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She specializes in covering altered states of mind, from postpartum depression to methamphetamine-induced psychosis to the insanity defense. Her investigative series on insurance companies sidestepping mental health laws won multiple awards, including first place in beat reporting from the national Association of Health Care Journalists. She is the recipient of numerous other prizes and fellowships, including a national Edward R. 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She is a classically trained violinist and proud alum of the first symphony orchestra at Burning Man.","avatar":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twitter":"adembosky","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"news","roles":["editor"]},{"site":"futureofyou","roles":["author"]},{"site":"stateofhealth","roles":["editor"]},{"site":"science","roles":["editor"]},{"site":"forum","roles":["editor"]}],"headData":{"title":"April Dembosky | KQED","description":"KQED Health Correspondent","ogImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/adembosky"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"stateofhealth_361907":{"type":"posts","id":"stateofhealth_361907","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"361907","score":null,"sort":[1510218031000]},"guestAuthors":[],"slug":"what-vets-want-at-the-end-of-life-is-very-different-from-what-civilians-want","title":"What Vets Want at the End of Life Is Very Different From What Civilians Want","publishDate":1510218031,"format":"audio","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>A lot of Ron Fleming’s fellow soldiers spent the last five decades trying to forget what they saw and did in Vietnam. Now 74, Fleming has spent most of that time trying to hold on to it. He has never been as proud as he was when he was 21.\u003c/p>\n\u003cp>“I take issue with those who say we lost. We didn’t lose that war,” he said, sitting on the edge of his hospital bed at the \u003ca href=\"https://www.sanfrancisco.va.gov/\" target=\"_blank\" rel=\"noopener\">San Francisco VA medical center\u003c/a>. “Everywhere I went, we literally kicked the crap out of them.”\u003c/p>\n\u003cp>Fleming was a door gunner in the war, hanging out of a helicopter on a strap with a machine gun in his hands. He fought in the Tet Offensive, sometimes 40 hours straight, firing 6,000 rounds a minute. But he never gave much thought to catching one himself.\u003c/p>\n\u003cp>“You see, at 21, you’re bulletproof,” he said. “Dying wasn’t on the agenda.”\u003c/p>\n\u003cp>But now, it is. Fleming has congestive heart failure, arthritis and breathing problems. He often lands in the VA hospital with asthma attacks, and the palliative care team visits him regularly. He thinks about death.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I wish it’d get off its ass and come on me. I’m sick of this crap,” he said, as his heart rate monitor ticked up. “You see, dying’s the easy part. Living is what’s hard.”\u003c/p>\n\u003cp>Fleming has had trouble holding down a job since he got back from the war. He had a girl he lived with for 10 years, but they never married, never had kids. He lives alone in Oakland now. He says he angers easily and is always hypervigilant. About 10 years ago, he was diagnosed with PTSD. More than anything, he says, he suffers from a \"rotten outlook\" on life.\u003c/p>\n\u003cp>“Sometimes I think that now I’m being paid back for all the men I killed,” he said. “I killed a lot of them. More than I can count.”\u003c/p>\n\u003cp>Unlike Fleming, some Vietnam vets don’t find out they have PTSD until they have just months or weeks left to live. Symptoms of terminal illnesses, like pain or breathlessness, can trigger flashbacks, making vets feel as threatened as they did on the battlefield.\u003c/p>\n\u003cp>“The war memories start coming back, they start having nightmares,” said \u003ca href=\"https://profiles.stanford.edu/vj-periyakoil\" target=\"_blank\" rel=\"noopener\">VJ Periyakoil\u003c/a>, a palliative care physician at the VA in Palo Alto. She says opioid medications, like morphine and oxycodone, that are often used for treating pain and breathlessness can make PTSD symptoms worse.\u003c/p>\n\u003cp>“The side effect of those medications, they make you fuzzyheaded,” she said. “Your defenses that you use to cope with the PTSD, which might help repress a lot of the difficult memories, that coping strategy starts to come apart.”\u003c/p>\n\u003cp>She has had patients tell her: “I would much rather tolerate the physical pain, the cancer pain, than take opioids and my defenses crumble.”\u003c/p>\n\u003cp>Some vets see their pain or PTSD as retribution for their work in the line of duty.\u003c/p>\n\u003cp>“Sometimes I’ve had patients refuse medications that might ease their experiences because they feel that they deserve to suffer,” Periyakoil said. “This is redemptive.”\u003c/p>\n\u003cp>The best thing to do in these situations can be to stand down, she said. With weeks left to live, there isn’t enough time to resolve the mental anguish, and staff have to let patients set the pace and tone for their care.\u003c/p>\n\u003cp>But doctors and nurses, just like soldiers, hate doing nothing.\u003c/p>\n\u003cp>“We talk about the moral distress that \u003cem>we \u003c/em>have sometimes about really knowing that we’re doing the right thing for this individual, so that we can be present for \u003cem>their \u003c/em>suffering, the way \u003cem>they\u003c/em> need to do it,” said Patrice Villars, a hospice nurse at the San Francisco VA.\u003c/p>\n\u003cp>For Ron Fleming, death is still likely a couple of years out. His doctors have been begging him, gently, to consider mental health counseling or antidepressants. But he has refused.\u003c/p>\n\u003cp>“I don’t want to take psychiatric drugs. The vets call them the happy pills,” he said. “I don’t want any of those, because they change you. I don’t want to change.”\u003c/p>\n\u003cp>He’s not sure if he deserves to be happy.\u003c/p>\n\u003cp>“That I don’t know,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>His pain is what connects him to the past. Fleming was awarded 18 air medals for acts of meritorious achievement and heroism. The loss and grief he experienced in Vietnam are woven into the same memories of victory and glory. He doesn’t want treatment that might make that go away.\u003c/p>\n\n","blocks":[],"excerpt":"Honor and respect can be much more important for dying vets than being comfortable or free of pain.","status":"publish","parent":0,"modified":1510279371,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":817},"headData":{"title":"What Vets Want at the End of Life Is Very Different From What Civilians Want | KQED","description":"Honor and respect can be much more important for dying vets than being comfortable or free of pain.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"What Vets Want at the End of Life Is Very Different From What Civilians Want","datePublished":"2017-11-09T09:00:31.000Z","dateModified":"2017-11-10T02:02:51.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"361907 https://ww2.kqed.org/stateofhealth/?p=361907","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/11/09/what-vets-want-at-the-end-of-life-is-very-different-from-what-civilians-want/","disqusTitle":"What Vets Want at the End of Life Is Very Different From What Civilians Want","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/2017/11/DemboskyVetsEndofLife.mp3","path":"/stateofhealth/361907/what-vets-want-at-the-end-of-life-is-very-different-from-what-civilians-want","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>A lot of Ron Fleming’s fellow soldiers spent the last five decades trying to forget what they saw and did in Vietnam. Now 74, Fleming has spent most of that time trying to hold on to it. He has never been as proud as he was when he was 21.