28 December 2013

Scott Adams on the death of his father

From the November 23 entry at his blog at Dilbert.com:
I hope my father dies soon.

And while I'm at it, I might want you to die a painful death too.

I'm entirely serious on both counts.

My father, age 86, is on the final approach to the long dirt nap (to use his own phrase). His mind is 98% gone, and all he has left is hours or possibly months of hideous unpleasantness in a hospital bed. I'll spare you the details, but it's as close to a living Hell as you can get.

If my dad were a cat, we would have put him to sleep long ago. And not once would we have looked back and thought too soon.

Because it's not too soon. It's far too late. His smallish estate pays about $8,000 per month to keep him in this state of perpetual suffering. Rarely has money been so poorly spent.

I'd like to proactively end his suffering and let him go out with some dignity. But my government says I can't make that decision. Neither can his doctors. So, for all practical purposes, the government is torturing my father until he dies.

I'm a patriotic guy by nature. I love my country. But the government? Well, we just broke up.

And let me say this next part as clearly as I can.

If you're a politician who has ever voted against doctor-assisted suicide, or you would vote against it in the future, I hate your fucking guts and I would like you to die a long, horrible death. I would be happy to kill you personally and watch you bleed out. I won't do that, because I fear the consequences. But I'd enjoy it, because you motherfuckers are responsible for torturing my father. Now it's personal...

I might feel differently in a few years, but at the moment my emotions are a bit raw. If I could push a magic button and send every politician who opposes doctor-assisted suicide into a painful death spiral that lasts for months, I'd press it. And I wouldn't feel a bit of guilt because sometimes you have to get rid of the bad guys to make the world a better place. We do it in defensive wars and the police do it daily. This would be another one of those situations.

I don't want anyone to misconstrue this post as satire or exaggeration. So I'll reiterate. If you have acted, or plan to act, in a way that keeps doctor-assisted suicide illegal, I see you as an accomplice in torturing my father, and perhaps me as well someday. I want you to die a painful death, and soon. And I'd be happy to tell you the same thing to your face.

Note to my government: I'll keep paying my taxes and doing whatever I need to do to stay out of jail, but don't ask me for anything else. We're done now.

[Update: My father passed a few hours after I wrote this.]
There's more at the link.  This is not a joke.

Blogger's addendum:  During the last month of my father's life, I lived with him in a single-wide trailer on the Texas/Mexico border while he endured the agonies of prostate cancer metastatic to his bones.  Every day and night I listened to him moaning because of pain that was not controlled by morphine sufficient to lock up his bowels.  It was an unpleasant and undignified exit for a pleasant and dignified man. 

I now have a 95-year-old mother who has repeatedly told me that when her time comes, I should "put her down."  I hope that when that time arrives, some form of doctor-assisted suicide will be available in this country - but I doubt it.  And I will continue to share Scott Adams' anger.

34 comments:

  1. This is a very moving post. Thank you for sharing it with us.

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  2. One of the quickest and least painful ways to die is via heroin overdose. Heroin is available in every major North American city.

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  3. This -- and other horrific deaths I have heard of, including the death of one of my close friend's parents via liver cancer -- is why euthanasia should be legal, everywhere.

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  4. Mr. Adams, I am sorry for your loss. I watched my father-in-law die a slow painful death from cancer in california. I fortunately live in one of the 3 states,Oregon, that has assisted suicide; but I agree with you on our elected officials, a long slow painful death that their family gets to watch.

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    1. > but I agree with you on our elected officials, a long slow painful death that their family gets to watch

      This, and the original vitriol from Adams, are simply staggering; I cannot imagine how anyone could utter such a thought. (From a practical perspective, our health system is so good at prolonging life that, without a doubt, statistically many of those same politicians you wish such a terrible fate on have already suffered it.)

      Is it that somehow you think elected officials are sitting around a table trying to think of ways to bring pain and despair to desperately ill people? Please.

