I have been trying to kill myself since I was sixteen. Before sleep, I pray to die while unconscious. I am a coward. But a gun ought to do it.
Shotguns. Hospitalizations where everything I ever dreaded was perpetrated against me. Scars are not limited to the psychological. Life is not scared.
I am rational. I just hate life.
Medical science is a satire. As a child I was repeatedly raped. No one wants to hear it. It has been like existing in a vacuum where no one hears anyone.
It has been a life of complete failure. Forget relationships. My anger about being forced to be here means no relationships. Safety net? None. Social security? None. I can hold a job for a couple of weeks.
Deep poverty is a deep well. Homelessness is a deeper well. Avascular necrosis is so deep, there are no words. Heroin will not touch it. All my bones have been broken just walking around. Brittle bones, I seek no medical assistance. How to pay? The pain is breath-taking. Yet I keep waking up and waking up. Alive.
Seriously, there is no god. Being here -- to me -- is in and of itself a convulsion of torment every waking moment. You either want to be here in this horrid life, or you are cast out. Writing is a waste of time.
I know what people think. You have no tools to reach me. Nothing changes. Homeless? I try to crawl into spaces where I am not kicked, robbed, urinated on, frozen, or clubbed by the police.
I just don't want to be here. You write about it, but you do not live it.
Let me go.
18
I fully support the decision of those who wish to avoid pain and suffering at the end of their lives. I was a caregiver and saw how families sought truly awful medical intervention for terminal illnesses, praying for a Hail Mary against the inevitable outcome of death. The results looked a lot like human torture to me, and I vowed I would not suffer a similar fate when my expiration date approached.
I myself am a suicide survivor, and while I’m grateful for the second chance, I will not allow my family to pursue outlandish and useless treatments at the end of my life. I reserve the right to call it quits on my terms.
20
Rational suicide? Is that like an “imaginative” death? Death with “reason”? The ability to take your own life without making an ungodly mess for someone should be on the table.
15
I recently watched the movie "Harold & Maude" again,for the first time since it was released in the early 70s. One thing I had completely forgotten was Maude's death. She believed in living big, living life to its fullest, but also in ending it before you lost control over it, so she took an overdose on her 80th birthday. It amazed me how completely acceptable that was when the movie was released, but now it would be subject to all sorts of suspicions. She had managed to put aside a stash of something that, taken in a large enough quantity, would end it all. Now with all the hand-wringing on opiods, the scolding on seniors taking benzos, etc., it would probably be nearly impossible to do that, leaving what many of us would consider less appealing, but certainly easy to get, alternatives -- guns, garages, etc. It's a shame.
21
This is not about the central issue, but to correct what appears to be a misconception about colonoscopy. A major reason to have regular colonoscopies is that they can identify very small polyps early enough that can be removed during the colonoscopy itself, without surgery or chemotherapy.
I can understand at some point wanting to avoid long and painful treatments, but that is not a reason to avoid colonoscopies.
9
I'd like to know why, it seems, anyone commenting here about this utra important and serious topic is rather ostracized for mentioning God. Not religion, but God. There is a pretty good possibility that many reading this editorial are looking for comfort. Looking for something spiritual and multidimensional... not laced with damnation and preaching, but understanding and compassion. For those who have been to Hell and back, or are contemplating suicide for the first time, reading something at least -soulful - may help.
5
I prefer “higher power”. That has much less baggage than the politicized ‘god’.
7
Earlier this year my mother's best friend and her husband decided it was time to end their lives. She was 85, with rheumatoid arthritis and he was 88 with Parkinson's disease and early signs of dementia. It was a supremely rational decision. They called in hospice and simply quit eating and drinking. Their three children flew into town and stayed with them until they died. It took almost two weeks, but they didn't suffer unduly, and they never wavered in their resolve. I was awed. And I was horrified that it was so difficult to actually die once they had decided it was time.
My father is in a memory care unit in an assisted living facility. At one time he was a law professor and a life master in bridge. Now he doesn't even know what bridge is and relies on others to do everything for him. He always said he didn't want this to happen to him, but dementia snuck up and took away his ability to make any decisions.
The decision to die in old age can be the most rational decision we ever make. No one has a right to interfere with it.
49
@Rachel I went to law school in San Francisco and recall reading, several years after I had graduated and ultimately moved to the east coast, of the death, along with his wife, of a much loved and highly regarded professor there. One of them was I think seriously ill, I can't remember which one, but recall they decided they didn't want to live one without the other or one suffering greatly, so they just ended it for both as far as I know. I had great respect for this man and knowing of his decision makes it easier for me to consider my own situation. I believe they were Jews who fled to the US from Europe during or after WWII. I can't imagine anyone more entitled to make such a decision.
19
When I was sixteen I wrote my confirmation paper from Hebrew school on euthanasia. Taking my position from the Talmud which loosely says;
When a man is dying and someone chopping wood outside his room keeps him from dying peacefully, he must stop chopping wood. But the man chopping wood cannot come into the room and chop the dying man to give him a quick death.
I took this to mean in modern terms that you cannot keep someone alive with extraordinary measures, but nor can you euthanize the patient.
At 63 I still believe this. I have a DNR and do not want to be kept alive if I become ill beyond hope. As an ovarian cancer survivor I am grateful to UCLA for saving my life. But should I get ill mentally or physically beyond hope of a normal life past treatment, I will refuse any medical interference. However, the thought of intentially ending my life still feels wrong all these years later.
13
Today is my 75th birthday. When I was around 35 I tried to kill myself, but my complicated plan apparently had a fail-safe, because here I am. And today, though I too do not want a prolonged interval of incapacity, hospitalization, etc. on the way to my demise, my thought is: I still have so much to learn.
15
In discussing this topic, imagine questions like these:
"I don't want you to spend the college fund/retirement savings/need to downsize your home/etc... for my health care".
"I don't like that you need to skip evenings/vacations/activities you really enjoy with your loved ones to accommodate me"
"I could live longer and I would enjoy their company, but my life has become a burden on my friends and loved ones. I can't drive anymore, I tire too easily, family has to skip work to help me run errandsds, my personal care can make others uncomfortable"
The discussion and comments in this article are great. But the tone in the comments assume we all have lived a life preparing to confront these decisions. Many are not equipped to handle this, and could become prey to taking a too expedient path. This must be part of the discussion, helping protect them from themselves, from an environment that may not understand what is being lost. And, finally, helping them when they are ready for this decision.
11
@DanH But aren't there always people who need to be protected from themselves, always prone to making the wrong decisions. Investments, careers, spouses, whatever, some are always going to need help and are often in many ways easy prey.
4
Yesterday afternoon I had a wake up call. A neighbor and I went to visit a tenant of my apartment building who was in a "rehabilitation center" but which really was a nursing home. It was the first time I had ever been in such a facility and it was also the last time. It was as depressing and horrifying as I could ever have imagined. Last night I promised myself that I will take whatever steps needed to make sure my life will end rather than being admitted to such a place. I feel at peace with my decision and pray that if it comes to that my resolve will not fade.
24
@Lady Parasol
from a retired medical attorney (F/70)
Use your horror to energize action on YOUR advance directive that will keep you out of the setting you saw and out of the SOPs of all EMS and ERs.
There is a constitutionally-protected cross-state-lines "right to refuse treatment" for those who write the right POLST. Enter their document into The Medic Alert Foundation's database and wear the bracelet that EMTs and ER physicians know to look for . . .and pay attention to. Find and follow my details at other Comments and - most detail - buried in Replies as n.c.fl . Then you'll be able to sleep at night - as I do.
You're a lucky woman. This could have been you in that place as a result of everyday wrecks and falls we all take. Breathe first. Then go find n.c.fl to-do list.
13
@n.c.fl
Thanks for the information.
4
I found wisdom regarding suicide in the words of the ancient Stoics, Epictetus in particular. If you're looking for well-reasoned thinking on the subject, you can Google "Stoics on suicide" or read any number of engaging books. I especially liked "How To Be A Stoic" by the philosopher and professor, Massimo Pigliucci. Stoic philosophers do not label suicide irrational.
15
What’s the debate, really?
There’s not one rational person who doesn’t ultimately want for their own self-determination. It should stand to reason that, if there’s any dignity to be found in death, it is in not being made to endure an arbitrarily prolonged suffering for the sake of anyone else.
28
Interesting how these articles and supporting/conflicting documentation are all written by people who are not changing the diapers of those suffering from advanced AD.
17
Have you ever visited a nursing home or even a hospital?
Turning down what the MDs offer is a rational decision .
22
A quirk of nature has me with a rather uncommon condition where I form scar tissue that make my internal organs to stick to each other and to the abdominal wall (the condition commonly known as bowel adhesions). After two major surgeries to relieve the condition following painful bowel adhesion attacks, the surgeons have told me that no more surgery is possible. So, when the next attack comes, and if the condition does not resolve by itself, the prognosis is clear: a painful end of life.
I am fortunate in that I live in a very progressive country Canada, where physician assisted end to life is legal and is widely available, with clear guidelines and process to prevent abuse. I am now 73 and I know when the need arises, I will be eligible. I have let my family know that I wish to exercise that option.
Right to life is incomplete and pointless without the right to end own life. And knowing that has brought me a wonderful peace of mind and clarity of vision!
34
Yes, we should start the conversation. But it's going to be along and drawn out one.
One case comes to mind, an account covered in The New Yorker: in Belgium, a country that has legalized euthanasia as a fundamental right, there was a case of a woman living with dysthimia, not full-on clinical depression and solicited euthanasia and completed it. Her son (an atheist by the way) contested that he should have been notified of her wishes, that she still had a reason to live and that she truly did not have an intractable illness that made her life so miserable that euthanasia would've been the rational choice. I invite people to read the article, https://www.newyorker.com/magazine/2015/06/22/the-death-treatment, to get the full story.
The points made by her son are also well-reasoned and rational, such as: wouldn't it be better to invest in mental health and palliative care than to have euthanasia as the default, as it has turned out?
I think it's also a helpful way of seeing how this plays out in society so we can ask ourselves, is this where we want to end up? Medical paternalism can be helpful as well as harmful, even when the patient gets what they want...
4
@Lmca Maybe it's the son that needs mental health treatment. Maybe it's him who made the mother commit suicide, not an "intractable illness." Why would someone have to have an intractable illness and what business is it of a child?
15
l am 74 and happily still of sound mind and body, but I know that I have 1 marker for late onset dementia and I have (had) 1 sister 2 years my senior who succumbed to Alzheimer's at 73 and a brother 4 years my senior who has dementia. I will not be like them. My friends and family know this and , as good friends and family, have nothing but understanding of my decision. I don't know, and really don't care, if they agree or not and that's ok. I am not asking that they follow my lead and after all, it is my life and I shall do exactly as I see fit, when I see fit, and how I see fit.
26
And what about those old timers like myself who subscribe to the Dickens maxim, "It's a far, far better thing that I do, than I have ever done; it is a far, far better rest that I go to than I have ever known." They decide to take their lives for environmental reasons. To save the planet by reducing its population, while sending a message encouraging others to follow. We have a catastrophic global climate problem because there are far too many people on our planet -- roughly 7 billion when a safer maximum would be a billion. I'm not saying we should suicide our way to that goal. But rational suicide that caps a long life ought to be an honorable way to help us get there. Birth control can also help, but seemingly only by slowing, not reducing, population growth. One thing that's certain: if humanity cannot do the job nature will do it with a vengeance, perhaps annihilating every last one of us.
18
@Duncan MacDonald,
I agree wholeheartedly with the view expressed here. However, when I mentioned this to my Zen teacher, she said that in her experience, when someone takes their own life, others inevitably suffer. Still, I agree with the view.
8
I find it a comfort to know there is the option of chosen death awaiting me. I don't want to be here to read about the extinction of polar bears and monarch butterflies. I don't want to keep reading about heavily armed and angry people gunning down or blowing the innocent. I don't want to witness the inevitable fight for water.
So I'm free! I don't have any desire to prolong life with treatment after treatment. I've done chemo--ten years ago. Never again.
I don't know when or where (some medieval city, I expect), but the end is my choice, unless a car or heart attack comes first. I'm happy(ish), fairly successful, smart, childless, and I seek out beauty and soak it up.
The best of humankind and mother nature will keep me company while I'm here. Then I'll be gone. No regrets.
30
@Leora Dowling I know what is ahead of me. I don't feel that I should have to get to the end stage of my disease before I am "allowed" to die. Pain treatment has become an impossible barrier to overcome these days. An extra amount of time is not worth the suffering...even an extra year or two. I'll take care of myself although I'd rather be able to count on a scientifically proven method of dying in case what I have in mind doesn't work.
20
My father did not commit suicide. He took his own life. At 84 years old, having suffered two major heart operations, a significant cognitive loss from so much time under anesthesia, and a diminishing of his world to a degree he found unacceptable, he called me one night, told me he loved me and several hours later, jumped off the roof of his condominium. In his note, he said he refused to wind up connected to tubes, as an experiment in a hospital.
He was not, in his life, a brave man. Far from it, but he came to that moment when death became his friend. I never had more respect for him than for his decision to take control of his life, and his death.
