Banner Graphic, Volume 15, Number 327, Greencastle, Putnam County, 3 September 1985 — Page 11

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Alice Mehling (left), and A.J. Levinson are just two advocates of the right-to-die movement. Mehling believes a patient's wishes should be paramount to others. On the other hand, Levinson says many people

Dying with dignity Once unheard of cause has thousands listening

c. 1984 N.Y. Times News Service Every day several sacks of mail arrive at the front door of a small rented house in suburban Los Angeles and in two crowded offices on West 57th Street in Manhattan. From the quarters of these three littleknown organizations a continent apart comes much of the current impetus for a better-known movement advocating the “right to die.” A good deal of attention has been captured by those who call themselves the “right to life” movement: activists who seek to protect the unborn by opposing abortion. But at the other end of life, where machines and drugs can prolong life often beyond the will of patients to live it, hundreds of thousands of people are organizing to secure the rights of patients who want “death with dignity.” Americans’ awareness is increasing rapidly, according to proponents. “Ten years ago,” A.J. Levinson, executive director of Concern for Dying, said, “I’d get up in front of some group and say ‘right to die’ and everyone would say, ‘What?’ Today, virtually everyone has heard of it. There’s a growing acceptance because there’s a growing segment of the population that has had a terrifying experience, themselves or a loved one losing their rights, to medical technology.” On the surface, there is little controversy over granting dignity to a dying person. The painful and increasingly complex conflicts come when the desire for a natural death by an individual or his family clashes with a whole host of legal, moral and ethical concerns of hospitals afraid of lawsuits, of doctors who control life-support machines and regard a patient’s death as a professional failure, and of emotional relatives under stress. There are also some who fear that making it easy for patients or relatives to have lifesustaining machinery turned off could lead to abuses under the name of euthanasia, or mercy killing. In these cases, a recent article in The New England Journal of Medicine concludes, “Technology competes with compassion, legal precedent lags, and controversy is inevitable.” Although their precise goals and strategies differ, the Society for the Right to Die and other such groups are striving, with some apparent success, to change the way American society looks at death. In their view, death is no longer a simple inevitability With machines that can pump and clean blood, fill and empty lungs with air and restart hearts, man can often control the time of death, although not always the quality of prolonged life. For a hopelessly ill person to choose a natural death instead of lingering on a machine, the groups maintain, is as much a moral and legal right as the right, long established in law, to consent to initial medical treatment. The three large organizations working to design and rewrite state laws, to alter public perceptions and to assist individuals and families in the emotional and legal confrontations that frequently erupt are the Society for the Right to Die and Concern for Dying, both at 250 W. 57th Street in Manhattan, and the Hemlock Society at Box 66218, Los Angeles, 90066. Several other groups conduct conferences and publish research on similar

Banner Graphic Greencastle, Putnam County, Tuesday, September 3,1985 Vol. 15 No. 328 gii)3s©®mwM—.

Stretching the life span Life expectancy at birth 80 ....... AllAmsricans • “ ===== Nonwhite Deaths of intents less than one year old in the U S , per 1 .000 live births SO White 1915 1940 1950 1982 I I I ...1 _ 30 1000 1920 1040 1980 1980 ’B3* •eetlmate Sources National Canter for Health Statistic*; Population Reference Bureau

