Latest / Miss Understood with Rachel Uchitel / Medically Assisted Suicide - Dying with Dignity

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Medically Assisted Suicide - Dying with Dignity · Miss Understood with Rachel Uchitel

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Speaker 1: real conversations in a new language today. Welcome back to Misunderstood.
1:00
Speaker 1: I'm your host, Rachel Yucatel. Today's guest opens up about
1:03
Speaker 1: a subject that is incredibly taboo, incredibly fascinating, and very controversial.
1:08
Speaker 1: That guest also happens to be my aunt, Judith. Judith
1:12
Speaker 1: Bishop spent her career as a midwife, helping bring countless
1:16
Speaker 1: babies into the world, including my own daughter, Wyatt. When
1:19
Speaker 1: she retired, she was not done helping families. Now she
1:22
Speaker 1: helps them in a completely different way. She volunteers to
1:25
Speaker 1: aid individuals who are terminally ill with ending their life
1:29
Speaker 1: through assisted suicide. It is a legal practice, although not
1:33
Speaker 1: legal everywhere. Brittany Maynard, a young woman, brought the difficult
1:37
Speaker 1: subject matter to the forefront when she was diagnosed with
1:40
Speaker 1: terminal cancer and decided it was the right decision for
1:43
Speaker 1: her and for her family. The country followed her story
1:46
Speaker 1: as she was forced to move to Oregon in order
1:48
Speaker 1: to do it legally. Judith brings humanity to this very
1:51
Speaker 1: hot button issue, allowing us behind the scenes to look
1:55
Speaker 1: at the doctors and patients behind the headlines. Some might
1:58
Speaker 1: not agree with what she does or those who choose
2:00
Speaker 1: to do it, but it's an incredible story worth listening
2:03
Speaker 1: to and worth learning from. I really hope you give
2:07
Speaker 1: this a chance. I know it might be a topic
2:10
Speaker 1: that some people are really against even listening to the
2:14
Speaker 1: details from, but it's highly misunderstood and one I think
2:17
Speaker 1: you are going to benefit from listening to. So sit back, relax,
2:21
Speaker 1: and listen to Judith Bishop.
2:49
Speaker 2: So hi, Judith. Thank you for joining me. I'm so
2:52
Speaker 2: excited you're here.
2:52
Speaker 3: Me too.
2:55
Speaker 2: So people don't know this, but you are my aunt
2:59
Speaker 2: and you delivered my daughter, Wyatt. You were my midwife
3:04
Speaker 2: in San Francisco. And I always get confused about whether
3:08
Speaker 2: or not I call you a doctor or not, because
3:10
Speaker 2: I think it's not really understood the fact that somebody
3:13
Speaker 2: could be a midwife, but kind of represent themselves as
3:16
Speaker 2: a doctor almost. You did all the same things that
3:18
Speaker 2: I would have expected from care from a doctor. We
3:22
Speaker 2: were in a hospital. We never did anything like in
3:26
Speaker 2: a pool, in my house, naked, you know, all these
3:30
Speaker 2: weird things. The naked part. Yeah. Well, I was sort
3:33
Speaker 2: of naked, but... So... But yeah, explain to people the
3:37
Speaker 2: difference between a midwife and a doctor and the credentials,
3:41
Speaker 2: but also, you know, what they do that's different.
3:44
Speaker 3: Yeah. So in this country, all licensed midwives, well, the
3:51
Speaker 3: main path, let me say the main path to becoming
3:54
Speaker 3: a midwife is through nursing. So the most common route
4:01
Speaker 3: is that You become an RN, a nurse, and then
4:06
Speaker 3: you do graduate training in midwifery. So it's more people now,
4:12
Speaker 3: I think, are familiar with things like nurse practitioners and
4:16
Speaker 3: physician's assistants. It's more at that sort of level. In
4:21
Speaker 3: a way, what we are is the experts in normal.
4:26
Speaker 3: The things that I don't do or didn't do are,
4:30
Speaker 3: for example, cesarean sections. So if everything's normal, a midwife
4:38
Speaker 3: is really the expert in that. And then when things
4:43
Speaker 3: start to look more complicated or get into territory where
4:48
Speaker 3: someone might need surgery, that's when you have an arrangement with.
4:54
Speaker 2: A physician.
4:55
Speaker 3: Just like one physician might send a patient to a specialist,
4:58
Speaker 3: this is like sending you to a specialist.
5:02
Speaker 2: On the same.
5:03
Speaker 3: Floor where you were having your baby, there were many doctors,
5:07
Speaker 3: many nurses, many pediatricians, many obstetricians.
5:11
Speaker 2: All a push button away.
5:13
Speaker 4: Right.
5:13
Speaker 3: But the thing is, you don't want them if you
5:16
Speaker 3: don't need them, because that's when you start getting into,
5:19
Speaker 3: you know, doing more than you need to do. So
5:21
Speaker 3: I think that's one of the things people like about
5:24
Speaker 3: midwives is that if things are going fine, things stay
5:28
Speaker 3: kind of normal and low key.
5:30
Speaker 2: And yeah.
5:31
Speaker 3: Yeah.
5:34
Speaker 2: And your history, I was talking about a little bit before,
5:36
Speaker 2: but explain to people how you got into the job
5:41
Speaker 2: that you did for a while.
5:44
Speaker 3: How I became a midwife? It was pretty random. And
5:50
Speaker 3: it was the times, I think it was the seventies.
5:53
Speaker 3: It's when women's health was sort of becoming an issue
5:58
Speaker 3: and women taking care of women and our bodies, ourselves
6:02
Speaker 3: and birth control and abortion reform and all of that
6:06
Speaker 3: was happening. And I was involved in all of that,
6:09
Speaker 3: but I had a pretty basic liberal arts education. So
6:14
Speaker 3: when I graduated from college, I really just couldn't find
6:17
Speaker 3: where to plug myself in. And I seemed overeducated or
6:24
Speaker 3: undereducated for most jobs I was looking at. One day,
6:29
Speaker 3: my very good friend told me that her mother had
6:33
Speaker 3: been a nurse practitioner. She must have been one of
6:36
Speaker 3: the first nurse practitioners after it became a thing. I
6:41
Speaker 3: had never heard of it. And then she also said,
6:43
Speaker 3: you know, there's such a thing as a midwife. And
6:47
Speaker 3: I just thought it sounded like a wonderful idea. The
6:51
Speaker 3: other thing is that there I was, a woman in
6:55
Speaker 3: my childbearing years, and it's so kind of a way to,
6:58
Speaker 3: you know, it's all about you. It's learning and being
7:02
Speaker 3: able to do stuff that, that was relevant to me.
7:06
Speaker 3: I'm probably going to say the same thing about the
7:08
Speaker 3: topic we're discussing today, but I just thought what could
7:12
Speaker 3: be more wonderful? And I turned out to be right.
7:16
Speaker 2: Ah, that's great. So, but like for doctors or residents
7:22
Speaker 2: that are going on a path, to be, to go
7:24
Speaker 2: into obstetrics, don't they have to have years of residency and, um,
7:28
Speaker 2: and kind of learn how to do this for many years?
7:32
Speaker 2: Like what's the difference between what you had to do?
7:34
Speaker 2: How'd you get so good at it? I guess is
7:36
Speaker 2: my real question. Well, a lot of it is experience.
7:40
Speaker 3: And, um, so, you know, you do learn as you
7:44
Speaker 3: go along, but you're right that for, um, for doctors,
7:48
Speaker 3: they do medical school, they do residency, then they sometimes
7:52
Speaker 3: do a, fellowship and a specialty, this is a much
7:58
Speaker 3: shorter thing, but it's a much narrower thing. So I
8:01
Speaker 3: didn't need to learn all the complications. I needed to
8:07
Speaker 3: know the signs of normal and not normal. In my
8:12
Speaker 3: job at the university, I taught residents and medical students.
8:19
Speaker 3: We were really an integral part of the teaching program
8:22
Speaker 3: for doctors. And the reason was, or the reason I mentioned,
8:27
Speaker 3: is that we were the experts in normal, and they
8:31
Speaker 3: needed to learn that before they went on to learn.
8:37
Speaker 2: The rest of it.
8:39
Speaker 3: So yes, the doctor training is longer by a number
8:43
Speaker 3: of years, but you know, during part of that time,
8:46
Speaker 3: they're just, they're gaining experience. And I guess you could
8:51
Speaker 3: say some of my experience was on the job.
