In addition to skills in organizational development and administration, Michael's professional experience includes over twenty years in the health and human services industry, including positions as Supervisor of Admitting, Business Office Manager, and, most recently, Program Director of an assisted living residence/hospice for people with HIV/AIDS.
Michael also brings spiritual sensitivity to this position as an ordained priest in the emerging Anglican denomination of the Evangelical Anglican Church in America. He studied theology at United Theological Seminary in New Brighton, MN, and is currently part of the teaching faculty at the Anglican Institute for Affirmative Christian Studies located in Redondo Beach, CA. He has also practiced Zen Buddhism for over six years, including a summer internship at the Zen Center and Zen Center Hospice in San Francisco, CA. In addition to theological studies, Father Michael holds a Master's Degree in Fine Arts in Creative Writing, from Vermont College, Montpelier, VT. Three of his plays have been produced (two off-Broadway), and his poems have appeared in several journals.
Fr. Michael is looking forward to his new responsibilities and the opportunity to combine his experience with death and dying, grief and bereavement, and patient case management with his personal and spiritual commitment to death with dignity and self-determination. With Michael on board, Barbara Coombs Lee (who has served for over a year as interim executive director) will turn her full attention to developing the Compassion in Dying Federation of America.
Since 1993 Compassion in Dying has offered information, consultation, and emotional support to terminally ill, mentally competent adults who are facing prolonged suffering at the end of life. We offer help in accessing all end of life options, including intensive management of pain, hospice, and comfort care, as well as consultation about obtaining the means for a hastened death should all other options fail.
It is now time to extend our mission throughout the country. The Compassion in Dying Federation of America will provide leadership in education and advocacy and offer patient consultation through its local affiliated organizations. Compassion in Dying of Washington will remain our flagship operation. Another affiliated group, Compassion in Dying of Northern California, has already formed, and a third is in the formative stages in Oregon. In addition to housing the executive director's office, the national headquarters also includes the Compassion in Dying Center for End of Life Law and Policy.
We currently provide information and consultation, as we are able, to distant patients over the telephone. But the core of our consultation program is personal, face-to-face discussion, home visits, and support. Therefore we stand ready to help people in other locales to set up a Compassion organization in their own state. In each location, health care professionals and volunteers will follow the Compassion model -- an interdisciplinary team functioning as case managers to respond to individual needs and provide information in a responsible, ethical manner. We follow strict guidelines and safeguards and make those publicly available.
An important part of our service component is the offer to be personally present at the time of death for those patients and families with whom an in-depth consulting relationship has developed. We do this because we believe that no person should die alone for fear of subjecting their loved ones to criminal investigation, and that no family should go through this experience unsupported unless they so choose.
The greatest tragedy of the current legal situation is that families often cannot share these final, most intimate moments. But another tragedy is that doctors cannot now openly acknowledge and respond to a request for such assistance; they cannot obtain a second opinion or confer with colleagues about whether the request is rational and enduring; they cannot enlist the help of a mental health professional in assessing whether depression is clouding judgment. Compassion can do these things, and does so routinely.
We do nothing illegal in our work with dying patients and their families. We do not provide medication or prescriptions, and we do not administer them. We do provide material to read, people to talk to, the careful exploration of options, and help in getting any care that can improve the quality of life. Most of all, we offer the careful evaluation and support that is necessary to make aid-in-dying available in a responsible, ethical, and safe manner.
There is much to be done as the country enters into the "profound and earnest debate" cited by Chief Justice Rehnquist. Barbara hopes that with her full attention, and the resources of Kathryn Tucker, Director of Legal Affairs, and other Federation supporters, Compassion will continue to participate vigorously in the national debate concerning a terminally ill individual's right to make a dignified and autonomous choice about the time and manner of their death.We invite interested readers to help us in this mission nationwide.
So on August 1 we said "good-bye" to what has been our home for the past three years, and moved to a larger, lighter, more cheerful suite of offices in downtown Seattle, close to the famous Monorail. We would still describe these offices as "modest," but they are also welcoming, and will accommodate guests, researchers, journalists, and our volunteers in much greater comfort. If you would like to visit, please call in advance so that we may give you directions.
