A terminally-ill friend is pursuing physician-assisted dying in a state where it is legal to do so. He’s talking about a “farewell weekend” sometime in the next several months: the details aren’t clear yet, so I don’t know yet whether this would be a gathering where people hang around while he takes the death pill and dies, or just a nice weekend together followed by his death at a later time/date after everyone has gone home. It’s all kind of freaky to consider; there’s just no good way to deal with the impending death of someone you care about.
Do you know someone who has undergone legal physician-assisted suicide? What sort of arrangements did they make/want for their final days/hours?
A friend of mine planned to, and got the pills, but by the time he got sick enough to want to ask for them, his brain had started shutting down and he was no longer coherent enough to do so.
I plan on getting them when it gets to that point. I don’t know if I’ll wind up taking them or not - it depends on how painful things are - but I really appreciate having the option.
Not a personal experience, but on the Netflix show “Grace and Frankie”, there was an episode where their close friend held a big going away party, after which she “went away”. Grace and Frankie helped make sure everything was taken care of properly afterwards. I can’t remember if everyone at the party knew what the party was really about, but I think not. It seemed like a good way to handle it. Have a big party where everyone can have fun, but only have a close friend or two know the whole truth. I think if everyone knew, it would be too somber and a very sad experience.
You might suggest to your friend to watch that episode to help figure out how he wants to handle his situation.
I have a physician friend who was doing the triage during a disaster, and some of these were people who were definitely going to die no matter what he or anyone did. And they got enough morphine to make sure they died without pain, and if they got enough so they didn’t continue suffering I don’t think anyone would blame him. I would hope that someone would be as kind if I found myself in that situation.
Hypothetically, if this is what happened, it’s unlikely to be legal. May I suggest that you don’t speculate about what your friend may or may not have done in a public space like this. He or she could get in a great deal of trouble.
I have not personally gone through this with anyone, but I live in a Right-to-Die state. It is different than “physician-assisted suicide,” because no physician takes part in any way except to the extent that they will prescribe the drugs if someone asks and qualifies under our laws. The rest of the process is handled entirely by the individual who obtained the drugs.
If the state you are referring to is Oregon, then I urge you to watch the film, How to Die in Oregon. It is very enlightening about how our law works.
From the film I learned that people utilize the option in all sorts of ways. Some people prefer small family gatherings, some want a larger farewell occasion… and a surprising (or maybe not) number go through it the way Maggie the Ocelot’s friend did. Once they obtain the drugs, it’s enough to know they have the means to control the situation if things get too bad. Some people want others present when they actually die. Others just wanted a chance to say goodbye but preferred their actual dying to be a very private matter.
My suggestion to you is to play it by ear. I am sure your friend has very definite ideas about what they want, and those will be included in their invitation.
Finally, I would say for you to do what is comfortable for you. If your friend wants people around when he dies and that’s a bit more than you want to take on, I am sure he will understand if you say your goodbyes and leave him to it with others who are ok with the process.
My best to you as you go through this. Saying goodbye, no matter how it happens, is a dreadful emotional wrench for all involved.
I don’t know how “doctor assisted” it was in detail but my former college roommate killed himself in his early 30’s because of a terminal brain tumor. His obituary uses the phrase “death with dignity” to describe it. We were never all that close especially at the end of two years together but it was really sad because he had a young daughter and he was an only child. His mother killed herself shortly thereafter as well out of grief.
I hope this doesn’t sound inappropriate, but I hope the OP will share how this goes with the rest of us. With appropriate concern for the privacy of the Guest of Honor.
States such as Oregon are leading the way out of our Dark Ages Papist morality about the challenging process of dying in the era of modern medicine. The more we each learn of this the better prepared we will be for when we get to play the role of the OP or his friend.
Here’s an interesting article I came across while looking for another article I remember reading. This is about a woman I’d call a death doula, for lack of a better term. She helps people with the death they want, rather than what’s foisted on them by the medical community or family members.
A big part of “dying well” is having the hard conversations with the people who will be acting on your behalf when you can’t speak for yourself.
My husband opted for more aggressive treatment that I might have in his situation, but that was entirely his choice. And when we ran out of things to combat the cancer we moved to keeping him as comfortable as possible. A half an hour before he died he stated he was *not *in pain, although he was afraid and felt very bad because he knew his death would hurt me terribly, but there wasn’t anything to be done for it. We didn’t have to drug him into a coma, but if that was required to keep him out of pain we would have done so.
