The Choice Is Yours

A look at death and dying in America

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"Death transforms our living in ways that we, in this culture, do not understand," Kansas City pediatrician Bill Bartholome said. Sharing his story with journalist Bill Moyers, Bartholome said his response to terminal esophageal cancer was about six months of profound grief, followed by acceptance of his fate through meditation.

"I don't know about the rest of you, but I cannot live each day as if it is the last day that I am going to be alive," he told Moyers. "That makes life really hard for me.

"But what I did discover is that I can live by the calendar method; I can live in year-long segments. I could live each day on the calendar as if it were the last time I would be above ground on that day. I could live each birthday that way, each wedding anniversary, each spring, each Christmas. And it not only worked, it actually made each of those days more special than it would otherwise have been."

Bartholome's end-of-life battle is just one of the vignettes featured in "On Our Own Terms," a four-part television special developed by journalists Bill and Judith Moyers for the Public Broadcasting System.

Scheduled to air at 8 p.m., Sept. 10 through Sept. 13 on KAET Channel 8, Moyers' documentary seeks to throw open the doors and shed light on the once-taboo topic of death and dying. It highlights the lack of care options given to Americans who are facing terminal illness, as well as the growing national trend to find better end-of-life options.

Primarily, the series is designed to spark debate between patients and doctors, families and care workers, and lawmakers and medical professionals as they continue to battle for the rights of their terminal patients, Vicki Dietz, executive director of RTA Hospice in Payson, said.

"We're expecting this to have a huge impact," she said. "We're hoping this will have a huge impact on hospices, on physicians, clergy, and advance directive planners, social workers.

This really pushes people to take control of the end of their life and to make choices."

Joyce Kerr of Chatham, N.J, was in her 60s when she was diagnosed with terminal ovarian cancer. With the help of her family, she chose hospice care, and faced the end of her life with strength and dignity.

Kerr's daughter, Nancy, a medical resident at a New Jersey hospital, said her mother's response to pain medications was refusal.

"She said, 'I don't want to feel like I'm not dying,'" Nancy told Moyers. "She wants to be able to experience her own death."

A precursor to hospice care, Dietz said, is palliative care a nationwide movement to provide comfort to patients stricken with a severe illness, patients who have not given up fighting through aggressive treatments.

Inside a Birmingham, Ala. hospital, Dr. Amos Bailey has opened the Balm of Gilead, an in-house hospice care center that also became the first palliative care center in that state.

One of Bailey's associates, Edwina Taylor, CRNP, said that through the Balm center and similar end-of-life specialty programs, attitudes are slowly changing. When asked why she fights so hard for her patients, Taylor relates the story of the starfish.

"A boy is walking along a beach covered with dying starfish. He picks up each one, throwing starfish after starfish back into the ocean. A man comes along and says, 'Why are you doing that? There are so many of them, you can't possibly make any difference.' The boy reaches down, picks up another starfish and throws it back into the surf, saying to the man, 'To that one, it made a difference.'

"That's how we're going to change our culture," she said, "one dying experience at a time. We can't make good deaths, but we can make better deaths."

One of the more controversial topics discussed in the PBS special is physician-assisted suicide. At this time, Oregon is the only state that permits patients to choose their own time of death, but a New England Journal of Medicine report from 1998 reports that one out of five doctors caring for patients with terminal illnesses has been asked by their patients to speed up their deaths.

"Maine is also looking at legalizing physician-assisted suicide, and Arizona has tried a couple of times, but failed to pass that," Dietz said. "Hospice's position on that is that hospice neither postpones nor hastens death. We are here to help patients, to assist them in their own choice-making for their end of life."

To learn more about American's choices in death and dying, watch Moyers' "On Our Own Terms," Sept. 10 through Sept. 13 on KAET Channel 8, or log on to www.thirteen.org/onourownterms. For answers to questions about hospice services in the Rim country, contact RTA Hospice at 472-6340.

ON OUR OWN TERMS: Moyers on dying

Sept. 10: Living with dying

The first night of "On Our Own Terms" explores American's search for new ways of thinking about dying, along with constructive ways of talking out our own mortality.

Sept. 11: A different kind of care

Discussion of the options available to patients, including "palliative care." Proponents of palliative care run the gamut, from pain management to symptom relief including physical, psychological and spiritual issues.

Sept. 12: A death of one's own

Most terminally ill patients are in search of a good death, and the right to choose how and when they die has become as hot a topic as abortion. Tonight's discussion looks at issues surrounding efforts to control how we die, as well as the implications on families, institutions and communities.

Sept. 13: A Time of Chance

The final installment focuses on the crusaders who are leading the debate for improved care for the dying.

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