70
In the mid 1960s I remember reading that the average male lives 66 years. I set my life’s expectations based on that number. So, since turning 66 and continuing on from there, I’ve felt like one of the privileged few, one of the lucky folks who experience the gift of a longer, fuller life. But now, at 80, I can say, without equivocation .. Been there - done that .. Enough already. I’ve met my goals .. Members of my family have met their goals .. I’m no longer of use to anyone anymore. It’s time to go. And after reading this fine article and the multitude of reader comments on the subject I feel just fine about that decision. So one day, after doing my part for friends and family on November 6th, and then when the mood strikes me, I’ll proclaim the fact that it’s been a good and often exciting life. At that point, with no regrets, I will go ahead and say that one final sayonara.
50
"Speaking for myself, I don't recall a single day in my life when I was contented with my lot, though as human destiny runs, it has been a not unfortunate one. Worse, I have got to a point. in my old age, that I can't imagine any concrete amelioration: experience has taught me that what I want today will only upset me if I get it tomorrow. But to give us hope is surely not the same as to embrace despair. The show remains engrossing, though it is no longer exhilarating. The horror of week after next will at least be a new one. It may be any one of ten dozen: I find myself vaguely eager to know which it is to be. Thus I advise against suicide. Life may not be exactly pleasant, but it is at least not dull. Heave yourself into Hell today, and you may miss, tomorrow or next day, another Scopes trial, or another War to End War, or perchance a rich and buxom widow with all her first husband's clothes. There are always more Hardings hatching. I advocate hanging on as long as possible."
--- H.L. Mencken, The American Mercury, 1929.
8
@A. Stanton Mencken did not live in a world with today's technological learning. He lived in a time when death came earlier to most people, there were no heavy duty medical interventions. If he lived today, I bet he would eat those words. And re-consider this life plan. I also wonder what he would say about our modern hatching of another Harding?
12
We have no choice whether we are born into life or not. But once born, it is our life to do with as we please - as long as we cause others no harm or infringe on their lives.
The medical industrial complex wants to suck up whatever wealth you have left before THEY decide how and when they will kill or let you go to the hereafter. All I need is a gun and a bullet when it is my time and decision to go and no stinkin' Republican death panels - yes 'Republican', that's not a typo - or frauds of God and religion or anyone else has the right to take that right away from me.
With no gun or bullet, I'll more likely sail into a hurricane, after I provide the USCG a DNR - Do Not Rescue me - form. If I chicken out and call for assistance, they should ignore the call and rescue everyone else first or lock me up if I am rescued.
25
I’m pro-choice.
That includes the right to choose an abortion and the right to end one’s life.
33
Killing yourself now means depriving the Democratic Party of your vote in November.
Killing yourself before Trump is forced to leave the White
House means depriving yourself of a very good party.
There are many good reasons for sticking around.
15
@A. Stanton That's only one reason. And when we are dead, we will be soon forgotten, joining the rest of the people who came before us and those who will come after. Even presidents have to face it, even if, in life, they refuse to face other big events.
2
One big problem with a death that is deemed suicide, however clear its intentions to escape the disastrous effects of dementia or cancer: many underwriters will not pay out a life insurance indemnity if suicide is officially ruled as the cause of death. In my Federal civil service job, this is widely known and considered a deterrent to an officer or civilian killing oneself.
8
@Tournachonadar
The "suicide" clause usually applies only in the first two or three years after taking out an insurance policy.
12
The simple principle has always been "whose life is it, anyway?"
15
@Fletcher
A very American sentiment. Historically, few cultures have seen it this way. And it does seem inadequate. We're all part of a larger social web.
I'm dismayed by the number of "I'll do whatever I please" posts here. From a generally liberal readership who, in most other contexts, would decry such a philosophy.
3
The real crime is when (as was the case with a friend) an 80 year old person who has decided to end his life has to suffer slow suffocation with a tape-secured plastic bag over his head. That’s the real crime...
25
My mother died a horrible death from Alzheimer’s at age 75. Nine years. Horrible is an understatement. I have no interest in the same for myself nor my family. If that does end up being my future then anyone who thinks I shouldn’t be allowed to end my life can go to you know where unless they want to trade places with me. Takers? Not likely.
24
What do mammograms & colonoscopies have to do with Alzheimers?
2
@A. Brown
I think the logic was that each test may reveal symptoms of other diseases and the person doesn’t want to know about these, in addition to the disease of Alzheimer’s in their body.
5
For me, a cancer diagnosis was a relief. It gave me hope that the cancer would kill me before dementia sets in. Either way, I do not plan to continue my life past age 78. My mother's agonizing slow decline from dementia set my course. She spent every minute of every day for 3 years not knowing where she was and in genuine fear. I will make my departure while the decision is still mine.
31
@Mrs Shapiro I read something recently where a woman talked about a friend who had received a terminal diagnosis and his reaction was "well at least now I don't have to worry anymore about outliving my money." I think a lot of people, including me, worry about that, and knowing when life would end would free us up to enjoy it more now.
15
I’m not sure if this has been mentioned previously in the many comments, but sometimes, people commit suicide simply by refusing to eat or drink. My 89-year-old mother , who was under hospice care, stopped eating and drinking when she was bedridden with COPD and residuals of a pelvic fracture. In effect, she did commit suicide.
13
@Baiba From what I've read, death by dehydration isn't easy -- unless there's terminal sedation, where you're unconscious.
However, Catholic hospitals are unlikely to allow this, due to the doctrine of "redemptive suffering." That means that suffering in this world is supposed to help redeem people from tortures in the next. Pope Francis has even claimed that, through their suffering, child cancer victims do “much good for the Church”. http://www.zenit.org/en/articles/pope-meets-polish-children-suffering-wi...
You have to be very careful (and lucky) to avoid letting some people prolong YOUR suffering for the sake of THEIR doctrine.
Editor’s note: This comment has been anonymized in accordance with applicable law(s).
10
One of the discussions we need to have is with the Medical Team. When a person has been admitted to a hospital (a well-known Washington, DC hospital) with a large stroke, “down”for many hours, the neuro-surgical team need to “man up” and allow the patient to die upon the family’s request. Now my 69-year young brother-in-law, who cannot participate in rehab, will probably die in a nursing home somewhere, never returning home.
Now, to another point, who is responsible for the huge medical bill? The doctors whom couldn’t bring themselves to face up to the truth - not being able to miraculously fix his stroke? Should my sister go bankrupt over something she tried to stop from happening?!
Instead, they could have invited the Palliative Care team to help allow this wonderfully talented craftsman die a peaceful and beautiful death. If not in the hospital - in Hospice.
Former critical nurse.
34
@Deby
from a retired medical attorney (F/70):
A spouse in the situation you describe has an absolute statutory right to dictate what care shall begin and what measures shall not be employed. In my experience, it is the ER Charge Nurses that are the best listeners and interlocutors with too-aggressive physicians.
And, for the record, all hospitals have individual beds that are designated as "hospice" beds . . .where hospice physicians take charge of a patient on request of a spouse or Power of Attorney holder. The right words: Comfort Care Only. No Dx or Tx interventions, no ports/intubation, After an MRI showed extent of this stroke, this spouse had an absolute right to stop all interventions and direct that Comfort Care Only be delivered and supervised by hospice people was to take place.
Now? This man can still be moved to an inpatient hospice bed with a pre-qualified Medical Director who will agree to deliver the Morphine & Methadone this patient's decision maker, his spouse, requests be done. Keep looking until you find that hospice Medical Director who will say "Yes" to her request.
For you, my friend, there is no such thing as a "former" nurse. You're spot-on about what should have happened and you can still work with your family to get to a quiet peaceful death with M&M by IV in a hospice inpatient bed . . .covered by Medicare or other insurers. Thank you for your service and be relentless in your pursuit of a good death.
20
Death is a rational choice. Those who would deny such a dignity are irrational.
23
Based on the many fine comments so far, it seems like we need a national organization to coordinate the effort to make rational suicide an option across all 50 sates, rather than a patchwork state-by-state solution. Does such an organization exist? If not, how could one be created and funded?
15
@Joseph
from a retired medical attorney (F/70):
There is one pathway to crossing-state-boundaries and over-riding state laws that conflict with an individual choice: SCOTUS-defined "right to refuse treatment" since 1990.
Details at my comment and several replies here. Easy to do. Easy to communicate. Easy for EMS and ER MDs to find when POLST recorded in The Medic Alert Foundation's database. Foundation bracelet or dog tags carry 24/7 contact information to get to your one-page plain-English directive. Always useful to designate a Power of Attorney who will reinforce your bottom line: Comfort Care Only!
Find and follow my approach here. It's working in about 26 states right now and useful in CA too. As is often the case, CA and OR legislators have created a much too narrow pathway for patients who need help. This constitutionally-protected pathway anchored in constitutionally-protected right to refuse treatment overrules state law any times there is a conflict.
When you're done with your homework, you can teach others and help them get to a remarkable peace of mind!
6
Right now I happen to be healthy and self functional .(and content )
I DO believe in the right to one’s own life .
I don’t see any point of suffering needlessly .
I think there should be legal assistance if wanted.
20
Fortunately for all my elderly patients they have a supply of as much of certain drugs they could easily ingest if they felt it was their time. Prescribed over a period of time there is no way that a clinicians could be implicated in a patient's death. Ironically, in the last twenty years not a single one has actually taken their own life. They have certainly expressed gratitude at having control over at least one aspect of their lives, a rarer thing as morbidities increase with the aging process. In most cases it is one's family members and friends that demand what they would like to see happen. Knowledge of an option to decide themselves gave them enormous freedom to enjoy life.
25
I never worked a job longer than I pleased, never saved for the future, always said my retirement would come out of the barrel of a gun. Now I'm 71, coaching soccer at a small college, making enough to get by and loving every minute of it. Still if I were to be diagnosed with dementia I would get my wife and kids together, say good bye, then do what needs to be done for their (and my) sake.
24
Rational suicide should be legal. When I'm 85 with scoliosis I want options to exit my old body. It is my body and my decision to make.
34
What a diversity of concept and opinions!
May I bring up the possibility of euthanasia for people who have completed a hopefully fulfilling - and sometimes not a fulfilling a long life. Who have done what they could, may physically be still reasonable fit but their work is done, their friends and family are gone and their are limits what can be add to further renewed fulfillment. Do they need to continue another 5 years?
This is a not uncommon scenario and topic of major discussion worldwide.
I like here the term euthanasia, emphasizing the mercy and self-determination in a respectful way and not requiring a medical label such as depression or suicide when enough is enough........
20
My Nana has expressed these ideas to me recently. Her husband has passed and in their later years of marriage their most common activity was driving back and forth to hospitals.
I think it’s admiral that she has decided how she wants to end her very full life. While I pray that it doesn’t happen soon, I think elders have earned that right to close their own chapter.
It’s easy for young & well people to say that its wrong because we still have so much time ahead. But for someone who has weathered a life why not let them determine their last date?
I enjoyed the article, thank you.
35
@Granddaughter And thank you for sharing with us your thoughts on this topic. May you live long and know when your time to do what you want, without-busy-bodies-stopping-you, actually arrives.
Perhaps, by then, the busy bodies will have calmed down and gotten a wider perspective on this critical issue? We can only hope--and take charge of our own lives at the end.
9
I believe in Americans having the resources and support to live long lives but there may come a time when someone would like to end their life and at such times there should be a counseling process for rethinking life termination and if suicide is the only option left then I advocate legalized humane assisted suicide. I do not think we should encourage ending life in a brutal and cruel manner like blowing their heads off with guns, or consuming poison or jumping from a high rise and falling on concrete or strangling themselves.
22
@Girish Kotwal Dead is dead, and fussing about how to do it to protect the feelings of the squeamish is irrelevant when it's all said and done. OTOH, enough conversations like this one, and the brutality of the deaths you think about might just provoke a discussion about helping people end gracefully, instead of making a mess for others to clean up. But dead is dead, and it makes no matter to the dead how i happened.
2
As long as most Americans fear that they are one serious protracted illness away from bankrupting their families, they will feel pressure to take action before they might otherwise. So monumentally sad that in such a rich country, one has to weigh dragging one's family into poverty as part of an individual's end of life decision.
34
@Jay. Yes, this is the elephant in the room—fear of bankrupting one’s family. Those so concerned with right to life might think about the failure of our healthcare system to ensure that such an irrevocable decision is not Based on concerns over money. Right to life exists all the way through life.
11
@Jay
Nothing is free.
Younger boomers and older GenXers are already having the suicide conversation. I'll turn 52 at the end of this month, and going by my family history I can expect to be in decent health until my mid-eighties. I believe that as the boomers really start hitting their eighties, you'll see assisted suicide become more and more acceptable, and millennials, who will be in power by that time, will help that along.
33
I am all for end of life care, keeping people comfortable but I stop short at suicide. To me 'rational suicide' is an oxymoron. We DO need to get away from this opioid hysteria and treat pain appropriately as pain patients are the ones suffering as limits on prescribing have been put in place. Loss of function and purpose would drive anyone to think they want the pain to end. The solution is not suicide. The solution is to treat the pain.
15
@Cat London, MD
from a retired medical attorney:
And for all other maladies that cause irremediable suffering, Parkinson's or Alzheimer's or MS . . .all share on trait: only downward spirals never reversed.
I leave for Zurich DIGNITAS 2023 with my disintegrating spine very well pain managed with ER tramadol 300mg/24 hrs and PT daily at home. It is the oncoming Alzheimer's that I have chosen to skip.
