The Human Face of Human Trafficking

chained wrists

Suppose, just for a moment, you are a 13-year-old girl who has been trafficked in America, the land of the free.

You’ve been brought to the U.S. – kidnapped, sold by your impoverished family, picked up from the streets of some land where girls have no value – and prostituted. Or more likely here, you’re a very unlucky American child victimized by traffickers. As a result of this tragic history, you are pregnant. Or, you survived God knows what only to become a 20-something victim of human trafficking – which now leaves you pregnant.

You should be forced to carry this pregnancy to term? Excuse me?

This is the human face of the human trafficking bill currently being held up in the Senate. Texas Senator John Cornyn’s “Justice for Victims of Human Trafficking” bill would “boost support for and protection of victims of human trafficking” – unless they happen to get pregnant. Once they become pregnant, that support and protection disappears. Tucked away within the multi-page piece of legislation is a stipulation that abortion could not be paid for with these funds.

It’s the old Hyde Amendment thing – the bill passed late in the 20th century that sent women’s reproductive rights straight back into the 19th century with the stipulation that never a federal dollar would be paid to help them end unwanted pregnancies.

Some young trafficking victims might still seek help, since there are now exceptions in cases of rape or incest. But the fact that the victim herself would bear the responsibility for proving the circumstances of her pregnancy is an insult added to egregious injury.

Human faces get lost in congressional rancor. Senators accuse one another of subterfuge and betrayal. Republicans accuse Democrats of one thing, Democrats accuse Republicans of another. Very little gets done. And in it all, the human faces disappear: faces of mere children who never had a break, of women of every age who deserve a life.

If they had voices, those faces might say, “Remember me?”

Russia-Ukraine Conflict in One Fast Hour

Foreign Affairs 101:

Ukraine_Majority_Language_Map_2001

Ukraine Majority Language Map

If it’s possible to condense the incomprehensibly complex Russia/Ukraine conflict into one coherent hour, Matthew Rojansky can do it. Rojansky, Director of the Kennan Institute and an expert on the region, proved that in a recent presentation at San Francisco’s Commonwealth Club. A listener who blinked could miss a paragraph, but Rojansky’s fast-paced illustrated lecture had most of his audience too engaged to blink. What follows is an abbreviated summary of the presentation.

Yanukovich estate

Yanukovych Estate

For openers, Rojansky explained that Ukraine, under now-deposed leader Viktor Yanukovych, was “a society absolutely primed for revolt. A few years ago,” Rojansky said, “I moved to Kiev with my family, (finding) Yanukovych one of the most corrupt politicians in history – and that’s saying something.” Illustrating his point, Rojansky showed slides taken during his time in Kiev including views of some of Yanukovych’s perks: a heli-pad; a palace with gold, jewel-encrusted design, 3-lane bowling alley, billiard room, private floating pirate-themed restaurant reported to have cost a few billion dollars – a rather definitive picture of excess. Rojansky also mentioned the stuffed lion guarding a corridor leading to the nail salon and spa, and a collection of exotic cars and animals. It was not just personal excess, he said, “there was government corruption on a grand scale.”

By the fall of 2013, Ukranian citizens were tiring of this. A peaceful protest known as the Euromaidan began in the square Rojansky and his family could see from their apartment window. “It was surreal.” Public sentiment favored closer connections to Europe, Rojansky said, but Yanukovych instead signed an agreement with Russia’s Vladimir Putin. Thus began the increasing protests fueled largely by social media, with help for the needs of Euromaidan solicited via constant Facebook postings.

Matthew Rojansky

Matthew Rojansky at the Commonwealth Club 3.6.15

Initially, Rojansky explained, the movement was not political. But also thanks to social media – Twitter users began receiving messages letting them know they were registered as protesters – things quickly changed. And on January 16, 2014, the dictatorship laws were passed: No protests, no groups, no gatherings. The movement against abstract corruption became ‘Yanukovych Must Go.’ Things came to a crisis when someone gave the order to fire and all-out shooting began. Despite the European Union intervening to broker a deal in late February, Yanukovych escaped – with boxcars of treasure – though leaving behind the exotic animals still being cared for on his former palatial estate outside Kiev.