8:54
Speaker 2: So, and you have the perfect personality for this kind
8:57
Speaker 2: of job. You're calm. You're not somebody whose heart rate
9:02
Speaker 2: goes up with stress. Usually you're soothing. And that was
9:06
Speaker 2: the experience that I had with you as my midwife. You,
9:11
Speaker 2: the whole time I was pregnant, it was all very calm,
9:14
Speaker 2: even though I wasn't calm, but you were and made
9:17
Speaker 2: me feel calm. And those are nine, 10 months that
9:21
Speaker 2: are stressful for people. And you don't know what, so
9:25
Speaker 2: your body's still like you're in, you're very helpful. And
9:27
Speaker 2: then the, um, when I had Wyatt, it was all
9:31
Speaker 2: somewhat normal with the exception of the fact that it
9:34
Speaker 2: took me 24 hours and, um, you know, it took
9:38
Speaker 2: me a while for my actual water to burst and
9:42
Speaker 2: that was a whole fiasco and then I felt I
9:43
Speaker 2: think everyone was on a lunch break when I finally
9:46
Speaker 2: went into contractions and I'm pressing my button and.
9:49
Speaker 5: Of course of course yeah I need I need an
9:52
Speaker 5: epidural immediately and um at first I thought maybe I'd
9:56
Speaker 5: want to be a hero and not do that but
9:57
Speaker 5: then as soon as I felt those pains um, you know.
10:01
Speaker 2: That you, uh, want it when you want it. And
10:04
Speaker 2: it was perfect.
10:05
Speaker 3: It went perfectly given that, you know, there's always some,
10:09
Speaker 3: some excitement, but, um, that's the point, but yes, exactly.
10:13
Speaker 2: And so what was it like for you bringing lives
10:17
Speaker 2: into the world?
10:20
Speaker 3: You know, people would ask if it ever lost its
10:26
Speaker 3: wonder and its magic. And it never does. Each one is,
10:32
Speaker 3: you know, you get busy with the labor and with
10:35
Speaker 3: everything that's going on. And I'm as shocked as anybody
10:39
Speaker 3: when you look up and say, oh, it's a baby.
10:41
Speaker 3: It's like you sort of forget what's happening. And then
10:46
Speaker 3: there it is.
10:47
Speaker 2: And it's just, it's just, incredibly.
10:51
Speaker 3: Mind-blowingly wonderful and also it's it's a way of relating
10:57
Speaker 3: to people that i found very satisfying which is you
11:02
Speaker 3: you enter the most intimate moment of their lives you
11:06
Speaker 3: never knew them particularly before you're not maybe going to
11:09
Speaker 3: know them after but for that one moment you're all
11:13
Speaker 3: together bringing this little life into the world and of
11:17
Speaker 3: course why it was the cutest baby ever. And, you know,
11:21
Speaker 3: it's just, you just are flooded with the sense of
11:25
Speaker 3: wonder of the wonder of it all. Cause it's pretty
11:28
Speaker 3: crazy when you get right down to it.
11:31
Speaker 2: Yeah. So it doesn't, it doesn't get old after it
11:34
Speaker 2: never got old each time. It was like, Oh my God.
11:37
Speaker 2: Oh my God. It's a baby. Right. So how many
11:41
Speaker 2: years did you do this before you finally retired? Almost 45,
11:46
Speaker 2: I think. Over 40. Yeah. And you and I have
11:51
Speaker 2: talked about it, that when you retire, you know, you
11:53
Speaker 2: can't just go to doing laundry and going to lunches
11:57
Speaker 2: and go swimming. You need something else in your life.
12:01
Speaker 2: So now let's talk about, you know, why were you
12:04
Speaker 2: here today and what we're talking about. Tell me how
12:07
Speaker 2: you even got interested in the path that you're in now. Well,
12:13
Speaker 2: I think.
12:14
Speaker 3: You know, in the same way that I was drawn
12:17
Speaker 3: to birth in my youth, that, you know, what competes
12:24
Speaker 3: with that in terms of, you know, just an incredible
12:29
Speaker 3: life event? And, of course, it's the other side of
12:32
Speaker 3: the coin.
12:33
Speaker 2: It's death. And I had thought about that.
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12:56
Speaker 3: And in fact, although most of what I did as
13:00
Speaker 3: a midwife involved, you know, happiness and joy, there were,
13:07
Speaker 3: of course, bad things that happened and people who died
13:12
Speaker 3: and So I was aware that that was the other
13:17
Speaker 3: side of the coin. And I remember thinking that I
13:20
Speaker 3: thought that would be a pretty interesting place to go
13:25
Speaker 3: if and when I had the opportunity. And I think
13:30
Speaker 3: I told you that my husband, Bob, before I retired,
13:36
Speaker 3: as a physician, he had been working on getting... an
13:41
Speaker 3: end-of-life law passed in California. And he was going to meetings,
13:48
Speaker 3: and he was lobbying the legislature and all of that.
13:55
Speaker 2: So I was.
13:56
Speaker 3: Definitely aware that there was an attempt to get a
14:00
Speaker 3: law in California, and I certainly felt supportive of the concept.
14:06
Speaker 3: But it wasn't until I retired that, and by the
14:10
Speaker 3: time I retired, there was a law. So then there
14:13
Speaker 3: was this gap of, oh, you've got a law, but
14:17
Speaker 3: how do people find out about it? How do people
14:19
Speaker 3: get educated about it? How do people access it? It
14:23
Speaker 3: turns out not to be that simple. And there was
14:27
Speaker 3: a newly formed organization after the law passed who's a
14:33
Speaker 3: nonprofit volunteer, all-volunteer organization that I now work with, that
14:41
Speaker 3: saw that as their mission to help move that law
14:45
Speaker 3: from being on a piece of paper to being something
14:49
Speaker 3: that people knew about and could take advantage of and actually.
14:55
Speaker 2: So it's interesting because the people that have mentioned this topic,
15:01
Speaker 2: two of end-of-life laws. They didn't even realize that there
15:08
Speaker 2: was nine states in America that this was legal. Am
15:11
Speaker 2: I right about that? Is it nine? Ten. Ten. Ten
15:15
Speaker 2: states and Washington, D.C. Wow.
15:19
Speaker 3: Okay.
15:19
Speaker 2: And do you know what the last one was, what
15:22
Speaker 2: the most recent addition?
15:24
Speaker 3: Yeah, the most recent were Maine and New Mexico.
15:30
Speaker 2: Right.
15:30
Speaker 3: But there've been a flurry of them. The oldest, the
15:33
Speaker 3: first was Oregon and that was 26 years ago.
15:37
Speaker 5: Yeah.
15:38
Speaker 3: And then not another 10 years. And then another in
15:41
Speaker 3: California was 2015, 2016.
15:45
Speaker 2: And we were like number seven. Right. So when people
15:49
Speaker 2: talk about end of life options, I think a lot
15:52
Speaker 2: of people are stuck in the mentality of like, um,
15:56
Speaker 2: you know, the Dr. Death, the guy who was sort
15:58
Speaker 2: of being hired, yeah, Kevorkian, who was being hired to,
16:04
Speaker 2: you know, help people with suicide and it wasn't legal.
16:08
Speaker 2: And so let's talk about the actual law. What are the,
16:12
Speaker 2: is the law the same in every state and it's
16:15
Speaker 2: a universal law or is state by state, is it different?
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Speaker 3: State by state, there are small things that are different,
18:37
Speaker 3: but all of them are essentially based on the law
18:40
Speaker 3: that Oregon developed back in 1997. And they all contain
18:48
Speaker 3: the same pretty much four requirements. So you have to
18:54
Speaker 3: be an adult. You have to be over 18. You
18:57
Speaker 3: have to be terminally ill. And the definition of terminally
19:02
Speaker 3: ill is that a doctor is guessing that you will
19:09
Speaker 3: die within six months without treatment. And you have to
19:15
Speaker 3: be mentally competent to make the decision for yourself. And
19:19
Speaker 3: you have to be able to ingest the medication. You
19:25
Speaker 3: have to be able to swallow it is the most
19:27
Speaker 3: common route. But you have to be able to, in
19:30
Speaker 3: some way, do it yourself.
19:34
Speaker 2: And that that was.
19:35
Speaker 3: A safeguard that was considered important to getting the law
19:42
Speaker 3: passed so that people wouldn't worry so much about people
19:48
Speaker 3: being coerced into.
19:50
Speaker 2: Something like this. And when is the law about living
19:54
Speaker 2: in the state before this takes place?
19:58
Speaker 3: So there is, in most of the states, there is
20:01
Speaker 3: a residency requirement. The thing is, the first thing I
20:06
Speaker 3: can tell people when they ask, they say, well, I
20:09
Speaker 3: live in Arizona, but, you know, I have a sister
20:12
Speaker 3: in California. Can I move in with my sister? And
20:16
Speaker 3: the answer is absolutely yes. It is establishing a residency
20:20
Speaker 3: is not difficult. And in fact, we're seeing the beginnings
20:25
Speaker 3: of that particular requirement being tweaked. And in two states,
20:32
Speaker 3: I think already they've removed the residency requirement. There's no
20:37
Speaker 3: longer one in Oregon and there's no longer one in Vermont.