You do your thing and I'll do mine. And help others just like me across all diagnoses and disabilities and ages.
34
@Cat London, MD
The medical community is frazzled and in disarray, hardly up to ameliorating suffering of the dying when it is already unable to cope with all other demands.
24
@n.c.fl
Take care!
1
Why not thirty somethings who have failed in their careers and can’t pay their debts? Or soldiers who have lost their legs? Life can be full of misery, but also joy and overcoming adversity. We shouldn’t start normalizing ending it early.
16
@Kenneth
Very easy to say let’s not do that, especially if one is young and healthy.
20
@Kenneth
If that's what they choose to do ... who are you to say otherwise?
It's not about "normalizing" anything. It's about respecting other people's wishes and decisions.
42
@Kenneth Clearly you've not witnessed death by Alzheimer's or you wouldn't be comparing it to economic hardship. Once you have Alzheimer's you're not able to "overcome" anything. As we move ever closer to a single-payer medical system, it makes no sense to treat terminal mental illness instead of younger Americans who have a chance for remission or cure. And, make no mistake about it, there are not resources to treat everyone for everything.
11
The risk of course is that suicide may be a permanent solution to temporary problems. But if we accept the reality of it in a non-judgmental way, we can reach people who are considering it and help them to consider all their options, before helping them to check out.
If at the end of a patient review, the desire for suicide does seem reasonable and well thought out, why not provide technical assistance?
It seems reasonable that if you want to reach suicidal people, you'd get a better response by offering suicide assistance, rather than suicide prevention counseling.
37
@Nobody You bring up an excellent point. A few years ago, I read an in-depth article about Switzerland's Dignitas, which provides physician aid in dying. One of the more fascinating aspects was that something like over 50% of their clients -- people who had paid thousands of dollars, made the cross-Atlantic trip, talked to their families, etc. -- decided after talking to Dignitas staff to NOT undergo what they had planned. And both they and the Dignitas staff were perfectly fine with the change in decision.
I like the way Dignitas offers a way for people to discuss these issues without judgement. I know of someone who did fly all the way over to Europe and died under Dignitas' care as well, a person with an incurable condition and declining health.
10
@ms
Why do we have to leave our country to obtain a dignified death. We are all aware of the downward spiral and if one has made a decision that life for whatever reason is no longer tolerable or desirable why have to beg for the privelge to make ones own decision. No on is owed an explanation so let us just do
It. Make sure your affairs are in order just so you don't force family rifts over petty money.
9
@MKAny money is not petty when we have family members getting away with all the cash in the bank and the property of an older relative with dementia. And there is no mechanism to stop this happening. Before dementia hits, people tend to think their family will take care of them if it does, then they continue on as if the opportunists they bred and raised suddenly sprouted wings. Or, alternatively, are grateful that someone is there to look out for them, even if they know everybody else in the family will be denied their share of the estate. Or they are unaware they are being treated in a way that will hasten death. And so on and so forth. There is not way to stop this happening, short of spending large sums on attorneys who MIGHT be able to stop it happening. Social Services seems totally lacking in resources to stop this theft. It breaks one's heart. Especially when seeing it happen to dear friends who are unable to get it. Fast intervention in my late father's situation saved him from kidnapping and money theft. But he realized his problem and actually had the wits to ask for help. Now I see it happening again.........when does one outside a family just give up and let it all play out? Will someone tell me that. Sign me, Broken Hearted.
I support the rights for both abortion and suicide for the same reason: it is no one else’s freakin’ business to regulate what I do with my own body.
42
First and foremost, I think suicide is subtly being pushed on the elderly. I am a 62 year old man and have worked hard all my life. Unfortunately, I find myself unemployed for 2 years now and with little prospects. In LA at 62 you are persona non gratis. Driving Uber is one of the most demoralizing ways to beg for a buck. And then you have our healthcare system. As my income goes down and my health starts to falter insurance keeps becoming more and more unaffordable. Obama(don't)care has been an abomination from the start. Although I'm sure others have had success my experience is as the prices go up the services go down I signed up for Kaiser this year and that's turned into the worst experience I've had in my lifetime. So, here I am with no job and paying much more than i can afford for insurance so why not check out. I've had some great years and experiences but now I'm just scrapping by. Is that a life worth living. And since America is a country that gets to decide who lives and dies in war torn countries that are our supposed enemies why should our government really care about suicide. The BS stories of people that survived a suicide attempt to live a good life do not take in the facts that just as many if not more had no choice but to end it on their own terms.
Finally, I am so sick an tired of hearing about the "selfish' nature of suicide. Basically, these idiots decide that it's really just about themselves and their comfort.
29
The whole US capitalistic, for-profit health’care’ system has been an unmitigated disaster. Singling out the ACA is disingenuous, to say the least. Keep in mind that, without it, no insurance company would take on a 62-year-old with pre-existing conditions.
24
@zigful26 Subtly? Sorry about your experience with Obamacare. I have thousands of patients, many elderly, that would be dead without it. It wouldn't be because they chose suicide. Perhaps you might want to advocate for a change in the amount of money someone could earn while still qualifying for any health care or support resource.
10
To all the self-righteous do-gooders out there: Your enforcement of someone else's pain and suffering to serve your own agendas is the height of arrogance and borders on abuse. Stop it. There is nothing lofty about mandating that human beings exist with terror and pain and despair just because it lets you sleep more soundly.
49
"END OF LIFE ISSUES " ... can only be understood by those dealing with end of life issues. At some point in your aging process a curtain drops and you're suddenly faced with aging issues. There's no going back and there's no one to ask about the ethical issues because these are you issues ... you own them. You don't need anyone's permission to determine your own fate. The judgmental banality surrounding suicide as blasphemy is from those that are on the other side of the curtain ... there time will come too.
23
Nobody should be forced to live.
34
@Dennis Hinkamp No one should be forced to give birth either, or be denied their right to an abortion if they so chose.
12
What else does one have if not control over their own life?
38
@Ashley
There is no more effective way of losing control of one's own life than to end it. That Irish song about the condemned man who breaks a fiddle so no one else can play it comes to mind.
If a person has a pet who is suffering there is no problem with helping the pet by putting it to sleep. With humans, the thought of helping a person die with dignity is an anathema. The problem is religious beliefs forced on a person by our system. It will only get worse with the Catholic church buying hospitals and forcing their "high moral authority" on everyone else.
Before people spoke openly about it, doctors would quietly give a lot of painkillers which would hastened death. Now with lawyers and unrelated people forcing their religious beliefs on everyone else it has become harder. People are forced to spend their last dollars on health care they absolutely do not want. It's time to stand up to these phony ideas that humans need to suffer when they really want to die. Politicians rarely have the guts to take on these issues. There are a few countries and states which allow assisted suicide, maybe the tide is turning.
47
@S.L. Actually there is an issue in this country with pets. Most pet owners that decide that they are ending the pet's life drop them off in their vet's office. The pet is left alone, confused, terrified, ill, wondering what they could have done to make their beloved owners desert them. If you are a pet owner, please have the decency to be with your pet as they die. They would never leave you.
8
@Ken- The issue I was discussing was the acceptance of pet euthanasia compared to humans. I understand your concern, but my sister has had to end the suffering of several dogs. In each case, she stayed with her dog. Some vets have special equipment, like a quilt to cuddle on. Not everyone is heartless. Choosing the right day is sometimes an issue.
5
Once again, religion interfering.
So many of us bear the burdens of religious beliefs, ingrained in our thoughts and actions, that the "free will' we are all endowed with is , is dismissed when we chose to exercise free will.
I can understand people choosing to end their lives when they think it's time to go.
I also understand people who chose to not marry, or not have children, or dedicate their lives to missionary lives, or those who choose to live isolated in a mountain top.
Free Will.
Respect others, as you want respect from them.
34
What is truly amazing in all this is the fact that six states in the union allow for physician assisted suicide and we still have problems in other states acquiring the drugs to perform state sanctioned executions. One would think if a pharmaceutical can be used in one of six states to perform state sanctioned suicide, those same drugs could be used and lawfully obtained in any other state in the performance of a state sanctioned execution. But such is not the case. Its as if someone asked for a cake for a celebration most folks find repulsive.
4
@Tim
The European manufacturers of those drugs will not allow them to be used in death penalty cases.
11
Two points. First of all, no mention of God. It is not up to us to decide when we live or die; life is a precious gift. Leaving this world is not easy for many of us; I watched my father die last year. Yes, he wanted me to kill him in his final two months. But that was not his or my decision to make; it was God's. I refused to bring him the means to kill himself; it would have been immoral to do so. And no, as a Protestant I do not have the old Catholic belief that those who commit suicide are doomed to damnation (although it is my understanding that they no longer have that belief).
Secondly, this seems to be just one part of a op-ed campaign by the Times in support of assisted suicide and euthanasia, based upon the number of opinion pieces on this topic in the last week. Do we really want to go down the slippery slope that some lives are less valuable than others? We have seen what can happen when this belief is put into action during the last century.
2
@Ron Wilson - That's right, "It is not up to us to decide..." It is not up to us, not up to society, not up to anyone else, and not up to you. But for some, it is totally and privately up to the individual and God. Just the two of them, alone, in a place where not one other person or group has access to, or could possibly have any knowledge of whatsoever. This is as rational as it gets. So, really, it seems as if you AND God made the decision for your father.
4
@Ron Wilson
There is absolutely no comparison to individuals wanting to control their own deaths and the holocaust if that is what you are referring to. There will be no mythical ‘slippery slope’ as people will make their wishes known in writing and verbally when they were competent to do so. No outside authority is deciding whose life has value and whose does not. This is just an excuse to force your beliefs in god down the throats of those who do not share them.
12
@Ron Wilson
So, decide that for yourself and stop foisting your template of morality on people who have differing beliefs.
10
This is certainly an option for me. I do not want to be a burden on anybody in my old age. I also don't want to use up resources to maintain an idle life, or one that is severely compromised. As someone here wrote, I want to make this decision while I still have my mind.
30
My father always said he would shoot himself before going into a nursing home. Unfortunately, he never knew that it would be too late to make that decision when Alzheimer’s destroyed all cognitive ability. He ended up in a nursing home - he was in a wheel chair and would stare for hours with his nose almost pressed against the TV in his room that only had a jumbled screen of flicking light with no picture at all and nothing but a static crackling noise. He was unruly and uncooperative so they gave him drugs to keep him manageable. When he wasn’t ‘watching’ TV he was placed in the hallway with all the other patients in wheel chairs - many could not communicate-their minds completely destroyed. One moaned constantly from a distant room. Yes, the place smelled as the staff no matter how deligent couldn’t keep up with changing diapers on so many people. He lived like this for a year. I would not wish that life and death on my worse enemy,
56
@DEF
from a retired medical attorney:
You have a choice with Morphine & Methadone in advance directives with a carefully chosen hospice Medical Director who will honor your request--inpatient IV only. Find my Comment and replies here and get what you need to not suffer like your father did.
IF you have the means to do so, as I do, DIGNITAS Zurich is our one way destination if we do not wait too long. I sleep very well at night knowing my exact terms with U.S. hospitals and physicians -- refusing ALL diagnostic and treatment interventions -- and knowing my fly out date to Zurich in 2023.
Don't suffer. Act now to protect yourself and announce to all what your advance directives are. Then put them into The Medic Alert Foundation's POLST database and wear a bracelet that EMS and ER people know to pay attention to.
Sleep well every night after you are finished with this homework, writing, braceleting, and decision making!
18
@n.c.fl: it is both funny and sad you think you can TIME THIS to five years in the future.
What if you get dementia or have a stroke in that time? Dignitas will not help you, as you must be IN YOUR RIGHT MIND -- and able to travel to Switzerland!
However many years you have left...you should be trying to live them with joy and purpose -- not fixating on killing yourself in an overly dramatic fashion.
1
@DEF: I am so sorry about your dad. He was in (sadly) an understaffed, badly run and abusive nursing home of the type that should be SHUT DOWN!!!
Florida is rife with such, as they have so many seniors. It is an exploitive business there.
There is no excuse even for a dementia patient to be put in front of a TV with no picture! or left in a hallway in a dirty diaper! I hope you photographed and reported all of this to your state attorney general as well as authorities who monitor nursing homes and rate them....state ombudsman for the elderly....and threatened the nursing home operators with a LAWSUIT for ELDER ABUSE.
You cannot "fix" dementia, but you can treat it with compassion and decency. The system utterly failed your father.
7
As someone who has extensively researched the issue, the only place on the planet where one can legally commit suicide is Geneva. The cost is astronomical; out of reach for most - unfortunately. Living in America severely limits anyone contemplating death with dignity.
I'm including two websites that will get those seriously contemplating what should be a right (the time and place to end one's life with dignity). Life circle and Exit.
https://www.lifecircle.ch/?l=en
https://exitinternational.net/
15
Of course suicide can be rational. Considered and deliberate too. And oh yes, done with "no apparent reason".
That last condition is what inspires this debate. Humans have a very high survival instinct, and they instinctively grope for some external motivation for a person who decides, rationally, to commit suicide: must have been mentally ill, must have been depressed, must have been had terminal illness, etc. etc.
Have you ever been on a perfect vacation and then made the decision that you've had enough?