Soon came the time of “the little green men” in Crimea, a significant chunk of Ukraine on the Black Sea. Rojanksy explained that there have always been Russians in Crimea; the little green men wore Russian military garb minus the insignia, carried Russian weaponry, but Putin at the time denied they were sent by Russia.

Donetsk airport

Donetsk Airport

By May of 2014, Rojansky said, regions of Ukraine that are heavily Russian-speaking began to hold referenda to break away – not to become independent, but to become part of Russia. Things accelerated significantly with the downing of a Malaysian Airlines plane in July, 2014, and the ground war began. “This was not World War II,” Rojanksy explained, but guerilla warfare with terror tactics, firing on civilian buildings, the destruction of the once-beautiful Donetsk airport. “This is insane stuff.”

As to what Mr. Putin wants out of all this? Rojansky listed three main points;

1 – Domestic politics are life-or-death. If the idea that when regular people take to the streets life gets better catches on, Russians might say “What about us?”

2 – Putin has a major image issue. He’s the tsar. He is never wrong. There’s God, and then there’s the Tsar.

3 – Geopolitics are important. If Russia and Crimea get together, Putin’s bargaining power is greater.

Rojanksky characterizes Ukraine as being between a rock and a Russian hard place. The hard place is boosted by the fact that half the people in Ukraine speak Russian, and many more watch Russian TV with its decidedly nationalist fervor.

For now, Rojansky says the wise course is “Don’t show up giving out cookies. Get observers on the ground as fast as possible, and eyes on the ground on the borders. Watch to see if sanctions are working.

And in the very long term: “Ukraine matters. We have to help Ukraine defeat corruption. Things we can do include letting Ukrainians come here, and knowing about the region.” In the end:

“There are no easy answers.”

Disclaimer: This writer knows as little about Russia and Ukraine as a few long-ago college courses and one unforgettable trip from Moscow to St. Petersberg might suggest. But listening to Matthew Rojansky’s take on the current situation is enough to convince one to pay attention.

 

 

 

Dying in the Fix-It Society

Buddhist teacher/lecturer Frank Ostaseski spoke recently to the Bay Area Network of End-of-Life Care on the subject of compassion – something Ostaseski preaches, teaches and practices himself. Co-founder, in 1987, of the Zen Hospice Project, the first Buddhist hospice in the U.S., Ostaseski currently heads the Metta Institute, created to provide education and training on spirituality in dying.Buddha

Buddhism, Ostaseski said, holds that life is supported by two wings, compassion and wisdom, and neither is at its best without the other. His audience, made up of physicians, hospice workers and others involved with end-of-life care, was in interested agreement with the renowned speaker as he expanded on the theme. But this writer, also in agreement, found one side remark particularly pertinent to today’s end-of-life issues.

Ostaseski spoke of a severe heart attack he suffered not long ago, and of the wisdom gained from that experience. It was insight on critical illness “from the other side of the sheets.” During his hospitalization most visitors, even longtime friends with credentials in compassion, said the wrong things. “They were always saying, ‘It’ll be better tomorrow, Frank,’ when I wanted to talk about what was going on that very moment.” Additionally, Ostaseski found that nurses and doctors “interacted with monitors far more than with the patient.” What could well have been an end-of-life situation was, in short, lacking in compassion and wisdom both.

“Hospitals are fix-it places,” Ostaseski remarked.

We may have gotten fixated on being a fix-it society. Whatever the problem, a chemical or technological answer, in the fix-it society, is instantly sought. We fix brain injuries, once-fatal diseases, missing limbs, and more. But can we let someone who is terminally ill quietly die? Seldom. More often than not we keep trying to fix her with extended interventions, futile and expensive treatments or hospital stays that make dying a horror.

