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Death and the Quality of Life Impact Study

A very old man I knew took his own life this past spring. I only met him once, and emailed with him several times after that, but he had quite an impact on me in that very short time.

We talked about the joy he still felt in his life, music, writing, being with friends and family. He also said that when he felt less interest in living, no interest in the future, and just worn out, he knew he’d want his life to be over.

I have only known or read about people who were suffering physically or mentally to want to end their lives. Disease, illness and other neurological situations such as Alzheimer’s and ALS have been the main reasons I thought people have wanted to end it all.

Here was a man incredibly fit on all levels – physically very spry, mentally as sharp as one can be and living with gusto. He had an illustrious career, had been extremely athletic, had a great and long marriage, was surrounded by art, was an extensive writer and poet, and was surrounded by a loving family and many friends. A long life well lived. What a gift for me to have known him.

I cannot imagine a man like this living unhappily on for years, being compromised, or confined, failing, run down. He knew when the time was right he would exit with grace and dignity.

The Final Exit organization has recently done some serious research called the Quality of Life Impact Study (finalexitnetwork.org/newsandevents/psychosocialresearch). They looked at the more social/emotional aspects of people who want to end their lives, along with the physical/health conditions they have been focused on for years.

The study included 341 people from ages 20 to over 100, with 70 to 79 being the median age. Fifty-two percent of participants had attended graduate school, and most were atheist or Unitarian Universalist members, or “spiritual” in some non-Protestant way.

The trends in the study were definitely toward more social/emotional factors as more influential reasons than physical limitations or being in pain, in why these people would consider hastening their deaths.

The more important issues in the group were the hopelessness of no further acceptable treatments to improve the condition or quality of life, having to move to a nursing home, the inability to have or create a meaningful life, feeling like a burden to family or loved ones, an overall loss of autonomy, less independence, and feeling like life conditions were intolerable.

Fear of the future carried more weight than predicted as a primary reason to end life. (Pain control was not nearly as important as autonomy and meaningful existence.)

The longer we have lived an active and enjoyable life before becoming significantly limited, the less unexpected and emotionally devastating it can be when diminished abilities come. Increased awareness of time running out, or the inability to regain previous autonomy may lessen the need to endure, accept, or wish to burden others with our diminished quality of life. This can also be a feeling of having had “a complete life.”

These are not symptoms of depression, Rather, these are the reactions of emotionally healthy individuals who are fully in control of their decision making, and want to remain in control even through their dying experience. It’s what leads many people to welcome emotional relief from what could otherwise be unbearable suffering.

It was important for my friend to have this choice for himself. Such an accomplished and fascinating man, he’s made choices all his life through all his opportunities and challenges. We all have. As we take these different forks in the road, we arrive at a more finite definition of ourselves until we grow old and become who we were meant to be. Our fullness. Our essence.

There is much respect and admiration for people who make this decision. It must be very difficult to actually come to the point of no return. But again, choice is important in both ends of life, and if one has lived a good life and feels finished with it, for whatever reason, so be it.

Again, there is a difference between committing suicide and an elder choosing to end their life to avoid continued and unbearable suffering.

Martha McClellan has lived in Durango since 1993 and has been an educator, consultant and writer. Reach her at mmm@bresnan.net.