Death with dignity
Thank goodness the days of dying like my mother did twenty years ago, with end stage Alzheimers Disease, are mostly gone. She was tied down in a bed and kept biologically alive with tube feedings because she refused to eat and drink. When I saw her in the nursing home a week before her death, she was unrecognizable. I had to ask a nurse which of the two identically situated women in the room was her.
Despite more than a little kicking and screaming in some sections, the Death With Dignity social reform movement is growing. Terminal coma is commonly used nowadays in hospitals and with hospice patients to hasten death and bring comfort to terminally ill, suffering patients.
In Canada physician assistance with death for terminally ill patients has been the law of the land since June 2016. In its first year 2000 people were given lethal injections in hospitals or their own homes. A majority had cancer.
Physician assistance with death is legal in California, Oregon, Washington, Vermont, Colorado and the District of Columbia. It isn’t prohibited by Montana’s constitution and multiple legislative attempts to make it illegal since 2009 have failed to pass.
Death with dignity is sometimes referred to as a “right to die.” But I believe it’s more appropriately considered as exercising the right of autonomy, self governance, in determining the time and circumstances of death in special situations. Put the other way around, to deny individuals the freedom of self determination begs the question: If not my own, whose life am I living? Or, to whom do I belong?
Final Exit Network (FEN), the national death with dignity organization I belong to and work with, has a core belief that when mentally competent adults determine their quality of life is no longer acceptable to them, they have the basic human right to end their lives. Situations that justify the right to choose death include terminal illness and/or chronic, progressive disability with intractable pain and suffering and impending loss of selfhood and the ability to make decisions.
Suicide, killing oneself, isn’t illegal. Providing assistance for suicide is illegal in a majority of states. FEN’s unpaid, volunteer members provide education and compassionate, human support for clients who qualify for their free services. FEN takes elaborate precautions to follow the law and protect themselves from allegations of assisting clients with suicide.
To qualify for education and support from FEN, prospective clients provide a letter describing their unceasing, unbearable suffering where there is no reasonable hope for improvement. They provide medical records with evidence of receiving appropriate medical and psychological services and knowledge of other available treatment options. In a phone conversation, and later an in-person interview with a FEN Guide, clients demonstrate mental competency. Conversations take place regarding family and close associates’ knowledge of, and the extent of their support for, clients’ intent to end their lives.
The usual method of death, self deliverance, for FEN clients is breathing inert, colorless and odorless gas. Unconsciousness is rapid. Death happens in a few minutes and is peaceful. Most FEN clients choose to have a loved one present at their death. A FEN Guide, who by this time has become like part of the family, will be present to provide compassionate support if desired. Sometimes there’s a brief ceremony. FEN also provides education for ending life via voluntarily stopping eating and drinking.
With appropriate safeguards to assure that decisions to end intolerable, unrelenting suffering by death are autonomous and made by mentally competent adults, as provided in the FEN protocol, the death with dignity social reform movement will one day seem intuitively obvious if not trivial.
One day people will wonder how my mother’s caregivers could have tortured her body after her mind had deserted her.
No force on earth can stop an idea whose time has come: Victor Hugo.