Our new telephone number is 206-256-1636, and the mailing address is 410 E. Denny Way, Suite 108, Seattle, WA 98122.
Kathryn L. Tucker, lead counsel in both of Compassion's federal court cases, has been named Director of Legal Affairs at the Center. Ms. Tucker also served as principal outside counsel to Washington Citizens for Death with Dignity during the 1990-91 initiative campaign. This was the first measure permitting physician assistance in dying to be placed on the ballot in any state, and it was only narrowly defeated. Prior to assuming the position with Compassion, Ms. Tucker practiced law in Seattle with the nationally prominent firm Perkins Coie. Ms. Tucker is an Affiliate Professor of Law at the University of Washington School of Law teaching in the field of constitutional law, with specific attention to individual liberties.
The Center will provide national leadership and strategic planning on various legal reform efforts. Among other strategies, the Center will identify the states most likely to recognize a liberty interest under their state constitutions and assist in the development of state court challenges that bar patients from requesting aid in dying from their physicians.
No one trusts the dying to know what they want. The U.S. Supreme Court found dying patients have no right to decide for themselves to cut short their suffering by asking their doctors to prescribe an overdose of sleeping pills or painkillers. According to the court, it is not a decision for patients and doctors, but for state legislatures, most of which have laws on the books prohibiting doctor-assisted suicide.
I see no reason for the state to require patients to die slowly, regardless of their wishes. After all, we are not talking about life vs. death, but about the manner of dying. Nor are we talking about "killing," despite some of the overheated rhetoric. We are talking about choice -- the same sort of choice the Supreme Court honors in a host of other personal decisions, such as abortion, marriage, and sexual behavior. Dying patients suffering intractably should have the option of taking an overdose, just as they now have the option of turning off life supports.
Doctors, for their part, would also have a choice. They would not have to comply with requests for an overdose, any more than they are required to perform abortions, but they would have the option of doing so without becoming criminals. compassionate doctors always have helped dying patients to end their lives. They do so not only by turning off life supports, but by giving large doses of morphine or by prescribing more sleeping pills than necessary. The problem is that the practice is secret and unpredictable, depending more on doctors' courage and Compassion than on patients' needs and wishes.
I wish the Supreme Court had recognized a constitutional right to doctor-assisted suicide for dying patients. It is the most personal and private matter, and it should be decided that way, not as a political matter in state legislatures. But sooner or later, one way or another, the practice will become legal, because dying patients need that choice, and their doctors need to be able to help them. For the state to require dying patients to endure unrelievable suffering is callous and unseemly. Death is hard enough without being bullied.
Apparently hoping to avoid the polarization that still surrounds its ruling in Roe v. Wade, this Court fervently hopes that further debate and discussion at the state level will relieve it of the duty to secure end of life liberty by judicial action.
Chief Justice Rehnquist's opinion ended with the pronouncement that: "Thoughout the Nation, Americans are engaged in an earnest and profound debate about the morality, legality, and practicality of physician-assisted suicide. Our holding permits this debate to continue, as it should in a democratic society."
Justice Souter cited legislatures' "superior opportunities to obtain facts necessary for a judgment about the present controversy." Aware that legislative "foot dragging" might occur in ascertaining whether the States' fears of abuse are justified, Justice Souter nonetheless chose to rely on legislative mechanisms for fact- finding and the "power to experiment, moving forward and pulling back as facts emerge within their own jurisdictions."
And Justice O'Connor asserted that "There is no reason to think the democratic process will not strike the proper balance between the interests of terminally ill, mentally competent individuals who would seek to end their suffering and the State's interests in protecting those who might seek to end life mistakenly or under pressure."
In the meantime the Court made some sweeping and important statements about end of life care upon which we can build to increase dying patients' options and eventually achieve legalization of aid in dying.
