A Tribute to Dr. Deborah Pasik in honor of National Doctor’s Day (March 30, 2021)
We honor Dr. Pasik, not only for her advocacy, but for her dedication and service to dying patients. She truly embodies the art and science of medicine as a human endeavor and professional calling. The following is an excerpt of my interview with Dr. Pasik.
What motivated you to take the leap from caring from patients at the bedside to becoming an advocate?
My mom, who was a physician, was a fierce advocate for end-of-life choices. She made it her mission to care for, be supportive and at times attend the deaths of her close friends and family. As a child, I was struck by the fact that she would come home frustrated and quote the movie, they shoot horses, don’t they? That memory has stayed with me to this day.
When I became a physician myself, I always had that belief that there had to be a better way. In my training, we barely had hospice and palliative care and it wasn’t accessible to most patients. And then, in 2014, my brother was diagnosed with a glioblastoma. In researching it, the first thing that came up was the story of Brittany Maynard. That’s when I found out about the death with dignity movement. And I thought, wow, I never knew this existed. This was the first legal example of what I had always thought was the right thing to do.
I followed the New Jersey legislation and contacted Compassion & Choices (C&C) in 2019 and said what can I do to help, I’ll do anything? And the rest is history. I testified before the New Jersey State health committee and I was there for the bill signing with Governor Murphy which was incredibly emotional. There wasn’t a dry eye in the house.
What have you found to be most challenging and the most rewarding in your political activism?
I always followed the politics, but I had never been to the state house and had never testified. The most challenging was getting my head full of thoughts into a 2-minute testimony. But the rewards far outweighed any challenges. Meeting the advocates who were ill or who had lost loved ones was so humbling. And I’ve made life-long relationships with my fellow advocates, the lobbying team, and the people at Compassion & Choices.
How did you come by your first patient who requested medical aid in dying?
I got a letter from the patient’s husband. I had written an op-ed in support of the legislation and recruited 23 colleagues to sign on. The gentleman had seen my name and wrote to me saying his wife was dying and they had been waiting for this law to pass. They had already contacted 30 physicians who would not help her and now he was writing to all 24 physicians who had signed the op-ed. So, I took her on as a patient. Dr. David Grube, the physician from Oregon who answers C&C’s Doc-2-Doc line really helped me understand the process and answered my questions.
I was fortunate to belong to a hospital system that was extremely receptive. It started a work group that would decide how we would implement the law. I found a really excellent, comprehensive article in the New England Journal that was written by the Seattle Hutchinson Cancer Center which was a very detailed outline on how to implement medical aid in dying. My hospital adopted a neutral policy and we developed a detailed, written policy based on the Hutchinson implementation. I’ve evaluated 47 patients for medical aid in dying so far.
How do you respond to your colleagues’ misinformation about medical aid in dying?
Everytime I evaluate a patient, I always make contact with the treating physician to get a sense of the patient and their disease prognosis and in having those conversations, I learn that many physicians have never heard of medical aid in dying. Most are willing to spend 15 minutes with me learning what medical aid in dying really is and what it accomplishes. Reaching out to physicians is really important. I offer myself as a mentor because there are a lot of supportive physicians who don’t feel comfortable taking that first step of becoming a prescriber or a consultant so I will walk them through it, give them the templates to put in the chart etc.
Physicians in very busy practices, from the productivity point of view, are resistant to spending an hour or more with a patient. I’ve heard some say, it’s not worth my time, which is unfortunate. I haven’t run into physicians who are personally against medical aid in dying but I know that they are out there.There are physicians who don’t know how to stop treating people and start listening to people. That’s something that some physicians are just not good at.
I’ve had two colleagues who have told me that medical aid in dying is against their religion but they want me to help the patients. So, I know there are physicians who grapple with their own moral or religious beliefs but also feel it is their duty to give their patients their autonomy. The physicians who understand the needs of their patients as human beings as opposed to diseases are the ones who see the merits of medical aid in dying even if they themselves don’t feel comfortable participating. I think that’s what really divides physicians.
We thank you so much, Dr. Pasik, for all that you do to care for patients, educate your colleagues and advocate for medical aid in dying. You truly embody the goal of National Doctors Day which is to recognize the contributions of physicians who serve our country by caring for our people.
It is an honor to be recognized. I’m launching a website that is going to be focused on getting information about medical aid in dying out both to the general public and to physicians. It’s going to be a bilingual site and we’re going to have a function that will match physicians with treating physicians. I want this very specific physician-to-physician interaction. That way we’re encouraging the physicians to get involved, even if it only means having a conversation.