How do you feel about legal medical assisted suicide?

I apologize for this long post, but I have personal experience with this to share.

I am strongly in favor of “end-of-life” choice. I respect anyone’s decision not to choose to end his or her own life, but I believe that doing so is a choice that everyone should be able to make for him or herself.

My mother took her own life five years ago under Oregon’s “Death with Dignity” act when her metastasized breast cancer caused her lungs to fill up with fluid so that she was literally gasping for every breath and drowning in her own body.

Here are important things my family learned while going through the process:

1) If you live in a state that gives you this option, do not make the mistake of thinking that going through the process of “qualifying” and obtaining the prescription means you have to use it. Even if you think you are unlikely to do so in the end, or are just not sure whether you will want to or not, it is better to make sure you will have the choice while you can.

We were told that 9 out of 10 people who go through the process of ensuring that they will be able to make the choice if/when the time comes – that is, who go through the process of qualifying for and then obtaining the prescription – do not actually use it in the end. My mother fully expected to be one of these people. We were very sad to realize that she would not be, but very glad that she had done what she needed to do to limit the worst of her suffering.

2) Just because you live in a state that offers you the right to end your life under these circumstances, do not assume that you might not experience difficulty fulfilling your choice. My parents lived in southern Oregon, which is a very conservative region. If you or your loved one is facing a terminal illness, you need to have a very frank conversation with your doctor NOW to find out if he or she will support your choice if you decide to end your life when you are within your “six months of death” prognosis. If not, NOW is the time to find another doctor ... not when you are really sick and frail and having trouble just getting in and out of the car.

My mother was terrified and desperate to find out how to exercise her legal right to end her life if she decided she would need to. Her doctor -- who, it turned out, was religiously opposed to the idea of self-delivery -- basically mocked and bullied her for even daring to ask about it, and told her that hospice would be “enough” and that the process of death was ennobling both to the person who experienced it and those who witnessed it. After that “conversation,” my mother came home and just shook, for days. I moved heaven and earth to find her a different oncologist, and she never went back to that woman’s office. And then I scoured the Web until I found the organization that helped us.

3) Once you have your six-month prognosis, it is also vital that you not wait to go through the hoops you will need to clear to actually fill the prescription. In Oregon, you have to be seen by two doctors over a period of (if I’m remembering correctly?) a couple of weeks. Both have to agree with the six-month prognosis and that you are in a sound state of mind. Then you have to find a pharmacy that will fill the prescription. Just as doctors who are philosophically or religiously opposed to the law are not required to prescribe the prescription, pharmacies are not required to fill it. If you live in a conservative/religious area, you may need to drive some distance to fill the prescription. None of these requirements would be difficult for a healthy adult, but all of this activity is exhausting for a person who is seriously ill. It is far better to jump through these hoops while you are still feeling fairly strong -- that is, to get the prescription, fill it, and then put it in a desk drawer at home where you’ll have it if you ever decide to use it -- than to wait until you are feeling REALLY bad, but are now too weak to do what you are legally required to do to get the drugs.

In my mother’s case, we were unable to find a local doctor or pharmacy that would help. A national organization that advocates for patients’ end-of-life choices helped to put us in touch with a choice-respecting doctor about an hour away from my parents’ home, and one of their volunteers also helped to get the prescription filled in a city four hours away and drive it to my parents’ home. They charged us nothing for their help, time, or gas (for the 8-hour round trip). I have never loved complete strangers the way I loved those kind people for helping my mother the way they did. She regarded them as her saviors. So do I, to this day.

4) Whether you live in a state with end-of-life choice or not, if this is an issue that is important to you, you should check out the wealth of information online at Compassion and Choices (dot) org. This nonprofit organization advocates strongly for choice on both the national and state levels. They have volunteers and counselors who can help patients get the information and the help they need. In states without end-of-life choice, they work to get these measures on that ballot, and they also advocate strongly for palliative care and other patient rights. They are a truly amazing organization that does incredibly important work, and I cannot recommend highly enough that you find out more about them if you want to know more about this topic for yourself or for a loved one in need.

