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.

Poems on Grief

 “I Suffer a Phobia Called Hope” by Maya Abu Al-Hayyat

“Black Snow [I came home]” by Carl Adamshick

“A Great Beauty” by Cyrus Cassells

“Aspen Tree” by Paul Celan

“Greensickness” by Laurel Chen

“I measure every Grief I meet (561)” by Emily Dickinson

“Audience” by Maritza N. Estrada

“Elegy for the Disappeared” by Forrest Gander

“Praise Song” by Hafizah Augustus Geter

“On the Last Day, the Bullet is Asked” by Sadia Hassan

“My Dead Friends” by Marie Howe

“Hail, Mary” by Maria Lisella

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. 

Funeral Poem - If I Should Go By Herself & All Her Friends - By Joyce G...

The Allure of Assisted Suicide

A Hospice Nurse on Embracing the Grace of Dying

From an interview with hospice nurse Hadley Vlahos in the New York Times:

What should more people know about death?

I think they should know what they want. I’ve been in more situations than you could imagine where people just don’t know. Do they want to be in a nursing home at the end or at home? Organ donation? Do you want to be buried or cremated? The issue is a little deeper here: Someone gets diagnosed with a terminal illness, and we have a culture where you have to “fight.” That’s the terminology we use: “Fight against it.” So the family won’t say, “Do you want to be buried or cremated?” because those are not fighting words. I have had situations where someone has had terminal cancer for three years, and they die, and I say: “Do they want to be buried or cremated? Because I’ve told the funeral home I’d call.” And the family goes, “I don’t know what they wanted.” I’m like, We’ve known about this for three years! But no one wants to say: “You are going to die. What do you want us to do?” It’s against that culture of “You’re going to beat this.”

...

Do these experiences feel religious to you?

No, and that was one of the most convincing things for me. It does not matter what their background is — if they believe in nothing, if they are the most religious person, if they grew up in a different country, rich or poor. They all tell me the same things. And it’s not like a dream, which is what I think a lot of people think it is. Like, Oh, I went to sleep, and I had a dream. What it is instead is this overwhelming sense of peace. People feel this peace, and they will talk to me, just like you and I are talking, and then they will also talk to their deceased loved ones. I see that over and over again: They are not confused; there’s no change in their medications. Other hospice nurses, people who have been doing this longer than me, or physicians, we all believe in this.