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The humorist Art Buchwald has proved what hospice professionals will also tell you: Just because you are diagnosed with a terminal illness, it doesn’t necessarily mean you are about to die. Buchwald has been in hospice for many months because it was thought his kidney ailment would end his life. Yet, even though he refused dialysis, he didn’t die but got better. He is now out of hospice and writing his next book.

Buchwald reminds me of the first patient I cared for as a hospice volunteer. The first time I met Ernie, an elderly man expected to die of congestive heart failure, he fell into my arms crying, “I want to die! I want to die!” When I asked him why, he said he worried about burdening his son. About three months later, I lost Ernie, not because he died, but because he had so improved he was no longer qualified for hospice care.

And these two cases teach us an important lesson about assisted suicide. The Oregon law requires that a doctor believe that a patient will die within six months before issuing a poison prescription. (This isn’t always adhered to, but that is a comment for another day.) What if Ernie had lived in Oregon when he said he wanted to die? His doctor might well have accommodated his desire not to be a burden by issuing a lethal prescription. Ernie might well have been dead before he knew he wasn’t actually dying.

Barbara Coombs Lee of Hemlock Society (now renamed Compassion and Choices) likes to say that suicide by the dying isn’t suicide because these people’s lives are over anyway. Well tell that to Art Buchwald and Ernie. As that great philosopher Yogi Berra once said, “It ain’t over ‘til it’s over.”

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