20:42
Speaker 3: So people could just travel there to take the risk.
20:47
Speaker 4: Okay.
20:47
Speaker 2: So I have so many questions that go along with this.
20:49
Speaker 2: And I think a lot of people, their main question is, well,
20:53
Speaker 2: first of all, there's a lot of stigma with this.
20:55
Speaker 2: Is this suicide? Is this right? Is that, you know,
20:58
Speaker 2: ending your life? And there's a lot of, I guess,
21:01
Speaker 2: religious beliefs that go along with that that make it
21:04
Speaker 2: difficult for people. But I think I've talked about this,
21:07
Speaker 2: a lot of people that are in the position to
21:09
Speaker 2: make this decision and have been researching this and want
21:12
Speaker 2: to do this are in a different place in life
21:15
Speaker 2: than we are, that we can even comprehend what that's like.
21:18
Speaker 2: What have you come into contact with, with the people
21:20
Speaker 2: that are reaching out to you? What's their frame of
21:22
Speaker 2: mind when they reach out to you?
21:24
Speaker 3: Yeah, this has been one of the most amazing parts
21:29
Speaker 3: for me is to see how people who are, who
21:35
Speaker 3: know they're dying, who are terminally ill, um, seeing how
21:41
Speaker 3: they think this through, seeing how they deal with this,
21:44
Speaker 3: seeing what, um, they have very little, I mean, they
21:49
Speaker 3: either want it or they know they don't want it,
21:52
Speaker 3: but there's very little waffling about, about how they feel
21:57
Speaker 3: about it. Their families may have questions, their other people
22:01
Speaker 3: may have questions, but they come at it, I usually
22:07
Speaker 3: say that it's as if they've crossed the line that
22:11
Speaker 3: I haven't crossed. So I can't be 100% in their body,
22:16
Speaker 3: in their shoes, whatever. But that they, it's something that
22:21
Speaker 3: just seems right and important to them that gives them comfort,
22:26
Speaker 3: gives them a sense of control in a situation where
22:30
Speaker 3: They don't have a really good choice to make. You know,
22:34
Speaker 3: they have some choices. They can do treatment forever. They
22:38
Speaker 3: can decline all treatment. But when you get right down
22:43
Speaker 3: to it, the bottom line is the same. They're dying
22:47
Speaker 3: and they have just a few decisions to make. And
22:51
Speaker 3: this is just one of them. That is an option
22:55
Speaker 3: that wasn't there before.
22:57
Speaker 2: Right. So I think what you're talking about is something
22:59
Speaker 2: that Brittany Maynard made popular or something that became mainstream news.
23:06
Speaker 2: She was a beautiful girl who had a brain tumor,
23:09
Speaker 2: I believe, and was given six months to live. She
23:12
Speaker 2: was terminal. And she decided to document her progress, her process,
23:18
Speaker 2: and the fact that she really wanted to do this.
23:23
Speaker 2: What do you remember from that story?
23:25
Speaker 3: What I remember is it, that I could see for
23:30
Speaker 3: a lot of people that had trouble with the concept
23:33
Speaker 3: of this kind of law, that this lovely girl who
23:39
Speaker 3: had just gotten married and had her whole life ahead
23:42
Speaker 3: of her now had to deal with the reality that
23:46
Speaker 3: she was going to die. And I think it humanized
23:52
Speaker 3: it for them in a way that nothing had been
23:55
Speaker 3: able to before. She was articulate. She clearly knew what
24:02
Speaker 3: she wanted. She wasn't saying this is for everybody. That
24:08
Speaker 3: was very thought through. And the point she made was
24:15
Speaker 3: that she lived in California. And so the point she
24:19
Speaker 3: made was that she wished she could stay.
24:22
Speaker 2: Home and be in her own home.
24:24
Speaker 3: And when she did this, but that that was not
24:28
Speaker 3: an option for her. And I think people started to
24:31
Speaker 3: feel like, well, yeah, that's kind of.
24:35
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24:41
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24:43
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24:45
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24:48
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24:55
Speaker 3: Sad and you know, gosh, she's got to pack up
24:58
Speaker 3: and go to Oregon to do this. And she did,
25:01
Speaker 3: you know, because it was so public, she did have to,
25:04
Speaker 3: you know, make sure she went through the right steps
25:07
Speaker 3: of establishing residency and so on. Jen, just to clarify,
25:12
Speaker 3: it was because it wasn't legal in California at the time, right?
25:15
Speaker 2: Correct. That's correct.
25:16
Speaker 3: And, and in fact, we credit Brittany Maynard with, with
25:21
Speaker 3: making a big leap in terms of the California law
25:24
Speaker 3: in particular, but even around the country, how these laws
25:29
Speaker 3: that had been on the books for decades trying to pass,
25:34
Speaker 3: and suddenly they were starting to pass. And she really
25:38
Speaker 3: had a lot to do with it. And I think
25:41
Speaker 3: for her, it gave her a sense of purpose, too.
25:43
Speaker 3: I mean, she really felt strongly about it, and it
25:46
Speaker 3: gave her the end of her life a a real
25:50
Speaker 3: sense of meaning that she could contribute something.
25:54
Speaker 2: Right. What do you say to those people that are,
25:57
Speaker 2: just feel like it's too soon to know when the
26:01
Speaker 2: end is really coming? What do doctors know? Does it always,
26:04
Speaker 2: you know, are they always correct? What about this maintaining
26:07
Speaker 2: hope for recovery?
26:09
Speaker 3: Yeah. So of course they don't know. And of course
26:13
Speaker 3: people live longer than expected and some people die sooner.
26:18
Speaker 3: So there's no way around that. But they can know
26:25
Speaker 3: that if they're dying of cancer or this particular type
26:32
Speaker 3: of brain tumor and so on, that there are certain
26:35
Speaker 3: things they can say. They see signs in the body.
26:38
Speaker 3: They know that this is only headed one place. And
26:43
Speaker 3: of course, if they do choose to end their life,
26:47
Speaker 3: then they're never going to know. So that's something that
26:50
Speaker 3: the person themselves has to deal with. But usually it's
26:55
Speaker 3: people who, who sense they're losing their, um, they're, they're
27:02
Speaker 3: losing their ability to do so much. They're losing their
27:06
Speaker 3: dignity from, from their point of view. I They've gone
27:14
Speaker 3: from being active, productive people to being bedridden, to being dependent.
27:21
Speaker 3: And they know that even if something happened, they're in
27:26
Speaker 3: pretty safe.
27:27
Speaker 2: Yeah. And would you say that this is, in some cases,
27:34
Speaker 2: their way to get rid of the pain? Or has
27:37
Speaker 2: the pain been something that you guys and doctors are
27:40
Speaker 2: able to really help make much easier for them at
27:45
Speaker 2: this point in their life and also about relieving pain.
27:48
Speaker 3: Yeah I think it's really important to know how many
27:52
Speaker 3: things have changed and improved about death in America and
27:57
Speaker 3: there have been lots of books about you know the
28:01
Speaker 3: sort of death industry and how people get you know
28:06
Speaker 3: get their lives extended by all kinds of treatments and
28:11
Speaker 3: things that are quite painful and put them in the
28:14
Speaker 3: hospital in intensive care. You know, if you ask people,
28:17
Speaker 3: if you survey people, and this has been done, most
28:20
Speaker 3: people would describe, you know, if you say, where do
28:22
Speaker 3: you want to die?
28:23
Speaker 2: I want to die at home. You know, what's important
28:27
Speaker 2: to you?
28:28
Speaker 3: It's not being a burden, not being in pain, not
28:32
Speaker 3: being dependent. So And even despite that, most people feeling
28:40
Speaker 3: that way, the majority, over 50% of people die in
28:44
Speaker 3: acute care hospitals. And more than half the people never
28:50
Speaker 3: even have any kind of documentation of what they would
28:55
Speaker 3: want and what their wishes are. So now we have hospice.
29:00
Speaker 3: Now we have, in some cases, these medical aid in
29:03
Speaker 3: dying laws.
29:04
Speaker 2: Now we have.
29:08
Speaker 3: Death doulas and death cafes and different, all kinds of
29:12
Speaker 3: things that help people get educated about choices they can make.
29:18
Speaker 3: And there's so much better pain control that if they
29:23
Speaker 3: come in with an image of having seen their grandmother die,
29:28
Speaker 3: and now they think that's going to be me, that
29:31
Speaker 3: it's important to educate people also on the alternatives and
29:37
Speaker 3: the options that they have. So this should never be
29:41
Speaker 3: like the first go-to thing. It's just a part of
29:46
Speaker 3: the choices that are available. And the choices, as I said,
29:53
Speaker 3: aren't really most people's, you know, the things they want
29:57
Speaker 3: aren't on the list. you know, a longer life of
30:02
Speaker 3: a longer life that has quality.
