By September, Nearly a Third of Americans Will Live in States With Legal Aid in Dying

From the New York Times: A Pew Research Center survey last spring found that almost two-thirds of respondents didn’t consider the practice “morally wrong,” either because they thought it was acceptable or not a moral issue. Support crossed many political and religious lines: A narrow majority of Republicans and 76 percent of Democrats both found “physician assisted death” (also sometimes called “physician assisted suicide”) permissible; so did most Catholics, Jews and nonevangelical white Protestants. In New York, a Siena Poll found that 54 percent of respondents supported aid in dying, including majorities of men and women, of all age groups, and of city, suburban and upstate residents. A plurality of Latinos supported it; Black respondents narrowly opposed it. Passing these laws has grown somewhat easier, said Thaddeus Pope, a bioethicist and professor at Mitchell Hamline School of Law in St. Paul, Minn., who tracks such policies. “You can say, ‘We have 10 years in California, 18 years in Washington and 29 years in Oregon, and nothing bad has happened.’ It becomes more accepted.” Yet legalizing medical aid in dying, or MAID, has been and remains a long, contentious process. Catholic leadership and many disability organizations staunchly oppose it. (Pope Leo XIV personally asked Illinois Gov. JB Pritzker not to sign the bill.)

More States Allowing Assisted Death

From the Washington Post: Oregon, the first state to enact an assisted-suicide law in 1997, extended the practice to nonresidents in 2023. Delaware, Illinois and New York legalized assisted suicide in recent months. And at least 15 states are expected to weigh similar legislation this year, although it is permitted only when people are terminally ill with just six months or less to live. They also must be mentally competent — disqualifying anyone with advanced dementia — and be able to ingest the prescribed life-ending drugs on their own. Other countries, including Canada, Belgium and the Netherlands, have made the practice even more readily available, allowing doctors to administer lethal injections to patients who doctors say face unremitting suffering with no hope of improvement, whether death is imminent or not. As I noted ten years ago in the HuffPost, "Baby boomers have spent more than half a century revolutionizing the way we live. Now it is time for us to revolutionize the way we die."

Gavin Newsom on His Mother's Assisted Death

California governor Gavin Newsom held his mother's hand as she died in 2002. In his book he talks about his complicated feelings about her and her choice to have an assisted death. From the Washington Post: It was the spring of 2002 when Gavin Newsom’s mother Tessa, dying of cancer, stunned him with a voicemail. If he wanted to see her again, she told him, it would need to be before the following Thursday, when she planned to end her life. Newsom, then a 34-year-old San Francisco supervisor, did not try to dissuade her, he recounted in an interview with The Washington Post. The fast-rising politician was wracked with guilt from being distant and busy as she dealt with the unbearable pain of the breast cancer spreading through her body. Newsom’s account of his mother’s death at the age of 55 by assisted suicide, and his feelings of grief and remorse toward a woman with whom he had a loving but complex relationship, is one of the most revealing and emotional passages in the California governor’s book.

A Place to Live While You Plan to Die

From the Washington Post In a pastoral Vermont valley, a former hospice chaplain named Suzanne runs a retreat center for artists, health-care workers and educators — and, since mid-2023, terminally ill people seeking a safe, peaceful place to die. Suzanne, who asked that her last name not be used for privacy reasons, is one of a small but growing number of property owners who have been providing space to people coming to Vermont for physician-assisted dying since the state lifted the residency requirement for a 2013 law allowing terminally ill patients to end their lives on their schedule.

