When talking about medical aid in dying, the short answer? No. Definitely not. But there is a better, more thorough answer.
The other night I was at a dinner party with eight intelligent, thoughtful people. At some point my husband thought it was necessary to let everyone know I had become involved in starting a new non-profit organization. He said this with great pride and of course, everyone asked, “What is this new non-profit?”. They seemed very interested and I, knowing what was coming, graciously answered by telling them about the national non-profit I used to work with that advocated for medical aid in dying laws and provided on-the-ground volunteer support to people who were facing terminal illness and death. These volunteers were trained to help them through the process, find the answers they were looking for to understand all their end-of-life choices, and if they qualified, help them access the End of Life Option Act, new to California since 2016. I explained that this national non-profit closed down their volunteer support service last year, and a group of us decided to carry on the work here in California, on our own, and hence the new non-profit organization.
Of course, as always, the conversation stalled as people digested this information, and the gentleman to my right said “Well, that’s an uplifting dinner topic.” I nodded my head, smiling, and everyone chuckled. Then he said, “But that’s suicide, right?”. Knowing this gentleman was a brilliant neuroscientist, I clearly and simply said “No, it’s not.” And before I could explain, my husband, a man with excellent ears over the last few years of hearing me work with end-of-life issues, said “Suicide is driven by mental illness. Medical aid in dying is driven by a desire to control the time and place of one’s death, hoping for a peaceful death.” Bravo, husband! He nailed it.
It’s true that many people, for many years, have thought of death with dignity or medical aid in dying as many things other than what it is. Some of the terms we see and hear are “assisted suicide”, physician-assisted suicide”, or “euthanasia”. In this country and in the states that have legalized medical aid in dying, none of these are true. It’s no wonder that some physicians are still uncertain and reluctant or fearful of being a prescribing physician under the law. I’m still astounded that in Oregon, after 20+ years of the Death with Dignity Act being in place, people (and physicians!) still either don’t know it exists or know nothing of how it works.
It never fails to amaze me how much people actually do not want to talk about death. Ever. As if it will never happen to them. Or that if they talk about it they might catch it and oh my gosh, then what? But those of us who work in the field see death as just another part of life. Sure, it’s the end of our worldly life and sure, none of us really knows what comes next, but that is a personal journey to think about. The fact is we all die. The question is “how do you WANT to die?” Many of us pass from this world without even having to think about it due to accident, trauma, quick medical deaths such as a life-taking myocardial infarction or stroke. But a greater number, and a number getting bigger as medical technology improves, end up with chronic disease that will eventually terminate our lives. And that is where the work comes of knowing what our options are, including being able to ask our physician to write a prescription for a lethal drug if we have a terminal disease process in front of us that will steal our dignity, our self-sufficiency, our bodies and eventually our lives. We don’t have to go down that road if we don’t want to. Or, we can travel that road as far as is acceptable to our own individual values, and then plan the day of leaving this world with our loved ones at our side, self-ingesting a dose of medication that will put us to sleep, then into a coma, and stop our heart and leave us in peace.
That is not suicide. Suicide is a wish to die when an individual could otherwise continue to live. There is cultural shame associated with suicide. Medical aid in dying is an intelligent, well-thought-out choice. It is a decision to end our lives when we would otherwise wish to live, but that option is no longer available as disease is going to cause our death . There is no shame in that.
End of Life Choices California came into being to provide sound information and personal support to people facing the end of life, either with serious or terminal illness. There are many choices. They are spelled out on our website. I have no particular bias towards one choice or another. As a retired physician, I believe it is the patient’s right to choose what is right for themselves. I have no idea what I would personally choose if I received a terminal diagnosis.
I think we can’t know until we truly walk in those shoes. But it gives me hope and peace of mind that I have options available to me and can choose medical aid in dying if I feel it is right for me.
An interesting fact out of Oregon and Washington is that of all terminally ill people who qualify under the law and receive a prescription, only about two-thirds of them end up actually taking the medication. They gain so much peace of mind and lessening of anxiety by having that medication readily accessible that they often are then able to relax into their dying process and never take the medication. I think this is an excellent example of successful palliative care.
So no, medical aid in dying is not suicide, not by a long shot.
End of Life Choices California is committed to being there when and if people need us. Our volunteer services are available at no charge to anyone. We hope you will reach out to us via email or call (760-636-8009) with any questions. Please share this information with people you know, people you love and your medical professionals. And, if you are feeling generous, we would certainly welcome any donation to support our work. We are happy to give presentations to groups, large and small. We wish you peace on your journey.
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End of Life Choices California provides information and personal support regarding California’s End of Life Option Act and all other legal end-of-life options to the medical community and to the public.