      Elected officials reflect the collective will of the voting public. (Though it can be like pushing on a string when the issues which are complex and controversial - there is a natural temptation for politicians to avoid long-term, controversial, issues, a predilection rewarded by voters, who are seldom patient enough to give complex issues the time and support needed to resolve them.)

      If you and Adams believe assisted suicide is humane and appropriate at least under specific circumstances, organize and promote your position, make it a local, state and national issue, get the support of a large enough percentage of the population...and require that politicians draft and pass legislation which will survive the inevitable court challenges (and undoubtedly the violent protest of those opposed - be realistic, this is a very volatile topic).

      Will it be slow? Will it be difficult? Sure it will! But this is going to take a huge amount of care, thought and attention to draft rules that will provide enough latitude but not be too easily abused. And if this is an important issue to you then you, and millions of others of like mind, will make it happen.

      Vilifying politicians solves nothing.

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    2. Wonder what would happen if someone specifically wrote into their will, "I do not consent to any of the following interventions, and the day they are used I gift my entire estate to the Hemlock Society" and made the beneficiaries aware of this clause. All of a sudden Dad would find a bottle of Jack Daniels, and another of Percocet, casually left by his bedside.

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    3. @embeetee -

      There are politicians who are so absolutist in their way of thinking that no matter how much "care, thought and attention" are given to "draft rules that provide enough latitude but are not too easily abused" that they will NEVER vote in favor of assisted suicide.

      If a piece of legislation were drafted so specifically that it only applied to ONE human being, and that ONE human being were to stand before the state or federal legislature and plead to be allowed to die, they would STILL vote against it, based on the principle that it is not within the legislator's moral code to allow someone else to make that decision about themselves based on the other person's moral code.

      It is against persons who harbor that kind of absolutist ethos that the anger is directed.

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    4. @embeetee
      If you really feel they reflect the will of the voters, your one of the too many clueless people out there...

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    5. Minnesotastan,

      > they will NEVER vote in favor of assisted suicide

      True, of course! The answer is, vote them out of office. If we can't, we're not caring enough or trying hard enough...or the issue is not one with enough force behind what we consider to be the right answer (and I am on the side of carefully framed legislation that would permit people to choose their own end in these circumstances).

      Anonymous, simply throwing up your hands, saying all politicians are evil and selfish and there's nothing to be done is worse than useless. Of course there's a range of politicians, of course they represent a range of reasons they are politicians, of course some are more amenable to reflecting the wishes of the voters than others... My eyes are open. But cynicism accomplishes nothing. Action, even when it requires struggle and patience, does. That philosophy doesn't make me Pollyanna.

      For sure, just shaking our collective fists at politicians and wishing terrible things on them - and their families - will accomplish nothing useful.

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  5. While I do not disagree with Scott Adams's sentiments, just to put a little bit out there about the reason why the Government has been so slow to act on this are two things: first almost everyone who has attempted to commit suicide by jumping off of a bridge has stated, upon finding themselves still alive, that they regretted jumping almost as soon as they had jumped. And, there is also the question of how do we let someone die with dignity, but at the same time prevent their cheap relatives (or their own stinginess) from forcing the issue, and prevent those who had curable problems (or survivable problems) from committing suicide.

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    1. My beloved sister died after apparently jumping off the Golden Gate Bridge, so I am sensitive to your concern, but you have to understand that the counterarguments you offer pale into nothingness when considered against a background of weeks and weeks of excruciating pain and suffering.

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    2. It's simple enough to make doctor-assisted suicide legal only when there's a terminal and painful disease involved. It doesn't have to (and in my opinion, shouldn't) extend to mental illness in otherwise healthy people.

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    3. They're slow to act because they'd face attacks my American religious conservatives. See the disgusting spectacle of Republicans grinding congress to a halt to cry crocodile tears over Terry Schaivo, while simultaneously not giving a damn about black children being "put down". His anger at some kind of nebulous "government" is completely misdirected, and frankly nonsense. It's these conservatives that year after year prevent progressive sensible policy from being made that are the ones responsible. As somebody already pointed out, it's legal in Oregon, Washington, and Vermont, yet not in a single anti-government Red State. Funny how us "big government" types in Oregon actually have better run state government than so many other states.....

