 Your host for Navigating the Journey. Navigating the Journey is dedicated to exploring the options and choices for end-of-life care and to assist people to talk about their wishes. It's time to transform our culture so we shift from not talking about dying to talking about it. It's time to share the way we want to live at the end of our lives and it's time to communicate about the kind of care we want and don't want for ourselves. Today is exactly what we're going to do. We're going to revisit with John Ratcliffe. John will talk about his wishes for the end of life. Ratcliffe is on a journey that most of us can only imagine. This is one of the most powerful journeys one can envision. Marcia, thank you very much. It's a pleasure to be here this morning. I am so happy to have you. For anybody that doesn't know, I can't imagine that anybody in Hawaii that doesn't know John. He has been here since when, 40 years now? Well yeah, I came here in 1975 to run the State Teachers Union and I did that for 13 years and following that ran for Congress in 1988. I lost, which was a very good thing for me. It really helped me a lot in life and then I settled in and started operating the University of Hawaii Professional Assembly. J. N. Musto and I pretty much ran that organization for 17 years and he for 30, you know, and then I retired from that and I've been a lobbyist for since around 1990 or so. So I do a lot of lobbying and I've been at the legislature now for your right 41 years. Yes. Have I known you that long? I guess it hasn't been like that. We've known each other a long time. We were doing civil rights stuff together back before when we were trying to get a Martin Luther King Day here. Yes. When it was very tough to get people to come out. It was. And we also did a lot of stuff for gay rights and stuff when it was not very popular. Are we always on that side? Well we're, yes, we are. Marcia and I are both card-carrying Democrats and liberals. So that's just the way that is. Yes. Well, but we want to talk about you today because you are venturing down a journey, a path that most of us have seen, have had family members, but we don't get to talk about it. Now the paper said that you actually had your chemo treatment while you were the guest at the legislative opening of the legislature. So how does that work? Well it is something I, it was hard to see it. I mean you could see it on me if you looked but I didn't make a big big deal of it. What happens is that when I have chemo it's three days of chemo, not just a minute. So I go down on a given day, in this case a Tuesday, and I put about five hours in when they infuse me with these chemicals. And then they take the infusion stuff off and they plug me into a machine that meters chemo into me every 90 seconds for two days. So that's what I was doing on the floor. I'm sitting there with a bag here that meters chemo directly into my system and then the next day I get it removed and then I get sick for a few days. And then about today, after all that goes through, that was last week. Now by today I'm pretty good. I'm tired but I'm pretty good. You look great. I'm pretty good. It's a lot of chemo. I don't know how much more I'll be able to take but I'm right now it's working. But there's no there's there's with with with cancer. There's a reason that it's called the emperor of diseases because it has a thousand a million ways to transform itself to move itself around in your body and do things to you. So you have to be constantly watching for things. I mean, it might be fingernails, it might be swords, it might be, you know, eruptions, it might skin eruptions, it might be terrible pain in your gut. It might be it might be anything. It could you could go, you know, have half blind and stuff. And various and sundry things happen to you when you have chemo because there are side effects and and they're not very they're not very pleasant. The question about life here and the thing that that we all should be thinking about is what's the quality of it? How long can you stand it? I've argued that what I've gone through and what I know that others have gone through who have suffered and suffered much worse than than even I have been suffering and painful terrible terrible things. Where was I going with that? I can't remember going with that because it's it gets me in a in a head but but you know I realized that that that that that happens and people don't talk about that the quality of life that's left to you at the end right are you gonna lay there in bed exhausted and in pain and suffering or not? Can you get better? How long can you stay better? That sort of thing. You know I get out and walk as much as I can. I exercise as much as I can. I think people can see that I'm making an effort. I do not want to die but I'm dying. So I'm not a fool. I think we have to understand what the thing is and deal with it and I'm dealing with it. It's unfortunate in life that not a lot of people want to confront this I guess ugly fact. Yes. I am willing to do it and I've always been willing to be the guy if I have to to do it so well there you go. I'm a cancer survivor and I know that pit of your stomach when when the doctor says this is what it is and it's really a difficult mentally as well as physically mentally to deal with this is what's going on and so I'm really honored to have you to talk about it your willingness to talk about it and you are as always which is in your DNA to lobby for the ability to have medical aid in dying. Yes. So let's talk about what is medical aid in dying. Right. What it is is a legal prescription that will allow a patient to personally take that medicine not being given to it but have to take it themselves. The doctor that does it you do it if you feel you need it when you feel you need it with your family around you and so forth. That's what that's about so that the doctor doesn't go to jail for doing that. Okay. What do you mean go to jail. Well right now it's not legal for doctors to prescribe medicine which will end a person's life. It's just not legal in the state of of Hawaii. It's legal in six other states not legal here. It's being it's in approximately 20 more legislatures this year as an addition to our own. So that's almost half the states in the union are involved in this and it's it's something which is moving nationwide because as in some other issues that have occurred socially