30:04
Speaker 4: Yeah.
30:05
Speaker 3: But when they don't see that and they don't see,
30:08
Speaker 3: that's when some people start to veer off and say,
30:11
Speaker 3: you know, I think I'm done.
30:14
Speaker 2: I think I've had a good life.
30:17
Speaker 3: I think I don't see these next months adding to
30:22
Speaker 3: my appreciation of my, of my life.
30:26
Speaker 2: And, um, And how do you run into that, that
30:30
Speaker 2: it's harder for the family to deal with and they're
30:33
Speaker 2: trying to talk the patient out of doing this because
30:37
Speaker 2: of their own, I hate to say the word, but
30:39
Speaker 2: selfish reason?
30:42
Speaker 3: Well, I'd say actually always, always harder for the family
30:50
Speaker 3: because families are the ones that are being left.
30:53
Speaker 2: The families are the ones that really... don't want to
30:58
Speaker 2: lose their loved one.
31:00
Speaker 3: So they feel uncomfortable with this concept and they sometimes
31:04
Speaker 3: feel guilty. Like, you know, what could I do? What
31:07
Speaker 3: could I be doing that would, that would change their
31:10
Speaker 3: mind about this? But I think also a lot of
31:15
Speaker 3: them have, have had conversations with their parents and have
31:21
Speaker 3: had their parents, you know, a lot of them say,
31:24
Speaker 3: you know, my mother's been telling me since I, I
31:27
Speaker 3: was 21. She wouldn't want to be kept alive. She
31:31
Speaker 3: doesn't want to die in a hospital. She wants to
31:36
Speaker 3: stay at home. Your grandmother was one of them. I'm
31:42
Speaker 3: sure she told you. She told us every time we
31:45
Speaker 3: would visit, I do not want to be taken out
31:48
Speaker 3: of my house.
31:48
Speaker 2: I never want to go to a nursing home.
31:53
Speaker 3: Those things aren't usually very appealing for the person who's
31:58
Speaker 3: looking down the road at it.
32:00
Speaker 2: Right.
32:01
Speaker 3: But I think that the families come around a lot
32:04
Speaker 3: of the times because they, when you point out to
32:09
Speaker 3: them that what they're really doing is doing what their
32:13
Speaker 3: loved one wants, you know, this is one way when
32:17
Speaker 3: you say, when they say, what can we do supporting, um,
32:23
Speaker 3: their husband, supporting their wife, supporting whoever it is that's dying,
32:28
Speaker 3: and hearing what they're saying and trying to help them
32:33
Speaker 3: get what they want is probably the thing that will
32:36
Speaker 3: be most comfort to them afterwards because they can say
32:40
Speaker 3: that's what they really wanted. And I, you know, I
32:44
Speaker 3: swallowed my own feelings about it to give them what
32:49
Speaker 3: they wanted. The other thing is that's so interesting is
32:57
Speaker 3: how much that support in itself can help the dying
33:02
Speaker 3: person relax and sort of think, well, okay, you know,
33:09
Speaker 3: I'm going to get the medication. I'm going to put
33:11
Speaker 3: it in my closet. And if it gets bad enough,
33:15
Speaker 3: I'm set. And then they kind of chill out and
33:19
Speaker 3: have some fun, you know. And I think it's about
33:26
Speaker 3: a third of people that get the medication don't end
33:30
Speaker 3: up taking it. Now, some of that is because they
33:34
Speaker 3: die too quickly or unexpectedly, or they lose the capacity
33:40
Speaker 3: to take the medication. But I think that a chunk
33:45
Speaker 3: of it is that now that they're not in a panic,
33:50
Speaker 3: about what if, what if, now that they've got what
33:53
Speaker 3: they need, that then they can just say, well, is
33:56
Speaker 3: it that bad?
33:57
Speaker 2: Or is this kind of okay?
34:01
Speaker 3: And then they start finding things they want to do
34:05
Speaker 3: and say, not yet, not yet. And that's great too.
34:10
Speaker 3: I don't care if people use it or not. I'm
34:13
Speaker 3: going to give it to them, but it's never with
34:15
Speaker 3: the idea of, well, if you do this, then you
34:18
Speaker 3: have to take it.
34:20
Speaker 2: That's a really good point because I think a lot
34:22
Speaker 2: of people have questions about that. So a doctor has
34:25
Speaker 2: to prescribe it based on the criteria that they have
34:28
Speaker 2: to fall under. Yes.
34:29
Speaker 3: And all the laws, in fact, two doctors have to
34:33
Speaker 3: be involved. And in some states now, actually, it can
34:36
Speaker 3: be also nurse practitioners and physician assistants. But in most
34:42
Speaker 3: of them right now, it's still two physicians, one who's
34:47
Speaker 3: called the attending physician or the prescribing physician is the
34:51
Speaker 3: main person, they have to be the ones to determine
34:57
Speaker 3: the terminally ill status. They have to be the ones
35:01
Speaker 3: to determine, is the person in their right mind? They
35:05
Speaker 3: know what they're talking about. Do they understand what this means?
35:08
Speaker 3: Do they understand the other options that they have? Then
35:12
Speaker 3: there's a second doctor, the consulting doctor, who's just like
35:16
Speaker 3: a second opinion. They follow up the first doctor by
35:21
Speaker 3: reviewing the records, talking to the patient, and then just
35:26
Speaker 3: signing off saying, I agree.
35:29
Speaker 2: And do the doctors have to be in the states
35:32
Speaker 2: that it's legal in, or the patient has to take
35:35
Speaker 2: the medicine in the state that they have to die in,
35:39
Speaker 2: or they're allowed to die? The physicians have to be
35:43
Speaker 2: in a state where it's legal.
35:45
Speaker 4: Got it.
35:46
Speaker 2: So now... Someone is given the okay to get the medication.
35:51
Speaker 2: It's prescribed at a pharmacy. I mean, can they just
35:53
Speaker 2: pick it up at a pharmacy?
35:56
Speaker 3: Yes.
35:57
Speaker 2: Yes.
35:58
Speaker 3: It's a compounding of five different medications. So it's done
36:02
Speaker 3: at what's called a compounding pharmacy, not your basic Walgreens
36:07
Speaker 3: or whatever wouldn't have it. But so that's been another
36:13
Speaker 3: little hurdle that we try to help with, knowing what
36:16
Speaker 3: are the pharmacies that offer it.
36:20
Speaker 2: It's expensive.
36:21
Speaker 3: And that's another thing we can talk about is the
36:26
Speaker 3: fact that there's sometimes some cost involved and that's sort
36:29
Speaker 3: of a barrier.
36:30
Speaker 2: What is the price point for something like that?
36:34
Speaker 3: Yeah.
36:35
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36:38
Speaker 6: weekly savings on thousands of brands you know and love
36:40
Speaker 6: when you scan at the till. All you have to
36:42
Speaker 6: do is simply download your Real Rewards app, scan the
36:46
Speaker 6: app at the till, and get great savings on your shopping.
36:49
Speaker 6: New Real Rewards prices from Super Value. Yes, you scan.
36:54
Speaker 3: The least expensive pharmacy that I know of in California,
37:00
Speaker 3: it's $ 450. And the most expensive I've had a pharmacy
37:07
Speaker 3: charge was over a thousand dollars. I'd say the average
37:11
Speaker 3: is around seven to $ 800. The thing is that insurance
37:16
Speaker 3: doesn't cover it and insurance doesn't cover it because most
37:21
Speaker 3: of these people have Medicare and that's federal money.
37:25
Speaker 2: And it's like.
37:26
Speaker 3: Abortion that you can't use federal money for that purpose,
37:34
Speaker 3: because not all the states are on board, not all
37:37
Speaker 3: the people have voted on this. So if you're in
37:40
Speaker 3: a state that doesn't want that law, they don't want
37:42
Speaker 3: their money going to pay for the medication for something
37:46
Speaker 3: they don't believe in. Right.
37:48
Speaker 2: So any doctor in, say, California or Oregon can prescribe
37:53
Speaker 2: this medication, but are people finding that there are a
37:56
Speaker 2: lot of doctors that have their own personal beliefs similar
38:00
Speaker 2: to that? I've abortion, you know, that they don't want
38:02
Speaker 2: to be involved. And that's what, what are people running
38:05
Speaker 2: into with that?
38:06
Speaker 3: And the law allows for that too, that if, if
38:10
Speaker 3: you don't want to do it, you don't have to
38:13
Speaker 3: do it. If you're a doctor, you don't have to
38:15
Speaker 3: be involved. You don't have to offer this to your patient.
38:21
Speaker 3: And if you, and the same with the people involved
38:26
Speaker 3: in hospice care, who are taking care of the person
38:30
Speaker 3: at home, If the nurses in that situation don't want
38:35
Speaker 3: to be involved, or as is more often the case,
38:38
Speaker 3: if the hospice makes a decision, they're not going to
38:41
Speaker 3: be involved. They don't have to be. Now, there are
38:44
Speaker 3: ways around that, but it does just create some hurdles.