It is simply time to go. And that's what you do.
25
A dear relative is 97 and has outlived his friends and most of his family. He is becoming frail but within his right mind. He has expressed a desire to die in his sleep. I do not discourage such talk, as it helps him express his feelings. He would act if he could.
23
Get over yourselves. Our lives have no value. When we end them is meaningless.
19
Glad to see rational suicide being discussed. In my view, there is no reason to limit it to the elderly or terminally ill. Not one of us opted into this life. There was no consent given. If we wish to opt out, after what we feel has been careful consideration, who has the right to prevent us from exercising our autonomy? Not everyone feels that life is worth living. To force someone else to continue living because we, ourselves, can't bear the thought of shaking our own mortal coil? Well, that's just paternalism of the worst form.
27
I’m very pleased this discussion is being had. I’m mid-40s and watched my father suffer and die from complications of Alzheimer’s. I would seriously consider ending my life if I knew this was my fate. Sad but true. It’s a horribly unimaginable existence and I don’t need someone else to tell me that it’s not the right thing to do.
22
@Eric C
from a retired medical attorney (F/70):
You will have more choices that you will assess in coming years. That said, you have to pay attention to early-onset Alzheimer's that starts in 50s and is self-evident in 60s as well as late-onset 14-yr arc Alzheimer's that is pre-clinical in 60s and self-evident mid-70s.
With your experience and self-awareness, you may be OK. Watch Invitae's DNA/exome-based only-by-physician-order portfolio. Since there may be a metabolic component that participates in plaque development, eat healthy and lots of water and no tobacco. No vaping either. If you need an anti-depressant, get an Rx drug from your physician. Not coteine/nicotine.
I leave for DIGNITAS Zurich one-way 2023. Ahead of near-certain now late-onset Alzheimer's and OA pain in both hands and disintegrating spine.
To protect yourself from unwanted medical rescues if you are unable to say "No" to EMS or ER MDs, find and follow my one-page POLST that crosses state lines. Several here in Comment and replies under n.c.fl .
7
I very much resent that the author of this piece assumes without question that "religious organizations" have the right to impose their superstitions on the populace at large. I doubt I am alone in thinking that some evangelical godbotherer has no voice whatsoever in my decisions on this or any other matter. I also find the condescending tone typical no only of the medical profession but of society as a whole. Clearly the position is that a person who turns 60 or so, is no longer rational nor of any great worth except as a paying customer.
12
Although it is likely that any rational person would choose to die rather than suffer and then die, I disagree that there is rational suicide. In saying this, I in no way mean to negate the suffering that is felt as health declines. I disagree with the idea of rational suicide for two major reasons: possible compromised decision making capacity and the implications of rational suicide. Compromised judgment can be at fault in suicides. The article states that the majority of suicides are committed by individuals with a diagnosable mental illness indicating that decision making capacity may be compromised in these individuals. This suggests that suicide may not be rational in these cases. However, several people in good health have preemptively made the decision to commit suicide conditional upon their decrease in health. So a compromised decision making capacity cannot always be blamed for suicide. My biggest concern in declaring age-related suicide rational is the possible implications for other suicides. What could this mean for the teenager- currently in good health and social standing- who decides to commit suicide at the onset of decreased fulfillment or social rejection? It seems that similar components of the argument for age-related suicide could be applied here. However, suicides of this nature are generally not deemed as rational. It seems that in order to most clearly define rational age-related suicide, it may require further exploration into these implications
4
@Chris: if posts here are correct and accurate -- Dignitas in Switzerland will EUTHANIZE healthy young people who are depressed or socially awkward, or middled aged folks with romantic disappointments…..or the disabled at any age, even if not in pain or terminal.
Very troubling indeed.
1
Some folks assume that only the despondent, the depressed and those with limitef facilities consider suicide.
Yet being in control, which the women's rights and many other movements are based upon, give entire control over one's body and existence, back to the person.
I know there are some conditions for which, if I had them, I would put a concrete plan in place so when I reached the point I felt was enough, I'd bring my happy life to a happy conclusion.
It's not as if death has ever been avoided.
The taking of someone's life against their will is wrong. But it is equally wrong to try to influence that person into months or longer of increasing pain and misery, knowing death is not far away anyway. Let them decide, and stand by them.
23
I see many commenters suggesting that they want to end their lives early because they fear what will happen when the money runs out, when they can no longer live on their own, when they face illness, when they fall and break a hip and must spend time in a nursing home. It seems our duty as a society should not be to actively encourage such suicides, but tackle the underlying problems that would cause someone to decide that ending their life is better than any of the ways our society addresses old age. If our nursing homes are worse than death, what does it say about those whose response is "We should stop stigmatizing elderly people who want to kill themselves" instead of "What do we need to do to fix our broken system." The real "choice" we should hope to offer people is not a choice between early death and misery but a choice between multiple ways to maintain dignity and comfort during the last years of life, whatever those years might look like. Life is a precious, wonderful gift that we should not be so quick to dispose of, sending a message that any amount of suffering or loss of independence makes someone's life worth less than that of the young and healthy.
7
@Jade: absolutely yes.
I've seen nursing homes -- Assisted Living facilities -- and dementia care units -- and I know they can be very bad places.
But the answer then is MAKE THEM BETTER! not "kill all the old people!"
4
@Jade The real choice is between money-making and not money-making. Of course anyone who makes money off housing people whose minds are like mush will oppose suicide. Medical facilities people keep mush-minds alive with expensive med care oppose suicide to make money. Long-term care is expensive and costs us all, in the long run. With my mind showing signs of becoming oatmeal as I have to look up the first names of my friends in my little book, I really don't want anyone profiting from my eventual irreversible mush mind condition. My plans are laid and mine will be a clean and relatively painless death. The only money made off me will be made by the (required) funeral director, the crematorium..... and my heirs, who get to inherit what the various life extending facilities fail to extract.
6
My parents are 90 and 94. Their quality of life is poor. They are able to remain at home with daily care and their three children helping out on the weekends. More people are living to be very old. My feeling is if I cannot do my own activities of daily living, if I am in pain or poor health, there should be a legal way to end my life. The world has limited resources. If there are old people who feel they've seen enough there should be a way to choose to die.
32
@KS
from a retired medical attorney:
There is a "legal way" to help your parents to end their suffering in hospice/inpatient only setting. There is a "legal way" to write advance directives that trump all state laws that conflict with your directors--anchored in the SCOTUS "right to refuse treatment" since 1990.
Find and follow my pathway in other Comments and replies here! Huge relief and great sleep once you're finished and your family is agreed on pathways for all.
3
@KS The issue of the free labor of, and emotional toll on, family members is rarely the focus of discussion. Easy for people who have no skin in the game to decide for others just how much of their lives they are required to use up caring for feeble and helpless parents. I will be so happy that my plan will save two generations of my family from caring for me, using up their own lives, possibly ruining their marriages, jobs, and their own health, just to keep me warm and safe. Heck, no.
9
1. discussed "pro-active" carefully considered end of life plans with important family.
(no surprises, "first do no harm")
put everything in writing.
way in advance of needing
2. in process of "The Gentle Art of Swedish Death Cleaning".
This takes time, care, high functioning, and is a
meaningful, meditative practice.
Having affairs in order frees you up to live in a "new way" and joie de vivre.
life long practice of wellness
73 and deteriorating health
read all comments
as a retired RN (birth to death)-
welcome this open conversation on what
used to be as taboo as childbirth, sex, money.
16
Depression can be a perfectly rational reaction to circumstances, too.
As for those "lives not considered of value"--the lives of the disabled and of the frail elderly are very expensive to maintain in modern societies. Now that women are mostly not regarded as household slaves, we've got to pay for the exceptional care fragile or non-self-sufficient people require. We do not have infinite resources even if we have the desire to care for all.
If you want to save 20-week babies you can't concurrently save all the elderly lingering on in life. The emphasis should be on enabling lives of dignity as much as is humanly possible for as many as possible, but we'll never be able to do that, 100%.
12
@SCA
The debate over suicide is not about babies versus disabled, frail old people. No one is asking you to save us. No one is asking you to choose between us and the young. No one is asking you to spend a dime,
This is about suicide and our rights to kill ourselves without anyone interfering. Not even you. This is about us deciding what is or isn't "dignity." Not you.
16
@Rea Tar
from a retired medical attorney:
Rea--I've read your contribution here and welcome your clear voice. Find my Comment as n.c.fl and in replies here to get to your constitutionally-protected across state lines "right to refuse treatment" in a one-page plain-English no-lawyer needed (or wanted!) POLST.
Least I can do in exchange for your energy and passion!
2
@Rea Tarr I understand your emotional response but I read SCA's response as a factual statement of the real world situation. SCA was not suggesting interfering in your right do do what you want at the end of your life. But was stating the obvious. Society, as it now is in this country, cannot afford the cost of caring for and keeping alive everyone.
Obviously, as we all are squeezed tighter to get every last dime out of us for the corporate welfare, we can't handle it all. Which is part of the issue of deciding whether to end our own lives.
To all of the legal eagles who think their fancy papers will save them for the medical community, you are mistaken.. As a retired hospital administrator I can guarantee that when you arrive at a hospital, you are giving consent for treatment and all of the papers you bring with you have no meaning to them, and the words DNR on you chest will not save you from their circular hell. They can legally disregard all of it and do on a daily basis, and yes, they do occasionally loose a case in court, but mostly they just do what they always do, treat patients.
22
My mother filled out an elaborate advanced directive to no avail. Each surviving family member had a different "take" on what constituted terminal illness or whether the consent that our mother had given was under some sort of "duress."My brothers and sisters were up in arms about whether one of us would garner a greater stake in his/her inheritance (thus, having more reason to want to “pull the plug” a bit sooner). My brother actually pulled a Smothers-Brothers' routine, exclaiming rather loudly (in the ICU, no less!) that, "Mom always liked you best and so that's why you feel entitled 'to run the show!'’ When all the tubes were finally removed, I felt a deep sense of relief. But not for long. On the heels of her passing came the funeral arrangements, which were a new issue to be reckoned with. I almost burst out laughing when my youngest sibling insisted that our mother be buried in the backyard of his newly built ranch house, as there was plenty of room and, that besides that, our mother had always loved the great outdoors! On and on it went, ceasing only when my frustrated uncle threatened to “sic” his lawyer on all of us if we failed to follow, word by word, the actual printed wishes of his sister's directive. Two lessons here: The first: That there's no panacea to dying. The second: That humans will continue being humans. Even unto death.
15
@Barb Porto
In other words, avoid hospitals like the plague, as they will ignore your wishes and your individuality and do exactly as they please - and then send you and/or your insurer a very large bill for unwanted treatments. Got it.
15
@Billie Tanner
from a retired medical attorney (F/70):
Sounds like each of your siblings needs your own unique advance directive in plain-English so there is no dispute about interpretation? Find and follow the pathway to individual POLST documents in my n.c. fl Comment and many replies here.
Siblings may or may not choose to act, but you can be protected from them being at YOUR bedside fighting with each other and physicians in your end-of-life or earlier crisis !
"... reflects an ageist assumption — one older people themselves aren’t immune to — that the lives of old or disabled people lack value."
All of us should be pulled-up short and dumbstruck by anything except the full realization that in OUR society, in OUR culture, in THIS country, its a mostly unspoken given that the lives of both the old and disabled inherently lack value.
Attention naysayers: Our words are one thing, but our actions clearly belie them! So lets not kid ourselves. From easily the middle of last century, we have been careening downhill towards this very reality.
Just because someone throws confetti in your face doesn't make it a party.
18
@lowereastside
So, what you're really saying is that people should be continued to be tortured (and have their pockets picked) by the medical industrial complex for as long as possible without any say in the matter.
21
My positions on suicide:
"You can't tell grown folks what to do."
"I've got six months to mind my own business.
And I've got six months to leave yours alone."
- If you want to go, then go. And farewell.
14
Of course there is rational suicide. My mother lost three husbands and worked as a hospice nurse. She lived a rich life until 93, and she considered her exit the most personal choice she had a right to make. I was present to hold her hand while she inhaled helium (must contain less than 4% oxygen). She left life gently, losing consciousness in about 90 seconds. It was exactly the way she wanted to go.
77
@Romaphile
Bravo to you for your compassion.
14
Before succumbing to his increasing dementia, an elderly relative attempted suicide three times. Each attempt was thwarted by well-meaning relatives, and this once-brilliant man was then diagnosed by well-meaning, law-abiding social workers as a danger to himself and repeatedly confined to a psych ward.
In Washington state, a suicide attempt is considered a sign of mental illness and forcible restraint is the only treatment.
As his disease progresses and his misery and incapacity has inexorably increased, I can only reflect that if we treated an animal in such a fashion, keeping it alive regardless of pain and suffering, we'd be justly accused of being inhumane. Humans, in other words, are expected to endure levels of torment from which "dumb beasts" are exempt. What shameful folly.
74
@jrsherrard Unfortunately, they haven't addressed the problem of dementia and it is very difficult in most cases for a doctor to say how much time a person has left to live. It took me 5 months to get my husband hospice care, and he died one week later. The Death with Dignity Act in Washington allows people to ask for a lethal prescription from their doctor if they have less than six months to live. But how do you find a doctor willing to participate, and how does he know how long you have to live? It's hard.
