Jack's Death, His Choice

July 10, 2005
The New York Times
By NICHOLAS D. KRISTOF
PORTLAND, Ore.

Jack Newbold is a 59-year-old retired tugboat captain who is dying of bone cancer. It's one of the most painful cancers, and he doesn't want to put his wife and 17-year-old daughter through the trauma of caring for him as he loses control over his body.

So Mr. Newbold faces a wrenching choice in the coming weeks: should he fight the cancer until his last breath, or should he take a glass of a barbiturate solution prescribed by a doctor and put himself to sleep forever? He's leaning toward the latter.

"I've got less than six months to live," he said. "I don't want to linger and put my wife and family through this."

I don't know what I would do if I were Mr. Newbold, nor if I were his wife or daughter (they're both supporting him in any decision he makes). But I do believe that it should be their decision - not President Bush's.

Unfortunately, Mr. Bush is fighting to overturn the Oregon Death With Dignity law, which gives Mr. Newbold the option of hastening his death. Oregon voters twice passed referendums approving the law, which has been used since 1998, and it has wide support in the state.

The Bush administration issued an order that any doctor who issued a prescription under the state law would be prosecuted under federal law. Oregon won an injunction against the order, John Ashcroft lost an appeal, and now the Supreme Court will hear arguments in the fall.

"I'm just grateful I live in the state of Oregon, where we have this option," Mr. Newbold said. "I'm just sorry the John Ashcrofts of the world want to dictate not only how you live, but also how you die. There's nothing more personal, other than childbirth, than passing on."

Mr. Newbold, a Vietnam veteran and former merchant seaman, is funny and blunt, with a flair for nautical language unsuitable for a family newspaper. He started with head and neck cancer. Now cancer is spreading to his bones, disabling him and forcing him to take morphine for pain.

"By God, I want to go out on my own terms," Mr. Newbold said. "I don't want someone dictating to me that I've got to lie down in some hospital bed and die in pain."

Mr. Newbold has started the process of obtaining the barbiturates; two doctors must confirm that the patient has less than six months to live, and the patient must make three requests over at least 15 days. Typically, the drug is secobarbital - the powder is removed from the capsules and mixed into water or applesauce - or pentobarbital, which comes as a liquid. Patients typically slip into a coma five minutes after taking the medication and die within two hours.

Like many patients, Mr. Newbold says that his biggest concern isn't pain so much as the loss of autonomy and dignity. That's partly why he wants the medication on hand - if he feels himself losing the self-control he has prized all his life, he can hasten the process.

"I may never use the medication," he said, "but the knowledge that you have the ability to end it gives you so much relief."

That's common - many patients who get the barbiturates do not in fact use them, but derive comfort from having the choice. Over all, 208 patients over seven years have used the law to hasten death, according to the Compassion in Dying Federation of Oregon, which helps patients work their way through the legal requirements.

When patients use the law, they typically set a date and gather family and friends around them. Those who have witnessed such a parting say it's not as morbid as it may sound.

"It's pretty weird knowing what day you're going to die, but we could plan for it," said Julie McMurchie, whose mother used the barbiturates about a week before she was expected to die naturally of lung cancer. "Two of my siblings lived out of state, and they were able to come, so we were all present. ... We were all there to hug and kiss her and tell her we loved her, and she had some poetry she wanted read to her, and it was all loving and peaceful.

"I can't imagine why anybody would begrudge us that opportunity to say goodbye, and her that opportunity to have peace."

The same applies to Jack Newbold and everyone in his position. Mr. Newbold faces an excruciating choice in the coming weeks, and he's got enough on his mind without the White House second-guessing him.

Back off, Mr. Bush.


E-mail: nicholas@nytimes.com