By CARRIE WOOD, Special to The Mirror

When doctors told Barbara McKay she would probably not live much longer, she began to think about how she would end her life.

“I was very determined I was not going to allow myself to get to the point where I couldn’t care for myself,” said McKay, recalling her diagnosis with late-stage ovarian cancer seven years ago. “I didn’t want to put my family in that position.”

McKay, 60, spoke with her family about her end-of-life choices. But she knew when the time came, she could not allow them to be with her. McKay didn’t want them to get in trouble for assisting her in any way.

So when Washington’s Death with Dignity Act took effect March 5, McKay was relieved.

The voter-approved initiative (I-1000), which models an Oregon law, allows doctors to prescribe lethal medication for a mentally competent adult with a terminal condition that is expected to be fatal within six months. The patient must self-administer the drugs.

More than 400 people have ended their lives under the Oregon initiative since it took effect in 1997.

McKay publicly signed a letter to her physician last week indicating her wish to take life-ending medication — if necessary and when she chooses — to help her achieve a “peaceful” and “gentle” death.

Compassion and Choices of Washington, a nonprofit organization that advocates for better end-of-life care and choices, created the form to help patients start the conversation with physicians.

“With terminal illness, it’s difficult to be in a position where you don’t have control over your body,” said McKay, a Kirkland resident.

Since her cancer diagnosis, McKay has undergone three extensive chemotherapy treatments and two surgeries. She has endured back pain, fatigue, indigestion and embarrassment from having a bald head.

She has also watched a number of women pass away — women whom she’s gone through chemo with, “and I’ve watched the different ways they die and seen the effects it has on families, and that’s no place to put someone,” she said.

“With the new act, it’s nice to know that you have that option if you choose it, and it gives me that feeling of control.”

McKay said she understands Death with Dignity is not for everybody, and “everyone has opinions on what’s important to them.”

McKay’s husband and children have been supportive of her choice to die with dignity, which she fears could be soon.

After a two-year break from chemotherapy, McKay recently found out her tumors have tripled and spread to her lungs.

“I hope to live for many more years,” she said, “But when my time comes, I want to be able to choose my time and my way.”

‘More honest way of doing things’

Dr. Tom Preston, a retired Seattle cardiologist and Compassion and Choices medical director, has worked on the initiative since 1991, when a broader attempt to legalize physician assistance in dying was rejected by Washington voters. 
He believes the new measure is a “more honest way of doing things.” Physicians have assisted patients in dying “back-alley for decades” by administering high dosages of morphine and other medications, he said.

The purpose of modern medicine, Preston said, is to prolong life.

“That’s fine for some, but the new law gives the choice of how to die to patients and families, not to doctors and machines,” he said.

The measure also means communication between patients and physicians is in place, he said. 
Much of the deep opposition has been ideological, Preston said. He said the “problem comes when their stance might prevent other people from living out their own values.”

Opposition

Some opponents, who refer to the law as “physician-assisted suicide,” say that people facing death need caring and compassion, not lethal medication.

Others, such as Bellevue probate lawyer Theresa Schrempp, said there is no safeguard in the measure to protect patients from financial or elderly abuse. She is also concerned that there is no requirement of a witness at the time of death.

On March 5, Schrempp protested the law with a group called True Compassion Advocates outside the University of Washington School of Medicine. The health facility is one of five in the state that has chosen to participate in the law so far.

The act allows facilities and individual healthcare providers not to participate.

“It’s really disturbing to me that they have chosen to become a hospital that voluntarily administers a lethal dosage,” Schrempp added.

Hospitals in the Franciscan Health System, which includes Federal Way’s St. Francis Hospital, will not participate in the Death with Dignity law.

“Franciscan hospitals do not participate in physician-assisted suicide,” said spokesman Gale Robinette. “As a Catholic hospital, there’s no way we can provide that service. This is rooted in our faith tradition.”

Robinette said Franciscan hospitals focus on alternatives such as hospice care through the end of life for the terminally ill.

“We believe in the sanctity of life from birth to death. That is the foundation on our position of this issue,” Robinette said.

King County Public Hospital District No. 2 — which includes Kirkland, Bothell, Kenmore, Redmond and part of Sammamish — operates Evergreen Healthcare, and more than 60 percent of the voters in the district supported the Death with Dignity initiative in the November 2008 election. Evergreen Healthcare will not allow people to take life-ending medication while they are in-patients, but it will adopt a formal policy later this month on how it will comply with the measure, said Dr. Hope Wechkin, medical director at Evergreen Hospice.

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Carrie Wood is editor of the Kirkland Reporter, a sister paper of The Mirror. Send comments to editor@federalwaymirror.com