13
@jrsherrard
When we had to put down our beloved Rottweiler dog we had a vet come to the house. She put him to sleep while I fed him treats and spoke softly to him. Then we buried him in our backyard. I could only comment that I wished my "final exit" would be as dignified and peaceful. But of course I know if I leave it up to the medical system it will fail.
34
@jrsherrard
I am against firearms, absolutely. But it might be a good idea to have one when it comes time for me to commit suicide.
After I take the drugs (if that's what I decide on), and until I'm out of it, I'll shoot anyone who tries to stop me.
11
I have a progressive, irreversible and untreatable condition that makes me progressively weaker. It began about a year ago and the decline has been slow but steady. My nerves are basically dying and there is nothing that can reverse it (look up Post Polio Syndrome).
I have a great life, a wonderful wife of 40 years, a lovely adult daughter, a beautiful home in a fantastic mediterranean countryside near the sea. I am happy, financially secure and have a cheerful disposition. People around me are surprised I am not distressed about it, nor am I depressed.
I am 76 years old, had a long career I really enjoyed and remember fondly. For 15 years of that I worked internationally in 6 different countries that spanned the globe. On the side, in San Fransisco, I started a fine art gallery for emerging artists that I supported for three years that gave the first one man/woman shows to a different artist 11 months out of each year. In other words I have lived a culturally rich and full life and have no regrets.
But, there is a limit to just how much deterioration I will accept. There will come a time when it will be rational for me to commit suicide. I have no idea when that will happen - maybe years, maybe sooner, but I will know it when it happens.
BTW, my wife knows about it and recognizes this as a rational decision that, when the time comes, I will make with her input.
60
@Al Fisher
from a retired medically-trained attorney (F/70)
You have both the self-awareness and means to use DIGNITAS. Zurich -- one-way flight for you and RT for family and friends. My date is 2023.
To protect yourself and your surrogate decision makers if you become unable to communicate, e.g., routine car wrecks or trauma, find and create the all-states one-page POLST described in other submissions here. Get it included in The Medic Alert Foundations database, wear your bracelet or dog tags with Foundation contact information so that those trained to look for and get Foundation alerts do so, and you're ready for your end-of-life peace.
Remarkable man. Thank you for your story!
21
We will all die. Once you are born, it is the only certainty. Why should this absolute be so far out of our control?
Degenerative death is fairly new — we used to die of something else before our body was completely broken. When I step back and objectively look at this discussion, it is absurdly simple. Should a fellow human be forced to suffer for an unknown amount of time, with the same exact outcome, or should they be allowed to make one final choice of when and how that ending will be?
51
Finding the right words,
Can be a problem.
How many times must it be said?
"There's no plan, it had to happen."
Got to move on sometime,
And it's about time.
By putting one foot
In front of another,
And repeating the process -
Cross over the street.
You're free to change your mind,
Strength through diversity.
Couldn't have put it more plainly,
Got to move on sometime.
~ Joe Crow "Compulsion"
2
In part this is a revolt against the over-medicalized profit-driven bureaucratic system that seems intent on torturing old people while extracting both their money and dignity on the way to the inevitable. We've seen it and we're not going to let it get us too.
64
@Guy Baehr
Yes Guy, you've said it well. The article states Mr. Shoots' reasons for feeling forced into a premature death, then ignores them.
4
@Guy Baehr
As a cardiologist who often deals with patients at the end of life, my experience is that physicians do not want to aggressively prolong life but the family often insists that everything be done. I think that this is in part because people don't think that advanced heart disease is as much a "terminal illness" as cancer can be.
16
I’m a 60-year old, otherwise healthy, man who was diagnosed with early dementia last year. I plan to end my life on the day of my choosing, well before I lose the emotional, intellectual and physical capacity to do so. (See the movie “Still Alice”)
I’m not scared of dying. I’m scared of living - and slowly losing my humanity to this brutal disease. I believe and hope that my loved ones will be less bereft, overall, by my decision.
My Dad died of Alzheimer’s over a span of 13 years. In his last three years, he couldn’t recognize me. Rather than the uncomprehending stare I got from him at our last meeting, I wish I’d been able to take his hand and say thank you.
I don’t know what I and my husband and three adult children will say to each other in my last days, but at least we’ll understand each other.
21
Of course suicide can be rational! For those st the end of their lives who are starting to experience the inevitable, unstoppable decline, it’s much more rational than the knee-jerk response to do whatever can be done to keep these people alive for however long possible.
36
Whether suicide should be considered as a legal, ethical, or moral option depends on whom one considers to be the owner of one's life. American ethics--if such a thing can be said to exist--emphasizes individual freedom of action. As such, we Americans are inclined to believe that we own our own lives and are responsible for making all decisions involving the disposition of that life. But unlike other possessions like houses, cars, or objects of value, we do not have a deed, title, or receipt to establish legal ownership of our lives. Do our lives belong in some sense to the people whom our life or death would affect? Do they belong to God, who alone should have the right to end our earthly lives? Should minor children who have been medically and psychologically declared sane be allowed to commit legalized suicide without the permission of their parents? It's not much of a stretch, considering that we already allow minors to procure abortions without parental permission. The only difference is that suicide robs the legal process of a defendant and renders it moot.
2
@Glenn Wright
The lives you speak of cannot exist without a being attached to it. If your notion is that lives belong to other people -- or to a god, that I happen to know doesn't exist -- then you are arguing that other people own me. Other people own my body and my mind.
I thought we'd settled that question in this country.
7
When I lived in Texas, I was carer for a friend who had no siblings, never married, and I loved deeply. She was 40 years older, and she often said I was like the daughter she never had. I was there by her side the last year as she suffered - suffered! - and finally died. She hated the pain and the dependence on others: she would NOT have chosen suicide, though she definitely would have been in support of it for others, if they wanted it. We discussed it, often.
Seeing hospice in action led me to become a hospice volunteer. I've seen death up close, often. Everyone is different - some would have hastened their death if given the chance, some would not. Why not allow that CHOICE?
My mother (in her 90's) died last year. She used to say "when you're over 90 you pray for a quick exit." I'll never forget walking down halls of her very upscale retirement home (the nursing building) and seeing people in chairs, no recognition of their surroundings, planted in front of TVs, day after day after week after month. No intellectual response to ANY situation. A life no one would choose if the had a choice. She did NOT want that! Lucky for my mom, she went - "poof!" - during the year she started saying "All I do is eat, sleep, and read books. That's not enough." This from someone who was "healthy" by medical standards (no meds. None. That healthy.) but couldn't walk 10 feet, and had difficulty doing ANYTHING without assistance. Why should someone ELSE force that choice in her? On you?
50
Before I was ten years old, I had read the Mahabharata several times. Of the many imagery's that was printed indelibly in my memory is that of Bhisma lying on a bed of arrows in the Kurukshetra battlefield. He would not die from mortal wounds and would only leave this world on his own accord 58 days later at a time and day of his choice (winter solstice).
By the time I was in my 40s and come to recognize the medical industrial complex's need to keep old people alive at all costs, I became determined that I should be in control of leaving this world at a time of my choosing. At 55, I am convinced that baby boomers will increasingly see the so-called rational suicide as the most logical and meaningful way of departing from this world.
25
I agree with the majority of comments here that suicide can be a rational choice for individuals for all the various reasons and examples shared. However, for me, I will wait until after the midterm elections where, hopefully, we will be able to elect a younger generation of politicians who agree that health care should be a right and not a privilege. So many issues about care, including end of life care, would be much less of a struggle if the 'for-profit' aspect were taken out of the equation.
What a parting gift it would be, if we changed health care for the next generation. That is a legacy worth postponing our exit and voting for.
137
@Karen M
End of life care should be available and priced so that everyone who wants it can get it.
But for those of us who have constant and continuing nightmares about all the ghastly horrors of being stuck in the hands of "caretakers" -- surrounded by other yowling, stinking old things --swift death at our own hands is the right we need.
11
So, I guess those arguments suggesting that "physician assisted suicide, was a slippery slope were not so far fetched after all. "Oh, we're only speaking about the terminally ill who are in constant pain," and, "oh yes, of course, there will be testing to make sure those requesting physician assisted suicide are not depressed, or coerced, "and no one here is suggesting suicide as a rational choice."
15
@brian: you nailed it, sir!
That is precisely correct.
The slippery slope is here in all its glory.
And by the logic here...it goes quickly from "terminally ill and in pain" to "just old" to "depressed"....to anyone disabled or unhappy or lonely. And of course....many young healthy people fit that bill!
As a non-religious geriatrician who grew up with an Asian background, I believe in rational suicide. I think a lot of this country's ideas and stigma about suicide are still too influenced by Judeo-Christian Western values, which is fine if that is what you believe, but all too often these values slip in without people recognizing where they are coming from.
I believe that if there reversible reasons for suicide exist (e.g. depression, uncontrolled pain, social isolation), we should work to address them. But at the same time, I have come across many patients who don't have these issues and feel that they should have control over such an essential issue as when/ how they die. Oftentimes, they have seen a close family member die up close. Personally, I am glad I live in a state and my parents live in a state where aid-in-dying is legal.
I'd also add that physician aid-in-dying has been around for as long as the medical profession has existed: it's just always been unspoken of and driven underground. One typical scenario is a clinician giving a patient pain medications and telling them the side effects of the medicines, both as a warning and as an idea of what it might do given a high enough dose.
89
@ms
from a retired medical attorney (F/70):
Well said. Now, I work with patients and friends to get them to write one-page plain-English directives anchored in SCOTUS' right to refuse treatment. No EMS/ER intubation/ports, no Dx or Tx interventions beyond Comfort Care Only. Document crosses state lines, including CA, and over-rules state law if there is any conflict.
For those who believe dying "at home" is their preference, I ask if they've ever been the caregiver for a person dying at home . . .and most say "No." My follow-on question: How much pain and agitation untouched by home hospice helpers or drugs can you stand? Not whether. But how much?
I remind all that Medical Directors of inpatient hospice can only help with dying, stop suffering, if we lose the "dignity" descriptors and focus on "pain." Build a medical record to protect the physician who orders Morphine & Methdaone (or methotrexate in Catholic facilities) by IV. As my very young hospice physician said in May 2013 when I got him to "Yes" on M&M under my POA for my 92-year old father: " . . .a quiet death in three hours to three days." And it was.
Avoided months of suffering for a man with end-stage Alzheimer's and cancers.
19
Almost everyone here expresses the idea that their life is their own to dispense with as they please. But our lives are not our own - they belong to those who love us. Suicide closes a door which never will open.
22
Death, by any means, closes those doors. The question is, should we be able to choose how those doors are closed?
24
@Anthony If you support the right to refuse heroic or other life-sustaining measures ( in the event of terminal or life end diseases or conditions) then the right to quickly and painlessly ending one's life should not be considered a drastic extension of that position.
Economic, psychological or pain related bases for taking one's last bow should be seen as rational, justified and ultimately, a personal decision.
19
@Anthony
I am not entirely sure where I fall on this entire question, but I do feel taken aback that so few of the commenters who insist, without qualification, on their right to decide for themselves when their life ends - so few mention that anyone else's feelings or sufferings count at all.
1
What about finances? There is no mention of it, and it is important; those “treatable” conditions are very expensive, period. No mention of the QOL concerns those treatments pose, either. I don’t intend to die bankrupt, with all my assets going to the criminal industry called healthcare in this country.
This article leaves out lot. I know, now, to never mention death or suicide if front of my many doctors; they freak out and read me a script. I tell them to relax, they won’t know that i’ve offed myself until I start missing appointments...
30
OJ's lawyer Johnnie Cochran said something like "innocent until proven broke". The corrolary applies to our medical system. Alive until proven broke. Complete vegetables kept alive to the tune of 100k/day while thousands of generally healthy people die young due to lack of access to the most rudimentary of cheap outpatient care.
31
@Ian: healthy young people are not dying in the US.
That is false.
Unless you mean those who deliberately abuse opioids. They are CHOOSING a kind of suicide, I guess.
We are told that is very wrong and epidemic…..but HERE, many are asking precisely for such kinds of suicide -- even for the not elderly or not dying.
We are told it is "bad to have guns, people kill themselves with guns" and THEN TOLD we should commit suicide to escape pain or old age.
The left is very hypocritical!
from a retired medical attorney (F/70):
DIGNITAS Zurich 2023 for me. Swiss have long been less judgmental and more helpful in bringing peace to those suffering, to those who make it clear when and where they wish to die. As the pre-clinical (symptomatic) signals all point to Alzheimer's at the usual arc of more than a decade, including plaque visible in MRIs, I have tremendous peace in my decision. Severe OA pain too. No surprises for friends or family.
Protect myself from the Standard-Operating-Procedures or SOPS among EMS and ER physicians/RNs in this country with a refuse-all-treatment and diagnostics and ports/intubation by EMTs written into my one-page plain-English POLST. On my frig. In my car's glove box. Known to all in my small circle. In Medic-Alert Foundation's database 24/7 access to MDs.
Anchored in SCOTUS' right-to-refuse treatment since 1990, my advance directive travels across state lines and over-rules state law where there may be conflicts.
Agree with all who say: NOT a physician's job to write the rules -- just check M.A. Foundation and honor known directives in POA hands.
