She chose it all on the day she died (Euthanasia)

The Oregonian ^ | 9/30/07 | Dan Colburn

[wagglebee]

Lovelle Svart woke up Friday knowing it was the day she would die.

There was much to do. Her family and closest friends would be gathering at 11 a.m. in her mother's apartment in the Southwest Portland assisted-living center where they both lived.

She directed trips to the grocery store and even called AAA to jump-start the dead battery of her 2006 Scion. She double-checked delivery of food platters from Fred Meyer: turkey sandwiches, strawberries and grapes, pretzels, almonds and sparkling water. There would be pink roses on the dining table and a boombox in the corner to play music, including the polka tunes she loved.

Lovelle made one last trip to "the bridge," a wooden footbridge in a nearby park where she had found quiet sanctuary the past few weeks as painful cancerous tumors spread from her lungs through her chest and her throat.

The consummate planner, she had choreographed the day. She wanted to leave time -- five or so hours -- for storytelling, polka dancing and private goodbyes. And at 4 p.m., she intended to drink a fatal dose of medication, allowed by Oregon law, that would end her life.

A smoker since age 19, Lovelle found out five years ago that she had inoperable lung cancer. Radiation and chemotherapy slowed the cancer's spread but could not stop it.

In June, Lovelle's doctor warned her that she was likely to die within six months, making her eligible for Oregon's unique, 10-year-old Death With Dignity Act.

What some call doctor-assisted suicide and others call physician aid-in-dying or hastened death is one of the most passionately argued issues in U.S. medicine and politics. Proponents frame the question in terms of personal choice, death with dignity and freedom from pain. Opponents say assisted suicide violates the Hippocratic tradition of "First, do no harm" and undermines the doctor-patient relationship by turning physicians from healers into accomplices of death.

Far more people ask for a lethal prescription than actually use the drug. Either their symptoms overwhelm them before they make a final decision, or they find other ways to control those symptoms, including pain.

Lovelle was determined to keep control, if possible, of when and how she died.

On July 1, she filled out and signed a one-page form titled, "REQUEST FOR MEDICATION TO END MY LIFE IN A HUMANE AND DIGNIFIED MANNER." By signing, she agreed that she knew the expected result -- death -- and was aware of alternatives, such as hospice care.

By law, she also had to make two oral requests at least 15 days apart. Her doctor wrote the prescription for a lethal dose of barbiturate in late July, and she had it filled Aug. 7. She kept the orange bottle of clear liquid in a plastic grocery bag on a stack of towels in her bedroom closet -- "hidden in plain sight," as she put it.

She was still unsure whether she would take the drug, but said she took comfort in knowing it was there.

Once she knew she had less than six months to live, Lovelle also decided to try to start a more open public discussion of dying. During the past three months, mostly through a series of online video diaries for The Oregonian, she shared publicly the experience of facing death.

Lovelle, 62, has "touched a chord" by chronicling her "deeply intimate struggle with mortality," said Dr. Susan Tolle, director of the Center for Ethics in Health Care at Oregon Health & Science University.

"People are following closely," Tolle said Friday. "They want to know what happens to her.

"Lovelle has become their friend."

Friday morning, Lovelle stuck a yellow note on the door of her mother's apartment: "Please Do NOT Disturb. Unless Urgent. Thank you."

She wore a blue sweat suit over a "Cancer Fighter" T-shirt.

Lovelle delighted in Friday's blustery weather and a forecast that included possible thunder and lightning about the time she planned to die. "Oh, the woo-woo crowd will have a blast with that," she said.

After AAA jump-started her car, she left the engine running to recharge the battery, returned to her apartment and set the kitchen timer for 10 minutes to remind her.

When a friend later expressed shock that Lovelle had spent part of the last morning of her life dealing with a dead car battery, Lovelle explained:

"The car goes to my sister. I didn't want it to be dead."

In the living room, her family and friends sat and told stories and jokes, sometimes with political references. Sometimes they laughed a bit too loudly, out of nervousness at the occasion. Twice, Lovelle came out of the bedroom where she was having private meetings to say, "No politics!"

A bit later, Lovelle and George Eighmey, head of Compassion & Choices of Oregon, an advocacy group that works with most of the Oregonians who end their lives under the Death With Dignity Act, danced a brief but rousing polka.

By midafternoon, the studiously punctual Lovelle was falling behind her schedule. No one complained.