ethical and legal issues. The Hemlock Society appears to be the most radical group. Its 10,000 members believe that individuals who want to commit suicide, which the society calls “selfdeliverance,” ought to be able to receive active assistance as well as to have medical treatment stopped on demand. Suicide itself is not illegal, but assisting one is, in most states. “There is a lonely terror out there, especially among the elderly,” said Derek Humphry, the society’s executive director, “of one day being strapped down and wired to those machines and kept alive miserably despite one’s wishes.” Like most of the groups, which are nonprofit, Humphry’s organization relies on donations, bequests and earnings from publications. Humphry, who helped his terminally ill wife, Jean, take her life in Britain nine years ago, has also published a how-to book on suicide, “Let Me Die Before I Wake.” Humphry, who plans a national conference Feb. 8-9 in Santa Monica, Calif,, says he hopes to have new laws passed in 50 states within 5 to 10 years, a goal he admits appears ambitious. “But then when we were founded in 1979,” he adds, “everyone thought we were a few crazies. Now ‘living wills’ are recognized in 22 states and the District of Columbia. I find support for euthanasia snowballing, although I’m afraid it may come for the wrong reason, because society fears the tremendous costs of continuing medical care.” Living wills are an individual’s advance directions regarding the stopping of lifesustaining procedures that would only "prolong artificially the dying process.” Both Concern for Dying and the Society for the Right to Die shun advocating active euthanasia and instead emphasize education of doctors, legislators, patients and their families to the rights of patients. Every day the two groups, separate offshoots of an earlier euthanasia

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have seen loved ones lose their rights to medical technology. Both are connected with Concern for Dying, an organization which has helped to rewrite laws pertinent to the issue. (N.Y.Times News photos).

organization, receive mail and phone calls from lawyers and family members seeking background and guidance for disputes with hospitals or nursing homes continuing unwanted medical care. “The patient’s wishes should be paramount,” said Alice Mehling, executive director of the Society for the Right to Die, which uses its mailing list of 130,000 names to muster support for laws on living wills. Fenella Rouse, a staff lawyer, regularly files briefs as a friend of the court in legal cases around the country. “People don’t want to think about death beforehand,” said Miss Rouse, “so they don’t know what to do when an emergency strikes.” The Society for the Right to Die has published a catalogue of the living-will laws in different states. A handbook for doctors that examines court precedents, ethics and the rising patient’s rights movement is due in the spring. Concern for Dying emphasizes programs to change the way people see the issue, using, for instance, quarterly conferences of young lawyers and health care professionals to plant the seeds of new attitudes for years to come. “It’s the ripple-in-the-pond effect,” said Mrs. Levinson, “You’ve got to change attitudes and behavior, not legislation. If legislation could change things, we wouldn’t have the Bartling case in a state like California that recognizes living wills.” William Bartling had five usually fatal diseases and wanted his respirator disconnected. The hospital refused. Although Bartling died after the legal action began, a state appeals court is still deliberating the case. “We try to get doctors to see the law not as an enemy but as a tool to help solve problems,” said A. Edward Doudera, executive director of the 5,009-member Boston society. “And we try to get lawyers to see that not all bad results in medicine