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    4. To be fair, I should add that I would imagine that in addition to religious conservatism, that the private medical lobby plays a part in this too. Not to put the blame on just one obvious DOLLAR/voting block. Of course, it's the anti-government types that are afraid of, and hold us back from having universal health care too......

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    5. I see Adams is Republican with Libertarian leanings. I wonder how Romney (who he endorsed) would vote on assisted suicide?

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  6. *contemplates a personal stash of heroin*

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  7. My personal nightmare. I've cared for these people, in a hospice setting. I may have to pass myself off as a dog and have a vet put me to sleep, one day. We are more humane to our pets than our elderly and terminally ill.

    Or, this by John Cooper Clarke,

    What me worry? I should care,
    
Shit for brains, wire for hair,

    I’ve seen the future and I ain’t there,

    Things are gonna get worse.

    Velcro slippers and a spandex wasteband,

    Washed up on Planet Wasteland,

    Zipped up like a nylon spaceman,

    Things are gonna get worse.

    Things are gonna get worse, nurse,

    Things are gonna get rotten.
    
Make that hearse reverse, nurse,
    
I’m trying to remember everything that I’ve forgotten.

    Things are gonna get worse nurse,
    
Things are gonna get crappy,

    colour me perverse nurse,

    bad news always makes me happy.

    Things are gonna get worse nurse,
    
things are gonna get dismal,

    smite me with a curse nurse,
    
make it something real abysmal

    Things are gonna get worse nurse
    
I ain’t optimistic
    
I’ve got a mouth like a purse nurse

    and a bungalow smelling of piss and biscuits

    things are gonna get worse nurse
    
murder by statistics,

    take me back to the first verse,

    the last ones just too pessimistic

    Euthanasia – that sounds good,

    An Alpine neutral neighbourhood,
    
Then back to Britain, all dressed in wood,
    
Things are gonna get worse.

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  8. Right on, Scott! As an ICU nurse, I've seen this happen all too often; it is the one & only thing I hated about nursing.

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  9. Many years ago, while in college, I had to take Political Science. (Still trying to figure out how politics can be a sciense of any kind, seemed to me it was just a rehash of American History 101 from high school.) Part of the class involved drawing a "controversial PoliSci topic" out of a jar and writing our term paper on it. I got euthanasia. I wrote a very complex paper, which was quite good to everybody else. The PS prof gave me a D because I didn't prove how it was "politically relevant" I told him it was HIS job to prove it was politically relevant, all he asked for was a term paper on the subject.

    Anyhow, part of my research, and this was in the days well before the internet (we're talking mid-90's here, AOL was just getting started good), I found magazine articles in the college library and the local public library that talked about humane euthanasia in the Netherlands, and the statistics there showed that it didn't increase patient deaths, but decreased them, or kept them them pretty much the same, depending on what disease you were talking about.

    Mainly because the patient had to be proven to be better off with humane euthanasia than if left alive. There were, as I recall, three levels at which the patient could be euthanized. One - the patient had to request it, and three doctors, one of whom had to be a psychiatrist and another the patient's primary care physician, had to agree that the patient would not be better off living and suffering. Two, if the patient were unable to make the request themselves, a family member or close friend with what we in the US would call a medical POA took the patient's place (a living will also sufficed for the patient's wishes in this case), along with the three doctors. Barring either of those, the doctors could decide for the patient. It was extremely rare for either the patient not to be able to make their wishes known or for the patient to have an advocate to speak for them.

