Ways of Dying

His death was little noted, but the way John Peyton chose to die — on the same day as Washington state’s first legal assisted suicide — sent a strong message on what constitutes a good death.

SEQUIM, Wash. — On May 21, Linda Fleming, 66, became the first recorded case of physician-assisted suicide in Washington state. Fleming had been dying from Stage IV pancreatic cancer.

She died at home in Sequim, Wash., where she lived alone. At her death bed were her family, her dog, her physician, and members of Compassion & Choices, the pro-assisted suicide organization.

Divorced and suffering from arthritis, she filed for bankruptcy in 2007, according to her lawyer. A former social worker, Fleming lived in subsidized housing with monthly disability checks amounting to $643.

When questioned by a New York Times reporter as to why assisted suicide was provided to Fleming, Robb Miller, Washington’s Compassion & Choices executive director, said that her situation raised “none of the red flags” preventing her participation, adding that Fleming’s two children and former husband “supported her choice.”

On the same day Fleming died, John Peyton, a former Boeing computer programmer who suffered from ALS (Amyotrophic Lateral Sclerosis), died at his home in Seattle, with his family surrounding him. Unlike Fleming’s death, Peyton’s departure from this life would not be noted in local and national media. But the two deaths represented two poles of a polarizing issue.

Although physician-assisted suicide was legalized in March, Peyton, 65, would neither agree to taking a lethal dosage nor allow Lou Gehrig’s disease to keep him from speaking out against the state’s Death With Dignity Act.

Since then, there’s been a second death by assisted suicide in Washington, and according to the state’s Department of Health, nine other people have in their possession lethal medications from Washington pharmacies.

Eileen Geller, hospice nurse and founder of True Compassion Advocates, said media coverage concerning Fleming’s death “sent the wrong message to people with life-limiting illness and their families — that assisted suicide, rather than good medical care and improved community support, is the solution to end-stage illness or disability.”

No Need to Suffer

Fleming only discovered her terminal cancer in April of this year, surprised by how quickly the disease spread and the pain increased. She said that her fatal illness had “arrived at a most inopportune time.” She chose assisted suicide owing to her dislike of being unable to “focus or concentrate” due to the effect of increased pain medication.

Dan Kennedy, CEO of Human Life of Washington, said that if Fleming were suffering, “there are certainly drugs and methods and means available to alleviate that. No one who is opposed to assisted suicide is in favor of any kind of suffering, and there’s no need for it.”

Marie Hilliard, director of bioethics and public policy for the National Catholic Bioethics Center, said, “There is ample evidence that the presence of pain and/or depression (both of which are treatable) in terminally ill patients is a deciding factor in the desire for physician-assisted suicide.”

Hilliard noted that “findings from a study by William Breitbart, M.D., in the Journal of the American Medical Association in 2000, indicate that ‘desire for hastened death among terminally ill cancer patients is not uncommon. Depression and hopelessness are the strongest predictors of desire for hastened death in this population.’

“According to a report by the New York Task Force on Life and Law, ‘treating cancer patients for depression and pain reduces levels of suicidal ideation,’” she pointed out. “‘Treatment for depression resulted in the cessation of suicidal ideation for 90% of these patients.’”

Faith and Support

John Peyton learned of his diagnosis a little over a year before he died. Although he was disappointed, he felt no “anger or bitterness” or “cheated of anything.” He explained: “If this is what God demands of me to improve my chances of living with him in the hereafter, mine is a pretty poor negotiating position.”

Devout Catholics, he and his wife had been active in the pro-life movement for many years. With his experience giving presentations, Peyton decided to use his illness as a platform to make a case against assisted suicide and in favor of better care for the terminally ill.

Laura Ingraham interviewed him for Fox News in June 2008 and asked about his “quality of life.” Peyton replied: “I have a marvelous quality of life.”

Though bedridden and dependent on others, he said: “I have a family. I have friends. I have my church community. I have loving support all around me.”

Seattle Auxiliary Bishop Joseph Tyson recalled a video that Peyton appeared in where he addressed “the loss of control and the kind of humility it required to let others tend to the details he would have rather handled himself.”

“For John, it was a new spiritual journey,” Bishop Tyson said.

Peyton worried about assisted suicide “victimizing people,” fearing that “people with disabilities or in tough financial circumstances and without adequate care would feel pressured to take the lethal drugs.”

“Rather than giving [the terminally ill] the temptation to kill themselves,” he said, “we should figure out how to help them have the quality of life that I enjoy.”

Elenor Schoen writes

from Shoreline, Washington.

Critics Say Washington state’s Death With Dignity Act lacks these basic safeguards:

• Family notification.

• Patient-competency checks.

• HMO coercion safeguards.

• Minimal mental-health standards.

• State reporting lacks accountability.

• No face-to-face meeting with patient required.

• Word “suicide” not allowed.

• Death certificates attribute death to disease, not suicide.

— International Task Force on

Euthanasia and Assisted Suicide