'Susan' - Documentary About Assisted Death

Study: Cancer and ALS Patients are the Most Frequent Users of Assisted Dying

A new study shows surprising consistency across the jurisdictions that allow medically assisted death. Overall, most people who accessed voluntary assisted dying had cancer (66.5% of cases). Neurological diseases were the second most common (8.1%), followed by heart (6.8%) and lung (4.9%) conditions. We also looked at what proportion of people with each disease accessed voluntary assisted dying versus dying by other means. Even though voluntary assisted dying rates and eligibility criteria vary by location, the rates for specific diseases were surprisingly consistent across regions and time periods. For example, people with amyotrophic lateral sclerosis (ALS) – a rare, progressive, fatal disease that damages the brain and spinal cord – had the highest rate of voluntary assisted dying. People with ALS accessed voluntary assisted dying at a rate nearly seven times higher than people with cancer. Meanwhile, cancer patients were four times more likely to access voluntary assisted dying than those with lung disease, and ten times more likely than those with heart disease. What does this tell us? Cancer and ALS, which appear to be the main reasons people access voluntary assisted dying, have very little in common. But both often cause a more rapid decline in health and a greater perceived loss of dignity than other conditions.

The Doctor Behind the ‘Suicide Pod’ Wants AI to Assist at the End of Life

From Wired Magazine:

The world's first assisted suicide pod wraps around the human body like a space capsule, tilting gently toward the sky. The device is designed to look as if the person inside were embarking on a journey, says its inventor, the Australian right-to-die activist Philip Nitschke. “It gives you the idea you’re saying goodbye to the world.” Last month, the 3D-printed pod was used for the first time. In a forest on the Swiss-German border, an unnamed 64-year-old American woman pressed the pod’s button to release deadly nitrogen gas. She died seven minutes later, estimated the Swiss assisted suicide group The Last Resort, whose president Florian Willet was present at her death and was later detained for “aiding and abetting” the woman’s suicide...With the Sarco pod, Nitschke proposes taking the assessment process out of the hands of medical professionals—whom he calls “gatekeepers”—and eventually delegating the task to machines. “I think a machine could do it better,” he tells WIRED. The Sarco machine has the ability to ask its users three simple questions, says Nitschke: Who are you? Where are you? Do you know if you press this button, you will die? If the person inside the pod responds to the questions with the correct preprogrammed answers, a blue button lights up.

She Was Not Incurably Ill But She Wanted to Die -- And She Did

"In the last months of her life, the only thing that appeared to give her real joy was the hope that she would be ending it." In New York Magazine, Evelyn Jouvenet (a pseudonym) writes about her mother's assisted death. In June, my sister and I had learned, almost by accident, that she was seeking an assisted suicide. I was on the phone with Mom, listening to her complain about an annoying bureaucrat at the New York County Clerk’s Office, when she mentioned it. “I am putting in an application to Pegasos,” she said impassively, “so I was getting some documents for them.” I texted my sister while we were on the phone: “What the fuck? Why didn’t you tell me about Mom applying to die?” Three little dots. “Wait,” My sister wrote back. “What. What is she doing?”... In the last months of her life, the only thing that appeared to give her real joy was the hope that she would be ending it. In the U.S., ten states allow physician-assisted death, which is available only to residents who are terminally ill with no more than six months to live. In Canada, the laws are more expansive, but citizens still need a diagnosis — if not a terminal condition, then an incurable one with intolerable suffering and an advanced state of decline. In Switzerland, where a foreigner can go to receive aid in dying, there are fewer restrictions on who is eligible. Pegasos is one of the only organizations that will help elderly people who have not been diagnosed with a terminal illness but who are tired of life. Its website notes that “old age is rarely kind” and that “for a person to be in the headspace of considering ending their lives, their quality of life must be qualitatively poor.” My mother had pinned her hopes on this “tired of life” catchall. She had a three-pronged rationale, she told us over the phone: The world was going to hell, and she did not want to see more; she did not get joy out of the everyday pleasures of life or her relationships; and she did not want to face the degradations of aging. This is exactly the situation that most horrifies opponents of medically assisted death. How can you be sure this is a rational decision and not the result of clinical depression? This article, heartbreaking from the daughter's perspective, will not reassure them. And yet, her mother's resolve, and her history of being immune to the impact her choices have on those who love her, make it clear that one way or another, she was determined to end her life.

