Some of us are starting to think seriously about our demise, the end of our lives, the inevitable.
Colorado’s law since 2016, the Medical Aid in Dying Act (MAID) is comforting. If we have a fatal disease, and are in severe pain, doctors are there to help us end our lives with medication, if we so desire. This requires two doctors’ signatures and much paperwork, proving that there is a diagnosis and that the patient has a six-month window in order to finish out their life. However, what about many of us, who will not be diagnosed with a disease, but who will suffer nevertheless?
It is difficult enough to find two sympathetic doctors here in Southwest Colorado to prescribe the medication, especially with a Catholic hospital at the forefront of our community. Perhaps I’m pushing the envelope a bit to want more options for those who may have other reasons to end their lives peacefully.
What about those who are extremely old, don’t have much quality of life left, are not finding any joy or are overwhelmed with terrible grief and loneliness? Or have so many physical ailments that they can no longer participate in life?
My Death, My Decision put out an interesting paper titled, “When Is a Life Complete?” It identifies some factors that people may find helpful to consider in making their own personal decisions, in their own circumstances. Everyone’s situation is different, and My Death, My Decision respects these diverse range of opinions.
“Elderly, mentally competent individuals may consider that their lives are complete when they have a chronic health problem (or a combination of more than one condition), which is causing them increasingly unbearable, irreversible suffering, with the additional loss of independence, purpose and meaning in their lives, so that they would now prefer to die rather than stay alive, especially as they dread what the future will soon bring.”
Other factors that can contribute to a feeling of having a completed life are: being in the 90s and coming to terms with the approaching end point; being mentally competent and starting to feel the gradual loss of mental and physical abilities that come with aging; chronic health problems; and any increased suffering (physical, mental or emotional).
Withdrawal from life because of bodily decline, loss of identity and self, loss of personal dignity and self-esteem, a declining social network and feeling a burden to others are more aspects of feeling the endgame of life.
Psychological factors seem to be more important than physical ones for those of us considering this choice at some point in our lives. Studies have shown that those contemplating what might influence them to hasten their deaths in the future thought lack of any further medical treatments and having to live in a nursing home as the biggest factors. Also, many of us just want a backup plan, something to fall back on if we desire to end our lives peacefully and the MAID law doesn’t work for us.
There are also the neurological diseases one may have, that offer no end in sight. These may include Alzheimer’s, ALS, or amyotrophic lateral sclerosis, and Parkinson’s disease.
I’m wondering when we can provide a medically assisted suicide as an option for those who feel their life is complete, without a six-month terminal time limit, within safeguards and with professional counseling for the person considering this choice.
Many organizations are working on this very thing. Compassion and Choices, a 501(c)3 nonprofit organization, works across the nation in communities, state legislatures, Congress, courts and medical settings to educate, empower, advocate and defend individuals working through this process of a compassionate death. Colorado has a strong chapter.
There is also the Final Exit Network (finalexitnetwork.org). They are again, a national organization that educates qualified individuals in practical, peaceful ways to end their lives, offer a compassionate bedside presence, and defend people’s right to choose.
The group’s vision says: “Any competent person unbearably suffering an intractable medical condition has the option to die legally and peacefully.” They also recommend a book, called “Final Exit 2020,” which has updated information (since the original publication in 1991) dealing with end-of-life choices for those who do not have a fatal disease. For more information about the book, visit www.finalexit.org/about_derek_humphry.html.
Canada is taking end-of-life options where the U.S. refuses to go. Their law now provides a separate pathway for people whose deaths are not imminent or readily predictable, but who suffer severe disease, illness or disability. This involves the challenging realm of dementia, where every U.S. law requires a requesting applicant to be “competent.”
Colombia has just recently allowed the first patient with a nonterminal illness (ALS) to receive euthanasia. Various forms of medically assisted rational suicide have been approved in Switzerland, the Netherlands and Belgium, each having its own limits, rules and guidelines.
Oregon had bills introduced in 2015 and 2019 to expand the six-month prognosis requirement to 12 months, but both failed to pass because doctors would have a great deal of uncertainty determining who qualifies and who does not. Terminal illness would be more difficult to distinguish between chronic illness.
With the recent addition of New Mexico and Spain, individuals who live in a jurisdiction where they have a right to Medical Aid in Dying (with a terminally ill time limit) now number 413 million worldwide.
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.