this is one in which the minds of America have changed over the years. For example we've done a poll here in Hawaii just recently which indicated that 80% of the people of Hawaii would like to have this. 20% have problems with it. Only about 12% of people in Hawaii are adamantly opposed to having this option. Now I guess my how it is how is it okay for a doctor to turn off the ventilator in the hospital. How is it okay for the doctor to prescribe morphine give her as much as she needs. How is it that they can do terminally sedation and that's okay. But to write a prescription for a person to take it themselves is not okay. I think we have a situation in which medicine has become better over the years to such a degree that we can be kept alive indefinitely for a very very long time anyway with nothing else going on than artificial stuff keeping you going that we can do. But we still have a prejudice against allowing people to control their own lives at the end. That is just a prejudice that is in the medical field. I understand it. It comes with the Hippocratic Oath, do no harm. But you know a little common sense would be useful with the do no harm part. And I think doctors have it most of the doctors that I talked to support this option. None of them that I know of except for Chuck and a few others are willing to come out and talk about it. Chuck is your doctor? Yes. He's the other guy on the suit with me. Okay so let's talk about you just said suit you are suing. Yeah we're also suing in court to determine what the law is. We have had two attorneys general in the state of Hawaii the last one David Louie and the current one Doug Chen who have indicated that this current status of the law does not allow doctors to proceed with with providing that medication and be assured that they were not going to be prosecuted. So we are going to the courts to say is that the way you see the law the attorney general opines this you be the judge so you say. So but I saw Mr. Louie say well he did backtrack and he said well if there are enough safeguards then he felt it would be okay. Sure and there are plenty of safeguards this is a very specific legislation. The legislation you have to be of sound mind you have to have less than six months to live that and have to be two doctors that have to say that. You've got to have you know two doctors willing to say that they're go ahead with this. There's all sorts of safeguards in it. It would be pretty much like the Oregon law which has worked now perfectly perfectly for 20 years. Good well we're going to take a break and then when we come back let's talk about the law what's in the law or what the safeguards are. Okay we'll be right back. Thank you. Hi I'm Tim Appichella I'm the host for Moving Hawaii Forward and the show is dedicated to transportation and traffic issues in Oahu. We are all frustrated by sitting in our cars in bumper to bumper traffic and this show is dedicated to talking to with folks that not only we can define the problem but we hopefully can come to the table with some solutions. So I invite you to join me every Tuesday at 12 noon and let's move Hawaii forward. Hi I'm Donna Blanchard I'm the host of Center Stage which is on Wednesdays at 2 o'clock here on ThinkTech. On Center Stage I talk with artists about not only what they do and how they do it but the meat of the conversation for me is why they do it why we go through this a lot of us are not making our livings doing this and a lot of us would do this with our last dying breath if we had to that choice and that's what I love to talk to people about. I hope you enjoy watching it and I hope you get inspired because there's an artist inside you too. Join us on Center Stage at 2 o'clock on Wednesdays. Bye. Aloha and we're back with a dear dear friend that I will preface his name by saying survivor. Thank you. John has been a survivor of polio. Yes TB polio virtually every other childhood disease known to man but survived most of it. The worst of those was the polio. I had polio when I was eight and was paralyzed for about three months fully recovered from that and that was wonderful. That was that was the most difficult childhood thing but it did help me become a terrific reader. So that's good. Yeah. So that's why I'm called him survivor and he's going to survive this also. Oh yeah. I mean now in terms of what you mean by survival is my body going to survive this. No. What's going to happen is that my body is already gone. I mean I was given six months to live two years almost three years ago. I've been working very hard on staying alive but trend lines don't go that way. The question is in people seriously say this to me. Well what about a miracle. Yeah I'm I'm happy. I'm open for a miracle. I'm I'm up for that. I would like a miracle. Well let's have a miracle. Okay. It happens that'd be great. But in the meantime in the meantime I think I've got to take action to because I know it's coming. Well we all we all do. I've been there. Yeah. I mean I've been there. We all and there isn't an end to it. We all is one of these days it's going to be the end. So you know folks and it's not that everybody dies and that's not the important thing. The important thing is what did you do when you were alive. Did you do the best you could when you were alive for the most people that you could you know. Were you helpful. Were you a good neighbor. That's the kind of thing that makes a difference. So let's talk about the bill. Sure. That is before the legislature and if us well and simply put what can we do. Thank you for asking that question because Marcia and I are both smiling at that because this is an organizing question. If you believe that you have a right to determine under certain circumstances your own method of death because of pain and suffering and things that cannot be otherwise prevented if you believe in that then you got to organize and you got to get down to the legislature and you got to make a scene because they are going to do and nothing nothing unless there's some reaction from the people they don't care about the fact that 80 to 88% of people in Hawaii want it that Catholics and other Christians are now supported. It's troublesome to have to take up these tough social issues. So unless people say take it up they're not going to take it up. They're going to fool around. So I urge every single person out there watching this if you know a