\u003c/p>\n\u003cp>“I take issue with those who say we lost. We didn’t lose that war,” he said, sitting on the edge of his hospital bed at the \u003ca href=\"https://www.sanfrancisco.va.gov/\" target=\"_blank\" rel=\"noopener\">San Francisco VA medical center\u003c/a>. “Everywhere I went, we literally kicked the crap out of them.”\u003c/p>\n\u003cp>Fleming was a door gunner in the war, hanging out of a helicopter on a strap with a machine gun in his hands. He fought in the Tet Offensive, sometimes 40 hours straight, firing 6,000 rounds a minute. But he never gave much thought to catching one himself.\u003c/p>\n\u003cp>“You see, at 21, you’re bulletproof,” he said. “Dying wasn’t on the agenda.”\u003c/p>\n\u003cp>But now, it is. Fleming has congestive heart failure, arthritis and breathing problems. He often lands in the VA hospital with asthma attacks, and the palliative care team visits him regularly. He thinks about death.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I wish it’d get off its ass and come on me. I’m sick of this crap,” he said, as his heart rate monitor ticked up. “You see, dying’s the easy part. Living is what’s hard.”\u003c/p>\n\u003cp>Fleming has had trouble holding down a job since he got back from the war. He had a girl he lived with for 10 years, but they never married, never had kids. He lives alone in Oakland now. He says he angers easily and is always hypervigilant. About 10 years ago, he was diagnosed with PTSD. More than anything, he says, he suffers from a \"rotten outlook\" on life.\u003c/p>\n\u003cp>“Sometimes I think that now I’m being paid back for all the men I killed,” he said. “I killed a lot of them. More than I can count.”\u003c/p>\n\u003cp>Unlike Fleming, some Vietnam vets don’t find out they have PTSD until they have just months or weeks left to live. Symptoms of terminal illnesses, like pain or breathlessness, can trigger flashbacks, making vets feel as threatened as they did on the battlefield.\u003c/p>\n\u003cp>“The war memories start coming back, they start having nightmares,” said \u003ca href=\"https://profiles.stanford.edu/vj-periyakoil\" target=\"_blank\" rel=\"noopener\">VJ Periyakoil\u003c/a>, a palliative care physician at the VA in Palo Alto. She says opioid medications, like morphine and oxycodone, that are often used for treating pain and breathlessness can make PTSD symptoms worse.\u003c/p>\n\u003cp>“The side effect of those medications, they make you fuzzyheaded,” she said. “Your defenses that you use to cope with the PTSD, which might help repress a lot of the difficult memories, that coping strategy starts to come apart.”\u003c/p>\n\u003cp>She has had patients tell her: “I would much rather tolerate the physical pain, the cancer pain, than take opioids and my defenses crumble.”\u003c/p>\n\u003cp>Some vets see their pain or PTSD as retribution for their work in the line of duty.\u003c/p>\n\u003cp>“Sometimes I’ve had patients refuse medications that might ease their experiences because they feel that they deserve to suffer,” Periyakoil said. “This is redemptive.”\u003c/p>\n\u003cp>The best thing to do in these situations can be to stand down, she said. With weeks left to live, there isn’t enough time to resolve the mental anguish, and staff have to let patients set the pace and tone for their care.\u003c/p>\n\u003cp>But doctors and nurses, just like soldiers, hate doing nothing.\u003c/p>\n\u003cp>“We talk about the moral distress that \u003cem>we \u003c/em>have sometimes about really knowing that we’re doing the right thing for this individual, so that we can be present for \u003cem>their \u003c/em>suffering, the way \u003cem>they\u003c/em> need to do it,” said Patrice Villars, a hospice nurse at the San Francisco VA.\u003c/p>\n\u003cp>For Ron Fleming, death is still likely a couple of years out. His doctors have been begging him, gently, to consider mental health counseling or antidepressants. But he has refused.\u003c/p>\n\u003cp>“I don’t want to take psychiatric drugs. The vets call them the happy pills,” he said. “I don’t want any of those, because they change you. I don’t want to change.”\u003c/p>\n\u003cp>He’s not sure if he deserves to be happy.\u003c/p>\n\u003cp>“That I don’t know,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>His pain is what connects him to the past. Fleming was awarded 18 air medals for acts of meritorious achievement and heroism. The loss and grief he experienced in Vietnam are woven into the same memories of victory and glory. He doesn’t want treatment that might make that go away.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/361907/what-vets-want-at-the-end-of-life-is-very-different-from-what-civilians-want","authors":["3205"],"categories":["stateofhealth_3012","stateofhealth_1"],"tags":["stateofhealth_2847","stateofhealth_2808","stateofhealth_3023","stateofhealth_2519","stateofhealth_2656","stateofhealth_3194","stateofhealth_136","stateofhealth_3193"],"featImg":"stateofhealth_361951","label":"stateofhealth"},"stateofhealth_339498":{"type":"posts","id":"stateofhealth_339498","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"339498","score":null,"sort":[1496869257000]},"guestAuthors":[],"slug":"physician-assisted-suicide-has-been-legal-in-california-for-a-year-hows-it-going","title":"Physician-Assisted Suicide Has Been Legal in California for a Year. How's it Going?","publishDate":1496869257,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>John Minor, a retired psychologist, epitomized the active Californian. A resident of Manhattan Beach, Minor ran long distances, bicycled, and hiked.\u003c/p>\n\u003cp>“He and my mom were both members of the Sierra Club,” said Jackie Minor of San Mateo, one of his daughters. \"They went on tons of backpacking trips, you know -- climbing mountains and trekking through the desert. He was just a very active person.”\u003c/p>\n\u003cp>But in the fall of 2014, Minor became ill with pulmonary fibrosis, a lung disease, and it was terminal. His family members said the disease slowly but surely eroded his quality of life. He became increasingly confined to his home, wracked by pain and violent fits of coughing, and suffered frightening episodes of choking and suffocation.\u003c/p>\n\u003cp>So two years after the diagnosis, on Sept. 15, 2016, John Minor sipped his last drink: apple juice laced with a lethal dose of medication his doctor had prescribed for him. He died surrounded by family members, at the age of 80.\u003c/p>\n\u003cp>“He laid down and went to sleep, and he was in a coma for about two hours and then he passed,” Jackie said. “It was very peaceful.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>California’s \u003ca href=\"http://coalitionccc.org/tools-resources/end-of-life-option-act/\" target=\"_blank\" rel=\"noopener noreferrer\">End of Life Option Act\u003c/a> went into effect on June 9, 2016. The law created a process for dying patients to ask their doctors for a lethal prescription that the patients can then ingest privately, at home.\u003c/p>\n\u003cp>Since then, at least 500 Californians have received life-ending prescriptions, according to newly released data collected by \u003ca href=\"https://www.compassionandchoices.