Ostaseski and others are working hard to help people find meaning in their final days, focusing on palliative care. Some, including this writer, are working hard to make medical aid in dying a legal option available across the U.S. ALL of us want a peaceful and compassionate death.

The_flame_of_wisdom

The flame of wisdom

 

The personal bottom line, yours and mine, is this: eventually we die. If the focus can be shifted away from constantly trying to extend our days, we can fix the final days that lead, one way or another, to the mysterious, inevitable, unpredictable, un-fixable but quite natural end. All it takes is a little compassion, and a lot of wisdom.

Walk, Text, Crash: the Orwellian future

Park.ukThe man coming toward me in the park, maybe 500 yards up the path, was walking a large, mixed-breed black-and-white dog. He (the man, that is) was bearded and graying, nattily dressed in black pants, a red plaid sports shirt and gray sweater.

Just ahead of me, walking in the same direction as I, was a younger man dressed in sweat pants and jacket and holding the end of a leash attached to a tan Labrador retriever.

Both men were totally absorbed in texting.

It was a slow-motion episode exquisitely orchestrated for a YouTube video, if only I had been quick enough with my cellphone; as it was, I could only watch, fascinated and wordless. They collided at full speed, one cellphone clattering onto the asphalt and one leash dropped. But there were no apparent casualties. The dogs, at least, had sense enough to have steered themselves safely onto the grass where they were sniffing each other with unconcerned abandon. I smiled politely and kept going.

The episode underlined the hazards of texting while walking, which can surely be as dangerous as texting while doing almost anything else. Almost: there are no available statistics on the adverse effects of texting while having sex, which seems popular in some demographics.

Not long ago, New York Times columnist Nick Bilton wrote a piece in which he shared a New Year’s resolution to quit texting while walking.

“The realization that I may have a problem (along with a lot of other people),” Bilton wrote, “hit me smack in the face, literally, a few weeks ago when I was strolling through Kennedy International Airport, avoiding obstacles with my peripheral vision as I clambered out a text message. Without any warning (as I couldn’t actually see), I was involved in a head-on collision with another man who was also texting while walking.”

Most walking-zombie texters do survive, as Bilton did, with only bruised egos or minimal damage, but that’s not always the case. An Ohio State University study links “distracted walking” to the dramatic increase in pedestrian injuries and deaths.

Equally dismal, for the future of the planet, is how texting while walking may alter human interaction, whether texters live or die with their devices. One report, an interview with Dietrich Jehle, professor of emergency medicine at the University of Buffalo, suggests an Orwellian solution to texting/walking hazards: a cellphone app that shows the landscape ahead, so that texters can text interminably, and see where they’re going without ever looking up.

Is there life beyond a 2 ½ x 5 inch screen?

The Shame of Abortion?

scarlet A“Help us protect the unborn, and save women from the shame of abortion” read the invitation.

It was an invitation to a fundraising event – this writer is on a strange variety of mailing lists – for a pregnancy crisis clinic. A friend who works at the clinic, and whom I respect although our opinions about abortion are poles apart, told me they never pressure or deceive women who come to the clinic. “We just explain that we don’t counsel on abortion,” she says. The fundraiser invitation sounds decidedly less compassionate.

The Shame word tears at my soul.

Thirteen-year-old Natasha, brutalized by more than one relative, is given another chance at childhood through an early abortion at a Planned Parenthood clinic. On top of all the trauma she has borne, she is supposed to feel shame?

Or the couple with a developing fetus they desperately wanted and loved, who decide to terminate the pregnancy later in its term to spare their baby a brief life of terrible suffering. In addition to their deep sorrow, anguish and grief, they should be ashamed?

