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The world rightfully mourns the loss of at least 6,000 lives in the Syrian and Turkish earthquake. But we must also remember that, according to the United Nations, between March 2011 and March 2021, at least 350,209 lives were lost in the Syrian civil war.

Earthquakes are natural disasters we don't choose and can't prevent. Wars are man-made disasters we can prevent if we chose to do so. Our failure to do so makes our mourning for the earthquake victims seem hollow indeed.

Tom Ehlinger, Bloomington

MEDICAL AID IN DYING

I used to oppose it. Not anymore.

As a board-certified hospice and palliative medicine physician for 30 years before I retired, I find myself frequently in agreement with Edward Creagan's counterpoint, "All lives matter, even the lives of the dying" (Opinion Exchange, Feb. 4).

In fact, when I practiced in Washington state, I was a strong and public opponent to the "death with dignity" ballot initiative. I opposed because, like Dr. Creagan, I believe we underutilize resources such as hospice in our death-denying culture. I believed that almost all physical, emotional and spiritual pain can be successfully eased with the care already available. I believed that death is a fulfillment of our time here on Earth, and I have witnessed great growth and healing of folks on their deathbeds, as well as in their families. I also knew I could never prescribe drugs to intentionally cause death because my entire ethical framework as a palliative care physician is to relieve suffering, knowing that the drugs I gave could hasten death — but that my intention was always to relieve suffering primarily.

All that said, I was wrong in my opposition to death with dignity.

In fact, in both Washington and Oregon, the legalization of physician-assisted suicide has been used sparingly, compassionately and thoughtfully. In 2021, the last year of reporting, one out of 215 people who died did so through the "death with dignity" law. Each person who enrolled in the program had complete agency in decisionmaking over the period required by the law. And all had imminently terminal disease. As a hospice medical director, I was witness to several patients who chose this option. All were well served by our hospices, but all had suffering beyond our capabilities to ease. I did not participate directly in their deaths, but I witnessed great compassion among the doctors who did.

I now am living with my own terminal disease, and it is very unlikely I would need or choose this option, as my suffering will likely be brief and treatable with hospice care. Nonetheless, I have come to see that not only are these laws being using conservatively, compassionately and wisely, I believe that as a person who has death on my horizon, I should be able to do with my body as I choose. Today, Minnesotans are depriving themselves of food and water in order to hasten their deaths to escape extreme suffering. That seems barbaric to me. Surely, we can treat them more humanely, as Oregon, Washington, Montana and more states are doing.

Joanne Roberts, St. Paul

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I believe Creagan in his Feb. 4 counterpoint has it exactly backward. The summary of his commentary: "If physicians offer death as an option, if we do not advocate for every patient, we lose our patients' trust." Physicians will lose their patients' trust when they fail to acknowledge that death is not optional.

We all die. I could not trust a physician who is doing his damnedest to keep me alive by every medical option available today! Given all the tools in his toolbox that he could use to keep me "alive," I am much more horrified at the prospect of not dying.

Creagan is clearly passionate about caring for, and, as he says, advocating for, his patients. He is also correct that "we need to encourage more access to palliative (pain management) care and hospice care." However, he is simply wrong to say that we should do that "instead of" medical aid in dying. We should have both, not one or the other!

I am in favor of establishing protections for potential abuse, especially around concerns for the disabled. Creagan, with his excellent credentials, would be valuable in crafting appropriate legislation.

He says that, because of his professional history, this is "a personal issue for me." This issue is personal to each of us! All of us will die. As my own death draws nearer, I adamantly want more say and more options in what that might look like for me when the time comes.

Paige Winebarger, Bloomington

REP. ILHAN OMAR

Her dissent is what's valuable

Peter Beinart asserts that the contributions of Ilhan Omar on the Foreign Affairs Committee are significant and essential, and I agree ("When Ilhan Omar asks questions, her colleagues should listen," Opinion Exchange, Feb. 3). The Republican focus on comments Omar made about Israel and the Democratic focus on her ouster as political revenge miss the more important role that someone like Omar plays on the Foreign Affairs Committee.

Too many politicians on both sides of the aisle express a myopic view of American exceptionalism. As a patriotic American, I take particular pride in the principles of human rights and civil liberties embodied in the Constitution and Bill of Rights. The history of the United States is filled with examples of exceptional people and institutions. Likewise, our history is littered with morally indefensible actions.

While at times I take issue with Omar's communication style, I believe the questions she asks are both appropriate and essential. It is not unpatriotic to question aspects of our relationships with allies like Israel, Saudi Arabia and India. It is not unpatriotic to identify examples of our foreign policy that undermine human rights and civil liberties in other countries. Failure to do so can lead to reducing our international stature, negative consequences for people across the globe and threats to our national security.

I am proud to be a citizen of the United States, and I believe the same is true for Omar. I am proud of much of what our nation represents, but I want us to be better. That improvement is made less likely when we silence voices of dissent. Our country currently experiences too many examples of censorship of dissent. It particularly is disturbing when present in the halls of Congress.

The irony for Republicans is that Omar's committee removal only will enhance her influence. The larger responsibility, however, rests with all of us to encourage and protect freedom of expression and dissent.

Phil George, Lakeville

MINNESOTA OPERA

Musicians deserve some answers

As a frequent attendee of our region's rich live music offerings, I am disappointed to learn of the Minnesota Opera's decision to cut its orchestra's employment opportunities this season ("Minnesota Opera Orchestra musicians authorize a strike," StarTribune.com, Jan. 27). Opera management has unilaterally decided to present fewer "grand operas" (in other words, full-scale) per season, resulting in a 40% drop in employment calls for the orchestra. Also troubling are claims that management is not transparently consulting with the orchestra about its organizational budget and staffing decisions that impact their presence on stage. As of this writing, the opera has yet to release a statement explaining its rationale. (Are cuts due to financial problems? Declining ticket revenue? A new opinion about the ideal size of its productions?)

Whatever the reason, I would expect management to at least include the orchestra in its decisionmaking as equal partners. I hope the opera will reflect on how its decisions are impacting local freelance musicians' ability to support themselves through gigs in the arts economy.

Will Haugen, Minneapolis