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Compassion and Choices\u003c/a>, an advocacy group that promotes aid-in-dying laws nationwide.\u003c/p>\n\u003cp>The organization also estimated that about 500 health systems and 100 hospice organizations now participate in the California law.\u003c/p>\n\u003cp>In addition, 80 percent of insurance companies in the state are paying claims involved in the process, such as doctor visits and the prescription itself.\u003c/p>\n\u003cp>“What the numbers are showing is that the law is working incredibly well,” said Matt Whitaker, the organization's director for California and Oregon. “It’s working as the lawmakers intended.”\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>But finding a doctor willing to prescribe the life-ending drugs isn’t always easy, in part because the state law allows doctors to opt out of prescribing -- even when the hospital where they work participates in the law.\u003c/p>\n\u003cp>The decision to prescribe does not come easily for many physicians.\u003c/p>\n\u003cp>“Even if they’re in support of aid-in-dying, they don’t necessarily want to be the person identified as the 'go-to' person for aid-in-dying. Because that’s a very different implication,” said Dr. Elizabeth Dzeng, an assistant professor of hospital medicine at the University of California, San Francisco.\u003c/p>\n\u003cp>About three dozen UCSF patients have requested such assistance since last June.\u003c/p>\n\u003cp>“There is a certain stigma for being known as a physician who writes these prescriptions,\" agreed Dr. Stephanie Harman, medical director of \u003ca href=\"https://stanfordhealthcare.org/medical-clinics/palliative-care.html\" target=\"_blank\" rel=\"noopener noreferrer\">palliative care services\u003c/a> at Stanford Health Care.\u003c/p>\n\u003cp>Harman decided to \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2628972\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> how the law was playing out in the Stanford system. She tracked 13 Stanford patients who received prescriptions for lethal drugs, and learned that half of them initially couldn’t get the drugs from their own doctor.\u003c/p>\n\u003cp>\"There is in the field, in medicine, a question of whether this is an ethical act for a physician,” she explained.\u003c/p>\n\u003cp>Other hospitals and health systems statewide are also trying to get a sense of what their terminal patients are experiencing. At the University of California, Los Angeles, about 20 patients have received prescriptions since the law went into effect — but only about half of them have gone on to take the meds, said Dr. Neil Wenger, a professor of medicine at UCLA and director of the \u003ca href=\"https://www.uclahealth.org/ethics-center/\" target=\"_blank\" rel=\"noopener noreferrer\">UCLA Health Ethics Center\u003c/a>.\u003c/p>\n\u003cp>Wenger helped develop a protocol for UCLA doctors, to guide them through the requirements of administering the medication to qualified terminally ill patients.\u003c/p>\n\u003cp>Among those he’s spoken with, there is a “whole range of preferences” regarding how and whether to participate in the law.\u003c/p>\n\u003cp>A “relatively small number” oppose the law outright, he said. Many others, however, believe patients should have access to aid-in-dying assistance, but don’t want to be involved in prescribing themselves, since it involves legal requirements, paperwork and conversations that can often be difficult.\u003c/p>\n\u003cp>“It raises a lot of feelings on the part of the doctor. It is something very, very different than what a doctor does -- which is saving people,\" Wenger explained. \"And it’s complicated. It takes a whole lot of time.”\u003c/p>\n\u003cp>Dr. Catherine S. Forest is one doctor who has committed herself to taking that time, and assisting patients who want the prescription.\u003c/p>\n\u003cp>Forest practices family medicine in the Stanford health system. Since the law passed, she’s assisted five patients who came to her practice after their own doctors refused.\u003c/p>\n\u003cp>Forest says what’s happening now in California is reminiscent of what happened in the 1970s, when abortion became legal. Even among doctors who agreed with the \u003cem>Roe v. Wade \u003c/em>decision, there was a reluctance to perform abortions.\u003c/p>\n\u003cp>“It takes awhile for people to train, to feel comfortable and to provide, and that was because it was not legal, and then it \u003cem>was\u003c/em> legal. And there are very few instances where we do that in medicine,” Forest says.\u003c/p>\n\u003cp>Aid-in-dying, she says, is one of those challenging moments for doctors. She expects it will take time for California to catch up with other states, like Oregon, that have well-established training resources to help doctors learn the process.\u003c/p>\n\u003cp>John Minor wasn't able to get a prescription at first. His doctors would not write the necessary prescription, so his family started scrambling.\u003c/p>\n\u003cp>“I started cold-calling just different hospitals and different departments within different hospitals,” Jackie said.\u003c/p>\n\u003cp>Ultimately, the family took the step of enrolling her father in a Kaiser Permanente insurance plan, and he received the prescription that he took last fall.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Mentally, he was ready,” said his widow, Sherry Minor. “It was an easy day for him.”\u003c/p>\n\n","blocks":[],"excerpt":"Hundreds of patients have requested the medication over the past year, but some report it took awhile to find a doctor to help. ","status":"publish","parent":0,"modified":1496812360,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":33,"wordCount":1057},"headData":{"title":"Physician-Assisted Suicide Has Been Legal in California for a Year. How's it Going? | KQED","description":"Hundreds of patients have requested the medication over the past year, but some report it took awhile to find a doctor to help. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Physician-Assisted Suicide Has Been Legal in California for a Year. How's it Going?","datePublished":"2017-06-07T21:00:57.000Z","dateModified":"2017-06-07T05:12:40.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"339498 https://ww2.kqed.org/stateofhealth/?p=339498","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/06/07/physician-assisted-suicide-has-been-legal-in-california-for-a-year-hows-it-going/","disqusTitle":"Physician-Assisted Suicide Has Been Legal in California for a Year. How's it Going?","nprByline":"Stephanie O'Neill","path":"/stateofhealth/339498/physician-assisted-suicide-has-been-legal-in-california-for-a-year-hows-it-going","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>John Minor, a retired psychologist, epitomized the active Californian. A resident of Manhattan Beach, Minor ran long distances, bicycled, and hiked.\u003c/p>\n\u003cp>“He and my mom were both members of the Sierra Club,” said Jackie Minor of San Mateo, one of his daughters. \"They went on tons of backpacking trips, you know -- climbing mountains and trekking through the desert. He was just a very active person.”\u003c/p>\n\u003cp>But in the fall of 2014, Minor became ill with pulmonary fibrosis, a lung disease, and it was terminal. His family members said the disease slowly but surely eroded his quality of life. He became increasingly confined to his home, wracked by pain and violent fits of coughing, and suffered frightening episodes of choking and suffocation.