But a little before 4 p.m., she decided it was time to make her final preparations. First, she had to take the two pre-medication pills -- to calm her stomach and control vomiting. They were hard to swallow, given the tumors in her neck, but she got them down with water.

"It" would be in about an hour, she told her family. Time now to sit alone with her mom, Vi Svart, in her bedroom for the last time. The rest of the group sat in the living room, debating whether they wanted -- and whether Lovelle wanted them -- to be in the room with her at the end.

Lovelle's three siblings and her mother, despite deep misgivings about her decision to end her life, supported Lovelle in her choice.

"I feel so at peace," she said. "I've had such a good time. . . . And today has been so wonderful.

"I'm really ready to go. I'm ready."

About 4:30, Lovelle announced she wanted "a hugging line" -- one last hug for everybody. "You'll be first and last," she said, turning to her mom.

Lovelle stood in the center of the living room and embraced them one by one -- long hugs with tears and laughter.

Then one last cigarette break on her favorite sitting stone next to the parking lot. Afterward, Lovelle took the elevator up to the third-floor apartment and hung up her coat and hat.

"OK," she said to no one in particular. "I'm going to get into bed now."

In many ways, Lovelle fits the pattern of Oregonians who choose to end their lives under the Death With Dignity Act.

Like most, she had cancer. She was in her 60s. Well educated and insured. Not formally religious. White. Enrolled in hospice care.

And fiercely independent.

"I could be very gregarious -- and very private," she said. "Very much the partygoer -- and very much want to stay home and read."

She was chosen Miss Cafeteria at Crater Lake Lodge in the summer of 1963, and she has the lemon-yellow rayon dress to prove it. She left it hanging in a plastic dry-cleaning bag on her bathroom door.

She loved surfboarding and polka-dancing and both her first and last names, "because they are different, and I like things that are different."

And she liked, as she was the first to admit, being in control.

Lovelle decided it was more important to die by taking the lethal drug while she had a degree of control over her body than to wait for nature to take its course. But how to decide when?

Her symptoms -- shortness of breath, stomach distress, weakness and pain -- were intensifying. If she waited too long, she would be unable to drink and swallow the lethal drug on her cupboard shelf.

Lovelle sought a shifty window between life-worth-living and incapacity, "this tiny bit of freedom" when, for her last act, she could swallow a fatal potion in the company of family and friends. "That's when I want to go."

Last Sunday, after a painful, restless night, Lovelle decided it was almost time.

Swallowing was more painful than ever, like choking on broken glass or razor blades, she said. She had barely eaten in two weeks. She started taking morphine to dull her pain.

She told family and friends to come Friday.

Lovelle sat on the foot of the bed, while 10 others gathered around. A photograph of Lovelle as a curly-haired 5-year-old stood on one bedside table; on the other were a glass tumbler containing the liquid medication, which looked like water, along with a container of morphine and Lovelle's ever-present mug of Gatorade. On the wall above the head of the bed were five more family photographs.

With some help, Lovelle yanked off her shoes and socks and slipped partway under the covers.

Eighmey stood by her bedside. He has attended more than three dozen deaths of this kind.

"Is this what you really want?"

"Actually, I'd like to go on partying," Lovelle replied, laughing before turning serious. "But yes."

"If you do take it, you will die."

"Yes."

Ever the detail person, she reminded him that she wanted her glasses and watch removed, "after I fall asleep."

Eighmey warned her that the clear liquid would taste bitter. She needn't gulp it. She would have about a minute and a half to get it down.

Lovelle dipped her right pinky into the glass and tasted.

"Yuck," she said. "That's why I need the Gatorade."

Holding the glass, Eighmey asked her again to affirm that this was her wish.

Yes, she replied.

Someone asked, "Can we have another hugging line?"

One by one, they came to head of the bed for hugs and teary whispers.

"Sweet dreams."

"It's all right."

"I know."

"Thank you for being my big sister."

"All the church is praying for you."

Lovelle was sitting up in bed, three pillows propping her up.

She held the glass tumbler in her right hand, raised it to her lips and drank. It was 8 minutes after 5.

"Most godawful stuff I ever tasted in my life," she said, making a face before taking a sip of Gatorade and plain water.

She laid back and scrunched down under the covers, glasses still on to see her loved ones.

She reached for her mother, who leaned closer, then laid down next to Lovelle, stroking her hand.

"Are you OK, honey?"

"I'm fine, Mom."

"You're not sick?"