38:49
Speaker 3: And when I think of things, some of it is
38:54
Speaker 3: discomfort with the law. Some of it is religious. Some
38:59
Speaker 3: of it is just doctors, you know, feeling like they're
39:04
Speaker 3: not about death. They're about life, even though on the continuum, life,
39:09
Speaker 3: death is a pretty important part of life. But I
39:14
Speaker 3: remember our governor when the law was passed in California
39:19
Speaker 3: was Jerry Brown, and he was raised a Catholic. Everybody
39:23
Speaker 3: knew he was a Catholic. And he was a kind
39:28
Speaker 3: of a spiritual guy. And he had to sign the law,
39:31
Speaker 3: the legislation into law. And we were all a little nervous, like,
39:38
Speaker 3: would he do it? Would he do it? Because he
39:40
Speaker 3: could have vetoed it. And when he did sign it,
39:45
Speaker 3: as he did, he just gave this lovely speech about
39:51
Speaker 3: how it might not be for him, it might not
39:56
Speaker 3: be a choice he would make for himself, but that
40:00
Speaker 3: he did not think it was right to stand in
40:04
Speaker 3: the way of others to whom it might bring significant
40:09
Speaker 3: comfort and relief. So he just was bigger than, you know,
40:15
Speaker 3: this is bigger than me, and he.
40:18
Speaker 2: Made that decision.
40:20
Speaker 3: And the other reason, on the other side, the other
40:25
Speaker 3: reason that doctors sometimes aren't involved is it's.
40:29
Speaker 2: A little more effort.
40:30
Speaker 3: It takes a little more time. There's some paperwork. They
40:36
Speaker 3: may be afraid of some kind of stigma also. But
40:42
Speaker 3: I think with more time, and that's one of the
40:44
Speaker 3: things we also try to do, if we have doctors
40:47
Speaker 3: who sound like they're sympathetic, to the patient that's asked
40:51
Speaker 3: them for the medication, but they just don't know much
40:55
Speaker 3: about it, we will offer to mentor them. We'll team
40:58
Speaker 3: them up with a doctor who's familiar with it so
41:02
Speaker 3: that they can learn it and then be comfortable with it.
41:05
Speaker 3: Once they know what they're doing, it's really not that hard.
41:09
Speaker 3: And it certainly can be very rewarding for the ones
41:13
Speaker 3: that do. Yeah.
41:14
Speaker 2: Yeah. So let's go back to the details a little
41:18
Speaker 2: bit more. So when you get the medication, how long,
41:20
Speaker 2: what's the expiration life in your closet? Yeah.
41:26
Speaker 3: You know how much debate there is about what those
41:28
Speaker 3: expiration dates mean?
41:30
Speaker 2: Are they meaningful?
41:32
Speaker 3: Just like the sell-by dates on your food. So I
41:37
Speaker 3: think we kind of stick to the fact of the
41:40
Speaker 3: expiration date, even though it probably... The medication is so strong,
41:45
Speaker 3: it probably doesn't really have much of an expiration date.
41:49
Speaker 3: But there is one on it. And I think.
41:52
Speaker 2: It's a year, at least a year. And something that
41:57
Speaker 2: I find interesting is that patients are actually allowed to
42:01
Speaker 2: do this at home or wherever they want with their
42:03
Speaker 2: loved ones. And a doctor or volunteer does not have
42:07
Speaker 2: to be present, correct? They can literally take charge of
42:10
Speaker 2: when they want to do it. I'd say half.
42:13
Speaker 3: half the people is the guests who get it, uh,
42:18
Speaker 3: have nobody but friends or family with them when they do.
42:22
Speaker 3: And that's both for some people that they like that
42:28
Speaker 3: about it, but really for a lot of people, they
42:31
Speaker 3: just as soon have somebody there who's a little more
42:34
Speaker 3: experienced and, um, to reassure them. Not everybody has been
42:39
Speaker 3: in a room when someone has died. It seems like a,
42:44
Speaker 3: kind of a heavy thing to lay on, you know,
42:47
Speaker 3: a wife or a child or a husband. They have
42:51
Speaker 3: to be worried about doing the mixing and the timing
42:54
Speaker 3: and all of this. So again, they're in most of
42:58
Speaker 3: the state.
42:59
Speaker 2: How would they know if it's going the right way
43:01
Speaker 2: or if they screw it up or, you know?
43:04
Speaker 3: Well, yeah, there's some instructions and that's the pharmacist's job, theoretically,
43:09
Speaker 3: to go through step by step how to do it,
43:12
Speaker 3: how to take it. you know, how long not to have,
43:16
Speaker 3: you know, not to eat a big meal before they
43:19
Speaker 3: do it. Oh, really? Wow.
43:21
Speaker 2: Okay.
43:21
Speaker 6: Yeah.
43:22
Speaker 2: Because you're right. You don't want to throw it up. Yeah.
43:26
Speaker 3: And there's some pre-medication actually that is sort of a anti,
43:32
Speaker 3: you know, anti-vomiting medication that you take beforehand.
43:37
Speaker 2: So it's a little bit involved.
43:39
Speaker 3: Some people have relatives or friends that are nurses or doctors,
43:44
Speaker 3: and they volunteer to do it, and that's fine. We
43:47
Speaker 3: have volunteers who are trained, and this is true in
43:50
Speaker 3: most of the states with laws, that you can get
43:53
Speaker 3: a volunteer without costs to do that. You can also get,
43:59
Speaker 3: there's a new field now beyond birth doula, there is
44:04
Speaker 3: now death doula, and they are just people that help
44:07
Speaker 3: walk you through it, pull what you need together, And
44:10
Speaker 3: some of those are for hire, some are volunteer. So
44:13
Speaker 3: you can get someone else to be there. And that's, yeah,
44:22
Speaker 3: that's enough. What would you call yourself? Like, are you
44:26
Speaker 3: a dad? I just call myself a volunteer. A volunteer
44:31
Speaker 3: for the End of Life Choices California organization. And just tell,
44:38
Speaker 3: you know, they just know that I've been... experience that
44:41
Speaker 3: I know what's up and that I'll take care of
44:43
Speaker 3: it in the kitchen or whatever, while they can be
44:47
Speaker 3: telling stories and sitting around with their, the person who's,
44:52
Speaker 3: who's dying.
44:54
Speaker 2: So I'm curious about your personal experience about it. How
44:56
Speaker 2: often is your phone ringing to be making these dates?
45:01
Speaker 3: Well, it depends, you know, we're a statewide organization. So
45:05
Speaker 3: one of the things, so every day there's someone on
45:08
Speaker 3: the phone, taking calls.
45:11
Speaker 2: I do it about one day a week.
45:13
Speaker 3: But if a call comes from the Bay Area and
45:18
Speaker 3: someone is looking for a volunteer, they've got the meds,
45:22
Speaker 3: all of that went fine, but they've got the meds,
45:24
Speaker 3: they're ready to pick a date, they want to volunteer,
45:27
Speaker 3: then one of my colleagues who gets that call would
45:31
Speaker 3: call one of the volunteers in the Bay Area and say,
45:34
Speaker 3: could you do this? And so it's not a It's
45:38
Speaker 3: not a daily happening. So to put it in perspective,
45:43
Speaker 3: less than 1% of all the deaths that occur in
45:48
Speaker 3: California are due to medical aid and dying. It's a
45:53
Speaker 3: really tiny percentage of people. But of course, all deaths
45:58
Speaker 3: include car accidents and everything.
46:02
Speaker 2: To put it into perspective on a given month, how
46:05
Speaker 2: often would you be doing that?
46:08
Speaker 3: Yeah, on a given month, a couple of times maybe,
46:11
Speaker 3: or maybe not at all. Um, so yeah, it's, um, it's,
46:17
Speaker 3: it's a small, it's a small number.
46:20
Speaker 2: And how many, um, people have you been with when
46:24
Speaker 2: they have asked, do you think?
46:28
Speaker 3: I think in the year and a half, not counting,
46:30
Speaker 3: you know, my previous medical life, but in the year
46:34
Speaker 3: and a half, I've been a volunteer, um, actually probably 10.
46:39
Speaker 2: Wow. Okay. And I'm curious about, has it ever been
46:47
Speaker 2: that you show up for your volunteer duties and you
46:51
Speaker 2: think it's happening that day and they say, you know what,
46:54
Speaker 2: I can't do it in the 10 times you've done it? Yeah.