\u003c/p>\n\u003cp>So two years after the diagnosis, on Sept. 15, 2016, John Minor sipped his last drink: apple juice laced with a lethal dose of medication his doctor had prescribed for him. He died surrounded by family members, at the age of 80.\u003c/p>\n\u003cp>“He laid down and went to sleep, and he was in a coma for about two hours and then he passed,” Jackie said. “It was very peaceful.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>California’s \u003ca href=\"http://coalitionccc.org/tools-resources/end-of-life-option-act/\" target=\"_blank\" rel=\"noopener noreferrer\">End of Life Option Act\u003c/a> went into effect on June 9, 2016. The law created a process for dying patients to ask their doctors for a lethal prescription that the patients can then ingest privately, at home.\u003c/p>\n\u003cp>Since then, at least 500 Californians have received life-ending prescriptions, according to newly released data collected by \u003ca href=\"https://www.compassionandchoices.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Compassion and Choices\u003c/a>, an advocacy group that promotes aid-in-dying laws nationwide.\u003c/p>\n\u003cp>The organization also estimated that about 500 health systems and 100 hospice organizations now participate in the California law.\u003c/p>\n\u003cp>In addition, 80 percent of insurance companies in the state are paying claims involved in the process, such as doctor visits and the prescription itself.\u003c/p>\n\u003cp>“What the numbers are showing is that the law is working incredibly well,” said Matt Whitaker, the organization's director for California and Oregon. “It’s working as the lawmakers intended.”\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>But finding a doctor willing to prescribe the life-ending drugs isn’t always easy, in part because the state law allows doctors to opt out of prescribing -- even when the hospital where they work participates in the law.\u003c/p>\n\u003cp>The decision to prescribe does not come easily for many physicians.\u003c/p>\n\u003cp>“Even if they’re in support of aid-in-dying, they don’t necessarily want to be the person identified as the 'go-to' person for aid-in-dying. Because that’s a very different implication,” said Dr. Elizabeth Dzeng, an assistant professor of hospital medicine at the University of California, San Francisco.\u003c/p>\n\u003cp>About three dozen UCSF patients have requested such assistance since last June.\u003c/p>\n\u003cp>“There is a certain stigma for being known as a physician who writes these prescriptions,\" agreed Dr. Stephanie Harman, medical director of \u003ca href=\"https://stanfordhealthcare.org/medical-clinics/palliative-care.html\" target=\"_blank\" rel=\"noopener noreferrer\">palliative care services\u003c/a> at Stanford Health Care.\u003c/p>\n\u003cp>Harman decided to \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2628972\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> how the law was playing out in the Stanford system. She tracked 13 Stanford patients who received prescriptions for lethal drugs, and learned that half of them initially couldn’t get the drugs from their own doctor.\u003c/p>\n\u003cp>\"There is in the field, in medicine, a question of whether this is an ethical act for a physician,” she explained.\u003c/p>\n\u003cp>Other hospitals and health systems statewide are also trying to get a sense of what their terminal patients are experiencing. At the University of California, Los Angeles, about 20 patients have received prescriptions since the law went into effect — but only about half of them have gone on to take the meds, said Dr. Neil Wenger, a professor of medicine at UCLA and director of the \u003ca href=\"https://www.uclahealth.org/ethics-center/\" target=\"_blank\" rel=\"noopener noreferrer\">UCLA Health Ethics Center\u003c/a>.\u003c/p>\n\u003cp>Wenger helped develop a protocol for UCLA doctors, to guide them through the requirements of administering the medication to qualified terminally ill patients.\u003c/p>\n\u003cp>Among those he’s spoken with, there is a “whole range of preferences” regarding how and whether to participate in the law.\u003c/p>\n\u003cp>A “relatively small number” oppose the law outright, he said. Many others, however, believe patients should have access to aid-in-dying assistance, but don’t want to be involved in prescribing themselves, since it involves legal requirements, paperwork and conversations that can often be difficult.\u003c/p>\n\u003cp>“It raises a lot of feelings on the part of the doctor. It is something very, very different than what a doctor does -- which is saving people,\" Wenger explained. \"And it’s complicated. It takes a whole lot of time.”\u003c/p>\n\u003cp>Dr. Catherine S. Forest is one doctor who has committed herself to taking that time, and assisting patients who want the prescription.\u003c/p>\n\u003cp>Forest practices family medicine in the Stanford health system. Since the law passed, she’s assisted five patients who came to her practice after their own doctors refused.\u003c/p>\n\u003cp>Forest says what’s happening now in California is reminiscent of what happened in the 1970s, when abortion became legal. Even among doctors who agreed with the \u003cem>Roe v. Wade \u003c/em>decision, there was a reluctance to perform abortions.\u003c/p>\n\u003cp>“It takes awhile for people to train, to feel comfortable and to provide, and that was because it was not legal, and then it \u003cem>was\u003c/em> legal. And there are very few instances where we do that in medicine,” Forest says.\u003c/p>\n\u003cp>Aid-in-dying, she says, is one of those challenging moments for doctors. She expects it will take time for California to catch up with other states, like Oregon, that have well-established training resources to help doctors learn the process.\u003c/p>\n\u003cp>John Minor wasn't able to get a prescription at first. His doctors would not write the necessary prescription, so his family started scrambling.\u003c/p>\n\u003cp>“I started cold-calling just different hospitals and different departments within different hospitals,” Jackie said.\u003c/p>\n\u003cp>Ultimately, the family took the step of enrolling her father in a Kaiser Permanente insurance plan, and he received the prescription that he took last fall.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Mentally, he was ready,” said his widow, Sherry Minor. “It was an easy day for him.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/339498/physician-assisted-suicide-has-been-legal-in-california-for-a-year-hows-it-going","authors":["byline_stateofhealth_339498"],"categories":["stateofhealth_12","stateofhealth_13","stateofhealth_1"],"tags":["stateofhealth_914","stateofhealth_2847","stateofhealth_2808","stateofhealth_2519","stateofhealth_754"],"featImg":"stateofhealth_339516","label":"stateofhealth"},"stateofhealth_281518":{"type":"posts","id":"stateofhealth_281518","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"281518","score":null,"sort":[1483743098000]},"guestAuthors":[],"slug":"bay-area-man-confronts-and-embraces-his-right-to-die","title":"Bay Area Cancer Patient Confronts and Embraces His Right to Die","publishDate":1483743098,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003cem>Last year, California became the fifth state to allow terminally ill patients to take lethal medication to end their lives. The new law -- the \u003ca href=\"https://ww2.kqed.org/stateofhealth/2016/03/10/californias-physician-assisted-suicide-law-to-take-effect-in-june/\" target=\"_blank\">End of Life Option Act\u003c/a> -- took effect in June, 2016.