    Too bad Dr. Kevorkian was punished for his deeds. He helped a lot of people, I think. And until the world allows a dignified death for everybody who chooses it, we're going to see a lot of folks dying in misery. It's too bad. My mom is 66 in a few weeks, and I hope like crazy that when she gets to that point that if she can't tell the doctors to let her go in peace, that I will be allowed to do so. Same for me, or my husband. No prolonging the agony, please. If it's that bad, let us go.

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    1. Heather, you would probably be interested in reading this old Guardian article about Dignitas:

      http://www.theguardian.com/society/2009/nov/18/assisted-suicide-dignitas-house

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    2. That was an excellent article. If only every country, every place, had something like that so folks could die with dignity.

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  10. Here, here, Stan. My mom "lived" with primary progressive MS for 17 years after her diagnosis. The first decade or so was still livable for her, but the last few were hell. She was a stubborn, angry woman and would have been against assisted suicide for most of her extended death, but somewhere between a year and a year-and-a-half before she finally died is when she accepted the end of her life- and nothing could be done to help her reach it. System after system shut down and I have no idea what the direct cause of her death was because so many things weren't working anymore.

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  11. Quoting Dr. Williams-Murphy (at OKtodie.com): Don’t wait until it’s your own father to do the right thing. See POLST.org Let’s get this done!

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  12. I've got my POLST on the refrigerator. My POA and living will are on file. A friend who is a physician sent me an article about how doctors die. I sent it to my daughters, telling them it expressed my wishes very clearly. I'm 72 and in good health, but dread the possibility of losing my mind to dementia or becoming ill in such a way that the illness goes on and on and so do I. We are indeed kinder and more loving to our pets. As for worries about family members pulling the plug too soon, I would much rather go too soon (in whose opinion?) than live too long.

    Part of this is that Americans fear death almost pathologically. Death is as much a part of one's life as birth, and we need to get over being so afraid of it. Please let me, or help me, go when it's time and not a minute later.

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  13. How sad is it that you had to witness the undignified end of your father and how sad that you have to worry about the prospect of going through it again. No wonder you feel angry and sore, and no wonder you are looking at your decisionmakers with disgust, however much they can or cannot do to effect change.

    Let us put aside the issue of assistet suicide here, what is really staggering to me is that neither you nor any of the other commenters here have asked for the blatantly obvious: A health service that is enabling good medical care, free at the point of use and indiscriminate for their users. A health service that is based on general taxation, not insurance payments which you may or may not be able to afford. In this country (GB) a situation as above would be handled like this: Your father has a General Practitioner who has known him for a considerable number of years. He ses him for a problem (no charge) and arranges some tests (no charge) which show that he needs some further tests (no charge) and a consultation with a specialist (no charge). He is diagnosed with cancer and requires an OP, Chemo or Radiotherapy (no charge). He gets a bit better but the disease is unfortunately terminal. He decides he wants to stay at home where he is looked after by his GP (no charge) and the community nursing team (no charge) including specialist cancer nurses who sort out his pain (no charge) and medication (no charge). He has some home help from Social Services (means tested charges apply) and dies peacefully.

    I know this sounds a bit blue eyed and idealistic but this is more or less what happens in a 'socialised' health system - Great Britain- a country well known for its left wing socialist monarchy (this is a joke).

    What I'm really getting at is that it is desperately sad to see you folks over there rather asking for help with killing yourself than demanding a national health service, out of fear of - yes what really? What is even more devastating is that our Conservative Government is holding up your system as something to aspire to and they are currently working their best to sell it off to the multi nationals. In this respect I share your sentiment with elected officials.

    All the best,

    Hubertus

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    1. We weren't discussing it because it's a different subject.

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    2. Yes, there is nothing in this world that can deal with pain that heroin wont' touch. the Quality of health care does NOT matter in this case because there is NOTHING even the most advanced health care can do at that point.

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  14. Funny that us here in the so-called "big gubmint" blue state of Washington, tucked away in the PNW with all of the quote-unquote Seattle libtards have the Death With Dignity act to prevent exactly this kind of prolonged torture. Wish the rest of the country had it too.

