Posted by: kevinfortruth | June 6, 2011

Eighty-nine dollars and fifty-two cents


Last weekend, I watched the HBO special “How to Die in Oregon”, which deals with people wanting to end their lives because of terminal diseases.

The Oregon law, that allows doctors to prescribe a lethal dose of drugs to a terminally ill patient who has made a written request to die, was passed in 1994 by 51 percent to 49 percent and has been upheld by court challenges.

Opponents of the Oregon law promise continued legal fights even though the Supreme Court has held that states have a legitimate right to pursue such laws.

The beginning of the film showed a gentleman purchasing his “dying with dignity” medicine at his local pharmacy. When the pharmacist said “eighty-nine dollars and fifty-two cents”, it stuck in my head and it does not appear to be going anywhere soon. I believe the amount was a co-pay and the gentleman was even surprised that his health plan even covered the prescription.

The drug he purchased was Seconal, the brand name for a drug containing an active ingredient called secobarbital – a barbiturate that is classified as a sedative-hypnotic, meaning it acts as a depressant and makes you feel sleepy.

Seconal is used to treat insomnia, and may also be prescribed to reduce anxiety or to help calm patients before surgery, but when enough is taken at one time, near term death is the expected outcome.

At Drugstore.com a bottle of 100 capsules of 100mg Seconal lists for $1169.90 but you only need to take 1500-1600mg, or 15 to 16 tablets, to end your life, so the manufacture is making a killing – selling you an excessive amount of pills, more than are needed to end one´s life.

Wikipedia describes the word “medicine” as: “A pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.”

The pills one purchases to assist a person in dying does not seem to fit the description above, even though they might be considered medicine if used in smaller doses for medicinal purposes. I may be looking at the wording too critically, but it just doesn´t seem right to have pills of this type, when used to end life, to fall under the category of medicine.

If a person is of sound mind yet suffering from a terminal disease with no expectations of ever getting better and that person decides to not continue living, then it makes sense to provide that person with the resources and the wherewithal to die with dignity – in a timeframe of his or her choosing, and in a manner required by state laws.

Most individuals exploring options to end their own life are frequently enrolled in some kind of health plan – be it Medicare / Medicaid or some other health plan coverage. These plans are very costly to individuals, to the health plans themselves, and in some cases governments and taxpayers.

Individuals choosing to end their life do it for a variety of reasons. They might have seen an erosion of their net worth due to increasing medical costs and after realizing they will never get better, they want to be able to leave their loved one´s with as much of their “estate” as possible – be it cash, stocks, real estate, or other tangibles and intangibles.

Other individuals might choose to expedite the dying process because they are simply tired – tired of living, tired of pain, tired of the loss of dignity, or tired of being a burden to others.

After watching the HBO movie, I am of the belief that the choice of dying lies with the individual who is choosing to die with dignity. Anyone else – family, friends, acquaintances, business associates, health care providers and even government employees at all levels are secondary. There will be those who are supportive of the decision and there will be others who will be very vocal in their opposition.

Once the timeline has been thought out and the appropriate “medicine” has been obtained, a suitable location has to be chosen. In addition, the last major decision to be made is regarding who will be in attendance. Anyone not supportive of the decision should not be “invited”, so to speak. The last thing a dying person needs is for someone to complicate the process – either vocally or physically.

Now, regarding the title of this blog – “Eighty-nine dollars and fifty-two cents.”

I can understand how a person would want to pick up the appropriate pills to be used to expedite the dying process.

What I cannot understand and I strongly object to is for any health plan to expect the person to pay for his or her own pills. I believe the pills should be provided by the plan itself without any CO-PAY – considering that all medical related costs to the various health plans will be coming to a screeching halt – i.e. no additional room fees, no future procedures, medicines, or services.

Instead of prescribing 100 pills at a cost of $1169.90, why don´t doctors prescribe 30 pills at a cost of $350.97. Thirty pills still represent twice the number of pills necessary to expedite death. With the $819.07 savings to the health plan, they should be able to easily spring for the entire cost.

On a side note, I do not feel that anyone taking their “last” medication needs to take an expensive brand name drug. I have been taken generics my entire adult life and if I were in this position – why change to an expensive brand named drug this one and only time?

There are several drug manufactures who make a generic equivilent of Seconal – why not use one of them? I do not think anyone taking the generic version would be around to experience any side effects.

On your birthday, friends usually spring for the meal, the cake, and the card – so why would your “death day” be any different?

A prisoner on death row is given a free meal of his choosing as his last meal.

You should be able die on someone else´s nickel – or as in this someone else´s eighty-nine dollars and fifty-two cents.

HBO is currently showing this movie almost daily on a number of its channels. It is also available on HBO On Demand.

Many of us have strong feelings on this subject but I highly recommend everyone see this movie. If you do not have HBO, find a friend who does and watch the movie – then have a meaningful discussion about the movie with relatives, friends, and anyone else who wants to have an open discussion.

So, how do you feel about having the option to die with dignity on your own timeframe, peacefully with little or no pain, with people surrounding you who support your choice?

If you live in another state besides Oregon, Washington, and Montana, do you believe your state or all states should pass a law allowing its citizens the option of dying with dignity at a time of their choosing?

I believe all states should pass legislation like the law in Oregon as long as the person requesting the right to die is of sound mind, has documentation from a physician that he or she is suffering from an incurable disease, that death is imminent, and there is no hope for a reversal of condition.

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Responses

  1. The writer of this article is seriously misinformed on one important point: It takes a lot more than 15-16 capsules of Seconal to achieve death. The Minimum Lethal Dose for Seconal is 125 mg. per kilogramme (2.2 lbs.) of body weight. Therefore, the “average” 150 lb. person (68 kilogrammes) would need around 86 of the 100 mg. Seconal capsules to achieve death. Bear in mind that this is a MINIMUM. Most of the sources I’ve seen have said that the average 150 lb. adult would need about 120 capsules to die; far more than the 15-16 capsules the author claims. Prior to retiring, I was a Nurse Practitioner, so I am not pulling this information out of my bum. The 100 capsule prescription that the author claims as excessive may actually be a bit short of the 120 capsules required; and even more capsules will be required if the person weighs more. Seconal is provided as 100 mg. per capsule; as noted above, 125 mg. per kilogramme of body weight is needed as a minimum lethal dose. Divide your body weight in pounds by 2.2 to find your weight in kilos; multiply this by 125; divide the result by 100 and you will have the minimum number of 100 mg. capsules required to kill a person of your body weight. As this is a minimum, adding a 50% increase in the number of capsules and washing them down with some drink containing 100 proof vodka and using a plastic bag over your head will dramatically increase your chances of success in crossing over. This is not something you get a do-over on if you screw it up the first time. The author specifies tablets, but Seconal is only provided as 100 mg. capsules to the best of my knowledge.


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