46:58
Speaker 3: You know, that was one of my things at the
47:01
Speaker 3: beginning that I would feel most anxious about, you know, I,
47:06
Speaker 3: I knew the drill. I knew that I was to
47:09
Speaker 3: go to the bedside and before handing them the glass,
47:13
Speaker 3: I want to tell them that they can do this
47:17
Speaker 3: or not. It's anything is fine. And, you know, I,
47:22
Speaker 3: they have to say one more time, no, that's what
47:24
Speaker 3: I want. And so I asked some, some of the
47:28
Speaker 3: volunteers that had been involved with this for longer. I've asked, um,
47:34
Speaker 3: at various meetings and conventions, you know, has anybody ever
47:38
Speaker 3: had anybody who just at the last minute said, forget it.
47:43
Speaker 2: And nobody had, nobody had.
47:46
Speaker 3: Now I've had people that have changed a date, maybe
47:49
Speaker 3: because someone was flying in from out of town or
47:52
Speaker 3: this or that, or they decided they wanted, you know,
47:57
Speaker 3: to do something one more time. But, I have never
48:01
Speaker 3: had and nor have I heard of anyone who's had
48:05
Speaker 3: someone change their mind at the last minute.
48:08
Speaker 2: And of course, I'm prepared for it.
48:11
Speaker 3: If they said, forget about it, I'd say, great, and
48:14
Speaker 3: go try and find a safe way to dispose of it. Again,
48:22
Speaker 3: my instinct is it is that line that I mentioned,
48:25
Speaker 3: that line that they've crossed. While I'm there sort of thinking,
48:28
Speaker 3: are they going to go for it? they're grabbing for
48:31
Speaker 3: the glass.
48:32
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48:53
Speaker 2: They're just ready.
48:54
Speaker 3: They talk about being done. They talk about just being done.
48:59
Speaker 3: And You know, they don't want their family to take
49:03
Speaker 3: it personally. There's actually, I'm laughing, but there's actually a
49:07
Speaker 3: fair amount of humor here. I mean, these people get
49:11
Speaker 3: so relaxed and I think so relieved that they've made
49:16
Speaker 3: a plan and that that they they actually sometimes get
49:21
Speaker 3: get pretty funny about it um you know someone who
49:25
Speaker 3: who didn't want to do it in the morning because
49:29
Speaker 3: she wasn't a morning person.
49:32
Speaker 2: I mean, it's sweet.
49:34
Speaker 3: But they're just acting like a regular person and they're
49:37
Speaker 3: really happy and relieved that they can just be this
49:40
Speaker 3: frank about this thing. That it's not some horrible, scary
49:45
Speaker 3: thing that nobody can talk about. Right.
49:49
Speaker 2: And I sense that even before I meet people on
49:51
Speaker 2: the phone, that it's just.
49:56
Speaker 3: Something that they've been having trouble talking to their families
49:59
Speaker 3: about or their friends about. They don't know how It's
50:02
Speaker 3: like certain subjects, politics and other things. If you don't
50:07
Speaker 3: know how other people feel, you're a little nervous about
50:09
Speaker 3: how to approach the topic. They just love it and
50:15
Speaker 3: they start joking and telling stories.
50:18
Speaker 2: I don't know. It's just a wonderful... Can they have
50:24
Speaker 2: a glass of wine right before? They could. They could.
50:28
Speaker 2: They ask if they can have a chaser.
50:31
Speaker 3: And people have chosen, they choose, you know, we ask
50:34
Speaker 3: them what, you know, do they want a certain soundtrack
50:37
Speaker 3: or we've had interesting things there too. You know, someone
50:42
Speaker 3: wanted to watch an old movie or somebody wanted, you know,
50:46
Speaker 3: the bed moved out into the garden or someone wanted.
50:50
Speaker 2: And, and that's all important also.
50:53
Speaker 3: And the family likes that because it gives them little
50:55
Speaker 3: ways to set things up. But, um, And what is
51:01
Speaker 3: the process after they drink this concoction? They take their
51:06
Speaker 3: wine chaser, if they so choose. How long do they
51:10
Speaker 3: have left? And what are kind of the signs of
51:13
Speaker 3: how they, I mean, does it seem like they fall asleep?
51:16
Speaker 2: What happened?
51:17
Speaker 3: Yeah, I'm going to say one thing, which is the
51:19
Speaker 3: chaser normally, which is not alcohol, is something like a
51:24
Speaker 3: popsicle because the medication is quite bitter. and people do
51:30
Speaker 3: complain about the taste. In fact, one guy, after he
51:34
Speaker 3: drank it, he said, this stuff tastes so bad, it's
51:37
Speaker 3: definitely going to kill me. So, yeah, it's usually a
51:43
Speaker 3: quick popsicle to kind of, you know, numb their mouth
51:46
Speaker 3: a little bit. Then, of course, there's variation, but pretty standardly,
51:54
Speaker 3: within five to ten minutes, they fall asleep. And then
51:59
Speaker 3: a little deeper, actually into a coma. And then the
52:05
Speaker 3: average is within two hours, they have died. It can
52:11
Speaker 3: be longer and it can be quicker, but that's kind
52:16
Speaker 3: of the normal range.
52:19
Speaker 2: It's about two hours. So they.
52:24
Speaker 2: Are aware for a few minutes and then it's almost
52:27
Speaker 2: like taking a sleeping pill and they just kind of
52:29
Speaker 2: peacefully go into sleep. Correct.
52:32
Speaker 3: Correct. Yeah.
52:34
Speaker 2: Do you think that, oh wait, let's talk about disposal
52:37
Speaker 2: of the, of the medication too. I mean, do you
52:39
Speaker 2: have to take the whole thing? What if there's some leftover?
52:42
Speaker 2: I mean, has it ever, have you ever run into
52:46
Speaker 2: issues where people abuse it because it's in a cabinet
52:50
Speaker 2: for so long? How do you make sure you're not,
52:52
Speaker 2: your daughter's not going to get into it, your dog?
52:54
Speaker 2: you know, all sorts of issues. Exactly. Exactly.
52:57
Speaker 3: And that's, that's been a topic of conversation. I think
53:00
Speaker 3: the amazing thing is that there are, again, no stories
53:06
Speaker 3: that I know of, no horror stories that anybody can tell.
53:10
Speaker 3: It's just that we all feel anxious about it because
53:13
Speaker 3: that would be terrible. I mean, I, I get anxious
53:16
Speaker 3: about what if I trip on the rug while I'm
53:18
Speaker 3: carrying the glass, you know, and it spills and then
53:22
Speaker 3: the dog licks it up or, you know, So, yes,
53:25
Speaker 3: it has to be taken seriously. And, you know, hospitals
53:32
Speaker 3: have disposal sites for medication. I mean, usually it's the nurse,
53:37
Speaker 3: a hospice nurse, whatever caregiver that person has would be
53:42
Speaker 3: responsible for getting rid of the medication if it wasn't used. Right.
53:49
Speaker 3: the medication is so strong that if there's, if they
53:52
Speaker 3: start to nod off before they've actually been able to
53:55
Speaker 3: finish it, it, it doesn't make any difference because it's
53:59
Speaker 3: so much more than they need. But it is why
54:03
Speaker 3: we say, you know, you've got two minutes to drink
54:06
Speaker 3: down this two ounces, which isn't very much, but sometimes
54:11
Speaker 3: we tell them to practice it if they want to
54:14
Speaker 3: you know, if they're ill and they've been having a
54:16
Speaker 3: little trouble swallowing, they sometimes will practice with water or
54:20
Speaker 3: something to see and maybe use a straw or something.
54:26
Speaker 3: But it can't take forever because if it takes five minutes,
54:32
Speaker 3: they'll be falling asleep. And then it's possible that they
54:36
Speaker 3: won't have taken enough. They probably would die anyway. And
54:43
Speaker 3: let us keep in mind they are dying anyway, which
54:47
Speaker 3: adds a little cushion there, you know?
54:49
Speaker 4: Yeah.
54:52
Speaker 2: But it could take longer. Right. What about your thoughts on,
54:59
Speaker 2: you know, so many people will say to me, well,
55:02
Speaker 2: I don't understand why you have to go to one
55:04
Speaker 2: of those states, be part of one of those states.
55:05
Speaker 2: I mean, couldn't you just do it where you are?
55:09
Speaker 2: And I think it's important to talk about the fact
55:11
Speaker 2: that it has to be done legally. in my opinion,
55:14
Speaker 2: I would think just for life insurance purposes. I mean,
55:17
Speaker 2: it cannot be suicide or the life insurance will correct. Oh. Um,
55:21
Speaker 2: and I think a lot of people are sort of
55:23
Speaker 2: ignorant to why it's so important to do this in
55:25
Speaker 2: one of the 10 state.
55:27
Speaker 4: Yes.
