Assisted Death

We all know, or at least have heard of, individuals who spent the last part of their lives in long-term facilities without any quality of life while eating up all of one’s lifetime savings. Medical costs at the end of life are a huge portion of one’s lifetime medical expenses. There are others who have a terminal and debilitating disease such as Parkinson’s who do not want to live helplessly until natural death occurs. Such people are likely to desire the end of life, but unless they live in certain areas of this country this is not an opportunity for them, at least not legally. In areas that do allow one to end their life, cancer is the number two diagnosis for self-deliverance, behind ALS. 

There is much controversy regarding the act of ending one’s life. The American Medical Association is against physicians being involved in such acts because the physician is to be seen as a healer instead. Others, particularly religious groups, see this self determination of the end of life as suicide and therefore a sin. Advocates see it as death with dignity. 

In 1990 the Patient Self-Determination Act was passed when the Supreme Court ruled that a person had the right to refuse nutrition and hydration to end life. This quickly lead to the Living Will with which most of us are familiar.   https://crookedcreek.live/2017/01/25/death-decisions/ At about the same time the Supreme Court ruled that assisted death would be up to the states. Since then, nine states and the District of Columbia granted that right to its citizens. One in five Americans live in those states and fewer than 4,500 have died utilizing this right. 

Interestingly, assisted death by injection is forbidden. The person choosing to die must be able to ingest oral medication. One-third of those who obtain the medication for this purpose do not take it, even though it is on hand.  

Maine, one of the nine states, named their law Medical Aid in Dying and the current medical protocol, called D-DMA: contains #1 powdered digoxin, which is normally used to treat irregular heartbeat but causes the heart to stop at extreme doses. And #2 a mixture of Diazepam (Valium), which suppresses the respiratory system in high doses; Morphine, a narcotic that also suppresses the respiratory system; and Amitriptyline, an antidepressant that stops the heart at high doses. This cocktail is said to produce peaceful sleep followed by death. It is not easy to obtain this method of dying. Maine requires an oral request followed by a second oral request. A written request is then required at least fifteen days later. 

Final Exit”, by the founder of the modern American right-to-die movement, Derek Humphry, was published in 1991 and offers information on ending one’s life where it is not legally permitted.This book offers various ways to end one’s life listing each by lethality, minutes to death, pain level and other factors. Some methods, e.g., the use of a plastic bag and helium or nitrous gases require that someone remove the apparatus prior to a coroner’s visit if the deceased doesn’t want it known that they ended their own life. The book even includes information regarding life insurance. The fact that this book has sold 2 million copies seems to indicate great interest in the subject and the many methods of suicide/euthanasia described within. 

Skin Cancer

Skin cancer is the most common type of cancer. There are several kinds but basal cell is the most frequent. More than four million cases are diagnosed in the US each year. Squamous cell is next, diagnosed in one million people annually. Both are easily treated either surgically or with special medications. Sometimes radiation or cryotherapy are used. The most important thing about these and any skin cancer is early detection.

Melanoma is a type of skin cancer which can be much more serious and difficult to treat depending upon the stage at the time of detection. Melanoma can spread to other parts of the body and require chemotherapy or radiation in addition to surgery. If a first-degree relative has had melanoma your chance of developing it is 50% higher.

Recognizing melanoma relies on the ABCDEs which stands for these characteristics:

  • A – Asymmetry
  • B – irregular Borders
  • C – changes in Color
  • D – Diameter larger than 1/4 inch
  • E – Evolving (changes over time)

 

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An example of melanoma skin cancer

 

Early detection of skin cancer requires close observation of your own body, including hard to see areas that might require enlisting the help of another person. Most important is having an annual skin check by a dermatologist.

Prevention includes the use of sunscreen every day regardless of the weather or your activity. UV rays are always present and even penetrate glass in your car, office or home.

The benefits of sunscreen for African Americans has not been fully established. One should discuss this with their physician.


You can read much more specific details of skin cancer and its treatment at this American Cancer Society website https://www.cancer.org/cancer/skin-cancer/galleries/skin-cancer-image-gallery.html

This site also has several photos of different types of skin cancer and includes a chat line if you have further questions.

The Cancer Helpline number is:  1-800-227-2345