Khin Myint on His Sister's Decision to Die

In Slate, Khin Myint says he accepted his sister's decision to die as her right. But "It took me years more to realize something deeper about how we view human euthanasia." He writes about the difficulty of accepting her decision because she experienced psychotic breaks and so the choice might not meet whatever standards there are for independent, rational judgment. My sister Theda had been bedridden for seven years when she first decided she wanted to die. She was 32 then, and a mysterious chronic illness had diminished her will to live. Though it wasn’t legal in Australia at the time, she wanted to die by euthanasia. Technically, this would classify the death she wished for as a suicide. But ethically—and within the family—we understood it differently. ... When we recognize that mental and physical illnesses are not so cleanly divided, we can also question the usefulness of that “divide” for deciding on someone’s right to die. Should a person experiencing a temporary mental health episode be considered a euthanasia candidate? Everyone would agree the answer is no. Just like someone experiencing a bad case of mononucleosis shouldn’t be given the right to a medically assisted death, nor should someone experiencing an episode of depression. But should someone’s right to die be explicitly about their diagnosis? When someone’s suffering is intolerable and without an end in sight, that should be enough of a reason to consider their right to a peaceful death, on a case-by-case basis. We should listen to people in that situation when they ask for more rights, no matter the cause of their illness, as a cause may not be able to be neatly untangled. ... I wasn’t mad at Theda for ending her life. She had chosen euthanasia after reaching the end of what she could tolerate. I knew that it no longer mattered whether her illness had been in her body or mind. All I knew is that she was no longer suffering.

A Loving Brother Writes About MAID -- Medical Aid in Dying

Steven Petrow writes in the New York Times, I Promised My Sister I Would Write About Her Death. An excerpt:

I joined a conversation my sister and her wife were having with a social worker, a new member of their hospice care team. They kept discussing “the MAID,” which I soon came to understand is the acronym for the New Jersey law referred to as Medical Aid in Dying. It allows New Jersey residents with terminal illnesses to choose to end their lives by taking a cocktail of life-ending medications. 

This important piece of legislation was enacted in 2019, and as of last year, 186 people had chosen to die this way. (That’s a very small percentage of annual New Jersey deaths.) Julie, a lawyer, had done her research and had told me that the Garden State is one of only 11 jurisdictions (10 states and the District of Columbia) that allow medical aid in dying, also known as death with dignity and end-of-life options....

With the MAID request approved, Maddy, Julie’s spouse of 35 years, picked up the prescription from a local pharmacy. The price: $900, which is not covered by Medicare, the Department of Veterans Affairs or many private insurance plans. A study published in The Journal of the American Geriatrics Society last year found that 96 percent of people who died by medical aid in dying were white and 72 percent had at least some college education. “The reality is that communities of color, for a wide variety of reasons, also are more likely to utilize aggressive care and less likely to use other end-of-life care options, such as hospice and palliative care,” explained Ms. Callinan. People without the resources to pursue MAID may be forced to make a different choice: suffer through a painful death or take matters into their own hands. “Be sure to include these statistics when you write about this,” my sister directed me.

With her pain unabated, my sister’s next task was to choose the day she would die. Our entire family supported Julie’s decision; still, we did not want to say goodbye. We made silly excuses for why certain days were inconvenient. 

The Allure of Assisted Suicide

A fact-checked debate about euthanasia

"Nature Has Its Way of Ending Life. I’m Changing the Manner and the Time" -- Voluntary Assisted Death

