On May 21, 2009, Linda Fleming, a woman with terminal pancreatic cancer, took a fatal overdose of medications prescribed by her physician to end her life.  She thus became the first person to commit suicide under the “Death with Dignity” law that passed the state legislature November 4, 2008 and took effect during March.

The law in Washington State is modeled after one that has been on the books in Oregon since 1997.  About 400 people have ended their lives through physician-assisted suicide in that state.

Under the assisted suicide law in Washington, a patient who is terminally ill and legally competent and who two physicians agree has only 6-months to live, can request lethal medication.  The request needs to be made verbally on two occasions, 15 days apart, followed by a written request witnessed by two people.  The medication is dispensed by a pharmacy.  Patients take the medication themselves, rather than having a doctor administer it to them.

I’ve counseled people battling fatal illnesses.  I’ve watched a friend struggle against cancer.  I’ve told family members in ICUs and ERs that their loved ones have died.  So I know how much pain can come at the end of life, when an illness takes hold. 

I understand where the desire for a law like Washington’s comes from.  It’s a tribute to human empathy that lawmakers resonated with the suffering of terminally ill patients enough to pass it.  But I wouldn’t have voted for it myself. 

Alleviating the suffering of 400 or so patients since 1997 in Oregon has carried a pretty high price tag.  It has opened the door to thinking of the medical profession not entirely as one devoted to prolonging life, but as one that is also empowered to help end lives.  And this can leave patients feeling as though they ought to consider suicide when they are given terminal diagnoses.  They ought to be reasonable, not just with what they are willing to go through, but with what they put their families and friends through.  They ought not expend health care resources needlessly in their final months.  Their clinicians aren’t only thinking about what treatment options to provide, after all.  They’re thinking about other patients who have elected to forego treatment and hasten death. 

I fear the law can also take away some of the motivation of doctors to “pull a rabbit out of a hat” and save a patient’s life.  There’s a reason you wouldn’t want soldiers going into battle who are also trained in the etiquette of surrender.  You’d worry it might unconsciously take away their edge, chip away a little bit at their determination to take that hill.

At present, the criteria which must be met under the Death with Dignity Law sound rational.  But laws are not static entities.  Now that the door to physician assisted suicide is open, the Death with Dignity law could be amended in the future, perhaps to include those who might not die for twelve months, or longer.  How about those who suffer unbearably from medical conditions that will only worsen over the years?  If we are willing to use the medical profession to help end the lives of those who have but six months to live, how about those who become quadriplegic and say they cannot bear it?

It is psychologically and spiritually perilous to do harm to the magnificent will to live that keeps us fighting for another day.  And it is no less dangerous to blur the mandate of physicians to try to win that fight, however daunting, however seemingly futile.  The physician’s white coat has meaning—to doctors and their patients.  It must remain a bright beacon of the healing powers of the profession, not a flag of surrender to the inevitable.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s Web site at livingthetruth.com.

When Drew Peterson was brought into court on charges that he murdered his third wife Kathleen Savio, he was in a good mood.  He yelled jokes to reporters about how “spiffy” his red prison jumpsuit was and called his shackles “bling.” 

Peterson is, of course, also a suspect in the 2007 disappearance of Stacy Peterson, his fourth wife.  He insists he is an innocent man.

Think of how you’d respond to being dragged into court on murder charges, especially if you were wrongly accused.  You might be terrified or confused or enraged at the injustice of your plight, but you wouldn’t be all smiles, spewing one-liners.

So how can Drew Peterson do it?

To have any hope of understanding Drew Peterson, one first has to understand human empathy.   Empathy is the ability to resonate with the feelings of others to such an extent that one actually experiences some of their joy or grief or anxiety.  It is a remarkable and inexplicable quality that we too often take for granted.  The fact that a friend can be brought to tears by a loss of yours, that you can intuit and share the worries or hopes or pride of your partner in life, or that the hunger of children thousands of miles away could spur you to action on their behalf is a tribute to this miraculous force.

Empathy does even more, though.  It helps us contain our anger and our destructive impulses, because we can imagine how it might feel to be the object of that rage.  It also helps us gauge what is appropriate language and behavior in various situations, again because we can imagine how others are likely to respond to us.  We can put ourselves in the shoes of our friends or neighbors or loved ones. 

I believe empathy is an essential ingredient in experiencing guilt, as well.  If you can’t imagine the injuries you may have done another person—can’t feel their pain in any measure—then you aren’t likely to worry over any harm you’ve done them.  The absence of empathy is the growing place for antisocial and narcissistic traits that set a person adrift from the interpersonal ties and sense of personal responsibility that bind the rest of us.

Drew Peterson may be largely devoid of empathy.  That’s why he just doesn’t get the fact that lobbing jokes to reporters while being dragged into court on charges he murdered a young woman is bizarre and macabre.  It’s why he believed he’d come across as credible on television during the media tour he orchestrated after the disappearance of Stacy Peterson.  It’s why he probably is confident a jury will acquit him (which, of course, it could).  Peterson may not be able to put himself in the place of others—at all.

One of the most toxic manifestations of having no empathy, of course, is that it leaves those without it free to inflict suffering on others.  There’s no wincing at causing them pain, even death.  In the forest of pure narcissistic and antisocial traits that grow in soil without roots of empathy, only self-preservation and one’s own needs matter.  No one and nothing else really does.

If Drew Peterson killed Kathleen Savio or is responsible for the disappearance of Stacy Peterson or both, he isn’t worried about any of that.  He’s busy with the opportunity to showcase what he believes is his extraordinary charm and intelligence and wit.  And he thinks you and I and every reporter and every judge and every juror will be mesmerized.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s Web site at livingthetruth.com.

Dear Yvonne,
You had an article on cohabitation and it mentioned that some states have common-law marriages. Which states recognize them and what are the major benefits of such domestic partnerships?
-Bart

Dear Bart,
Common-law “marriage” is recognized in these states: Alabama, Colorado, Washington, DC, Georgia, Idaho, Iowa, Kansas, Montana, New Hampshire, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Texas and Utah.

In such partnerships, assets may be mutually owned, which means that if a couple splits up, they may have to fight for money, for example, trust funds, a 401(k), or savings accounts.

Among the benefits of a domestic partnership are:

- Health, dental and vision insurance
- Sick and bereavement leave
- Death benefits
- Accident and life insurance
- Parental leave
- Housing rights and tuition reduction
- Use of recreational facilities 
 
If you’re considering a domestic partnership/common-law “marriage,” it would be wise to read up on the latest laws in your state before taking this big step.

Dr. Yvonne Kristín Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, “Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots.”