But it was hard - and I’m not referring to the difficulty of facing the death of a loved one. Modern medicine is very interventionist. I had one doctor trying to talk me into putting my husband on dialysis up until the day before he died, accusing me of giving up on him, of killing him, because his kidneys had failed and OMG YOU HAVE TO PUT HIM ON DIALYSIS! Umm… no, actually I don’t. For one thing, he was able to state he didn’t want it. If you then insist he’s too sick to make that decision I still don’t have to do that on his behalf. And, oh yeah, my sister, the hospice MD, also agrees with that decision. Fortunately, both his PCP and oncologist were on board with his wishes and also concurred that, at that point, dialysis was pointless. But that’s just one example of what I was facing at the end of his life, there really is a push by some people to DO SOMETHING!!! Well, we were doing something… we were trying to make him as comfortable as possible. Which did not include dialysis. Or another CT scan. Or surgery. Or transferring him to intensive care. Or a bunch of other stuff. He didn’t want assisted suicide, he just wanted to go out as painlessly as possible with his loved ones next to him. And that’s what he got. It was hard, but I’m really glad I could do that for him.
Oh, yeah - my sister with her MD spends every day at her job taking care of the dying, trying to maximize the quality of their life rather than the quantity. Sometimes the hardest thing to do is “do nothing”, to step back, but sometimes it’s also the best thing.
Something I have heard of many times in Ca. was situations where the Dr, would say just give him as much as he needs to stay out of pain. Almost like it was some kind of code word to give him an overdose when the time comes. This was almost always at the very end anyway.
Even if just prescribing the drugs is all the physician does, it’s still considered “physician-assisted”. The patients couldn’t obtain the drug without the prescription. AIUI, all the other states that have it closely followed Oregon’s law. Well Vermont didn’t follow it real close, but I think this aspect is the same for their law.
Now some sources will say that Montana has physician-assisted suicide, but that’s not strictly true. They don’t have a law; they have a court decision giving physicians a legal fig leaf to cover their butts if they engage in assisting suicide. So there, doctors may or may not get more involved in the process.
When the doctor says “give him what he needs to stay out of pain” that is entirely legitimate medical use but at no point is a deliberate overdose given. That is NOT a code for “kill the patient”.
Because most of the more effective painkillers suppress the breathing reflex it is possible for a large dose to hasten death but that is NOT the end goal - the goal is to relieve pain. Not kill the patient.
Spreading around the myth that doctors are using code phrases to instruct people to deliberately kill patients is NOT going to help the debate or the fight to make end of life care more humane.
Thanks for the suggestion, but my friend is in Colorado. The law there was just passed last fall, so it’s all quite new. I don’t know whether I’m using the terminology correctly. AIUI, the process (after lots of checking, double-checking, and counseling by medical professionals) involves receiving a prescribed pill; it’s then up to the patient to self-administer the pill. No outside assistance is allowed for that step: the patient has to be able to get the pill into their own mouth and swallow it unaided.
Thanks for the link. I think this is probably the sort of thing my friend has in mind. I can’t say it sounds like a pleasant occasion, but I suppose it might be the least unpleasant. It would be hard for me (as an attendee) to sustain any sort of revelatory mood, knowing what comes next.
I’ll let you all know how things unfold in the months ahead.
Have heard of both scenarios - a farewell gathering with death either at the time or delayed.
People have been killing themselves due to intolerable illness for many years.
Thomas Edison comes to mind - His was not a particularly nice exit. The gathered thought they were just witnessing a will.
In first year, CA had 111 persons get the barbiturates. Don’t know how many took them (not unheard of for a person to simply want to have them on hand as an option).
The problem is the requirement that the patient have no more than 6 months to live.
That can mean the difference between a coherent petitioner and a person too far gone to make his request understood.
There needs to be a mechanism whereby the patient can, long before the final 6 months, say “When time comes, please acquire and administer the lethal dose to me”.
The kindness thing a person can do is, from time to time, deliver a bullet to the temple of a loved one.
If there was a pill that would end a loved ones suffering, I just might break one more law.
And you know such behavior would be written as Murder in the First Degree.
Nice country we have here, isn’t it?