ALS Patient, Who Fought Same Sex Marriage Ban and Married on Airport Tarmac, Dies

ALS Patient, Who Fought Same Sex Marriage Ban and Married on Airport Tarmac, Dies

Posted on Monday, October 28th, 2013 at 8:06 am by lifemediamatters

Arthur And Obergefell Speak To The Cincinnati Enquirer

Arthur and Obergefell spoke to The Cincinnati Enquirer after their marriage

John Arthur, the terminally ill man who flew from Cincinnati to Maryland in July to marry his  longtime partner on an airport tarmac, died this week of complications associated with Lou Gehrig’s disease at age 48. His action this summer sparked a legal battle that would force Ohio to recognize his marriage and those of other same-sex couples.

After a ceremony of less than 10 minutes at the Baltimore International Airport, Arthur and his partner, Jim Obergefell, immediately flew back to Cincinnati before Arthur’s health could further deteriorate. Arthur had been diagnosed with amyotrophic lateral sclerosis (ALS) in 2011, an incurable and progressive neurodegenerative disease.

Arthur and Obergefell had been a couple since 1992, but they decided to marry only after the U.S. Supreme Court’s decision on June 26 to strike down portions of the federal Defense of Marriage Act (DOMA).

Both men indicated that they wished to be buried together in Arthur’s family plot, one which is restricted to direct descendants and spouses. So the couple sued Ohio Gov. John Kasich and Ohio Attorney General Mike DeWine, urging the state to recognize their union. U.S. District Judge Tim Black ruled that Obergefell may be listed as Arthur’s surviving spouse.

The terminal nature of Arthur’s disease expedited the case through the judicial system. The couple’s attorney argued that the pair would face “irreparable harm” if Arthur’s death certificate listed him as “single.”

“We’ve been beside each other for 20 years. We deserve to be beside each other in perpetuity,” Obergefell testified.

“It’s huge,” Obergefell said on MSNBC’s The Last Word shortly after the ruling. “It’s something we never thought we would see in our lifetime. It just helps us feel more valid, more valued, and prouder to be Ohioans, prouder to be Americans.”

Arthur was born in Chicago in 1965.

Judge Black also referenced the recent Supreme Court ruling in his 15-page opinion:

Under Supreme Court jurisprudence, states are free to determine conditions for valid marriages, but these restrictions must be supported by legitimate state purposes because they infringe on important liberty interests around marriage and intimate relations.

In derogation of law, the Ohio scheme has unjustifiably created two tiers of couples: (1) opposite-sex married couples legally married in other states; and (2) same-sex married couples legally married in other states. This lack of equal protection of law is fatal.

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Terminally Ill Opt For Less Treatment When In Communication With Doctors

Posted on Tuesday, November 27th, 2012 at 1:43 pm by Life Matters Media

Cancer patients who talk with their physicians about how they want to die are less likely to opt for aggressive end of life treatments in the last two weeks of life, according to a new study published in the Journal of Clinical Oncology. Instead, these patients end life more comfortably at home or in hospice care, and as a result spend much less on hospital care.

“Aggressive care at the end of life for individual patients isn’t necessarily bad, it’s just that most patients who recognize they’re dying don’t want to receive that kind of care,” said Dr. Jennifer Mack, lead author of “Associations Between End-of-Life Discussion Characteristics and Care Received Near Death: A Prospective Cohort Study.”

“We should at least consider having these discussions soon after diagnosis if we know that a patient has incurable cancer,” Mack, from the Dana-Farber Cancer Institute in Boston, told Reuters Health.

The researchers studied more than 1,200 patients with stage IV lung or colorectal cancer who survived at least one month from the time of diagnosis, but died during the 15-month study period. Using interviews of the patients and/or their caregivers and a comprehensive medical record review, the researchers determined if and when the patients had discussions with their doctors about end of life.

Researchers found that 88 percent had end of life discussions, but more than one-third of those took place less than a month before the patient died. Those patients who had end of life discussions documented in the medical record but did not recall them in the patient or surrogate interviews were more likely to have chemotherapy within the last 14 days of life, or acute intensive or hospital care within the last 30 days of life.

Patients who reported having the discussions with doctors were almost seven times more likely to end up in hospice than those who didn’t have those talks. Hospice focuses on comfort care and pain management for terminal patients, instead of treatment.

“A lot of patients don’t want (aggressive treatment), but they don’t recognize that they’re dying or that this is relevant for them,” said Dr. Camilla Zimmermann, head of the palliative care program at University Health Network in Toronto. She wasn’t involved in the study.

She told Reuters: “The earlier you discuss these things, the more options you have. If you wait too long, you end up having these discussions with someone you don’t know, that you just met, in an inpatient setting,” instead of with your primary doctor.

According to Mack, “If we start these conversations early, then patients have some time to process this information, to think about what’s important to them (and) to talk with their families about that.”

In 2010, Medicare paid $55 billion for doctor and hospital bills during the last two months of patients’ lives- more than the budget for the Department of Homeland Security, according to CBS News. Twenty to 30 percent of those medical expenses may have had no meaningful impact on the patients’ health.

Reuters is reporting data from the Dartmouth Atlas of Health Care, which found that 32 percent of total Medicare spending goes to caring for sick patients in their last two years of life.

National guidelines recommend patient-physician talks begin soon after a terminal cancer diagnosis. Researchers found that physicians initiated end of life discussions an average 33 days before death.


Some Choose Assisted Suicide

Posted on Sunday, August 12th, 2012 at 6:06 pm by Life Matters Media

According to a recent feature in The New York Times: “Dr. Richard Wesley has amyotrophic lateral sclerosis, the incurable disease that lays waste to muscles while leaving the mind intact. He lives with the knowledge that an untimely death is chasing him down, but takes solace in knowing that he can decide exactly when, where and how he will die.” Dr. Richards is based in Washington, which has the Death With Dignity Act.

Katie Hafner’s feature probes the issue of “Right to Die.” She notes critics of the law’s morality, some of whom feel the poor will be unjustly persuaded to die early for financial reasons. Ironically, Hafner notes: “Dr. Wesley is emblematic of those who have taken advantage of the law. They are overwhelmingly white, well educated and financially comfortable.”

The law is similar to what Massachusetts will vote on this fall. According to Hafner: “Two physicians must confirm that a patient has six months or less to live. And the request for the drugs must be made twice, 15 days apart, before they are handed out. They must be self-administered, which creates a special challenge for people with A.L.S.”

Some doctors, such as former president of the Massachusetts Medical Society, Dr. Barbara Rockett, oppose assisted death. “We as physicians must avoid the so-called slippery slope of attempting to save money by doing less for our patients rather than rendering the proper care to them. To substitute physician-assisted suicide for care represents an abandonment of the patient by the physician,” she wrote for Boston.

There is support for the Massachusetts law. Hafner quotes Stephen Crawford of Dignity 2012, “Support isn’t just from progressive Democrats, but conservatives, too.”According to Crawford: “It’s even a libertarian issue. The thinking is the government or my doctor won’t control my final days.”