55:28
Speaker 3: So, so the first, you mentioned the first thing and
55:32
Speaker 3: sometimes families are aware of it and they still think
55:35
Speaker 3: that's why you can't do it. Um, it's that, you know,
55:39
Speaker 3: we won't get our life insurance. Um, Other people, another
55:43
Speaker 3: interesting one I came up with was, or I heard,
55:46
Speaker 3: was someone didn't want them to do it in their
55:50
Speaker 3: house because they thought it would affect the resale value
55:53
Speaker 3: of their house. You have to apparently disclose.
55:59
Speaker 2: If someone's died. There's a dead body, yeah.
56:03
Speaker 3: But then, so that led me down a rabbit hole
56:06
Speaker 3: talking to a lot of realtors, and it turns out
56:09
Speaker 3: really not to be an issue. Now, oh, but the
56:16
Speaker 3: reason that, and then there's all kinds of stigma besides
56:20
Speaker 3: the issue with insurance to suicide. Nobody wants to think
56:25
Speaker 3: somebody killed themselves. That sounds bad. So again, it's not
56:32
Speaker 3: suicide because this isn't someone who could live and chooses
56:35
Speaker 3: to die. This is someone who is dying, who chooses
56:39
Speaker 3: their method of death. And so we never use the word.
56:44
Speaker 3: It doesn't, suicide or even medical aid in dying does
56:48
Speaker 3: not appear on the death certificate.
56:51
Speaker 2: It's not written.
56:52
Speaker 3: They die of their underlying disease. And that's part of
56:57
Speaker 3: the law. And I think that's a comfort to families.
57:00
Speaker 3: They don't want a death certificate that's advertising whatever. And
57:06
Speaker 3: the real thing is, and again, we seem to have
57:09
Speaker 3: a lot of abortion advocates analogies here but the real
57:14
Speaker 3: thing is that uh that people who do try to
57:20
Speaker 3: do things on their own the way women used to
57:24
Speaker 3: feel desperate enough that they would try to abort on
57:28
Speaker 3: their own and we know where that went it went
57:32
Speaker 3: with women in some cases dying and but certainly ending
57:36
Speaker 3: up sometimes seriously ill in the hospital, maybe ruining their
57:45
Speaker 3: fertility for the rest of their life, etc. And people who,
57:50
Speaker 3: it's not that easy, as it turns out, to kill
57:54
Speaker 3: yourself in a way that's efficient and quick and not
58:00
Speaker 3: messy for your family and not traumatizing for your family.
58:05
Speaker 2: And the.
58:07
Speaker 3: The odds are, I don't know what the odds are exactly,
58:12
Speaker 3: but they're pretty good that it won't work, that you'll
58:15
Speaker 3: get something will intervene and instead you'll be in a
58:18
Speaker 3: worse state than you started. Absolutely.
58:22
Speaker 2: Yeah.
58:23
Speaker 3: So I think for the sake of families and for
58:26
Speaker 3: the sake of all those reasons, the fact that it's
58:31
Speaker 3: not very effective, there isn't a very good way to
58:35
Speaker 3: do it. Sadly, that doing it, that's why we need
58:44
Speaker 3: the law. So it's not underground. It's not sneaky. It
58:51
Speaker 3: accomplishes what it wants to accomplish in the best way possible.
58:56
Speaker 2: You brought up a couple of times the word choice.
58:58
Speaker 2: And I think that's and having the opportunity to make
59:02
Speaker 2: their own decision and also be aware of what they're
59:05
Speaker 2: doing until the very end. And I think that's really
59:08
Speaker 2: important to talk about because, you know, whether or not
59:12
Speaker 2: you agree with this decision or this law, it's not
59:17
Speaker 2: for us to make that decision if it has nothing
59:20
Speaker 2: to do with our bodies, which again is very similar
59:23
Speaker 2: to what you hear when people are talking about abortions.
59:25
Speaker 2: But also I think it's important for people to realize
59:28
Speaker 2: that the people doing this have to be aware and
59:33
Speaker 2: actually have to drink it themselves, right? Because I don't
59:36
Speaker 2: want people to think, oh, my loved one is in
59:40
Speaker 2: hospice right now and I want to think of a
59:42
Speaker 2: way to end their life. Then can this just be injected?
59:45
Speaker 2: It doesn't work like that. It has to be something
59:49
Speaker 2: that they choose to do, that they do themselves. And
59:53
Speaker 2: I'm curious if you think that the laws will be
59:58
Speaker 2: challenged ever in the future like they're challenging abortion laws. Yes,
1:00:02
Speaker 2: they are all the time.
1:00:04
Speaker 3: And that's why the groups that support this and the
1:00:10
Speaker 3: one that Brittany Maynard supported and advertised was a national
1:00:17
Speaker 3: group called Compassion and Choices. And one of the things,
1:00:22
Speaker 3: the main things they do is... the legislative side, and
1:00:27
Speaker 3: they're keeping an eye not just on the states like
1:00:31
Speaker 3: New York, Massachusetts, ones that are trying again and that
1:00:34
Speaker 3: we think will be the next ones to get the law,
1:00:37
Speaker 3: but to be sure that the ones that have the
1:00:39
Speaker 3: law get to keep it because we've already had at
1:00:45
Speaker 3: least one challenge to the California law, and we won it,
1:00:49
Speaker 3: so we kept it.
1:00:51
Speaker 2: But, you know, Absolutely.
1:00:54
Speaker 3: This is something that people need to be vigilant about
1:00:58
Speaker 3: to be sure that it doesn't get removed.
1:01:02
Speaker 2: Yeah. Don't lose it. So I'm just curious then you've
1:01:06
Speaker 2: brought lives into this world and you've been there to
1:01:11
Speaker 2: see that happen many, many times over the course of
1:01:15
Speaker 2: 40 years. And then you have been present when people
1:01:18
Speaker 2: are ending their life. Is there something that is similar
1:01:22
Speaker 2: is there something that is different is there something that
1:01:25
Speaker 2: rings true to you for both of those stages in life.
1:01:30
Speaker 3: Well i mean they they are the bookends you know
1:01:35
Speaker 3: and i think i think i speak more for what
1:01:39
Speaker 3: i get out of it than than perhaps the the
1:01:43
Speaker 3: families themselves but by observing this just it it it
1:01:50
Speaker 3: is I have to think about that. You know, when
1:01:54
Speaker 3: you bring a baby into the world, there's that whole
1:01:57
Speaker 3: unknown future ahead of it, that whole expanse that's coming,
1:02:01
Speaker 3: but you're just there for that one intense moment. And
1:02:05
Speaker 3: I guess when I'm there at the end of someone's life,
1:02:09
Speaker 3: I've missed all of that. Although I love hearing about it.
1:02:12
Speaker 3: And I usually get engaged in a conversation where, you know,
1:02:17
Speaker 3: they'll tell me what they did and, a little bit
1:02:20
Speaker 3: about their life and their family and all of that.
1:02:24
Speaker 3: And it's how it's wrapped up and being able to
1:02:30
Speaker 3: make it as good as possible coming in and to
1:02:34
Speaker 3: make it as good as possible going out just feels good,
1:02:41
Speaker 3: feels right somehow. And, you know, medical aid in dying
1:02:46
Speaker 3: has no monopoly on dignified deaths. I do want to
1:02:52
Speaker 3: be clear about that, that we could be talking about
1:02:55
Speaker 3: just end of life and death in general. But my
1:03:01
Speaker 3: ability to be there has more to do with medical
1:03:03
Speaker 3: aid and dying because that's what I'm there for. Yeah.
1:03:07
Speaker 3: But there's, you know, there's people make their own, as
1:03:14
Speaker 3: I said, their own sense of dignity, their own police,
1:03:18
Speaker 3: all of that plays into it so much. And it's
1:03:21
Speaker 3: just fascinating and wonderful. It does, in what I've seen,
1:03:26
Speaker 3: it makes me feel good about the human race after
1:03:30
Speaker 3: a day of reading the newspaper when I don't feel
1:03:33
Speaker 3: so good about it.
1:03:34
Speaker 2: Yeah. And from what you said, you know, it doesn't
1:03:40
Speaker 2: have to be, death does not have to be sad
1:03:42
Speaker 2: and scary and something to really you know, be, you know, not,
1:03:49
Speaker 2: it's not like you need to look forward to it,
1:03:51
Speaker 2: but it can be something that can be peaceful and
1:03:54
Speaker 2: that you are actually happy in the moment. That correct. Correct.
1:03:59
Speaker 3: And I think, I think all, the more we can
1:04:01
Speaker 3: talk about it, the more we can explore it, the
1:04:04
Speaker 3: more we can, you know, it just makes everybody more
1:04:08
Speaker 3: comfortable with it. And then once it's kind of out there, um,
1:04:13
Speaker 3: then it's still sad. There's still the grieving. In fact,
1:04:18
Speaker 3: I know for a fact that initially there's kind of
1:04:22
Speaker 3: a euphoria because there's been so much tension and sadness
1:04:25
Speaker 3: and suffering and so on. And then it's done and
1:04:29
Speaker 3: you feel so good and you bond around this very
1:04:33
Speaker 3: intense experience. But of course, then the family members go
1:04:38
Speaker 3: on and they have to go on without this person
1:04:40
Speaker 3: that was so important to them. And that's That's tough.
