EUGENE, Ore. - Ted Pomerantz still hasn't pictured what he calls "the last
scene."
As a pretty decent golfer, he knows how the mind is real and powerful and it
motivates the muscles and reflexes to send the little white ball where his
eye wants it to go.
On the green, he positions his feet just so, tightens his fingers around his
club handle and imagines the sweetest, cleanest swing.
But the 82-year-old Oregon man is in a peculiar spot right now. He knows
he's dying and he knows he wants to leave this world in the way he lived his
life - on his own terms.
Just a few months ago, he and his wife Ann Councill were taking brisk,
hour-long walks in their quiet neighbourhood. Last year, they trekked around
China with a tour group half their age.
This morning, Pomerantz takes a few sips from a mug of tea, takes a nibble
from a half-eaten cookie and leans back gingerly on the black leather couch
in the couple's livingroom.
He's done the chemo, the radiation, the naturopathic supplements. He's come
to terms with the fact that he's dying and the "Las Vegas odds are not too
great."
Since he was diagnosed with inoperable pancreatic cancer in March, the
retired engineer and brokerage firm manager has struggled with a sharp left
turn in whatıs been a happy and charmed life.
"My options are not bountiful at this point," says Pomerantz of his
prognosis that has left him with a few months left to live.
But at a nearby drug store, one option is ready. With one phone call, a
pharmacist will prepare the prescription and Pomerantz can pick it up
whenever it suits him.
It's a powder to make six ounces of a desperately bitter liquid. If
Pomerantz chooses to take it, it would be the last drink of his life,
killing him within minutes.
Like others with a terminal illness, Pomerantz has lost his appetite and
craves sleep. His clothes hang off his tall, gaunt frame.
But he's now a member of an exclusive, if ambivalent, club. Pomerantz can
choose when he will die and the state will help him end his life.
If he decides to take the lethal medication, he will become one of nearly
300 Oregon residents since 1997 who have used the Death With Dignity Act to
hasten their death.
He could swallow the drink or ingest hundreds of capsules and then curl up
with Ann in their bed and take his last breaths in her arms.
But today, he hasn't decided when - or even if - he will take the overdose
that would kill him.
"We're not there yet," he says with a slight smile as his wife looks on from
a nearby loveseat.
"It gives me a choice or an option," Pomerantz says. "I may never use it. I
may never have the courage to use it ... itıs good for me to know that this
is available to me."
***
For the last nine years, a terminally ill person in Oregon with a prognosis
of six months or less to live can obtain a lethal prescription of
barbituates from a doctor. The person must be competent, with no psychiatric
or mental health problems, and capable of taking the medication by him or
herself.
Last year, 35 people died after taking the prescription. Since the Death
with Dignity Act was passed in 1997, 292 people have ended their lives with
lethal medications through the law.
In terms of statistics, the three dozen people make up only 0.1 of 1% of all
Oregon deaths in a given year.
For the woman who helped turn a 1994 citizen's petition into law, the
aid-in-dying law revolutionized how nearly four million Oregonians talk
about dying.
"Even if not one patient in Oregon ever took medication to cause their
death, it would still have an enormous beneficial impact on end-of-life
care," says Barbara Coombs-Lee, president of Compassion and Choices, the
national nonprofit organization that lobbies for choice in end-of-life care.
The law gives terminally ill people the freedom to talk to their doctors,
their family and their friends about how they want to die, says Coombs-Lee.
Speaking at the September 2006 conference of the World Federation of Right
to Die Societies in Toronto, Coombs-Lee described the lethal prescription as
a symbol of how the dying take control of their last days.
"It is in their bedside table, it's under their pillow. It's their safety
blanket, it's their parachute, it's their insurance policy. They close,
they know it will be there when then need it but they don't need to take
it," Coombs-Lee told the conference.
During the last nine years, 40% of those who have waded through the law's
red tape never ended up taking the lethal drugs to end their own lives.
In his family health clinic in Portland's southeast district, Dr. Nicholas
Gideonse sprints up the stairs to his second-floor office. Like other Oregon
physicians, the medical director at the Richmond clinic of the Oregon Health
and Science University delivers babies, treats infections and counsels dying
patients about having a hastened death.
Since 1997, Gideonse has written nine lethal prescriptions for patients.
Seven of his patients ended up taking the drugs to end their lives and
another six patients are now at various stages of the consulting process
with Gideonse.
Before he voted in the citizens' initiative in 1994, Gideonse worried about
the proposed lawıs slippery slope how the poor, the socially isolated and
the disabled might use the law to end their lives.
But talking to cancer patients and other physicians helped him work out his
views.
"When they were having their worst days on chemotherapy, there was nothing
left but their worst days. Just knowing the option was really available
would be tremendously relieving," says Gideonse.
Before the law, terminally ill Oregonians would speak in whispered code
about what Gideonse calls "that deepest personal need."
"I'm just very grateful to be freed from that kind of need of thinking of
going out of the country or making an illegal request or a misunderstood nod
and a wink," he says.
Now, patients have what Gideonse calls "the Conversation" - talking out in
the open about getting the lethal prescription. Pomerantz recalls how his
first meeting with his consulting physician went "beautifully."
"She took us through all the hoops, right down to the 'You know what happens
when you take this stuff? You get dead-ed,'" recalls Pomerantz.
Most patients who take the first steps to get aid-in-dying want to stay in
control during their last weeks, says Gideonse. They also worry about
unbearable pain and getting lost in an overmedicated fog, he adds.
No doctor in Oregon is obliged to approve an aid-in-dying request but
Gideonse says some patients get a "sense of abandonment" when a doctor wonıt
talk about it or refer them to another doctor.
However, some Oregon physicians feel the law - which survived several court
challenges from 1994 to 2006 with a U.S. Supreme Court ruling - has done
serious damage to the doctor-patient relationship.
"People at the end of life are vulnerable and the law just takes away this
sort of protection where we used to protect people," says Dr. Charles J.
Bentz, the president of Physicians for Compassionate Care, an association of
physicians formed in 1994 to fight the Oregon law.
Bentz adds that "patients that used to be helped are now just being killed."
EDITOR'S NOTE
Ted Pomerantz, 82, died Oct. 14, 2007, less than a month after sharing his
story with Sun Media. In early October, as his health deteriorated,
Pomerantz decided he did not want to die suddenly and chose not to take a
lethal overdose of barbituates, available to him through Oregon's Death With
Dignity Act. Shortly after he took his last breaths in the early hours of a
still-dark Sunday morning, Ann Councill, Pomerantz's wife, wrote these
reflections.
"He made it easy for me and all of us, truly. I was stroking his brow and
reminiscing about our Perry County solar home and our wonderful camping
trips in our funky little trailer. He was smiling. The breathing stopped. A
mensch all ways, always."