legislator call a legislator call a legislator talk to a legislator every single one of them you know find out how they stand on this and if they're against it move them toward it if they're for it thank them and get their vote. Just to let you know that when you know this only in Hawaii or all of the legislators all the city council people all of the ohaha trustees their phone numbers are listed their doors are not locked go call be there if you feel this is something that you can benefit now you know we that it's the he doesn't want to go but it's the cancer that's that's taking him away from us and so we need to not only support John but hundreds of other people in the same condition. I watched my mother she had emphysema and you know you can't breathe and every breath she labored for a year and having to watch her because we had her at home with hospice it tore me up just. Marcia I gotta tell you again folks that are watching this because I'm in the situation now people call me all the time and it's the damnedest thing people are calling me for things that happened in their families 25 years ago that they feel guilty about today that dick I people have called me that are crying themselves to sleep at night now what they did or didn't do didn't do 25 years ago and still with them you know that's not right no I mean that's not fair for people and it's just time folks you and you know I I say I say to the people ask ask your own moms and dads out there how they feel about it and talk to them the title of the bill is relating to aid in dying and it's a HB house bill number 201 right there is a Senate bill there will be Senate bill because a companion bill coming out of the Senate I can't remember the number off hand but it's should it's out now I think it's a lot today's the last day for introduction I think it's out today yes a senator in oh yeah senator noise got Lorraine annoying Lorraine's got a house or Senate bill five something but I'm not sure and yeah so but we do need your support we do need you to call to right to visit do whatever you need to do now there's also this is easy we need this this is not just really not about me okay I'm over with in that sense this is about other people the reason I decided to do it because I knew I knew that other people needed to have this done and as I sit with chemo patients all the time you know it's it's rough just getting up and walking around for most chemo patients so they can't do this and then they weren't gonna do it anyway I mean wasn't their thing it's you know I'm the kind of guy that stands on the street corner and says the people look at this I did it when yeah the civil rights movement I did it for the Vietnam War I've done it for teachers I've done it for university professors I've done it for all my clients be fair you know and that's what this is about well me trying to help others get a fair shot I think that just seeing you willing to talk about it willing to be vulnerable willing to put yourself out there so that the rest of us can say yeah here's somebody that's really knows what they're talking about it's not somebody that says well if right no this is real your your listeners might be interested your watchers might be interested to know that I also spent 10 years on the employee union health fund trust board some of that time is the chair of the of that that's the largest public sector health trust in the state of Hawaii and so I know a good deal about how health insurance works and and and what it's about this is extremely costly for the state as well I thank God that I have Medicare and and I'm able to you know to get through this because I'm also have insurance if I didn't have insurance this wouldn't be an issue because it's costing to keeping me alive is costing thousands of dollars a week yes nationwide statistics say that Medicare spends more on people at the end of their lives and all of their lives and it's estimated that one day in the hospital with what you're doing is a $10,000 a day oh yeah and I've been in lots of days yes so I've been in lots of days so I've yeah now now let's let's separate this we don't want you to think that oh it's costing so much money so we're going to get rid of grandma no no no no let's do not confuse the issues go back and look at the legislation very clear yeah so this isn't something that somebody does to somebody yeah so let's let's let's clean that up don't don't think for a moment that you often hear that I know yeah well we couldn't do that you know because yeah so no trust my own siblings but seriously grandma's estate is gone by the time you get through this the medical cost we're not talking about grandma so we're not so we're not doing that okay so don't go there don't even think about that this is your choice that you get to do for yourself and nobody else gets to make that choice nobody else gets to make that decision so right don't let anybody scare you and say oh we're gonna do this no this is your choice and it is about your choice it is about each one of us we get to choose who we're gonna marry we get to choose who we go to school with when we go this place when we go on vacation we get to choose so we should be allowed to choose when the illness has taken the quality of life away from you when there is no choice when there's nothing else that medical can do for you you need to be able to make that choice so without this without this choice my end my choice is is going to be what the what what I'm left with which is starvation well don't do it yet we need you for a while so listen please self-starter thank you so much for spending this time with me and we look forward to seeing you again next Wednesday at the same time and same place hello should join her inviting you to join us as we navigate the journey the journey to the end of life the journey of looking at our possibilities of choices and options and this is a conversation we want you to join us in this conversation as we visit with people of different traditions different religions and different cultures and see what they do toward the end of life it is a wonderful time to enjoy to talk about things that we don't usually talk about and that we should talk about before the intensive care as well as the elephant in the room the elephant in the room is healthcare and we really need to look at that as we approach the end of life so join us as we navigate the journey aloha