"No. I'm peaceful. It stopped raining, the sun's out. And I've had a wonderful day.

Her eyes closed.

"It's starting to hit me now."

For a while, no one moved or spoke, as Lovelle drifted into a coma. Then Lovelle's mom asked for a prayer. Others spoke up with prayers and memories, which prompted other stories. Lovelle's brother Larry read part of William Wordsworth's "Intimations of Immortality."

Lovelle lay motionless but for the gentle rise and fall of her chest. Her heart slowed but didn't stop.

About an hour into the vigil, Lovelle's mom lit three white candles in cut-glass candlesticks in the living room. "She's still with us," she said.

Hours passed. Given what Lovelle's body had been through -- not only lung cancer but also open-heart surgery in 2004, Eighmey was surprised how long she was lingering. But not her family.

"I hate to say this," one said with a smile, "but this is just like her."

"A little spitfire," agreed another.

"Above average -- that's Lovelle."

"One last reminder that she's the one in control."

Jane O'Dell, a volunteer for Compassion & Choices, sat at Lovelle's bedside all evening, holding her right hand, monitoring her breathing and regularly checking the pulse in her wrist and neck.

About 10:30 p.m., more than five hours after she had taken the drug, O'Dell signaled that Lovelle's breathing had become shallower and more labored. Her pulse dropped, her skin turned pallid and her fingernails bluish. It was more than a minute between breaths.

Family and friends resumed their bedside vigil, and silence again fell over the dark room. Lovelle's chest stopped moving.

Eighmey leaned over at 10:42 p.m. and put his ear to her chest to listen for a heartbeat. He stepped back, shaking his head and spoke in a quiet voice.

"She's gone."

[Glenn]

Good for her.

[the invisib1e hand]

So... you really didn’t want clarification...... only a platform from which to lob the missiles. Enjoy! *chuckle*

Not so. "choose to die with dignity" is as loaded a phrase as there is. clarification was essential.

If that's lobbing missiles then call me a warrior.

[LaineyDee]

Not to take away from your warrior work, but it sound like a bunch of self-esteem-pop-psychobabble to me. *chuckle*

Hope you never have a need for those of us that really care. :)

[Salvation]

Such a sad story. This girl could still be alive and fighting for her life and giving other people hope!

Lord, help her.

[Salvation]

Pray for and end to euthanasia and the conversion of America to a mindset of life!

[linn37]

I fail to understand why some Christians believe this woman would be a better person had she hung on for a few more months in agony and in pain rather then be whole again in heaven.

[Salvation]

**And at 4 p.m., she intended to drink a fatal dose of medication, allowed by Oregon law, that would end her life.**

One of the reasons I am not proud to live in Oregon.

[Salvation]

Prayers for your mom and for you and your family too.

[linn37]

I’m going to pray that this woman had God in her heart on the day of her death.

[Salvation]

The Catechism of the Catholic Church

Euthanasia

2276 Those whose lives are diminished or weakened deserve special respect. Sick or handicapped persons should be helped to lead lives as normal as possible.

2277 Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons. It is morally unacceptable.

Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator. The error of judgment into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded.

2278 Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of "over-zealous" treatment. Here one does not will to cause death; one's inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.

2279 Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable Palliative care is a special form of disinterested charity. As such it should be encouraged.

[Neuromancer]

Five years ago my best friend “Smitty” called me (he had retired to Miami Beach and I live out West), he was having trouble swallowing food.

Richard had smoked Camel cigarettes and joints every day that I had the pleasure of his acquaintance.

We are old hippies - I had grown into a conservative businessman and He remained a Willie Nelson lookalike hippie.

Richard Smith was the only truly honest and descent man I ever knew.

His integrity helped change me from a ethically challenged youngster to a responsible man, citizen, husband and father.

In the spring I would go fishing in Florida and visit the old crew.

But his first call soon was followed by another - he had throat cancer. And was entering the hospital.

From that time on I communicated with his twin brother. He was never able to eat again. The cancer had spread and Richard was sent home with painkillers.

He could not speak nor eat, the pain was horrific and his cognitive awareness deteriorated to the point where he was readmitted to the hospital and died a horrible combative death.

I miss him.

God bless those who help us make these choices when our time draws near and I pray for those who choose.

[Salvation]

She chose it all on the day she died (Euthanasia)

Pope May Have Been Euthanized

Was John Paul II Euthanized? (red herring alert!)

