view.

3) Pushing for higher quality standards in palliative care, including administering adequate pain relief and funding the necessary nursing resources. Data demonstrates that there’s been a decline in pain relief success in Oregon since their assisted suicide law went into effect. It’s essential to improve the quality of care that can, and should, be provided before rejecting the care categorically. Palliative sedation, in which you are sedated in order to ease the dying process, is a legal right in all 50 states but poor quality care results in too many patients’ ignorance of it as an option.

All of which I did my best to say in four minutes on this segment.