Or the countless young women in circumstances similar to my own: after choosing to end an unwanted pregnancy for widely varying, compelling, always unique, deeply personal reasons because we are rational women in control of our own bodies – we need a shameful scarlet ‘A’ tattooed on our foreheads?

Words matter.

LIES 5 (2)

The banners proclaiming “Abortion Hurts Women” – posted by groups that seek to end legal abortion – testify to this fact: The posters work, but the words lie. Abortion is in truth far safer than childbirth. It does not hurt women, it protects women. The words are not true. But they work in exactly the same way that the shame word works.

Some words, even when they lie, go straight to the emotions. Emotional appeals become tools to generate support for political positions which hurt women. They should shame those who seek to deprive women of dignity, health and autonomy.

‘Shame’, ‘hurt’ – the emotional trigger words are being used to turn the clock back to the dark ages when women had no voice, no power, no control of their own lives.

As one who has been hurt, not by abortion but by powerlessness, and who strenuously objects to shaming, I declined the invitation.

Women deserve better.

 

Lunar New Year: Hedging One’s Bets

lunar new year

The Lunar New Year, Year of the Goat/Sheep/Ram, is at hand. In honor of the occasion my acupuncturist — this traditionalist writer is an absolute convert to acupuncture – offered a special gift, in the form of instructions about how to start the year in the most auspicious way.

A good start is halfway to success, according to an old Chinese proverb quoted atop the instruction sheet.

“Both the timing and direction of your initial exit from wherever you are on February 19th, 2015 are of utmost importance,” reads the instruction sheet. We are admonished to make our initial exit between 5 AM and 7 AM, or between 11 AM and 1 PM. “To welcome good luck, walk in the South West direction. To invite divine help and wealth-spirit, walk in the West direction. Please do not have initial exit facing the South direction…”

Well, here’s the problem. The only exit from the building in which I live faces south. Walking in a southwest, direction, furthermore, will take me straight into the Post Street traffic, not a good way to start any year. I’m unlikely to get moving early enough to be headed out by 7 AM, and if I wait until 11 there will be meetings missed.

None of this is to disrespect the Lunar New Year.

Depending on which part of the Lunar-calendar-observant world you live in, festivals, rites and customs (such as the above) abound. My current favorite, passed along by a State Department friend newly arrived in Hanoi, is this one: “Vietnamese tradition,” she writes, “holds that, a week before the Lunar New Year, each person should release a live carp into the lake. The Kitchen God then rides the carp to Heaven, and reports to the King of Heaven about whether the people in that person’s family have been ‘naughty or nice.’ The King of Heaven either rewards or punishes the family, based on the Kitchen God’s yearly report.” The tradition strikes my diplomat-wife friend as “A little bit eastern, a little bit Christmas-y and a little bit smelly.” But definitely good for anyone fishing for carp – and unworried about pulling in one with a Kitchen God riding on its back.

Like the eastern mysteries of exit times and feng shui, western religions have plenty of their own.

Soon after studying the instructions about starting the Year of the Goat, I went to a Sunday morning Presbyterian church service about the transfiguration of Jesus. (Transfiguration comes right before Lent, if you’re following these lines of thought.) For serious-but-still-questioning Christians such as this writer, the transfiguration ranks right up there with the resurrection and the ascension. Disputed and discussed from every corner of Christendom (certainly including poor, avowedly neutral Wikipedia), these are central to the faith – and you want to believe, because the faith has such good, basic stuff about how to live in the world – but still. Most Christian beliefs require little more than loving justice, mercy and one’s fellow creatures and working to advance them all. But around holidays we do get pretty zany about Santa and the Easter Bunny; so stockings are hung and eggs are hidden — just in case.

Which brings the story back to personal behavior up to and on February 19. This sideline observer will pass on the carp thing, but my New Year’s Day plan is to exit the building sideways, facing west.

 

A new fight for good death

Kathryn Tucker

Kathryn Tucker

Christie White and Dan Swangard are fighting to live – and also fighting for their right to die: peacefully, at home, surrounded by those they love.