Write a one-page plain-English document refusing all Dx and Tx interventions by EMS and ERs. Comfort Care Only acceptable. Get two witnesses and Notary Public signature. Put document in Foundation's database. Then sleep well!
Too bad it still takes a law degree and 40+ years working in medicine to get to a bulletproof advance directive . . .
15
@n.c.fl
Still - do you really think staff on the floor - if you're in a care facility - are going to dash to the file cabinets or the computer to pull out this document if you have a crisis? They're still far more likely to just call 911 and off you go in the ambulance. If someone finds that document, it'll be a week later.
10
Thank you for the advice. You’ve given me a kick start to do this.
4
@DW
I have hand-carried to two local hospital ERs and hospital CEOs my unique POLST. Answered all questions. And each has called me to help them with patients who need help to write their own directives . . .while in a hospital bed, e.g., a 67 yr old man who stopped dialysis and wants help dying. I handwrote his one-page plain-English POLST with his medical history and refusal of all treatment except comfort care. He and his POA/spouse signed. Then two RNs not treating him witnessed and a 24/7 Notary signed. Copies taped to his chart + his wall + his bed. Training at each shift change.
RN moved a patient from the room, brought in recliners and food for his family, and he passed painlessly the next evening. This was among the first local uses of my POLST based on our SCOTUS-defined "right to refuse treatment," but RNs and ER physicians were ecstatic when they saw how simple and unambiguous the whole process could be.
poco a poco We make progress.
For those souls now locked away and vegetative, first-degree family and spouses have Power of Attorney under every state's law to get their lives ended . . .humanely. By refusing all treatment/Comfort Care Only authorized. My detailed pathway is set out in other submissions and replies here.
My retired lawyer's no-charge contribution to a more sane and humane end-of-life directive that can cross state lines to protect me until I leave for Zurich DIGNITAS 2023.
I have experienced too many people who are wasting oceans of money and time suffering from cancer.
I hope if I am terminally ill like that, that I can take a simple painless exit under my control before the disease makes each day being a living hell that I must suffer through until the inevitable which is what our laws, conceived from religion, force many of us to endure.
24
One unspoken reason the medical system resists rational suicide is that end of life patients represent an enormous amount of income -- to hospitals, medical professionals, and most especially nursing homes. Ask yourself this: have you ever seen a nursing home in which you would want to spend the last six months of your life?
25
My father will be 83 this month, and he’s in constant pain. I’m in my fifties, suffering from debilitating chronic depression and insomnia, poor health, loss of friends, my creative life, financial hope. He’s fighting to live, seeing doctors, going on. I desperately want him to live, I’d make him immortal if I could. But, I want to die. What keeps me alive? Not wanting to hasten my father’s death. Irony, my suicide would kill him. When he goes, I want to go. Yet...everyone here who has planned suicide for when the time comes, my morbid curiosity is, how? Another irony is I’m afraid of any means that aren’t pills. I can’t be the only one that’s ready to die, yet afraid of the methods, or of failing and being in worse condition than I am now. I don’t expect a manual on how to commit suicide successfully in these comments, but I am struck by how sure those with plans are, of the outcome.
15
@nicki
Nicki, yours is a tough comment to read recognizing that there is an actual person on the other end.
I have no great answer, nor advice other than to think hard and to reach out to someone to talk through what you are feeling, even if it is an unknown someone at a help line. I don't know you and perhaps you have done all that you wish.
I am not arguing pro or con, judging, nor am I anti death with dignity or anti 'rational suicide'. Just maybe it is helpful to know that someone read your comment and responded.
Best wishes.
12
@nicki
from a retired medically-trained attorney:
If you have the means to fly one-way to Zurich, consider DIGNITAS as your "not a manual" to stop your suffering. Do your research on this organization that is used by those with knowledge and the means to set their own plan for death?
On the subject of your father who is pursuing immortality at Medicare's expense, you may need to get out of his orbit? Completely? My mother is your father and I left what I cal her "alternative reality" eight years ago. For those who judge, instead of observing others with compassion, get away from them too.
We owe our parents nothing when our values and our pain, our suffering, leads to diametrically opposing pathways. Be Strong.
9
@nicki
I know exactly where you are coming from. I would have a lot of peace of mind if I knew HOW to commit suicide should I be faced with a health issue that would involve a long suffering death or an illness like Alzheimer. Like you, only pills appeal to me but I have read that many times what you take may not kill you. Only compound horrible health problems. I could do helium but they now have altered the tanks that you used to be able to buy for balloons so that they can no longer be used for a painless death. I actually I’m a member of DIGNITAS just to support their movement but don’t relish flying to Switzerland to end my life should I want to. Sometimes just knowing that suicide is a doable option brings comfort.
3
I am concerned that advocacy for the right to die risks enforcing a duty to die. However, intellectual humility demands that I consider whether my duty to die could be legitimate.
How badly do I want to live for a few uncomfortable years under 24-hour nursing care? How badly do I want keep my son's house out of foreclosure? What does a particular course of action say about my commitment to my loved ones? If I am competent to weigh these questions, I have the right to act on my conclusions.
18
@drfeelokay: you feel OBLIGATED to commit suicide, so your son can get your money and save his house from foreclosure?
You have just literally DEFINED "slippery slope".
1
Why, as a culture, do we fear death so strongly? To those who overcome extreme pain and drastic disabilities, or remain cheerful well into their dotage, congratulations. That is your path or perhaps your genetic good fortune.
But why must I drag a rotting carcarcass through an eighth decade, when the outcome is assured-I will die, but many, many pain-wracked years on...because the law forbids me access to to means of a peaceful death.
No one should be pressured to end their own life, or to assisst another in that attempt. But for those who feel their life is complete, or unbearable, and those whose compassion enables them to honor their wish for release, there should be support, not condemnation.
36
@jani
I hear you. But I think it is also possible that those who favor "rational suicide," may fear death more than those who do not. Knowing you can kill yourself anytime you wish, deflates the fear of death, makes it less of a cipher, a wild card A healthy fear of death is natural and I think good. Defanging death, may also rob life of its beauty and grandeur.
2
@jani
Religion has its roots in people's dislike of death. Folks believe they're going somewhere afterwards where they'll enjoy endless life and be forever happy. (As long as they behave on earth, or ask nicely for forgiveness when they don't.)
3
I have said for over 20 years that any adult should be free to take their own life at anytime for any or no reason. The notion that others should FORCE someone they dont know and dont care about to live is no different than randomly taking people and forcing them to have children at your command. And we dont dictate when and how other people live and create life but we feel just in telling someone that they have to be in incurable pain.
30
@MP I also feel as you do about ones right to end their life under any circumstance regardless of how other people try to interfere including family, doctors, or religious beliefs of others. I personally find it silly that anyone thinks we are not free to do so now. It is the the control of ones life that no one can take away no matter who tries. I do hope some day our society will understand and make assisted suicide a simpler and less traumatic event for all concerned. When I begin to fail and life becomes intolerable I will do so, but family and friends will understand because I will not keep my intentions a secret and I will leave behind no guilt for anyone to bear, it's that simple.
14
Beyond the medical, legal and physical 'practicalities' there is the spiritual aspect of transitioning between states of existence. Having thought considerably about ending my physical life over many years (I am 64 in ok health) I keep coming back to the linear sequences: pre-existence, existence and post-existence and I always come back to the ever present Now. It centers and transcends.
We are always, and can only be ever in the Now. Our quiet enduring guide.
3
When my father was dying of ALS I used to go and visit him from time to time. When I asked him if there was anything I could do for him her always asked for a gun. I seriously considered leaving my 1911 on the table in front of him, telling him that I loved him, and taking a walk.
Ultimately I did not do it because my mother was not ready to let him go. Ultimately the living are left with the death of a loved one and this influenced my decision. My father died a horrible, protracted death that was not of his choosing. If I ever get to that point I hope that the state will not interfere with my autonomy. If they do I will have to seek splice in the barrel of a gun.
11
70 seems to me, being rather older than that, to be too early to begin thinking this way. Still, the views expressed in this essay are well taken. I hope all can take comfort in considering them as needed!!
12
Quality of life and the right to a good death is not limited to the elderly. Disability and illness can occur at any age. We need to be able to have these discussions safely and without fear.
I'm neither elderly nor a millennial, and when I sustained permanent injuries from a sever car accident (random drunk driver's fault, not mine) I lost both autonomy and quality of life. After years of painful rehabilitation, I discussed my desire to complete suicide with my family and was subsequently locked in the mental health ward of a hospital. This took away any humanity I had left and added to my humiliation. A doctor at this hospital actively shamed me for thinking I had the right to die on my own terms. He called me selfish.
The desire to end one's life when quality of life is lost does not need to be perceived as a problem to be fixed. It's OK to acknowledge you had a good run and it's time to move on. We all deserve a death with dignity, at any age.
399
@Marie
Thank you for your honesty. I agree with you.
40
@Marie, let me share a quote from an unlikely source that hits the nail on the head: “They were afraid of being selfish, for they had never understood what [he] knew instinctively, that selfishness is not living as one wishes to live, it is asking others to live as one wishes to live.”
From a novel by Ruth Rendell.
How dare that doctor.
60
@Marie ...which suggests that, depending on the family, it may NOT always be a good idea to have "the conversation."
11
At 80 and in decent health, after helping nurse my mother, only sibling, and her only daughter through fatal cancer, down the road, if circumstances are ripe, I plan on snuffing out my own candle. Ethically, I figure all the actions we take to stay alive, from shots to surgery, apparently interfere with the will of "God" who evidently wanted us to die earlier so, just as we or others "decided to prolong our lives, what's the big deal about deciding when to end matters.
74
Very many comments focus on the need for the legal suicide option when the pain (physical, mental or both) gets too great (with which I agree) but then frame the issue in starkly libertarian terms.
But if the issue is personal autonomy, what business is it of society why and when I die? What need we for some special recitation of the horrors of dementia and nursing home care, when a college student in perfect health decides that a lost love relationship requires ending his life? Or that a businesswoman's fraud conviction and imprisonment for 5 years requires her to kill herself? Would it be downright *unethical* to try to persuade them otherwise?
Would it be wrong to try to dissuade a poor person that their meager financial prospects do not justify suicide? Who is anyone to say that that is not a "rational" response to poverty?
Mechanically reciting the imperative of personal autonomy is a simplistic answer to a more complicated question, i.e. whether we as a society embrace principles about the value of life that go beyond mere individual, momentary choice.
19
@Wine Country Dude: according to many comments here… it's not just OK for a dying patient in pain to end their life.
Now it is ANYBODY with the slightest gripe -- even the young and otherwise healthy --- bad job? disappointments? romantic partner left you?
Call DIGNITAS and fly to Switzerland and they will kill you!!!
One wonders why they even write about the opioid crisis and all the deaths. Are they not just acting out precisely the suicides applauded here?
@Concerned CitizenNo, they are not. You have a problem if you can't see the difference. Or are unwilling to.
3
Belgium, the Netherlands, and Canada offer euthanasia to their own citizens. Why can't we just follow their example since their citizens seem happy with this freedom? It would be wonderful if these countries offered compassionate euthanasia to people from foreign countries. Only Switzerland offers Physician Assisted Suicide to foreigners but there is extensive paperwork involved and a sizable fee. I wouldn't mind paying the fee, but I don't like the paperwork which involves parties from both sides examining medical records.
27
@epf
from a retired medically-trained attorney:
I have a one-way flight to DIGNITAS Zurich 2023.
May be if you're put-off by "paperwork" you're not suffering like those of us relieved to have access to this lawful and generous alternative?
8
@epf: according to n.c.fly here….DIGNATAS will kill you, even if you are young and healthy -- if you want to go!
Apparently they have no morals or guidelines and will euthanize a healthy teenager if they are depressed!!!
The paperwork cannot be too onerous, obviously -- if they happily kill ANYONE who applies!
Must be a lot of Dr. Kevorkians in Switzerland!!!
@Concerned Citizen
I'm sorry you're unable to get past your vitriol to understand the many thoughtful and useful ideas being offered here. We will choose to ignore you!
3
Interesting that in an article about the possibility of rational suicide (which I believe is a very real thing and has been throughout the ages in all sorts of different cultures) there's a link and phone number to a suicide hotline.
Not everyone who commits suicide or considers it needs help or guidance.
46
But some might.
7
@LR
As I mention above, offerimg suicide hotline numbers is at least an implied abridgement of the value of absolute personal autonomy....at least until future articles provide contact information for those who have made the "rational" decision to exit stage left and simply need some guidance how to do it.
7
Instead there should be a recommendation to read “Final Exit” by Derek Humphry if you are rationally considering suicide.
5
This article makes a half-hearted attempt at defining a rational option for suicide, one that can be tolerated, but then spends most of the ink on how suicide is "preventable" in the elderly, as if it is not really an option at all. Suicide should be no more preventable then say, hip replacement surgery. Both are personal options for personal conditions. The fact that one leads to end of life is a matter of concern only to the person taking that option.
It is not the business of the medical industry to be imposing their personal beliefs onto the patient, beliefs which are very subjective and heavily influenced by culture and religion. We need to get over the belief that we should all live until we fall apart in some hospital ward, and start recognizing the right of self determination that we all possess.