My Mom never expected to use her “final” prescription. She told me she wouldn’t do so unless things got “really bad.” Well ... things got really bad. Everyone’s cancer takes a different path. Hers caused respiratory problems, with regular build-ups of fluid in her chest so that she could barely breathe. She couldn’t lie down. She couldn’t stand up. All she could do was perch on the very edge of a chair, gasping miserably for air through her oxygen mask. They couldn’t give her morphine or other pain-killing meds because these had a further suppressive effect on her ability to breathe. By the time she elected to end her life, she was desperate to go. She hung on an extra day so that my husband and I could come up and be with her and Dad as she died.

She lay back in her favorite recliner at home. My Dad sat on one side of her and I sat on the other, holding her hand. The volunteers who had brought the prescription mixed it up, gave it to her, and took themselves discreetly away (but stayed close by in case we needed them). The law requires that the patient be able to administer the drug him or herself. My mother tipped back that glass without a single second of hesitation, and then she leaned back in the chair, gripping our hands. Over the next few minutes, she relaxed. Then her breathing just ... stopped. A few minutes later, my Dad checked her pulse and said that she was gone.

It was an incredibly gentle and peaceful death, after what had been a year and a half of painful, nauseating treatments, and at least four months of increasing agony and decreasing quality of life.

It was what I have been legally allowed to provide for every beloved animal in my life who has reached a point where suffering crowds out all else ... but which I am legally prohibited from choosing for myself, or from helping a loved one to provide for him or herself, in the state where I live.

It is what I want for myself, if and when I find myself in similar circumstances.

It is why I am terrified of developing a dementia, since that will likely prevent me from being able to exercise the right even if I live in a state that recognizes my “right to die."

It is what I grieve for my Dad not being able to choose, now that he has developed a progressive dementia (and is therefore, unlikely to be in a legally “sound state of mind” by the time he gets a prognosis of being within six months of death).

It is why I contribute to the work of Compassion and Choices ... why I support the fight to give every human being in every state the right to end his or her life when suffering becomes overwhelming ... and why I will move to a state that supports this choice if my husband or I become terminally ill.

On a final note, I strongly recommend the documentary film, “How to Die in Oregon.” It is an amazing account of the illness and self-delivery of one incredibly courageous Oregon woman who permitted her journey through this process to be documented. Aside from the fact that she lived in a progressive area and did not have difficulty finding a helpful doctor or pharmacist, her story rings very true to my family’s own experience -- and if you want an inside view of the overall decision-making process against the backdrop of family relationships and disease progress, I cannot think of a better film.

I hope this helps.

Sorry, just meant to say "This is definitely an individual's choice."

You can now add VT to the list of states that allow physician assisted death. This is definitely and individual's choice.

All my life I've made my own decisions. No one can know for sure what those last days might bring but this is one last decision I would like to make for myself. No one but me can know how I feel. While I wouldn't ever presume to make that choice for another, I want the right to call my own shots, regardless of other's opinions. Death should be at the very least humane.

I think it would be wonderful to have that option. I don't think very many would do it, but we should have the right to decide our own life....and death.

I would find the legalization of Dr. assisted suicide a great comfort. I don't know if I would actually go through with it, but knowing that it was a legal option would relieve the anxiety I feel about dying. Having watched my Grandmother and Father suffer for years has made me dread coming to the end of my life. Death doesn't frighten me, but the loss of dignity, the pain, the dependance upon others for everything, that really does frighten me. My Grandmother wouldn't have been able to make that decision for herself and I can't imagine that my Father would have chosen to end his life early for religious reasons, but I would like to have the right to decide for myself when my time comes.

I don't really have an opinion. I wouldn't want to be one involved in the final decision for someone else. One thing I am concerned about is the assisted "livacide." There is a pill or procedure for almost anything that will get a few more months/years of life. Often the life is lived in misery and pain, which can be a fate worse than death for everyone involved. I often think about how lucky the people are who are taken suddenly when they get older. They don't have to face the indignity of being kept alive against the will of their bodies.

Some people say that assisted suicide is playing god. But really prolonging life through artificial means (pills, procedures) could also be called playing god. If a person is ready to die and wants to die, I think they should have the right to let go. Someone asked recently about when should they stop giving medications. I think the answer is that when a person is dying, the only things they should receive are medications for comfort. We never stop to think that the other medications or forced food supplements we are giving are just trying to squeeze a little more life out of the person. They would not choose them for themselves, so we are guilty of assisting them to live against their will. What egos we can have!