Kathryn Tucker and Nico van Aelstyn are now taking that fight to the Superior Court of the State of California; and it will be a fight worth watching.

Tucker, a distinguished attorney now serving as the executive director of the Disability Rights Legal Center, has already led a number of such battles for peace at life’s end, including defense of the Oregon Death With Dignity Act several times in the early years of that now 18-year-long success story. van Aelstyn has a similarly notable record and an award-winning history of pro bono work on end-of-life issues. Many supporters of end-of-life choice, including this writer, are optimistic about the potential outcome.

But court battles aren’t settled overnight, and White and Swangard know they may not have a lot of time left.

Christie White

Christie White

“My mother will tell you,” White remarked during the press conference announcing the lawsuit, “that from the time I took my first steps I wanted to be in control. I want to be in control. I am adamant about not wanting to die in a hospital, but at home, surrounded by my family. I want to be able to gather my loved ones and meet my death with some dignity and peace of mind.”

Since first diagnosed with non-Hodgkin’s lymphoma and then acute myeloid leukemia or AML Leukemia more than five years ago, White has undergone chemotherapies, radiation therapy and a bone marrow transplant. Because of those prior interventions, her medical options would be severely limited should her leukemia recur.

Dan Swangard, MD was diagnosed with tumor of the pancreas, with metastatic disease to the liver, and had major surgery in 2013. “Not to state the obvious,” he told the press, “but dying is something we all do. It can be loud, quiet, filled with anxiety, pain and suffering, at home or on the road. It can also be peaceful, filled with connections to people we love the most – if planned.”

Swangard has practiced medicine for 22 years. He has also served as a volunteer with Zen Hospice and at Laguna Honda Hospital in San Francisco, experiences that add to his own understanding of what a good death can be.

This lawsuit is about the possibility of a good death for everyone in California. Christie White and Dan Swangard are two good Californians who deserve such an option.

 

Death, Dying & the Grey Zone

clouds

Death-and-dying usually goes with I-don’t-want-to-talk about-it.

Katy Butler wants us to talk about it. She worries, though, about the culture of death-denial, and about the lack of language when we do try to talk. How, for instance, do you say “I don’t want any more surgeries,” without its sounding like “I’m giving up”? Or how do you say “She doesn’t want that treatment” without its seeming you don’t want to keep Mom around? Especially when you know what Mom wants, but the doctors don’t?

Butler, author of the acclaimed 2013 memoir of her parents’ dying years Knocking on Heaven’s Door, spoke at a recent meeting of the San Francisco Bay Area Network for End-of-Life Care. Network members – physicians, teachers, counselors and individuals associated with a wide variety of end-of-life organizations – were clearly in tune with the message: death comes, but few acknowledge or prepare for it. It’s that vast majority, those who don’t want to talk about it, who concern Butler and her audience, including this writer.

Knocking on Heaven’s Door details, in graceful prose, how Butler’s highly educated, physically active, devoted parents managed to get caught up in the brutal reality of dying in the U.S. Her father, a decorated veteran of World War II, suffered years of gradual descent, including having a pacemaker put in when that was mainly a cruel prolongation of suffering; her mother suffered in parallel but very different ways as his caregiver. It is all, Butler fervently believes, unnecessary suffering. She quotes her father as he declined:

“I don’t know who I am any more.” Another year or so later: “I’m not going to get better.” And still later, “I’m living too long.”

Butler speaks of this in terms of “the Grey Zone.” Whereas most of us want simple, black-and-white answers – “This pill will fix everything;” “you can expect to live another four to six months” – in truth, the time before dying is the Grey Zone. And whereas the Grey Zone used to be short and swift, today – thanks to modern medicine and technology – it is forever expanding.

