Barbara Mancini’s father was dying. He asked her to hand him a bottle of morphine, and when she did, he drank it all.
A hospice nurse arrived and, hearing what happened, had Mancini’s father taken to the hospital and revived against his wishes. He died four days later. Mancini was arrested and charged with aiding a suicide.
Mancini will share her story as the keynote speaker at a forum Thursday in Chapel Hill about death with dignity, also called physician-assisted suicide. The event is sponsored by the Orange County Department on Aging and UNC’s Partnerships in Aging Program.
“It’s an opportunity for the public to discuss an issue that’s contentious, emotional, difficult,” said Nathan Boucher, a senior fellow at the Duke Center for the Study of Aging and Human Development.
A 2015 Gallup survey shows that 68 percent of Americans support allowing doctors “to assist the patient to commit suicide” if that person cannot be cured and is in severe pain, a 10-point jump from last year.
But polls show support for medical aid in dying is lower among Republicans and church-goers. Disability rights advocates and the American Medical Association also oppose it.
The forum’s organizers strove to include speakers reflecting the range of perspectives on the issue.
“We’ll find out for sure when we get up to speak - did we hit a balance?” said panelist Paul Gerritson, the area director-pastor for Triangle Christian Medical and Dental Associations. “But the effort was there.”
Gerritson started volunteering with emergency medical services in rural New Mexico after leaving the U.S. Air Force.
“At virtually the same time I became a follower of Jesus Christ,” he said. “Jesus had a very methodical medical practice. He never ever killed anybody who was suffering. His goal was to relieve their suffering, not to kill them.”
Gerritson draws a distinction between medical efforts “which are prolonging life and which are extending death.”
Dr. Jacques Mistrot, a retired surgeon who now specializes in bioethics, will represent the Catholic Diocese of Raleigh at the forum. “I’m coming at it with the basic idea and premise of our faith that all life is sacred from conception to natural death,” he said.
Mistrot emphasized the role of advance directives in allowing people to withdraw from or reject further treatment. “We already have legal methods where people can state their wishes,” he said. “They don’t have to undergo severe pain. They don’t have to undergo these terrible procedures people are afraid of.”
But people of faith hold different positions on medical aid in dying.
Rep. Verla Insko, who represents Orange County in the N.C. General Assembly and identifies as a Southern Baptist, said, “My religious convictions don’t prevent me from understanding that a Christian could have a spiritual experience that would say it’s time.”
‘The best option’
“In another state, a person I have known for a long time had cancer and was able to have a physician provide assistance when he decided it was his time,” Insko said. “The report from the family was that the whole experience was beautiful, something that they shared together and gave the patient total control over the decision.”
“There are times when that’s the best option,” she said, although she acknowledged, “there are clear pros and cons that policymakers need to consider before making any legislative changes.”
Insko is one of two legislators who will speak at the forum Thursday. The second, Rep. Pricey Harrison, introduced a Death with Dignity bill in 2015.
“I lost my sister to a brain tumor five years ago this week,” Harrison said. “At the same time, a documentary came out called ‘How to Die in Oregon.’”
“It got me thinking that this is an alternative that we ought to be able to provide to North Carolinians,” she said.
Orange County Rep. Graig Meyer co-sponsored the legislation. “We recognize that that bill is not likely to pass in the current legislature, but it’s the type of thing that would require some time and public discussion to see where the public would want to go with this,” he said.
Meyer said he expects to revisit the issue in 2017. “I think that we will be paying keen attention to the evolving social debate about this issue and decide whether to keep the same bill or to make adjustments or not propose it at all,” he said.
Since Oregon became the first state to pass a Death with Dignity law in 1997, three other states have followed suit. Only California and Vermont legalized medical aid in dying through their legislatures. Oregon and Washington did so through ballot initiatives, which Harrison explained is not an option in North Carolina.
“I know it’s an uphill battle,” Harrison said. “But we ought to get started. I think eventually it won’t seem so far fetched.” She believes its eventual passage is inevitable.
‘Civil rights perspective’
Not everyone is so sure. Carol Sutton represents Not Dead Yet, a national disability rights group, and says the bill would cause a “breakdown in society.”
“I actually approach this from a civil rights perspective,” she said. “The disability rights movement has for many years opposed physician-assisted suicide and euthanasia.”
“Right now there are more than enough means to relieve pain and suffering,” she said. “Framing it as something that people in extreme pain and suffering are going to choose is not really true. People apply for this because of psychosocial reasons.”
Sutton also expressed concern that physicians would miscalculate the time people have left to live. Only those with six months or less would be eligible for medical aid in dying according to the proposed legislation.
“My parents were told I wouldn’t live through the night when I was 5 weeks old,” she said. “That was over 60 years ago.”
“I’ve talked to different people on the other side of this, and I’ve often wondered if they’re not just trying to justify what they did,” she said. “It’s amazing how many of them are not in jail.”
Dr. Beth Rosenberg, a Chapel Hill cardiologist and another panelist, said she is “looking forward to a civil, balanced discussion about something that’s really important.”
Rosenberg supports medical aid in dying as an option. “There are a limited number of situations where it would be a reasonable alternative,” she explained.
“If you really practice medicine in the most compassionate way, you want to relieve people’s suffering,” Rosenberg said. “Right now, what we do in order to accomplish that is give palliative care.”
Many of the panelists discussed their experiences with palliative or hospice care, some describing positive experiences and others calling for dramatic improvements.
“We had relatives who had used hospice in the past and had very good experiences,” Mancini said. “We expected the same for my father.” She explained that he was not given the pain medication he needed in his last weeks.
“We’ve gotten good at getting people to live a lot longer, but we haven’t eased the dying process,” she said.
“I don’t think we communicate well with patients and families enough at the end of life,” Boucher said. “Our health care system is based on curing and fixing things. We don’t always do good palliative care at the end of life. If we did, there would be less need for a law like this, but that’s a whole other forum.”
A Pennsylvania judge dismissed the charges against Mancini in 2014. Since then, she has become an advocate for medical aid in dying and better end of life care. She hopes the event Thursday will be a “conversation starter.”
“The most important thing for people to take away is how important it is for people to discuss their end of life values and wishes and preferences with their loved ones,” she said.
The event will be held from 4-7 p.m. at the Friday Center in Chapel Hill. The forum is free but you must register by Tuesday at orangecountync.gov/departments/aging or by calling the Seymour Center, at 919-968-2070.