Constable: Activists seek 'medical aid in dying' law for Illinois
By Burt Constable
The weekend sun has melted the snow and is encouraging the green grass. Fish are swimming lazily around the large backyard koi pond at his Elgin home. And Ralph McFadden looks good and feels good.
None of which is ideal for a serious column about the suburban Compassion & Choices group he's working with to pass a "medical aid in dying" law in Illinois.
"For your interview, I really ought to be dying," McFadden, 87, says. "But I guess I will hold off on that for a while."
McFadden, a former pastor and hospice chaplain, says he's pretty sure there will come a day when his multiple myeloma, a rare blood cancer that manifests in the bones and killed his father, will cause such distress and pain that he'll want to end his life. He's seen dozens of people die in agony during his career.
"Hospice was a huge point of my learning curve," says McFadden, who got his chaplaincy training at Rush Medical Center in Chicago and worked as a hospice chaplain in Colorado and in the Northwest suburbs. "It was not unusual for me to see an old man sitting in a wheelchair, unable to talk, wearing a diaper, needing someone to feed him. I didn't want that."
He remembers a patient at a hospice in Denver, who was angry at God "because she couldn't die."
"It made me think: 'How do I want to die?'"
Nine states and the District of Columbia have Death With Dignity statutes modeled after the original enacted in Oregon in 1997. It's not euthanasia, which remains illegal in every state; the Compassion & Choices legislation would require patients to administer the fatal dose themselves without help from a doctor or loved one. Those patients would have to be terminally ill, older than 18, in sound mind, and likely to die within six months. The patients would need written approval from two doctors and a lethal dose of medication prescribed by a physician for that purpose.
Citing the "sanctity of human life," Catholic hospitals and most organized religions oppose medical aid in dying. Even in states where it is legal, doctors and institutions with an ethical objection can refuse to take part. During 2019 in Oregon, 290 people received prescriptions for lethal doses of medications and 188 died from taking those drugs. Since the law passed in 1997, 2,518 people have received prescriptions and 1,657 people died from ingesting the medications.
In 2019, the American Medical Association voted to uphold the existing guidance in the Code of Medical Ethics when it came to medical aid in dying, which recognized "differences in moral perspective between thoughtful, morally admirable individuals who oppose physician-assisted suicide and equally thoughtful and morally admirable individuals who support it," said Dr., Barbara A. McAneny, immediate past president of the group. "How each individual understands and acts on physicians' common goals of relieving suffering, respecting autonomy, and maintaining dignity at the end of life is directed by their individual deeply held beliefs."
A Gallup poll in 2018 found that 72% of Americans agree that doctors "should be allowed by law to end the patient's life by some painless means if the patient and his or her family request it." That idea spanned political divides by winning support from 62% of Republicans, 80% of Democrats and 73% of Independents, as well as from 69% of regular churchgoers.
"I understand and I'm OK with it," Dr. Stan Nabrinsky, McFadden's hematologist-oncologist, says as he monitors McFadden's intravenous immunoglobulin treatment to boost his immune system at Illinois Cancer Specialists in Elgin.
"The patient has a right to say, 'I've fought enough. Let it go,'" Nabrinsky says.
Many health care professionals say giving people the option to take their own lives is the right thing to do.
"One of the terrible things about working in the emergency room is that you had to save their life even if they were begging you not to," says Molly Miceli, 69, a Compassion & Choices leader from Elgin. A certified nursing assistant at 16, Miceli went on to work as a registered nurse in emergency rooms and intensive care units at hospitals in Arlington Heights, Elk Grove Village and Hoffman Estates before launching a company that provided private-duty care, mostly to seniors, to let them stay home instead of moving to a facility.
She discovered Compassion & Choices after she sold her company and was looking to volunteer for a good cause. "This is exactly what I believe in," Miceli says. The group is showing the award-winning documentary "How to Die in Oregon" and hosting discussions on the topic at several suburban libraries.
Nineteen more states are considering such a law this year, according to the Death With Dignity organization. "And Illinois is not one of them," says McFadden, a former executive with the Church of the Brethren who has written several books, include "Dignity: In Living & In Dying."
Married for 38 years to his wife, Barbara, with whom he has two children, McFadden has spent the last 20 years as a gay man with his partner, Keo Xayavongvane.
"I especially learned something about dignity, integrity, openness, compassion, reconciliation and justice when I decided to come out as a gay man to my family, friends and to the church," McFadden writes in his book about dignity. His wife has died, but their son Joel and his wife, Laura, and their daughter Jill and her partner, Anne, support McFadden's wishes, as does Xayavongvane, McFadden says.
While he says he "wants to be around" now for his family, partner, friends at Highland Avenue Church of the Brethren, and granddaughter, Emma, he expects to reach a point when he doesn't. Some nursing facilities allow patients to refuse food and water. "I don't know how painful that is," says McFadden, who hopes to be in Illinois when he decides to end his life. "I have to take the pill and I have to be conscious enough to do that."
He's certainly in no hurry to get there, but when the time comes McFadden says he's made up his mind.
"I'm 87. I've had an excellent life," says McFadden. "I think I may leave the party early."