90
It's so disturbing that some voices in this conversation treat the elderly like toddlers. (I'm in my 40s.) The people who are doing this are adults--mentally, the same adults who raised you to adulthood, worked a job, traveled the globe, and barbecued with friends on weekends. THEY get to make these decisions. THEY get to choose whether or not they deserve to end their suffering. How dare we treat them like lumps of flesh? The government has no business telling me when I can end my debilitating, painful, so-called life.
66
I have made preparations to depart this world sometime in the next 60 days. I am 88 and have complicated and painful medical issues that make living "well" increasingly difficult. Otherwise I expect to be in a wheel chair soon which is an unacceptable option for me.
I am reminded of my father who commented to me that "his life had become too dangerous to stay alive" before committing suicide at age 94.He was still in reasonably good health but increasingly frail and was terrified about falling and ending up in a nursing home unable to control his life.
This after watching his wife waste away in such a facility.
I really don't understand the reluctance of society to allow competent individuals the right to make this decision, with reasonable limitations, and provide the means to do so.
It's almost barbaric. Fortunately, most but not all are able to perform this task in spite of efforts to block access. How much more civilized it would be if this departure could be performed as part of a ceremony with family and friends rather than alone and in darkness.
127
@Brodie
"with reasonable limits"
___
And there's the rub. Who decides what's reasonable? The Church--discredited. Politicians--discredited, at least if they don't belong to your own warring camp. The Pentagon--nah. Men, as a group--discredited. Women, as a group--nobody believes this, and see my discussion of "men" above, anyway. Suicide "survivors", anyone?
Framing the issue in starkly libertarian terms is no answer, alone, to anything. We are going to have to face the fact that, as long as we remain a civilized society, there are going to be limits on personal autonomy, in this area, and others. The issue is what they are, how they will be set out and how compliance will be secured.
6
@Brodie: I hope that your passing is good and peaceful. Thank you for your contributions here.
13
@Brodie I hope you find peace, whatever you decide. You write so eloquently that it is obvious that your mind is very sharp. I'm sorry your body isn't too.
13
Nobody is getting out of here alive, if I choose not to have a painful death it is my choice.
68
@Mr Ed
What if your decision means your spouse will forfeit an insurance policy, that she desperately needs to survive? A conflicting interest, perhaps? Acknowledging that society, and other individuals, may rightfuly have an interest does not mean that they should prevail. But maybe the issue is not quite as simple as "my body, my self"?
9
@Wine Country Dude
Most of the insurance policies I've seen (and I've seen a few) are invalidated only by a suicide that occures within a specified time after the policy is purchased, usually around two years.
7
@Wine Country Dude
Most life insurance policies have suicide forfeiture clauses only for suicide within a specified period after the policy was purchased. Two years is common.
5
Viz Jack London, The Law of Life.
3
Older people, just like any other people, can be competent or not competent. Competent people have the right to make their own decisions about living or dying. However, they must take the responsibility themselves (no asking children or friends to kill them) and plan ahead. It is often baffling to read about famous people who seem to have it all commiting suicide, but no one can live inside another person's head. We need to get over the idea that it is somehow heroic to "fight" to the last agonizing moment.
30
Before you pull that plug please read the book Lost Connections by Johann Hari available at a library for free. Never mind the subtitle that refers to depression. It's about how one's life and perception of the value of life is intertwined with one's society's values. Don't police yourself for the state because you can't buy happiness as defined by the state. It is true that the state has failed us so absolutely on the subject of health care that it does feel right to chose death over the kind and quality of "care" available to us, but one wonders, is this a personal "choice" or more of an unheard protest vote against the state's callousness and hypocrisy?
7
@freyda
Any comment that infringes on, or miltates in any way against, personal autonomy as an absolute value will not be welcomed here. They say it is not for you, or us, to judge the weight of mere protest votes against poor healthcare, as opposed to the simple desire to be dead.
5
@freyda
It can be a personal decision as well as a protest against the state. I would consider it to be wonderful if my suicide, or others, helped bring healthcare to all, not some, in this violent and cruel country.
5
Thank you for a thoughtful examination of a difficult issue. I especially agree with the point that we too often shut people down at the mention of suicide--or similar subjects. This also happens when patients want to discuss halting or avoiding aggressive treatments. Here’s a brief video that looks at why these discussions are so important: https://www.youtube.com/watch?v=4B8iGXjyejI
5
'but she monitors herself closely for signs of cognitive and functional decline. “When I start to slip too much,” she said, “it’s time.”'
The problem with this idea is that it's too soon until it's too late. My mom always said the same. But now that she is well past the point of decline where her earlier self said she would end it, she clearly does not want to die. She is no longer the same person.
34
Since the majority who have commented have been in favor of having the choice of when to end their own lives that I totaly agree with, can anybody recommend source material on how to do with the least impact of the person who finds you and how to do it without any chance of accidental survival. No, I am not being facetious Don't own a gun or seem to have enough pills, etc. I am old, in pain and very tired with limited financial resources. Lost most of my friends, relatives, daughter, and I cannot engage in activities that always gave me joy. Was once in a nursing home in my mid 50's. I was horrified. Not for me. This article should have given us some reference material. I am guessing there are some organizations that help you with this process. Probably need to do an internet search.
27
The NYT magazine had an article you can google called The Last Day of Her Life about Sandy Bem’s decision, including how she took her life. It was an excellent read.
18
@Vail
Suggest you log on to "Peaceful Pill" an international organization that offers such information.. You can purchase their book (or web access) that provided detailed information.
16
My father was 79 and in reasonable health. We three siblings and our mother thought he had more good years ahead. He felt he was slipping. He stripped to his briefs, took some pills with alcohol, reclined in the empty bathtub, placed a plastic bag over his head and pulled socks over his hands, presumably to inhibit their ability to remove the plastic bag. Apparently he learned these steps from online research. I learned some of these details from the police report. He made his decision. We move on.
7
My poor mother has been longing for life to let go of her for 9 long years; unfortunately she didn't have her dose handy when she fell and the health care system rescued her. She's paralyzed with a great deal of dementia, and the stress on her friends and family goes on ... and on ... and on.
Modern health care can keep us alive, and public opinion refuses to recognize that this is what is unnatural, not letting go when our time has come.
I can't even talk about this with most caregivers, who are trained to save rather than to let go.
Let's hope we can move towards giving life - and death - its true value as time goes on. Living well is better than living at all costs.
Meanwhile, the health care system is perfectly willing to let go of people who can't afford even good care. The costs of preserving life at all costs don't seem to apply to the underclass and "those people".
66
To me, now securely beyond the foothills of old-far*hood, the key in any civil society, is to respect and support the autonomy of its sentient members. That means that individuals decide the manner and timing of their own dying with whatever discussion, or lack of same, they choose to have with loved ones.
I find incredibly intrusive and offensive the notion that any religious or political ideology could deny me that right, and I would oppose such denial with every breath in my still-living body.
On a lighter note, a dear friend recently told me that, after we reach the age of 70, nobody pays the slightest attention to a word we utter. Maybe, but when I crossed the boundary into the septuagenarian ranks, I failed to notice the slightest difference.
20
@John LeBaron
70 is the new 50 (or younger). (It takes one to know one.)
5
@Susan Anderson. 50 or 70? Whichever, the best to you! ;-)
4
My father had a very serious stroke. He was left largely physically incapacitated and could only speak a few words ("yes" and "no" among them), yet he seemed able to comprehend things normally.
After a year, he decided to end his own life. But, legally, the only way for him to accomplish that was to refuse food and water. He was able to make his decision clear to both family and medical staff. He, and we, did not want his decision countermanded through medical intervention. We felt it was a decision he was entitled to make, especially given his situation. And, he had said many times earlier in his life he would never want to live the way he was now living.
He died 9 days later. Physically, it was a very difficult and uncomfortable way for him to die. He had such courage and fortitude, all the way to the end. It was tragic that there was not a better, more humane way for him to end his own life. Our society needs to be much more compassionate for those who want to end their own life, for good reason, on their own terms, and with dignity.
216
@fact or friction - When someone dies through a death sentence in prison, they offer them a last meal of their choice and they don't rush them to finish it (within reason). Then they try to make the death process as physically painless as possible.
Why should it have to be any different for a person who chooses to end their own life? Why should people be forced to starve themselves to end their life?
38
@fact or friction
from a retired medically trained attorney (F/70):
With hospice that you have interviewed to get the inpatient Medical Director to "Yes," one can direct caregivers directly and/or via Power of Attorney holders to use Comfort Care Only during IV infusion of Morphine & Methadone. Morphine handles pain. Methadone blocks morphine nightmares. Sometimes methotrexate in Catholic facilities.
Spread the word and keep looking for a humane hospice inpatient Medical Director until you get to "Yes" for M&M.
As my father's very young hospice MD said after we got him to "Yes" in 2013, . . ."three hours to three days of quiet with no suffering until he dies." And it was.
7
Here is how this can be accomplished. Tell your family members way in advance and discuss, in depth, how the idea of being helpless, totally dependent on others for basic needs, in pain, or completely addled, horrifies you. Say you want to leave this life with as much dignity as you can muster. If, eventually, you qualify for hospice, get admitted to hospice. If you are on life-sustaining medication, gradually take yourself off of it. This is your right. Nobody can force you to take it. These would be heart medicines, blood pressure medications - any medication that keeps you alive. Stop eating. Have some valium for anxiety, should you experience anxiety. Say your goodbyes. Apologize, if necessary. Have supportive people around you. Music if it soothes you. If your illness is painful, hospice will manage your pain. Hospice is NOT there to end your life. They provide palliative care and emotional support. You can orchestrate and control your own demise, but there’s no need to hurt your friends and family by doing something that will devastate them. My very elderly father did exactly this and his whole family was there when he drew his last breath. He died on his own terms. I hope to do the same when it’s my time.
103
@Kathryn
I would caution that a little bit of Valium may not be enough to take the edge off THAT.
2
@DW - i hear you, but my father was over 94 and Valium completely calmed him when he stopped eating. That was actually the only thing he took, drug-wise. He was not in excruciating pain but of course people in pain need heavy pain medication administered by hospice. He was a determined and brave guy, my father, and I miss him every day. But, he felt done.
3
@Kathryn
This is excellent advice. Family and friends are prepared and pain is minimized while dignity and choice are maintained.
1
There is an evil lurking in this "movement' that isn't apparent until you are confronted with it when someone is near the end of their life. The pro-suicide advocates refuse to recognize it or even talk about it.
3
@Aristotle Gluteus Maximus
The real "evil" is forcing people who are debilitated and suffering to stay alive until the bitter end.
30
@Noodles
Sure. God, or whatever, cellular metabolism, is forcing people to stay alive, so, therefore, they must be killed. That's not a difficult problem to solve. Killing is easy. The most inconvenient thing is what to do with the bodies.
1
@Aristotle Gluteus Maximus: quite a few comments have shocked me and I am hard to shock.
They have stepped right off the slippery slope -- it's a LONG way from "my 94 year old dad refused excessive medical treatments" to " young people, the depressed and disabled should be able to kill themselves".
One horrific poster actually gave INSTRUCTIONS to a young, healthy depressed person on how to END HIS LIFE!!!
If the Swiss organization DIGNITAS is actually euthanizing HEALTHY young people who are depressed or disabled (but not sick or dying)….this is a monstrous evil and speaks poorly of the Swiss people that they tolerate it.
I’ve enjoyed reading the Stoic philosophers on death, dying and suicide. They believed we had the right, at anytime, to end our lives.
This is Epictetus, one of the earliest Stoics, from his “Discourses.”
“Remember that the door is open. Don’t be more cowardly than children, but just as they say, when the game is no longer fun for them, ‘I won’t play any more,’ you too, when things seem that way to you, say, ‘I won’t play any more,’ and leave, but if you remain, don’t complain.” (Discourses I.24.20)
If healthy people visited an “assisted living center,” they’d immediately see the wisdom in Epictetus’s statement.
35
https://www.nytimes.com/2002/01/12/us/with-suicide-an-admiral-keeps-comm...
Admiral Nimitz (the son) agreed.
5
The Medical Industrial Complex in the US will never allow rational suicide when there is so much money to be made fleecing Americans at all stages of their lives.
35
The last year of my MIL' s life was a nightmare-- brought to the family and her by the all-knowing docs (not); who threatened that not treating this or that would be more painful than going through the invasive and expensive treatments. Baloney. In the end she passed, somewhat in peace. This will not be my fate, no way.
11
The GOP only shows interest in humans only from conception to birth and from terminal illness to death.
23
But just trust your care to hospice. They know how to fall asleep while you fall out of bed and gash your scalp.
7
Among A Troubled Schools Alarming Death Rate, with Could I Kill My Mother, and now this, I'm wondering if I'm the only one who thinks The New York Times, is now the place to find morbid articles?! Or are they just trying to compete with NBC 's dateline?! Or, is this the way they think they can increase their Millennial readership?! Not my uncle's New York Times, anymore!!!
2
@Counter Measures I find these kinds of articles, and readers' comments on them, interesting and informative.
12
“Il n'y a qu'un problème philosophique vraiment sérieux: c'est le suicide. Juger que la vie vaut ou ne vaut pas la peine d'être vécue, c'est répondre à la question fondamentale de la philosophie.” Albert Camus, Le Mythe de Sisyphe
(Philosophy has only one really major question: Suicide. Deciding whether life is, or is not, worth living. This is philosophy's most fundamental question)
Two years ago, my sister-in-law's 60-year-old brother was diagnosed with early onset dementia. As he saw his mind slipping away, he made a decision and carried it out: To end his life. He was loved by his family, and so losing him cause his family hurt. But he was not willing to continue living, knowing that he would be less and less in control. Thus, his decision made perfect sense to me.