Patients and family members should know about these options so they can request them if shortness of breath, nausea, pain, or other symptoms become intolerable. The Court relies on the legality of these treatments as the standard of care. It would appear from this ruling that local law enforcement activities that deter aggressive treatment and require suffering would probably not survive constitutional challenge. Physicians and others who use such treatments have a strong defense if ever accused of overdosing a patient in pain, or causing death by sedation. As Justice O'Connor concluded, "There is no dispute that dying patients in Washington and New York can obtain palliative care, even when doing so would hasten their deaths."
Justice Souter provided some guidance for such claims as he explored the reasoning in a line of cases that eventually granted constitutional protection for the use of contraception. The implication seems to be that the Compassion cases are much like the early contraception cases, which began to seek relief in 1943 but failed until Griswold v. Connecticut established in 1965 that states could not bar married couples from obtaining contraceptives.
In essence, the Court used a slight of hand to rule as though these cases were a broad facial challenge to the laws against assisting a suicide. The Justices pretended they did not have before them an individual suffering patient. In fact, our cases were carefully crafted to present exactly the facts the Court said it did not have before it and thus needn't address at this time. The only explanation for such a position is that the five Justices who, like Justice O'Connor, joined Rehnquist's holding but not his reasoning, believe that society is simply not ready to grant full autonomy to dying patients. As Dr. Marcia Angell says, "No one trusts the dying," and specifically not our current Supreme Court.
A group of researchers at the University of Washington, led by Dr. Robert Pearlman, will interview individuals and their family members to learn more about the reasons why individuals consider a hastened death, and the effects of these decisions on family members.
Dr. Pearlman and his colleagues are currently recruiting present and former Compassion in Dying clients from the Greater Seattle area. They will meet with interested people to hear their stories and learn from them. All interviews will be strictly confidential -- no names will be shared with anyone outside the research team.
Information from this study should have a substantially positive impact on the Death with Dignity movement by educating health care providers, policy makers, and the public about what really happens when people explore the option of a hastened death.
If you are interested in talking with members of the research team, you may call them at (206) 788-5383.
I want to tell you about Sally's contributions to Compassion in Dying's Case Management Program -- the heart of our work, the patient work. This was Sally's life work, even if she didn't have a lifetime to do it. She was passionate about our cause, devoted to her patients, and unequaled in the extent to which she gave of herself in this work. Her patients loved her; they trusted her, relied on her, and had full confidence in her. She was knowledgeable, caring, and compassionate. She connected totally with her patients and brought an absolute concentration and focus to her interactions with them.
Sally had a true gift for this work. Many people care for the dying in hospice and nursing home work, and of course physicians, nurses, and members of religious communities, but not many have the gift to make a loving connection the way Sally did.
In our new office there will be a space dedicated to Sally, a picture of her, smiling, because I want her spirit to remain with us. Her focus was always on the patient work, and she looked at policy decisions from the point of view of the people we serve. She was always true north in that focus, and I want her memory to keep us on course.
In closing, I'd like to share a fantasy I've had of Sally and I as old ladies together. We would get together at a time when it was legal all over this country and the world for terminally ill people to receive aid in dying. And I wanted us to remember having been pioneers together -- and what fun it had been, and how scary and meaningful, and the good, good people we had known and worked with. And she and I would brag about the difference we had helped to make.
I will continue in this work -- Sally would haunt me if I didn't, but it will never be the same without her. From now on part of my personal motivation will be to do this work in memory of Sally. And when we get there some day -- when we win -- Sally's spirit will be celebrating with us.
Contributions in Sally's memory may be mailed to Compassion in Dying of Washington, 410 E. Denny Way, Suite 108, Seattle, WA 98122, or San Juan Preservation Trust, PO Box 327, Lopez, WA 98261.
Both the Washington and Federation offices of Compassion in Dying depend on interested and dedicated community members to educate themselves and others about death with dignity, so that terminally ill, mentally competent adults can ask their physician for a prescription for drugs that would be effective in hastening death in the event that suffering were to become intolerable. We appreciate your support, and welcome your involvement in this continuing civil rights struggle.