ER

Everyone will enter the Grey Zone sooner or later. You, reader of these words, and I, writer. You may ski into a tree, or get hit by a truck tomorrow, causing your Grey Zone to be little more than a blur; I could have a major stroke or aneurism and be at the crematorium tomorrow. But in all probability, our Grey Zones will come in bits and pieces, and will extend for many months or years. They are likely to include a few hospital stays for broken bones or debilitating illnesses, chemotherapy for cancer, possible time on a ventilator, multiple medications with occasional unpleasant side effects, outpatient and inpatient experiences with doctors we have never seen before and encounters with medical technology yet to come.

Butler advocates shifting our Grey Zones away from the relentless need to prolong life at all costs to the consideration of what really makes life worth living. We would do well, she says, to be aware of when “that space between active living and dying” should shift from Cure to Care: to easing our way from good life into good death.

Butler’s understanding of these issues come from witnessing her father’s long, anguished journey through a Grey Zone of many years and her mother’s steadfast refusal to allow a similar prolonged struggle to mark the end of her own life.

Quite apart from the expanding battles to legalize medically hastened dying, the need to acknowledge the Grey Zone is equally urgent. Most of us would opt to shorten that space between active living and dying, or at the very least to move gracefully from good life into good death.

It can happen, but not without paying attention. Reading Butler’s book, with an eye to how you would like to knock on heaven’s door yourself, is a good way to start.

Because looking realistically ahead makes infinitely more sense than zoning out.

Climate Change? What Climate Change?

Albert Bierstadt: "Storm in the Mountains"

Albert Bierstadt: “Storm in the Mountains”

About that climate-change argument…

Snowstorm Barrels into Northeast was the headline on the New York Times at the door; Rainless January sparks fears, fires proclaimed the lead story in the San Francisco Chronicle lying next to it. At some point, the argument begins to seem absurd.

But it is easy to find individuals and groups who maintain that the globe is not really warming, the climate is not really changing, it’s all just part of Mother Earth’s cycle through her planetary life. Climate change deniers even have their own formal designation – which this writer only now learned: Anthropogenic Global Warming (AGW) Deniers. By whatever name, Deniers are those who think we humans have nothing to do with it so we might as well go right on doing what we’re doing forever.

Some of us worry that forever could come sooner, rather than later, if we don’t pay attention.

Heat_Wave_by_FlamingClaw

Heat Wave by Flaming Craw

 

Watching the ice melt in arctic regions, wishing for air conditioning in San Francisco in January – those things suggest paying attention to fossil fuels probably makes sense. Carbon dioxide sent into the air by the burning of fossil fuels is the proven culprit in global warming. One gallon of gas, when burned, puts 16 pounds of CO2 into the atmosphere; the math is pretty easy to do.

We non-deniers worry about fossil fuels (which of course does not keep us from driving cars) but also about little things, like aerosols. Natural aerosols? Lovely. They translate into mist and fog and Old Faithful Geyser. It’s the un-naturals that are problematic, those tiny particles that spill into the atmosphere every time you reach for that handy aerosol can.

“Scientists call airborne particles of any sort — human-produced or natural — aerosols,” explains Carol Rasmussen on NASA’s Vital Signs of the Planet site. “The simplest effect of increasing aerosols is to increase clouds. To form clouds, airborne water vapor needs particles on which to condense. With more aerosols, there can be more or thicker clouds. In a warming world, that’s good. Sunlight bounces off cloud tops into space without ever reaching Earth’s surface, so we stay cooler under cloud cover.”

But the bad news is that there are different kinds of aerosols, and different kinds of effects that are hard to predict – so cloud cover becomes sooty haze, and what bothers the people walking outdoors in Beijing can affect people fanning themselves in San Francisco in January.

City smog

City smog

 

Which brings us back to the news headlines:

Storm Batters Coastal New England Town.

California’s Hottest Year On Record. China’s Air Pollution at Danger Levels.