Man Set to Be Euthanized Regains Consciousness

Dying pope didn't ask for euthanasia - doctor

'Pope didn't seek euthanasia'

(Vatican) Commentary on Artificial Hydration and Nutrition

Vatican says no to euthanasia even in the case of “vegetative states”, there is still a person

World Leaders Gather for First International Anti-Euthanasia Conference

Largest Ever International Euthanasia and Assisted Suicide Symposium - Toronto Nov. 30 (Pro-Life)

Czech Parliament Unlikely to Legalize Euthanasia

University conference to focus on life, death (Abortion, Stem Cell Research, Euthanasia)

Wisconsin Pro-Life Group Wants to Help Patient Targeted by Euthanasia

A Threat to the Disabled ... and to Us All (Euthanasia)

House Backs CHAMP Act Pro-Life Groups Opposed On Abortion, Euthanasia

Pro-Life Group Tells House to Oppose CHAMP Act Over Euthanasia Worries

Louisiana Attorney General Won't Drop Hurricane Katrina Euthanasia Case

Neighbor's Complaints Succeed in Evicting Dignitas from Residence (Swiss Euthanasia Company)

Treatment of Depression Decreases Suicide Study Indicates: Findings Linked to Euthanasia ...

MEPs call for radical rethink on euthanasia

Nurses in Katrina Euthanasia Case Offered Immunity for Grand Jury Testimony

Pope Benedict sees abortion, euthanasia as "attacks on peace"

Spain Government Wants to Legalize Euthanasia Based on Woman's Case

Euthanasia Robs Dying of Opportunities for Reconciliation, Family Connections

Respectable Baby Killing.....legalizing euthanasia for ill and disabled newborns.

Church of England Does Not Support Infant Euthanasia

Church of England Supporting Euthanasia? [Commentary / Analysis]

Church supports baby euthanasia

British Doctors Recommend Euthanasia for Disabled Newborn Babies[UK]

Euthanasia? How Can a Secular Society Claim Anyone is “Better Off Dead”?

Bishop Fabbro on Voting: Abortion and Euthanasia are Priority over War and Death Penalty

Doctor Charged in Katrina Deaths Denies Committing Murder, Euthanasia

Swiss Euthanasia Group Demands Assisted Suicide for the Depressed

Nations Move to Ban Suicide Counseling; Euthanasia Movement Complains

Haleigh Poutre Almost Victim of Euthanasia, Now Making Good Progress

Why the Christian Worldview Matters (Euthanasia)

Belgium Palliative Care Workers Unable to Kill Patients Due to Shortage of Euthanasia Drug

Selling Death: Euthanasia, Assisted Suicide Advocates Market Their Agenda

Pro-Euthanasia Documentary Wins EBU Festival Award

We Need Non-Voluntary Euthanasia, Says British Expert

Neighbors of Switzerland Euthanasia Clinic Tired of Constant Corpse Removal

'Do-it-yourself' euthanasia clinic to open in Britain

Euthanasia Case Hinges on Jurisdiction Questions

Netherlands Plans Expansion of Child Euthanasia Policy

Dutch Set to Expand Euthanasia Guidelines

Active euthanasia in New Orleans: An urban legend in the making?

[Salvation]

**GEORGE EIGHMEY**

The new Jack Kevorkian?

He better watch out or he will find himself behind bars too.

[Salvation]

Click my name to read about my husband’s death from lung cancer. Been where you have both been. FReepmail me if you want to talk.

I know of healing weekends that you or members of your family can attend in your area.

[Salvation]

So sorry about your daughter.

Click my name to read about my husband’s death from lung cancer. Been where you have both been. FReepmail me if you want to talk.

I know of healing weekends that you or members of your family can attend in your area.

[estrogen]

They shoot horses don’t they

[Squantos]

And these pro suicide types think lethal injection is cruel ?

[Salvation]

Bautiful.

Here are some more things to think about.

Imitation of Christ: 1, 21, Sorrow of Heart [Devotional]
Imitation of Christ: 1, 22, Thoughts on the Misery of Man [Devotional]
Imitation of Christ: 1, 23, Thoughts on Death [Devotional]
Imitation of Christ: 1, 24, Judgment and the Punishment of Sin [Devotional]

[Salvation]

But don’t the pallative drugs contribute to their death? I’ve always wondered. (My husband’s death and Terri Schiavo’s death)

[Salvation]

Only in Oregon!

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