From Rachel Handler in New York Magazine's The Cut: A few weeks ago, my partner Adam’s grandpa David called to let us know he was proceeding with his plan to have a peaceful, dignified death. David had been diagnosed with Parkinson’s ten years earlier, and in the last two years, as his mobility and quality of life had slowly declined, he’d been openly considering what is commonly referred to as voluntary assisted death (VAD)....On that Wednesday morning, we spoke for about 20 minutes, and I peppered him with questions about the logistics and decisions behind his planned death. I recorded the conversation, because I knew that Adam would someday want to hear it — he’d told me earlier he was worried that without me (obsessive, exhaustingly curious) by his side in Chicago, he (calm, normal) would forget to ask all of the questions he wanted to ask of David....I found his decision to die on his own terms fascinating, brave, terrifying, devastating, infuriating, and awe-inspiring. Selfishly, I wanted to understand everything about that choice. Some coomments from David: I started the process two years ago. I didn’t know whether or not I’d need it. That’s why we buy insurance; you may never need it, but if you do, you’ve got it. But it changed when my eyes no longer worked and I couldn’t control my fingers. That’s when I said, “I have to go.” ... I’m not the least bit scared. I’m scared if I don’t do it — that’s my fear. That’s why I am calling the people I know to say good-bye. I want them not to be scared for me. I’m not happy I’m doing it. It’s contrary to my belief about life, which is so precious, so unique, so wonderful. I don’t want to do this. I don’t want to leave this wonderful world, leave you and Adam, and what life’s about. But I don’t want to end up like people I’ve watched die. It is brutal. That’s where I’m going. And I have a choice not to do it. I have a choice to be remembered as being alive, and not looked at with pity. Climbing the hill of life is challenging but marvelous. The way down is slippery. Literally. It’s easier to walk up than down. Even though gravity helps you. I have these conversations so people like you can process it and not feel sorry....I don’t want to let Mother Nature dictate me. I’m challenging Mother Nature. How presumptuous of me. Who am I not to allow her to do her thing? But when I see friends, what they’ve gone through in their dying days … I’m just preventing that. The burden on individuals and on society. Consuming medical attention that the young people are entitled to. I’ve thought this through for two years. I’m very comfortable with what I’m doing.

An Assisted Death Machine is Being Tested in Switzerland

From the Washington Post:

People wishing to end their lives in Switzerland — one of a handful of countries that give the option — could soon have access to a new method: a 3-D-printed pod that its creator says can painlessly end someone’s life in a matter of minutes. Real-life participants will start trying the coffinlike “Sarco” during trials set to begin in early 2022, the capsule’s creator, Philip Nitschke, told The Washington Post this week. A legal analysis commissioned by his nonprofit, Exit International, recently concluded that use of the pod will not violate Switzerland’s assisted suicide laws, he said. At the push of a button, the pod becomes filled with nitrogen gas, which rapidly lowers oxygen levels, causing its user to fall unconscious within a minute, Nitschke said. A person does not suffocate or experience distress, he said, but rather dies of oxygen deprivation after they’ve fallen asleep. In theory, the capsule can be towed to a place of someone’s choosing, said Nitschke, who described the machine as a “stylish and elegant” way to die.

"Don’t call it ‘assisted suicide’"

 A letter to the editors of The Washington Post from Donna Smith of Compassion & Choices objected to the term "assisted suicide."

Using the term “assisted suicide” to describe medical aid in dying is inaccurate and offensive to terminally ill individuals, who want to live but their disease is killing them. They just want the option to end their suffering peacefully if it becomes intolerable.

In fact, data from authorized jurisdictions shows one-third of terminally ill individuals who receive aid-in-dying medication don’t end up taking it, but they get peace of mind from knowing they can take it if they need it.

A New Machine for a Gentle Assisted Death

The Washington Post reports on a new machine for those who wish to have an assisted death.

People wishing to end their lives in Switzerland — one of a handful of countries that give the option — could soon have access to a new method: a 3-D-printed pod that its creator says can painlessly end someone’s life in a matter of minutes....

At the push of a button, the pod becomes filled with nitrogen gas, which rapidly lowers oxygen levels, causing its user to fall unconscious within a minute, Nitschke said. A person does not suffocate or experience distress, he said, but rather dies of oxygen deprivation after they’ve fallen asleep. In theory, the capsule can be towed to a place of someone’s choosing, said Nitschke, who described the machine as a “stylish and elegant” way to die.

BLACKBIRD Trailer (2020) Mia Wasikowska, Kate Winslet, Sam Neill, Drama ...

Canada debates offering physician-assisted death to patients who aren’t terminally ill

Ron Posno has early-stage dementia. He wants to make sure that if his capacity becomes so diminished, he can take advantage of Canada's assisted death law. But it does not provide for people with dementia.

Posno figured Canada, which in 2016 passed a federal law on what people here call medical assistance in dying, would be a place where he could set out his wishes to die on his own terms while he was still competent. As it turns out, “advance requests” like the one he tried to make are not allowed.