\u003c/em>\u003c/p>\n\u003cp>\u003cem>Piedmont resident \u003cstrong>Ray Perman\u003c/strong> always knew this is the way he wanted to go. He’s 64, a retired pilot, like his father, and an entrepreneur. He’s dying of cancer. I interviewed him about his decision. The following words, culled from that interview, are his.\u003c/em>\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/301315866\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>My pelvis is fully populated by prostate cancer. I have a one-inch tumor in my tailbone. I have seven tumors in my ribs, like little Christmas tree lights. So about two months ago, my physician called me in and said, 'Well Ray, we've done everything we can.' I said, 'Well then I want to be on hospice. And I'd like to have you start with End of Life Options.' He looked at me and said 'I'll write the prescription.'\u003c/p>\n\u003cp>So now I have my medical aid-in-dying drugs up in my bedroom, ready to go. You're not allowed to go to the pharmacy and go pick them up. They won’t have you inadvertently leave them on the seat of the 57 bus. It has to be delivered like a loaded weapon. So the end-of-life options team came here with three people, the pharmacist with the drugs, my case manager and also another witness. They arrived here with these drugs and they went through the instructions on how to use them, and had me sign all the appropriate documents under witness, which is what they should absolutely do.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Remember that I have to take these prescriptions on my own. No one can assist me. No one can cajole or put the straw in my mouth or squeeze the drugs into my mouth. I have to take them, which means I have to have the ability to swallow. So what the hospice team is learning, they give you about a five-day window when you can do this drug and do the deed. And they’re learning, because they’ve missed a couple of times with other patients. They didn't call it early enough, and the person could no longer do the drug and they feel very badly.\u003c/p>\n\u003cfigure id=\"attachment_281642\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-281642\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/01/RayPermanPercussion-800x1002.jpg\" alt=\"Ray Perman is a percussionist, avid traveler and self-described “manic volunteer.” Here he plays the Cuban bell during a trip to Havana last March, where he played with six bands.\" width=\"800\" height=\"1002\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-160x200.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-768x962.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-240x301.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-375x470.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-520x651.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ray Perman is a percussionist, avid traveler and self-described “manic volunteer.” Here he plays the Cuban bell during a trip to Havana last March, where he played with six bands. \u003ccite>(Courtesy Ray Perman)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>They’ve giving me markers, clues as you get closer to the end. You look for changes in perception of food taste, general weakness, or the need to take a mid-morning nap, which I'm starting to do now. My stairway is a measuring device. People say, ‘Ray, should you get a hospital bed down here?’ I say, no I don't want to die in my living room. I have a beautiful bedroom with windows on three sides, I want to look at my view. So if I can't get up the stairway anymore, it means we’re darn close. And we are kind of close.\u003c/p>\n\u003cp>It will be a hard decision. People who go for the aid-in-dying option, I understand only 65 percent actually do it. Of the people who don't, some basically die of symptoms prior to using the option, some simply change their mind. You know, I'm not a hero. I may chicken out.\u003c/p>\n\u003cp>I attended my daughter's wedding in September and afterwards my oncologist said, the whole department, we figured you had 50/50 odds of attending. And I had a 70 percent chance of dying last month in December. I mean, who knows how it'll go. Some days I wake up and I can feel cancer coming. It feels like I'm not going to make it to January 15. I have meetings on January 15 -- I’ve got to make those meetings. And my wonderful in-home care provider, she’s pregnant and she's going to give birth around February 15.\u003c/p>\n\u003cp>Our goal is for me to hold the baby. It'll be great. Maybe I’ll get there.\u003c/p>\n\u003cfigure id=\"attachment_281644\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-281644\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/01/RayFlying-800x778.jpg\" alt=\"Ray Perman’s first career was as a pilot, similar to his father. He poses here with his daughter, Andrea, before a recreational flight. Andrea is now 24. His son, Eric, is 27.\" width=\"800\" height=\"778\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-160x156.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-768x747.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-240x233.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-375x365.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-520x506.jpg 520w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-50x50.jpg 50w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ray Perman’s first career was as a pilot, similar to his father. He poses here with his daughter, Andrea, before a recreational flight. Andrea is now 24. His son, Eric, is 27. \u003ccite>(Courtesy Ray Perman)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>I made sure that the newspapers don't say 'Ray lost his battle with cancer.' There’s no battle. If I were to be battling or struggling I would be preempting my ability to soak in all the wonderful things that are happening to me emotionally.\u003c/p>\n\u003cp>For me the epiphany in all of this is that I shifted from wanting to die quickly to wanting to enjoy this last phase. I think it's the explorer in me. I want to carry the torch into that last phase and say 'My gosh, look what I'm discovering. It's beautiful.' You shouldn't miss it. Don't fear death. It's wrong.\u003c/p>\n\u003cfigure id=\"attachment_281521\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-281521\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/01/KP-Racing-Team-2016-05-1-800x450.jpg\" alt=\"Ray Perman says he's maintained his "rollicking" sense of humor after being diagnosed with two types of cancer.\" width=\"800\" height=\"450\">\u003cfigcaption class=\"wp-caption-text\">Ray Perman says he's maintained his \"rollicking\" sense of humor after being diagnosed with two types of cancer. \u003ccite>(Courtesy of Ray Perman)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When the hospice team gives me the five day window, I will announce to my relatives: It's time. I'm going to make it this day, come.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>I will have my closest loved ones around me when I do that. I'll have an open house in the morning for my friends to give me a hug goodbye and then we'll probably do the deed in the afternoon. Then my family can have time with my body in the evening, as long as they’d like. And I have a complete description on where to dispose of my ashes. It'll be in the departure path of a Boeing aircraft that took off with my father, on an outgoing tide.