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  15. My father died from complications due to late stage Alzheimer's disease on Nov. 20,2013. I still am shocked that we, as a society, treat our pets more 'humanely' than our own humans. Dad's brain was already destroyed by the ALZ and his body was finally ready to go. 2 weeks of outrageous bills and pain and agony for my poor (formerly brilliant) father and my entire family could and SHOULD have been spared. Dad would never recover and thankfully had signed his advanced directives. (So, his No Not Resuscitate and incubate were already in place). I can't tell you how many times I considered giving him a big handful of Extra-Strength Tylenol (look it up!), but I was too afraid to spend time in prison for murder - simply to put my Dad out of his misery.

    Humans deserve to be treated 'humanely' at the end of life. This must be changed!!!

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    1. " I can't tell you how many times I considered giving him a big handful of Extra-Strength Tylenol"

      This happens way more often that you realize. People don't talk about it.

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  16. One of the many, many reasons I am glad I live in Washington. (State). Two things:

    One, as a lawyer, I cannot stress enough how important it is to have a Durable Power of Attorney with an Advanced Health Care Directive in place. You never know when you might suddenly be incapacitated, or when a wasting brain illness might finally take control, and so you want to make sure that your directives are followed and not the wishes of your default decision maker who might contravene your expressed, but not legally binding, wishes; out of love, grief, religion or even spite. The exact requirements of a DPA change state by state, but they are reasonably cheap and easy to have drafted.

    Two, my favorite Author (and possibly favorite Human) Terry Pratchett has been an outspoken advocate for Death with Dignity since his Alzeheimers diagnosis several years ago. In 2011, he made a powerful documentary on the subject. Here's the link: http://www.youtube.com/watch?v=slZnfC-V1SY Well worth a watch.

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  17. Very moving words from Adams, and I wholeheartedly agree. My mother has suffered a series of aliments since she was a child... neuromuscular problems due to Charcot-Marie-Tooth, tumors from Neurofibromatosis, a battle with breast cancer and all that follows: a full mastectomy and removal of lymph nodes from her left side, and of course, chemo. Doctors recently discovered that she has a particularly troublesome tumor obstructing her small bowel---most likely a gastrointestinal stromal tumor. It something that could potentially turn in to pancreatic cancer. Doctors will know more when they open her up next month. She's stated that if the surgeon finds a abdomen full of cancer, to close her back up and leave her be. She doesn't want to go through all of the hassle she experienced during her breast cancer battle. My mom is in constant pain and will likely be the rest of her life. She has also expressed that she'd like to be put out of her misery (and thinks suicide a viable option)if it gets too bad. My mother isn't as bad off as others when it comes to the amount of suffering; she's still functional. However, it's awful to see someone you love in so much pain (and that pain'ss only going to worsen over the next few years) and there's nothing you can do about it.

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  18. Elders in my family have demanded little from us, save one thing- that we do not let them suffer when faced with the inevitable. "No feeding tubes." "Do not let them do exploratory surgery if I have advanced cancer." And then they whisper advice about the taboo subject, how to die peacefully, painlessly.
    I suppose this was the way it was long ago when nice women did not publicly discuss birth control but shared hints in private. Secrets passed along, just in case, as needed....

    I love them all dearly and there is no pleasure in discussing their passing but they cared for too many patients who suffered lingering deaths and they know that is what they do not want but they are afraid that we will not be brave on their behalf.

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  19. There's a good CBC radio program about medicine called White Coat Black Art and a recent episode deals with the grey area of resuscitation of very ill patients. You may find it worth listening to, the podcast:

    {{
    Slow Code and Going through the Motions
    Host Dr. Brian Goldman looks at the Slow Code: the Code Blue procedure that's all show and no go. He examines the gray ethics of doctors going through the motions of CPR without actually trying to save a life.
    http://www.cbc.ca/player/Radio/White+Coat+Black+Art/ID/2412926487/?page=2
    }}

    ~E

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