Now the government of Prime Minister Justin Trudeau has introduced a bill that would overhaul the process.
Polls show widespread support in Canada for broadening access. But much like the law it is intended to replace, the bill has faced criticism — for being too restrictive or too expansive or too confusing.

For Posno, “it failed dementia patients again completely.

...

Canada’s law is more liberal than those of the U.S. jurisdictions where the practice is legal. In those jurisdictions, which include California, New Jersey and the District of Columbia, only mentally capable, terminally ill patients with a prognosis of six months or less who can self-ingest the drugs are eligible.

But implementing the law in Canada has not been without challenges.

Doctors puzzled over the definition of a “reasonably foreseeable” natural death. Ellen Wiebe, a physician based in Vancouver and one of the first in Canada to provide medical assistance in dying, remembers hashing out policies in email discussion groups.
Criticism exploded in 2018 over the case of Audrey Parker, a 57-year-old woman with terminal breast cancer that had spread to her brain. Fearful that the disease might rob her of the mental cognition to consent a second time, she scheduled her death earlier than she otherwise would have wished.

Doctors reported that patients were forgoing pain medication, even though it increased their suffering, so they could provide that second consent.

”

Canada debates offering physician-assisted death to patients who aren’t terminally ill

Washington Post: My terminally ill mother wanted to end her own life. What would it take to fulfill her last wish?

Tim Zimmermann writes about his mother's assisted death in Washington DC, the great difficulty they had in filling the prescription, and her determination to die on her own terms:

On a Sunday evening in July 2018, my 81-year-old mother raised a small red glass to her lips. In it was a mixture of water, grape juice and 10,000 milligrams of Seconal powder, a massively fatal dose of a barbiturate most commonly used for insomnia. She was sitting up in a hospital bed in her Washington, D.C., home, bathed in warm early evening light and wearing a thin white nightgown. She had spent the weekend calling close friends and loved ones to say goodbye, and chatting and passing time with me, my sister and all her grandchildren....According to the D.C. Department of Health, my mother was one of two D.C. residents to kill herself last year using the 2016 Death With Dignity Act. (A third, Mary Klein, the law’s most vocal citizen-advocate, also took her own life but for some reason does not show up in the department’s statistics.) The law, which allows terminally ill patients to end their lives with a fatal dose of drugs prescribed by a doctor, puts Washington at the leading edge of humane end-of-life options: Only nine states plus the District — and just a handful of countries — allow medical aid in dying.... As she approached her 80s she had already decided that, when the time came, whatever illness or decrepitude she might confront, she wanted to be master of her fate....There was no way she was going to let a disease dictate her fate, or try to hang on day after day while it slowly consumed her. “I want to be remembered as ‘Teeny full of life,’ not ‘Teeny the cancer patient,’ ” she told my sister Quinny.

The (Planned) Death of a Champion

The New York Times reports on the scheduled death of Marieke Vervoort, a para-athlete, eleven years after initially preparing the paperwork.

[A]fter more than a decade of uncertainty and pain and joy, of opening her private life to friends and strangers and reporters, of inspiring others, of vexing them, of wishing for the end of her life and at the same time fearing it, Vervoort had invited her loved ones to her home for the most heart-wrenching of reasons:

In three days, she had an appointment to die....

There was, also, a faint feeling of uncertainty in the air — an unspoken question of whether this really was the end, a nanoscopic hope that it might not be. Almost three years had passed since two journalists from The New York Times — the photographer Lynsey Addario and I — began spending time with Vervoort to chronicle the end of her life, to observe a top athlete taking control of her destiny in an extraordinary fashion. Being around her during that time sometimes felt like one extended, indefinite goodbye.

She had come close to scheduling her euthanasia on multiple occasions, but had always switched course, found a reason to put it off. Something would come up. Conflicts would emerge. There would be another date to look forward to, another reason to live....

“I’m looking forward to it,” she said of her death. “Looking forward finally to rest my mind, finally have no pain.” She paused. “Everything I hate will be over.”