I too am a person of faith but I believe all of us should have a legal choice. I agree with Fitzgerald, in too many cases death is prolonged under the guise of giving what is described as sound medical care. I do not fear death. What I fear is getting ill and being kept alive for years on end while exhausting my bank account or Medicare or insurance, ripping the hearts out of my family, etc. I pray this doesn't happen. Im not above begging God.
I'd just like a choice of assistance if I find I can't or don't want to handle this horrible fate. When my father learned he had Alz, mom had to take the guns out of the house. I often wonder if she hadn't what my dad would have done. He clearly knew what was ahead of him, he was from a family plagued by Alz who he watched die from it. Witnessing your parent slowly die with this disease affects you mentally in addition to breaking your heart.

I think that the fact that 'assisted suicide' is gaining support is a sad commentary on modern medicine's treatment of the elderly. There's a very hungry and very profitable machine in place that feeds on a very long, very tortured dying process. Patients are being 'propped up' long past their ability to have any quality of life by pharmaceuticals and procedures. There are some astounding statistics out there about the number of cancer treatments and heart procedures performed on people who have a diagnosis of late state dementia and a host of other terminal health problems. In the future, it may be that 'assisted suicide' will be our only way to end the torture.
Nowadays, unless you are lucky enough to die in your sleep, every last ounce of your billable ailments are wrung out you before you're allowed to go.

All for it.

In many cases, the protocols of our medical-pharmaceutical-insurance complex claim to prolong life, but are really only prolonging death.

For reasons as complicated and sometimes irrelevant as we are individual, we too often seek to delay the inevitable.

I can see how simply declining medical care can be construed as "assisted suicide."

I think that it is important for people still in their right minds to have choices. And I can see that various kinds of "assisted suicide" might be sane, even humane, choices. I would not like to be denied any of my options.

I say these things as a person of deep faith.

I know for certain my own mother would have opted for this choice. She was a huge supporter of Jack Kervorkian when she was younger and we had many an argument about this back in those days. In her later years she didn't suffer from pain, but her aging and health conditions severely affected the quality of her life. I knew she was unhappy and depressed and we were getting her treatment for that. I know she felt trapped and locked in her aging and deteriorating body and lost the independence which made her who she was. Then she had a stroke which robbed her of her ability to communicate. She could speak but was mostly unintelligible. The doctors told us in her mind, however, she was talking and making perfect sense. She could not understand why we weren't understanding her. I watched her be confused, frightened and then downright angry and frustrated. It was so hard. I loved talking to my mom and she was a great person to converse with. Fortunately, that was two weeks before she died. Her body was shutting down. She was ready (and had been ready) to go. We moved her from the hospital into a beautiful hospice facility with the most caring and wonderful workers. Mom was there less than 24 hours before she passed. Her last words to me were as clear as day, "I'm so very tired" she told me as I left. I told her "that's ok, Mom, just rest". Little did I realize she was wanting me to give her my approval to go. When I got to the hospice facility the next morning she had just passed. So like her, to go without a fuss and not having everyone standing around. She hated being the center of attention.

Well, all that being said and getting back to the original question (finally), I don't think I would be ok with this for myself or for others in my immediate family. I certainly wouldn't want to be the one to make the decision that "now is the time". I hate doing that for my pets...I can't imagine doing it for my loved ones or having someone do that for me. But that's JMHO.

My grandmother with Alzheimer's developed severe stomach pain. Her doctor who was dying of cancer himself gave her what was probably an overdose of morphine. We are forever grateful to him.

But my mother will have bad days where she thinks she's dying and just wishes it will all end. But she's not dying and I worry she would talk someone into doing it.

I just worry it will be abused.

Hospice should have been the one determining the dosage of pain medication for your grandmother and not the nursing home. As I understand it, the NH is not qualified to determine a dosage only a Hospice physician or other physician.