States are doing everything to get the mighty tourists' dollar

c. 1985 N Y. Times News Service From Alaska to Louisiana and from Oklahoma to Maine, states are viewing tourism as an important source of revenue and new jobs and are spending increasing amounts of money to promote their attractions to the public. “A few years back, who ever thought of going to New Mexico or Alaska?” asked Flo Snyder, director of the California Office of Tourism. “But now those states are taking out stunning, fourcolor ads. It’s a very effective strategy and it appears to be working.” State spending on travel development and promotion increased from $98.1 million in 1979 to more than $lB9 million last year, according to the United States Travel Data Center, an independent research organization based in Washington. And spending by American tourists in the United States increased from $140.7 billion in 1979 to $217 billion last year, the center says. In addition, the center says the number of jobs generated by the tourism industry has increased from 3.5 million in 1974 to 14.7 million last year. Industry observers say that states began turning to tourism in the early 1980 s as their economies declined and the manufacturing and industrial sectors slowed. As the smaller states join the spending bandwagon, state tourism directors say, they are luring tourists away from bigger states, such as New York and California, which have been promoting tourism for years. In 1983, the last year for which figures are available, the number of people traveling to California dropped 9.8 percent, Snyder said. “Our attitude was that people are going to come to California anyway, so why bother to promote,” she continued. “We can’t afford to think that way any longer.” “The competition is intense,” said Bern Rotman, director of tourism in New York State. “We have to run twice as hard just tostay in place." While Rotman could not cite statistics, he said New York’s share of the tourist market had “eroded a bit” because of competition from such states as Illinois and New Jersey. Several states are now following New York’s lead and enlisting celebrities to push their campaigns. Brooke Shields and Bill Cosby tout telene e tte oe state. In 1969, when Virginia introduced its “Virginia Is for Lovers” campaign since reproduced on thousands of T-shirts, buttons, mugs and bumper stickers the state was virtually alone in its attempt to lure tourist dollars But now all 50 states have developed their own slogans as part of a comprehensive advertising campaign. The messages range from whimsical (Utah’s “The Greatest Snow on Earth”) to adventurous (“lowa, Come Explore the Heartland”) to clever (“Once You’ve Gone to Alaska, You Never Come All the Way Back.”) Still, industry observers say it is only in the last six or seven years that tourism has come to be recognized as an important revenue producer. According to Dr. John Hunt, director of the travel and tourism program at George Washington University, two events have affected the industry’s growth. The first was the National Tourism Policy Act of 1981, which he said “basically established tourism as a legitimate business, one that is important economically, socially and educationally.” The other turning point, he said, can be traced to the recession of the early 1980 s, when states turned to such service industries as tourism to pick up the slack as manufacturing declined. Oklahoma, for example, began promoting tourism heavily three years ago when the petrochemical industry “bottomed out,” said Eugene Dillbeck, director of the State Tourism and Recreation Department. “The tourism industry is stable,” he said, adding that travel expenditures in Oklahoma amounted to $2.6 billion last year. “Travel has been a bread-and-butter industry for us,” said Don Dickey, Alaska’s director of tourism. “When timber is flat

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Illinois ad stresses Abe Lincoln ties and our fisheries have pricing problems, we fall back on the service sector.” Alaska, along with 27 other states, recently hired a private market research company to help improve its promotional efforts. It found that most Americans living outside Alaska perceived that state as a cold wasteland with few recreational activities With this in mind, the state began a $5.7 million advertising campaign showing the Anchorage skyline at night. The point, said Dickey, was to let tourists know “that they’re not going to come here and sit out in the tundra.” New York is continuing to reap the rewards of its campaign. The state Chamber of Commerce says 10,000 new jobs have been created in the lodging industry since 1977, when the actor Frank Langella, dressed in a cape and baring a pair of fangs, declared, “I Love New York especially in the evenings.” About $3.8 billion of the $66 4 billion spent by people visiting New York State the past seven years is a direct result of advertising drive. Even cities not usually regarded as traditional tourist attractions are vying for a piece of the tourist pie. Wichita, Kan., for example, is spending $l5O million on historic restorations in the next three years. The current project involves the restoration of Old Town, an eight-block area that includes the place where Carry Nation, the temperance advocate, hurled a hatchet through a mirror at the Eaton Hotel in 1901 to emphasize her demand that the hotel remove a picture of a partly nude woman over the bar. Although the picture has since been destroyed, the hatchet will be on display when the refurbished hotel opens. About 125 miles northeast of Wichita, on Interstate 70, there is a sign that causes some weary travelers to stare in amazement. It says, “Discover Manhattan.” Underneath, in smaller print, are the words, “The Little Apple.” Cities across the country are also trying to gain more tourist revenue. The United States Conference of Mayors reports that 20 cities, including Charleston, S.C., San Antonio, Nashville and Pittsburgh, have subscribed to a new program designed to inform the traveling public about cultural and sporting events in those cities. Through this program, 95,000 travel agents around the country receive computerized listings describing art exhibits, concerts, operas and festivals, which they then pass on to travelers. Many cities give special tours to visiting travel agents, according to Allison Cryor, a spokesman for the American Society of Travel Agents. Other cities mail videotapes of the sights and sounds of their locales to travel agents across the country, Cryor said.