 

 

Arguing With the Doctor – A plea for end-of-life choice

Dandelion

Does the doctor always know best? And in the case of one’s own precious life and death, is it wise to argue the point?

“No One Here Gets Out Alive” – a quote from Jim Morrison – led the title of a lively (pun intended) debate about aid in dying held recently at San Francisco’s Exploratorium. Part of a series on the intersection of science and politics, the event’s full title was “No One Here Gets Out Alive”: The Science, Politics and Law of Death and Dying. The program sought to address a few issues not easily covered in two hours – but still – including (reprinted verbatim):

Is there a constitutional right to “physician-assisted suicide”? What about a “dignified death” – and what is a dignified death? Should terminally ill patients facing mental incapacitation or unbearable pain have access to fatal ingestion – also known as physician aid in dying? Or would that jeopardize our society’s progress toward more compassionate, comfort-based care?

Participants included John M. Luce, Emeritus Professor of Clinical Medicine and Anesthesia at the University of California San Francisco; Laura Petrillo, MD, a Hospice and Palliative Medicine fellow at UCSF; and program host David L. Faigman, Professor of Law at UC Hastings College of the Law and Director of the UCSF/UC Hastings Consortium on Law, Science and Health Policy.

The program kicked off with a discussion of the science of death itself – defining death being more and more problematic these days. Think Nancy Cruzan, kept alive through a feeding tube in a “Persistent Vegetative State” for nearly a decade until her family managed to convince the State of Missouri that she would never have wanted to be “kept alive.” Or Terri Schiavo, whose PVS ordeal lasted even longer. More recent is the tragic story of 13-year-old Jahi McMath, declared brain-dead by multiple physicians more than a year ago but whose body is still existing somewhere, connected to machines that keep her heart beating.

Those cases are just a few of the markers on the path toward today’s critically important death with dignity movement. This writer’s involvement in the cause began with work as a hospice volunteer in the 1980s, a member of an HIV support group in the ’90s and a volunteer with Compassion & Choices (and its predecessor organization Compassion in Dying) since the late 1990s. C&C is currently leading the fight to make aid in dying legal throughout the U.S., having won significant battles – five states now protect that right for terminally ill, mentally competent adults – with others underway in many areas.

And that issue – should medical aid in dying be legalized in California (and elsewhere) – was the heart of the two-hour program. Of the two physicians, Luce was eloquently in favor, and Petrillo was adamantly opposed. In this writer’s admittedly biased view, Luce’s lifetime of experience as a distinguished physician and professor rather embarrassingly outweighed Petrillo’s credentials, but it is possible to see her emerging-palliative-care-physician status as basis for her absolute certainty that everyone on the planet can experience graceful, pain-free death if only he or she has access to palliative care.

I am less certain. Thus my argument.

In the Q&A period, I posed this question to Petrillo: “If you were my doctor, which is unlikely, and I were dying, which is increasingly likely (I’m 81, for heaven’s sake,) and I have expressly, repeatedly made clear that I do not wish to linger – why should you have the right to insist that I linger?”

Petrillo dodged the question. “I would ask what is causing your pain,” she said. “I would try to determine if you are depressed, and talk about how we can alleviate your pain and possible depression…”

After several abortive attempts to get a response to my question, and figuring the audience had not paid good money to listen to me rant, I gave up. But here are the arguments I had for Dr. Petrillo, questions I wish the minority of physicians who do still oppose aid in dying would answer:

Why should you have the right to insist that I linger, when I am dying?

How can you presume to understand my pain better than I? And why should I have to describe it if I don’t choose to do so?

When I have watched dying people with the very best care and pain control suffer in ways I would not choose to suffer, how can you insist on my going that route?

Why should your conviction about the efficacy of your medical field trump my autonomy?

Dr. Petrillo said she is not religious, so this question would be addressed to others: Why should your religion overrule my religion? Or dictate to me?

It’s my only precious life, after all. Why should I be denied control of its precious end?

 

 

 

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