I just read on line today where this measure passed both houses in New England (New Hampshire I believe) I believe in this, but it should be ones personal choice, I care for my husband with ALZ, I watched my sister in law die of complications with Severe ALZ, only problem with these laws that have passed or will pass the person in question has to be able to ask for this to be done themselves, which would rule out severe dementia situations.

i read a book online last night that was rather melodramatic but this book insisted that americans are being euthanized in big numbers by hospice and that organs are never taken from dead people, only people declared brain dead and possibly coma induced. the book was pretty exxagerated but they were clear on things like dnr's under pressure and the cap that hospice can recieve for each patient. there did appear to exist hospice motives to move people to hospice houses and hasten their demise. ativan seemed to be the drug primarily used to make patients stuporous and helpless. then morphine was poured into people with copd who could never tolerate opiates and whom according to family members were not complaining of pain. hospice is a growing multi billion dollar industry and govt loves them and will block investigations and prosecution. this part i firmly believe.

Christina, I'm glad you feel tuff enough! I don't worry so much about the next life, but the transition at the end of this one....not lookin' forward to it any time soon.

Thank you all for your replies! And Mishka, great point it is a delicate topic no doubt. I think that if medically assisted suicide had been available my grandmother would NOT have chosen it based on her religious beliefs. Still I remember a few points where she was just yelling out in pain, it was so awful. Then trying to get the nurses to give her more pain meds and they looked at me like I was some vicarious drug fiend. Wikipedia has a great page on this topic and lists the status in other countries - in France they say they have a great hospice program so the subject isn't controversial except for one celebrity case. If I knew with certainty that effective hospice care would be available for my mother and me in the future maybe I wouldn't even think about this other stuff. There's just such tremendous variation from state to state on ALL aspects of aging care.

And Jinx, yep you are right most of the time the dementia has set in anyway so it's all moot.

My position on this is actually similar to my position on ab****on and divorce. They are all awful things, but under certain terrible circumstances, a person should be able to make his or her own choice. Please let's not get onto a discussion about ab****on. I know how strongly some people feel, and I don't entirely disagree.

I don't think I would ever do any of the three things, but I would feel better to know that if my husband started hitting me, I could get him legally out of my life, and to know that if I was afraid of the pain or indignity of my position, that I could keep a stash of pills in my dresser as an emergency exit.

I'm pretty sure my husband would never choose suicide. For him, I would want to make sure he got enough drugs to keep him comfortable. As a depressed person with intermittent suicidal ideation (never any attempts) I can barely relate to that, but I know what he thinks and would respect it.

One thing to know about medically assisted suicide is that a lot more people get pills and then never use them. Just having the pills helps them to relax and let nature take its course.

Another thing to remember is that our demented care receivers will never qualify for medically assisted suicide because they are not competent to make the decision for themselves. So as much as we might wish, that's not a way out for us. Just Kidding!!! (sorta.)

Hi whirlpool,
I am just plain too scared to weigh in! Good to know you are not thinking of offing yourself-- or anyone eles for that matter.

I would not choose medically assisted suicide for myself. Personally, I believe that all journeys in life are for a reason even those most painful. I do think that extraordinary measures taken to extend life is not always a good thing either. I prefer to leave a lot of things in God's Hands.
I would not move to a state based on that , obviously, then -also-who knows when that could change. Right now I would rather move to a state where marajuana is legal. Seriously.

I think this is one of those topics people might be afraid to touch. But interesting!

LOL! I took the 4 question poll today. "What if" is a biggie to consider. Definitely determined by spiritual, moral, and philosophical positions. I think faith plays a huge part. Depends on beliefs and tenets. I don't beleive in doing it. There are means to ease pain, as with hospice. Mental anguish, guilt, feeling alone and hopeless I don't think is good enough reason. But I'm tough. I believe in overcoming. I have also experienced terrible physical pain in my life, so I'm not ignorant about that. And, I'm not afraid of "death." It intrigues me. I'm ready:)
How about you, whirlpool?

bumping this up......does nobody else think about these things? I promise I'm not trying to kill myself off or anybody else.

Just thought of something else to add. Part of the issue is how good is hospice these days? I was very involved in my grandmother's end of life and she suffered quite a bit during her last decline, the nursing home didn't cooperate that well with the hospice nurse. Part of that was due to the culture of the region the home was in - they resisted giving her enough pain meds to actually work I suppose for fear of accidentally ending her life. I look forward to hearing all your opinions about this difficult topic.