1:04:44
Speaker 3: But I still think it's helpful for them to be
1:04:47
Speaker 3: able to hearken back and to have been part of it.
1:04:50
Speaker 3: Just like, you know, birth used to be women strapped
1:04:55
Speaker 3: to a stretcher. No one could be with them. You know,
1:04:59
Speaker 3: it was just, you were in an operating room for
1:05:02
Speaker 3: the delivery.
1:05:03
Speaker 2: Didn't it take chloroform, some women, to kind of knock
1:05:08
Speaker 2: them out or something?
1:05:09
Speaker 3: They gave some very bad medications so that you were
1:05:12
Speaker 3: really out of it and you didn't remember what happened
1:05:15
Speaker 3: and you had no control over your behavior. And it
1:05:18
Speaker 3: was a lonely, I mean, everything, you know, just all
1:05:21
Speaker 3: went to the, got so medicalized. And that's what happened
1:05:25
Speaker 3: with death as well. And I think that just coming
1:05:28
Speaker 3: back to a place where people have some choices, if
1:05:31
Speaker 3: they want to try every treatment they can try, if
1:05:34
Speaker 3: they want to, do that chemo one more time. Nobody
1:05:37
Speaker 3: has a problem with that. But people also need to
1:05:40
Speaker 3: know that that's not a requirement and that they could
1:05:43
Speaker 3: make an intelligent decision for themselves at some point just
1:05:47
Speaker 3: to say, I think I've done enough. I think I'd
1:05:50
Speaker 3: rather enjoy my life a little bit, what time I
1:05:54
Speaker 3: have left, and not spend it in the hospital.
1:05:57
Speaker 2: Yeah, right. So now that you know what you know,
1:06:01
Speaker 2: I guess, and if you feel comfortable answering that, Great.
1:06:05
Speaker 2: If not, I understand. But can you talk about your
1:06:07
Speaker 2: personal experience? Would you choose to do this? Would you
1:06:11
Speaker 2: choose for your loved ones to do this?
1:06:14
Speaker 3: So I'll talk about me for a minute.
1:06:19
Speaker 2: I have no idea.
1:06:21
Speaker 3: And I think it's because I'm smart enough to know
1:06:27
Speaker 3: that I can't imagine yet being in that position. It's
1:06:33
Speaker 3: like I was a midwife. I knew all about having babies.
1:06:37
Speaker 3: When I had a baby, all bets were off. I
1:06:42
Speaker 3: was like any other laboring woman. And it was like, bing,
1:06:46
Speaker 3: the little light goes off. It's like, okay, there's one
1:06:49
Speaker 3: thing being smart, understanding it and being able to sort
1:06:54
Speaker 3: of manage it.
1:06:55
Speaker 2: And it's another thing being it.
1:06:58
Speaker 3: But I feel very strongly that that I would want
1:07:03
Speaker 3: to know that that was one of my choices. I
1:07:06
Speaker 3: would not be happy to think that I didn't have
1:07:10
Speaker 3: that option if I needed it, because I don't know
1:07:13
Speaker 3: how I'm going to feel.
1:07:14
Speaker 2: And I don't know. Yeah. Yeah.
1:07:20
Speaker 3: How bad, and what is that bad? And, you know,
1:07:23
Speaker 3: or is it kind of okay? Who was it that
1:07:26
Speaker 3: said someone, some famous person, oh, Daniel Ellsberg, who died recently.
1:07:34
Speaker 2: What a guy.
1:07:35
Speaker 3: But he apparently was quoted in his obituary that he
1:07:39
Speaker 3: said he died at home and he had all his
1:07:42
Speaker 3: friends and family there and he said goodbye to all
1:07:45
Speaker 3: his buddies. And he said to his wife, if I'd
1:07:49
Speaker 3: known dying was going to be so good, I would
1:07:51
Speaker 3: have done it sooner. Because he was enjoying that end.
1:07:56
Speaker 2: It was just lovely. It was wonderful. He was euphoric.
1:08:00
Speaker 3: I'm not sure. So maybe it would be like that.
1:08:04
Speaker 2: And then I wouldn't.
1:08:04
Speaker 3: Necessarily think about that. But I think the other personal
1:08:10
Speaker 3: thing is we're talking about my husband who has lymphoma.
1:08:16
Speaker 3: He is terminally ill. He has lived longer than they
1:08:22
Speaker 3: would have expected. He's the one that worked on the law.
1:08:26
Speaker 3: And with his first diagnosis, he He signed up, he
1:08:29
Speaker 3: got the meds, and they sat in our closet.
1:08:33
Speaker 2: But then he.
1:08:35
Speaker 3: Improved and improved with some treatment. He wasn't going to
1:08:39
Speaker 3: take them. He knew he was going to try some treatment.
1:08:43
Speaker 3: And he did, and he had a good response to it.
1:08:46
Speaker 3: He had a recurrence. We didn't order up the meds
1:08:49
Speaker 3: this time, just because we did have to get rid
1:08:51
Speaker 3: of them.
1:08:52
Speaker 2: They expired.
1:08:53
Speaker 3: And he would say, one of his expressions is, you
1:08:58
Speaker 3: know I'm a person who likes to, when the movie's over,
1:09:02
Speaker 3: I like to stay for the credits. When, when my,
1:09:06
Speaker 3: when I finished my drink, I like to suck the
1:09:10
Speaker 3: juice from the line. I, you know, I may want
1:09:14
Speaker 3: to see this to the very, very end. I don't know,
1:09:18
Speaker 3: but he, he knows he can have it and i
1:09:22
Speaker 3: think for both of us that has um is that's
1:09:26
Speaker 3: all we want to know that's all we need to
1:09:28
Speaker 3: know at this point right.
1:09:31
Speaker 2: Well sorry it made me cry i love bob still
1:09:34
Speaker 2: yeah yeah um okay well so if people want more
1:09:39
Speaker 2: information on this where could they find.
1:09:42
Speaker 3: It you know every um Do you want me to
1:09:46
Speaker 3: list the states that have the law? I know everybody
1:09:49
Speaker 3: all over the country listens to your podcast, right? Well,
1:09:52
Speaker 3: I wrote them down because I don't have them memorized.
1:09:55
Speaker 3: So Oregon, Washington State, Montana, Vermont, California, Colorado, Washington, D.C., Hawaii,
1:10:06
Speaker 3: New Jersey, Maine.
1:10:09
Speaker 2: And New Mexico.
1:10:10
Speaker 3: So people in those states, I would recommend you can
1:10:14
Speaker 3: just look up anything like if you just put in
1:10:19
Speaker 3: end of life or end of life act or anything
1:10:23
Speaker 3: like that, it will pop up your state organizations around
1:10:28
Speaker 3: your laws. And you should learn, you know, what is
1:10:31
Speaker 3: the law and how do you get it? And you
1:10:33
Speaker 3: should have conversations with your doctors about how do you
1:10:36
Speaker 3: feel about it? And I might be interested in this.
1:10:38
Speaker 3: Would you be willing to do this? It's never too
1:10:41
Speaker 3: soon to start chatting about it and finding out about it.
1:10:46
Speaker 3: In the states that don't have the laws, I know
1:10:49
Speaker 3: there are at least 12 that are on the books
1:10:53
Speaker 3: that are trying again, but there is interest in every state,
1:11:00
Speaker 3: I'll say that, and there are end-of-life organizations in every state.
1:11:05
Speaker 3: So again, I would just Google end-of-life, end-of-life choices, medical
1:11:11
Speaker 3: aid in dying, and then put in your state and
1:11:16
Speaker 3: see what comes up. Because I promise you, every state
1:11:19
Speaker 3: has mostly these nonprofit organizations of people who have devoted
1:11:26
Speaker 3: their life and time to these kinds of issues.
1:11:32
Speaker 2: Well, Judith Bishop, thank you so much for being here.
1:11:35
Speaker 2: I think you answered so many important questions and all
1:11:39
Speaker 2: my rough to vol.
1:11:42
Speaker 1: Thank you so much for listening to our podcast, Misunderstood
1:11:44
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1:12:04
Speaker 1: Thank you so much, and I can't wait to see
1:12:06
Speaker 1: you next time.
1:12:09
Speaker 4: Don't miss the USL Championship Final on CBS, November 21st
1:12:14
Speaker 4: at noon Eastern. Will the Pittsburgh Riverhounds retain their crown,
1:12:18
Speaker 4: or will new title winners emerge? Don't miss the conclusion
1:12:22
Speaker 4: to the 2026 season, Saturday, November 21st, noon Eastern, on CBS.