\u003c/p>\n\n","blocks":[],"excerpt":"Piedmont resident Ray Perman tells the story of how he's approaching his last phase of life.","status":"publish","parent":0,"modified":1483754678,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":1049},"headData":{"title":"Bay Area Cancer Patient Confronts and Embraces His Right to Die | KQED","description":"Piedmont resident Ray Perman tells the story of how he's approaching his last phase of life.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Bay Area Cancer Patient Confronts and Embraces His Right to Die","datePublished":"2017-01-06T22:51:38.000Z","dateModified":"2017-01-07T02:04:38.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"281518 http://ww2.kqed.org/stateofhealth/?p=281518","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/01/06/bay-area-man-confronts-and-embraces-his-right-to-die/","disqusTitle":"Bay Area Cancer Patient Confronts and Embraces His Right to Die","path":"/stateofhealth/281518/bay-area-man-confronts-and-embraces-his-right-to-die","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Last year, California became the fifth state to allow terminally ill patients to take lethal medication to end their lives. The new law -- the \u003ca href=\"https://ww2.kqed.org/stateofhealth/2016/03/10/californias-physician-assisted-suicide-law-to-take-effect-in-june/\" target=\"_blank\">End of Life Option Act\u003c/a> -- took effect in June, 2016.\u003c/em>\u003c/p>\n\u003cp>\u003cem>Piedmont resident \u003cstrong>Ray Perman\u003c/strong> always knew this is the way he wanted to go. He’s 64, a retired pilot, like his father, and an entrepreneur. He’s dying of cancer. I interviewed him about his decision. The following words, culled from that interview, are his.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/301315866&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/301315866'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>My pelvis is fully populated by prostate cancer. I have a one-inch tumor in my tailbone. I have seven tumors in my ribs, like little Christmas tree lights. So about two months ago, my physician called me in and said, 'Well Ray, we've done everything we can.' I said, 'Well then I want to be on hospice. And I'd like to have you start with End of Life Options.' He looked at me and said 'I'll write the prescription.'\u003c/p>\n\u003cp>So now I have my medical aid-in-dying drugs up in my bedroom, ready to go. You're not allowed to go to the pharmacy and go pick them up. They won’t have you inadvertently leave them on the seat of the 57 bus. It has to be delivered like a loaded weapon. So the end-of-life options team came here with three people, the pharmacist with the drugs, my case manager and also another witness. They arrived here with these drugs and they went through the instructions on how to use them, and had me sign all the appropriate documents under witness, which is what they should absolutely do.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Remember that I have to take these prescriptions on my own. No one can assist me. No one can cajole or put the straw in my mouth or squeeze the drugs into my mouth. I have to take them, which means I have to have the ability to swallow. So what the hospice team is learning, they give you about a five-day window when you can do this drug and do the deed. And they’re learning, because they’ve missed a couple of times with other patients. They didn't call it early enough, and the person could no longer do the drug and they feel very badly.\u003c/p>\n\u003cfigure id=\"attachment_281642\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-281642\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/01/RayPermanPercussion-800x1002.jpg\" alt=\"Ray Perman is a percussionist, avid traveler and self-described “manic volunteer.” Here he plays the Cuban bell during a trip to Havana last March, where he played with six bands.\" width=\"800\" height=\"1002\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-160x200.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-768x962.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-240x301.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-375x470.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-520x651.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ray Perman is a percussionist, avid traveler and self-described “manic volunteer.” Here he plays the Cuban bell during a trip to Havana last March, where he played with six bands. \u003ccite>(Courtesy Ray Perman)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>They’ve giving me markers, clues as you get closer to the end. You look for changes in perception of food taste, general weakness, or the need to take a mid-morning nap, which I'm starting to do now. My stairway is a measuring device. People say, ‘Ray, should you get a hospital bed down here?’ I say, no I don't want to die in my living room. I have a beautiful bedroom with windows on three sides, I want to look at my view. So if I can't get up the stairway anymore, it means we’re darn close. And we are kind of close.\u003c/p>\n\u003cp>It will be a hard decision. People who go for the aid-in-dying option, I understand only 65 percent actually do it. Of the people who don't, some basically die of symptoms prior to using the option, some simply change their mind. You know, I'm not a hero. I may chicken out.\u003c/p>\n\u003cp>I attended my daughter's wedding in September and afterwards my oncologist said, the whole department, we figured you had 50/50 odds of attending. And I had a 70 percent chance of dying last month in December. I mean, who knows how it'll go. Some days I wake up and I can feel cancer coming. It feels like I'm not going to make it to January 15. I have meetings on January 15 -- I’ve got to make those meetings. And my wonderful in-home care provider, she’s pregnant and she's going to give birth around February 15.\u003c/p>\n\u003cp>Our goal is for me to hold the baby. It'll be great. Maybe I’ll get there.\u003c/p>\n\u003cfigure id=\"attachment_281644\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-281644\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/01/RayFlying-800x778.jpg\" alt=\"Ray Perman’s first career was as a pilot, similar to his father. He poses here with his daughter, Andrea, before a recreational flight. Andrea is now 24. His son, Eric, is 27.\" width=\"800\" height=\"778\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-160x156.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-768x747.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-240x233.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-375x365.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-520x506.jpg 520w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-50x50.jpg 50w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ray Perman’s first career was as a pilot, similar to his father. He poses here with his daughter, Andrea, before a recreational flight. Andrea is now 24. His son, Eric, is 27. \u003ccite>(Courtesy Ray Perman)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>I made sure that the newspapers don't say 'Ray lost his battle with cancer.' There’s no battle. If I were to be battling or struggling I would be preempting my ability to soak in all the wonderful things that are happening to me emotionally.