Faces of hope for women’s rights

The universe may, after all, be unfolding as it should (apologies to Max Ehrmann’s Desiderata.)

This could be encouraging.

Within the past several days I’ve been to a number of events concerning our rapidly disappearing reproductive rights; I’ve discussed end-of-life options with a friend newly diagnosed with ALS; and — this one puts things into a new perspective — listened to the remarkable nuclear arms experts Eric Schlosser (Command and Control: Nuclear Weapons, the Damascus Accident and the Illusion of Safety) and Joseph Cirincione (Nuclear Nightmares: Securing the World Before It Is Too Late) explain how easily we could obliterate one another.

StethoscopeMore on compassionate dying and nuclear weaponry later. I just finished talking with about 40 young medical students and healthcare professionals about reproductive rights. Many are students, and members of an excellent organization, Medical Students for Choice. They are committed to protecting women’s health, educating other healthcare providers and the general public about women’s health needs, and making sure that women everywhere have access to safe, legal abortion.

These young people can make believers of you. Belief, that is, that women’s rights will indeed be protected and that lack of access will not lead again to women dying from botched abortion. The articulate president of MSFC (who bought a copy of Perilous Times and said everyone should know these stories; no wonder I’d follow him anywhere) told me he was certain that each and every member of MSFC would continue to provide safe procedures even if abortion becomes illegal again; but he also said, “I don’t believe that will ever happen.”

I wish. But even though I am a hopeless optimist I’m not optimistic about Roe v Wade staying in place once it’s challenged at the Supreme Court level, which is likely to happen soon. Many of the young healthcare professionals were also upbeat with the belief that women don’t stand to be harmed as severely as pre-Roe “because medical abortion is so simple now, and misoprostol (the abortifacient pill) so readily available.” I wish again. Many, many women today are already facing harm because they take misoprostol without proper supervision, in improper dosages or too late. But these women are — as obvious in the statements of the young professionals at this seminar — essentially invisible. They are poor, disempowered and living in remote (even not so remote any more) areas where they have no access to safe abortions. They’re not dying in droves — one of the things that prompted passage of Roe v Wade — but they are often harming themselves… or having more unwanted babies.

I’m siding with the students. Their dedication and commitment are an inspiration and their hope for the future admirable. My hope is just that they are right… and the universe will continue unfolding, with justice, as it should.

Dementia, the last taboo

Dementia, the elephant in the conversational room, has begun to lift its trunk and trumpet around. Ask anyone over 60, or almost anyone whose parents are over 60, to list the Big Fears, and dementia will be up there at the top. But precisely because it defies solution, can’t be predicted and won’t go away, it has long been among the great taboos for meaningful public discourse.

Perhaps that’s beginning to change. There are a few answers emerging as alternatives to warehousing, or being warehoused, in an institution somewhere when Alzheimer’s or other dementia takes over. Some of them make very good sense. All of them require consideration with a cold, clear eye while still sane and healthy, and that’s when the elephant in the room needs to be shoved aside so conversation can happen.

At a recent meeting of advocates for improved care and expanded choice at the end of life, a small group gathered to discuss raising awareness for Compassion & Choices, one of the leading organizations addressing these issues today. The talk quickly turned to the subject of advance directives – everyone in the room had such documents in place – and from there to dementia.

“I suppose if my Alzheimer’s gets really bad I won’t care any more,” said one, “but I absolutely hate the idea that the images my friends and family will be left with won’t be images of who I am at all.” Said another, “To me, it’s the money. I just don’t want every last penny I want to leave my family going instead to some nursing home.” And a third added, “My husband has promised to slip me poison.”

Actually, there may be better solutions, even if they remain only partial solutions. Compassion & Choices now offers a “Dementia Provision” document that may be attached to one’s advance directives, stipulating that in the event he or she winds up with dementia the signer declines all measures that would prolong life. Author/ethicist Stanley Terman is taking this concept farther (devising stronger, more explicit instructions) for those wanting to avoid prolonged life after dementia strikes. While I don’t always agree fully with Dr. Terman (except for his inclusion of a story of mine in The Best Way to Say Goodbye; I don’t get royalties) I applaud his dogged search for answers, partial or absolute, to a problem that defies easy solution. The conversation is also being aided and abetted by some good new books, including John West’s The Last Goodnights, and everything starts with the conversation.

If the conversation continues, the elephant may leave the room.

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