\u003c/p>\n\u003cp>For me the epiphany in all of this is that I shifted from wanting to die quickly to wanting to enjoy this last phase. I think it's the explorer in me. I want to carry the torch into that last phase and say 'My gosh, look what I'm discovering. It's beautiful.' You shouldn't miss it. Don't fear death. It's wrong.\u003c/p>\n\u003cfigure id=\"attachment_281521\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-281521\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/01/KP-Racing-Team-2016-05-1-800x450.jpg\" alt=\"Ray Perman says he's maintained his "rollicking" sense of humor after being diagnosed with two types of cancer.\" width=\"800\" height=\"450\">\u003cfigcaption class=\"wp-caption-text\">Ray Perman says he's maintained his \"rollicking\" sense of humor after being diagnosed with two types of cancer. \u003ccite>(Courtesy of Ray Perman)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When the hospice team gives me the five day window, I will announce to my relatives: It's time. I'm going to make it this day, come.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>I will have my closest loved ones around me when I do that. I'll have an open house in the morning for my friends to give me a hug goodbye and then we'll probably do the deed in the afternoon. Then my family can have time with my body in the evening, as long as they’d like. And I have a complete description on where to dispose of my ashes. It'll be in the departure path of a Boeing aircraft that took off with my father, on an outgoing tide.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/281518/bay-area-man-confronts-and-embraces-his-right-to-die","authors":["3205"],"categories":["stateofhealth_14","stateofhealth_1"],"tags":["stateofhealth_914","stateofhealth_3024","stateofhealth_2847","stateofhealth_3022","stateofhealth_2808","stateofhealth_3023","stateofhealth_2519","stateofhealth_754"],"featImg":"stateofhealth_281571","label":"stateofhealth"},"stateofhealth_223932":{"type":"posts","id":"stateofhealth_223932","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"223932","score":null,"sort":[1470964515000]},"guestAuthors":[],"slug":"terminally-ill-california-artist-hosts-two-day-rebirth-party-before-ending-her-life-2","title":"Terminally Ill California Artist Hosts Two-Day 'Rebirth Party' Before Ending Her Life","publishDate":1470964515,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>In early July, Betsy Davis emailed her closest friends and relatives to invite them to a two-day party, telling them: \"These circumstances are unlike any party you have attended before, requiring emotional stamina, centeredness and openness.\"\u003c/p>\n\u003cp>And just one rule: No crying in front of her.\u003c/p>\n\u003cp>The 41-year-old artist with ALS, or Lou Gehrig's disease, held the gathering to say goodbye before becoming one of the first Californians to take a lethal dose of drugs under the state's new doctor-assisted suicide law for the terminally ill.\u003c/p>\n\u003cp>\"For me and everyone who was invited, it was very challenging to consider, but there was no question that we would be there for her,\" said Niels Alpert, a cinematographer from New York City.\u003c/p>\n\u003cp>\"The idea to go and spend a beautiful weekend that culminates in their suicide — that is not a normal thing, not a normal, everyday occurrence. In the background of the lovely fun, smiles and laughter that we had that weekend was the knowledge of what was coming.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Davis worked out a detailed schedule for the gathering on the weekend of July 23-24, including the precise hour she planned to slip into a coma, and shared her plans with her guests in the invitation.\u003c/p>\n\u003cp>More than 30 people came to the party at a home with a wraparound porch in the picturesque Southern California mountain town of Ojai, flying in from New York, Chicago and across California.\u003c/p>\n\u003cp>One woman brought a cello. A man played a harmonica. There were cocktails, pizza from her favorite local joint, and a screening in her room of one of her favorite movies, \"The Dance of Reality,\" based on the life of a Chilean film director.\u003c/p>\n\u003cp>As the weekend drew to a close, her friends kissed her goodbye, gathered for a photo and left, and Davis was wheeled out to a canopy bed on a hillside, where she took a combination of morphine, pentobarbital and chloral hydrate prescribed by her doctor.\u003c/p>\n\u003cp>Kelly Davis said she loved her sister's idea for the gathering, which Betsy Davis referred to as a \"rebirth.\"\u003c/p>\n\u003cp>\"Obviously it was hard for me. It's still hard for me,\" said Davis, who wrote about it for the online news outlet \u003ca href=\"http://www.voiceofsandiego.org/topics/commentary/what-i-learned-helping-my-sister-use-californias-new-law-to-end-her-life/\" target=\"_blank\">Voice of San Diego\u003c/a>. \"The worst was needing to leave the room every now and then, because I would get choked up. But people got it. They understood how much she was suffering and that she was fine with her decision. They respected that. They knew she wanted it to be a joyous occasion.\"\u003c/p>\n\u003cp>Davis ended her life a little over a month after a California law giving the option to the terminally ill went into effect. Four other states allow doctor-assisted suicide, with Oregon the first in 1997.\u003c/p>\n\u003cp>Opponents of the law in lobbying against it before state legislators argued that hastening death was morally wrong, that it puts terminally ill patients at risk for coerced death by loved ones and could become a way out for people who are uninsured or fearful of high medical bills.\u003c/p>\n\u003cp>Marilyn Golden of the Disability Rights Education & Defense Fund, said her heart goes out to anyone dealing with a terminal illness, but \"there are still millions of people in California threatened by the danger of this law.\"\u003c/p>\n\u003cp>Davis spent months planning her exit, feeling empowered after spending the last three years losing control of her body bit by bit. The painter and performance artist could no longer stand, brush her teeth or scratch an itch. Her caretakers had to translate her slurred speech for others.\u003c/p>\n\u003cp>\"Dear rebirth participants you're all very brave for sending me off on my journey,\" she wrote in her invitation. \"There are no rules. Wear what you want, speak your mind, dance, hop, chant, sing, pray, but do not cry in front of me. OK, one rule.\"\u003c/p>\n\u003cp>During the party, old friends reconnected and Davis rolled in and out of the rooms in her electric wheelchair and onto the porch, talking with her guests.\u003c/p>\n\u003cp>At one point, she invited friends to her room to try on the clothes she had picked out for them. They modeled the outfits to laughter. Guests were also invited to take a \"Betsy souvenir\" — a painting, beauty product or other memento. Her sister had placed sticky notes on the items, explaining each one's significance.\u003c/p>\n\u003cp>Wearing a Japanese kimono she bought on a bucket-list trip she took after being diagnosed in 2013, she looked out at her last sunset and took the drugs at 6:45 p.m. with her caretaker, her doctor, her massage therapist and her sister by her side. Four hours later, she died.\u003c/p>\n\u003cp>Friends said it was the final performance for the artist, who once drew pictures on a stage with whipped cream.\u003c/p>\n\u003cp>\"What Betsy did gave her the most beautiful death that any person could ever wish for,\" Alpert said. \"By taking charge, she turned her departure into a work of art.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Her guests agreed to meet again on her birthday in June to scatter her ashes.\u003c/p>\n\n","blocks":[],"excerpt":"Betsy Davis, 41, who had Lou Gehrig's disease, was able to choose the circumstances of her death because of the state's new doctor-assisted suicide law.","status":"publish","parent":0,"modified":1470964927,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":852},"headData":{"title":"Terminally Ill California Artist Hosts Two-Day 'Rebirth Party' Before Ending Her Life | KQED","description":"Betsy Davis, 41, who had Lou Gehrig's disease, was able to choose the circumstances of her death because of the state's new doctor-assisted suicide law.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Terminally Ill California Artist Hosts Two-Day 'Rebirth Party' Before Ending Her Life","datePublished":"2016-08-12T01:15:15.000Z","dateModified":"2016-08-12T01:22:07.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"223932 http://ww2.kqed.org/stateofhealth/?p=223932","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/08/11/terminally-ill-california-artist-hosts-two-day-rebirth-party-before-ending-her-life-2/","disqusTitle":"Terminally Ill California Artist Hosts Two-Day 'Rebirth Party' Before Ending Her Life","nprByline":"JULIE WATSON \u003cbr /> Associated Press","path":"/stateofhealth/223932/terminally-ill-california-artist-hosts-two-day-rebirth-party-before-ending-her-life-2","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>In early July, Betsy Davis emailed her closest friends and relatives to invite them to a two-day party, telling them: \"These circumstances are unlike any party you have attended before, requiring emotional stamina, centeredness and openness.\"\u003c/p>\n\u003cp>And just one rule: No crying in front of her.\u003c/p>\n\u003cp>The 41-year-old artist with ALS, or Lou Gehrig's disease, held the gathering to say goodbye before becoming one of the first Californians to take a lethal dose of drugs under the state's new doctor-assisted suicide law for the terminally ill.\u003c/p>\n\u003cp>\"For me and everyone who was invited, it was very challenging to consider, but there was no question that we would be there for her,\" said Niels Alpert, a cinematographer from New York City.\u003c/p>\n\u003cp>\"The idea to go and spend a beautiful weekend that culminates in their suicide — that is not a normal thing, not a normal, everyday occurrence. In the background of the lovely fun, smiles and laughter that we had that weekend was the knowledge of what was coming.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Davis worked out a detailed schedule for the gathering on the weekend of July 23-24, including the precise hour she planned to slip into a coma, and shared her plans with her guests in the invitation.\u003c/p>\n\u003cp>More than 30 people came to the party at a home with a wraparound porch in the picturesque Southern California mountain town of Ojai, flying in from New York, Chicago and across California.\u003c/p>\n\u003cp>One woman brought a cello. A man played a harmonica. There were cocktails, pizza from her favorite local joint, and a screening in her room of one of her favorite movies, \"The Dance of Reality,\" based on the life of a Chilean film director.\u003c/p>\n\u003cp>As the weekend drew to a close, her friends kissed her goodbye, gathered for a photo and left, and Davis was wheeled out to a canopy bed on a hillside, where she took a combination of morphine, pentobarbital and chloral hydrate prescribed by her doctor.\u003c/p>\n\u003cp>Kelly Davis said she loved her sister's idea for the gathering, which Betsy Davis referred to as a \"rebirth.\"\u003c/p>\n\u003cp>\"Obviously it was hard for me. It's still hard for me,\" said Davis, who wrote about it for the online news outlet \u003ca href=\"http://www.voiceofsandiego.org/topics/commentary/what-i-learned-helping-my-sister-use-californias-new-law-to-end-her-life/\" target=\"_blank\">Voice of San Diego\u003c/a>. \"The worst was needing to leave the room every now and then, because I would get choked up. But people got it. They understood how much she was suffering and that she was fine with her decision. They respected that. They knew she wanted it to be a joyous occasion.\"\u003c/p>\n\u003cp>Davis ended her life a little over a month after a California law giving the option to the terminally ill went into effect. Four other states allow doctor-assisted suicide, with Oregon the first in 1997.\u003c/p>\n\u003cp>Opponents of the law in lobbying against it before state legislators argued that hastening death was morally wrong, that it puts terminally ill patients at risk for coerced death by loved ones and could become a way out for people who are uninsured or fearful of high medical bills.\u003c/p>\n\u003cp>Marilyn Golden of the Disability Rights Education & Defense Fund, said her heart goes out to anyone dealing with a terminal illness, but \"there are still millions of people in California threatened by the danger of this law.\"\u003c/p>\n\u003cp>Davis spent months planning her exit, feeling empowered after spending the last three years losing control of her body bit by bit. The painter and performance artist could no longer stand, brush her teeth or scratch an itch. Her caretakers had to translate her slurred speech for others.\u003c/p>\n\u003cp>\"Dear rebirth participants you're all very brave for sending me off on my journey,\" she wrote in her invitation. \"There are no rules. Wear what you want, speak your mind, dance, hop, chant, sing, pray, but do not cry in front of me. OK, one rule.\"\u003c/p>\n\u003cp>During the party, old friends reconnected and Davis rolled in and out of the rooms in her electric wheelchair and onto the porch, talking with her guests.\u003c/p>\n\u003cp>At one point, she invited friends to her room to try on the clothes she had picked out for them. They modeled the outfits to laughter. Guests were also invited to take a \"Betsy souvenir\" — a painting, beauty product or other memento. Her sister had placed sticky notes on the items, explaining each one's significance.\u003c/p>\n\u003cp>Wearing a Japanese kimono she bought on a bucket-list trip she took after being diagnosed in 2013, she looked out at her last sunset and took the drugs at 6:45 p.m. with her caretaker, her doctor, her massage therapist and her sister by her side. Four hours later, she died.\u003c/p>\n\u003cp>Friends said it was the final performance for the artist, who once drew pictures on a stage with whipped cream.\u003c/p>\n\u003cp>\"What Betsy did gave her the most beautiful death that any person could ever wish for,\" Alpert said. \"By taking charge, she turned her departure into a work of art.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Her guests agreed to meet again on her birthday in June to scatter her ashes.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/223932/terminally-ill-california-artist-hosts-two-day-rebirth-party-before-ending-her-life-2","authors":["byline_stateofhealth_223932"],"categories":["stateofhealth_1"],"tags":["stateofhealth_2848","stateofhealth_2847","stateofhealth_2808","stateofhealth_2519"],"featImg":"stateofhealth_223920","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. 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Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. 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