For centuries, the Roman Catholic Church classified suicide as a mortal sin. Such a person would be condemned to Hell and his family ostracized by the fact that the victim could not be buried in the church. Fortunately for his family (it didn't matter to him), a person who is diagnosed as mentally ill is no longer condemned by the church. In the past, Catholic family would have to lie and cover up suicides to avoid social castigation by the pious "fathers" in the church.
13
@Jay David
I don't think that the Roman Catholic church really has much moral authority over anything these day, do you? It's pretty much forfeited its right to make pronouncements about individual choices, given its institutional moral transgressions.
8
@Jay David
The Catholic CHurch also said that eating meat on Friday was a mortal sin and we did that at the peril of 'losing our soul.' That's how rational the Catholic Church is.
4
Why is it that we always talk of "preventable suicide" as if the only choice is not to. YES I beleive in rational suicide and wish doctors and others would understand that. Discuss "the exit bag" and other alternatives. Why do we always see it as a tramatic drama rather than a peaceful alternative?
27
Most of these posts refer to old age. The same rationale can apply to younger people who have found issues in their life overwhelming for a long period of time. They can decide that life is not worth living if it involves unbearable suffering with no hope of relief, such as physical incapacity or yes, mental suffering. Often depression is a rational response in such cases. I don't think teenagers are capable of a rational response because they don't have the maturity that life experience brings. But I think experienced adults are capable, and should have the right, of deciding to check out without being accused of being mentally ill.
20
To say that suicide at end of life is irrational or impulsive is to belittle those that are brave enough to understand what life truly means to them and how they wish to live it and end it. I find it extremely difficult to read the hypocritical perspectives of the established medical community on this topic since they are part of the broader medical-industrial complex that puts profits before patient care in this country.
The medical community has little credibility as, in majority of cases, they are in the business (literally) of prolonging life whatever the expense and regardless of the quality of that life. Let's remember that the medical community has aided and abetted the opioid crisis in this country; where is their likewise concern about if dispensing this amount of drugs is 'rational' or 'justifiable'? Where is the medical community's outrage as millions of American lose their health coverage because it's too expensive and therefore don't seek medical or mental health attention?
33
One supposes this conversation is more easily broached and perhaps promoted as a series of US administrations have cut - and intend to further eliminate - social "safety net" programs which protect seniors against the need to consider "rational suicide."
A cross-cultural or transnational comparison would be interesting, to ask whether and how different political approaches affect the issue of "rational suicide."
16
I just had this discussion less than 48 hours ago with a close friend, who was very angry at me for logically thinking about how and when I'll end my life, telling me how it will devastate my kids. My four children are aware of my plans and the logic behind them and support me in any decision I make. It's my life and my decision. My parents, who both lived to be 90, spent almost all of their hard-earned savings living in assisted living and memory care. They were both miserable for over 10 years, making everyone else around them miserable as well. Not for me. When I have more bad days than good ones, I'll exit this world knowing that my children will get my assets instead of the medical industry.
71
71 yo, good health. Have made what I hope are fail-safe preparations for when the situation changes. My life, my decision.
55
I recently spent one night in the hospital. The care was good, but the thought of a long stay followed by death is unbearable. No chemotherapy. No disfiguring operations. Suicide for me.
36
I am now sitting in a room in a hospice facility room with my father whose mind is quite good but body is failing badly from simply old age. He's had a very good life. Death is not imminent. So, we are making arrangements to take him home and put 24x7 care in place at his condo which is not an assisted living place. It's where he wants to be despite our pleas over the years to come be closer to one of us. He chose to go into hospice to add certainty to never seeing the inside of a hospital again and to avoid restorative therapies. He is just a month shy of 100 and has been suffering unbearable pain from postherpetic neuralgia since 2014. As his ability to move declines (because the only relief from the pain is if he's perfectly still) he consistently says he just wants to move on and is ready to 'meet his maker'. He tells every doctor and asks me often if there isn't a way to end it. He can't do anything on his own at this time and certainly doesn't want us to do anything illegal. So, in a few days his apartment will be outfitted with a bed and all like hospice necessities. With the 24x7 care and we, his family who live in far flung cities, and his abundant local cadre of younger friends will do the best we can to care for him, making him smile as often as we can. Hospice will oversee his ongoing pain until, most likely, his body completely shuts down. I've no doubt he will keep asking daily, "can't you just give me a pill? This isn't a life'.
209
@Maggie After a joy-filled family Christmas, a good friend's 100 year old grandmother chose to stop eating and drinking. Her family and friends respected her wishes. Within 5 days she slept most of the time, often reaffirming her refusal of food and most water when she woke. After 10 days she stopped breathing. She was at peace, in her own bed, in the home where she had been born. Her grace and determination throughout her life were an inspiration for many.
22
@Maggie - I don't understand your post. Your father has made it to nearly 100 years old, is in constant pain and says that he wants to end his life but yet your family is going to spend gobs of money putting him on 24x7 care in his condo. Why?
Why not fly to Switzerland where assisted suicide is legal? I recall an article that said the cost is around $10k.
16
Yes, he has asked about this option, but the point is it takes a discipline not every person has. Why can't we make it easier with proper parameters in place?
4
A read through these revealing comments puts suicide in excellent perspective. Suicides are not all wring-your-hands, I've-given-up-and-have-no-options-left situations. Not at all. Many times they become logical conclusions.
My logical conclusion will arrive when I have simply "had enough," and I can see no reason for any other excuses.
Similar to many other commenters, I have had a brush with cancer and its devastating cure results: results that put "survivor" in a different light. I now have a pacemaker which has renewed my energy level and made me feel pretty darn good (for a change). Medically, I am well cared for and other than taking too many meds, I am a healthy 81 year-old.
In a properly run society, there would be a plausible solution for people who have "had enough." I don't want someone to say, "Poor man, He is losing it," because that won't be addressing my reasoning.
"Had enough" is all the valid reason I should ever have to provide.
135
It is important to clarify, I think, that financial concerns are a legitimate part of considering this option. Why would anyone who has worked his or her whole life want to give all that effort and savings to the nursing home industry? This often happens. It seems reasonable to assume that the billion dollar industry has lined the pockets of our so-called representatives -- and that's why in all these years the government seems to drag it's feet, offering one objection after another as to why a person should not have control over one of the two most significant events in life. Nonsense about some sort of "slippery slope" and the subsequent abuse! Abuse? Does anyone who has ever visited (or been in) a nursing home filled with vegetative and demented old people think such warehousing isn't the real abuse -- and on a massive scale?
229
If you want to make the rational choice to kill yourself you have the freedom to do so. But if you want societal support for that right in the form of legislation you’re helping take away that freedom from others. Many feel pressured to commit suicide for economic reasons or because they don’t want to be a burden. The problem we should be trying to solve is how to give people more options to live in the form of better health care and living conditions. The last thing we want to do is make suicide so convenient that it will be considered a legitimate option for insurance companies or busy children to encourage it as a cheaper alternative to adequate care.
We don’t need to make suicide easier; we need to make the choice to live easier.
32
@James Jacobs Mr. Jacobs, I DO applaud the sentiment. But in the last few years, we watched hard won progress ripped away and the GOP's joyful reversion in stripping healthcare away from millions. The apparent "substitute" of junk plans along with still obscenely expensive drugs is what's in our future, not "adequate care." I wish it were otherwise but such consensus is NOT on the political horizon.
23
@James Jacobs: one poster here wrote that he feels he must kill himself, so his medical needs do not consume his estate -- and his SON needs the fathers MONEY to get his home out of foreclosure!
He's going to KILL HIMSELF so his son can inherit money!!! rather than face the real reasons his home is in foreclosure (like….buying a house you cannot afford?)…..
The slippery slope is in full view here!
1
The right to choose one's death seems rational and irrefutable.
36
Damn right. My life belongs to me, and I will end it when I want to. It's not up to a judge, a doctor or a rabbi to make the most important decision of my life.
46
@tankhimoThe good news tank is that you don't need anyone's consent to do what you need to do with your life... including the right to terminate it at will.
1
@Peter Cini: True, but I think the problem that so many people run into is that, by doing it themselves, they are forced to do it earlier than they otherwise would. The fact that you must do it while you still have physical capacity means that many people will kill themselves years earlier than they would if they could be assured of help later if they need it.
13
@Peter Cini
The problem with that is, most of the ways available to most people are not fail-safe, and when they work as planned it's still up to the person's loved ones to find his or her body and deal with that. The Swiss way is better - help from skilled professionals, and an easier exit from life on the person's own terms.
4
I'm 55 years old, have progressive MS and am in constant pain. Right now I can do it. A decade from now, not so sure. Damn right we should be talking about this.
54
It takes a lot of self-confidence to tell people what they should or shouldn’t do with their lives.
13
@Asen Ivanov Or just ignorance.
When a healthy, intellectually keen woman in her eighties has no family; very few friends (none close); not enough money to travel or buy tickets to a concert or afford to eat well, or buy a good book; and is not able to find employment, she begins to plan how she will end her life. And is immediately the target of people who don't know her -- whom she wouldn't sit with for a cup of coffee -- who say she's being irrational. Or depressed. Or cowardly.
And she replies, "Nuts to you. It's been my life and it will be my death. C'est la vie."
78
@Rea Tarr Busy-body, professional "do-gooders" are paid to snoop on and interfere with the lives of others... just avoid them as much as possible and be careful not to divulge your plans
12
At the bottom of this article is the info for the suicide hotline ‘ If you’re having thoughts of suicide’. Hello- everyone reading this article is having thoughts of suicide, however temporarily. Maybe we need a hotline for those looking into a future of long term care, tubes, diapers, and not thinking of suicide, aka, death with dignity. Maybe they need a psychological evaluation.
Ok, ok - good info article and past time to discuss this rationally.
22
@Jo Williams
No, not everyone reading this is thinking of committing suicide.
There are families. There are friends. There are also multiple related issues, such as health care, such as mental health treatment, such as the devaluing of the elderly, such as the trauma experienced by children when close relatives commit suicide, such as the ethics associated with the radical insistence that the individual is free to do as he or she pleases. And some of the concerns associated with the much-derided "slippery slope" are real.
There are multiple personal ramifications for many people, not just people who are personally contemplating suicide. And there are societal implications. We all live in society.
1
It is ironic that if you took an older dog home, hooked them up to all the tubes and the ventilator and feeding tubes, and forced them to live every last breath before they succumbed to the pain of dying from a terrible disease, that it would be politely incorrect and the animal lovers would call it torture and animal cruelty laws would apply. If that standard applies to dogs, why doesn’t it apply to people? Why is putting down a suffering dog right and a good things to do, but putting down a suffering person down morally wrong even if the person has indicated that they want to die? Only two reasons come to mind: medical system profits and religion. Neither seems like a terribly good reason.
62
Some European countries and a few American states permit suicide. But I shouldn't have to move to Oregon, find a doctor and go through endless bureaucracy to exercise my right to die. Once again we have religious people attempting to impose their personal beliefs on others. To spend vast sums of money keeping a person alive who would prefer a dignified death is absurd. When you live in daily pain, have no possible enjoyment out of life and wish to end it that is a right that should be accepted by society.
50
@simon rosenthal Oregon and other US states permit physician-assisted suicide ONLY when one has a diagnosis of terminal illness with a life expectancy of 6 months or less. No US state permits physician-assisted suicide for those with chronic but not imminently terminal illnesses, or for those who are slipping into dementia, or for those who are losing physical competence and simply feel that they've had enough.
5
@simon rosenthal
This article and your comment, and many in a similar vein, are conflating two different things. No one is stopping a moderately competent person from committing suicide. Do it before one is incapacitated. Inate fear and awe of death and possible reprisal in the world to come would give me pause, but they also give me pause about murder.
1
@me
from a retired medically-trained attorney:
FIND my submissions/some replies that describe our one lawful pathway to assistance-in-dying that crosses all state lines and over-rides any state law that is in conflict, including states like OR and CA that have very limited bases for "physician-assisted" death: SCOTUS' "right to refuse treatment" (1990) and advance directive allowing Comfort Care Only.
Follow the pathway I provide, get your advance directive anchored in your right to refuse treatment added to the Medic Alert Foundation's always reachable database for EMS/ER physicians, and wear a Foundation bracelet that medical professionals routinely look for . . .from patients with severe allergies to drugs to disabilities that can affect consent to treatment.
Get informed and take action so that you're feeling less trapped by state legislators too timid to do the right thing?
1
I took care of both my parents and my 71 year old sister as they declined and died from dementia. I know for a fact that my sister's was genetic. I will not put my children through what I experienced with the with the horror this kind of death entails. If I get a diagnosis of dementia, I will commit suicide. I consider this a very rational choice and not an impulsive one. My family all know that this is my plan and support me in it.
45
I am a 75 year old retired physician in great health. In the past year I have seen three of my closest friends die miserable deaths. I will never let that happen to me. Fortunately, I have the means to comfortably achieve my demise.
This country does not have a problem killing those they believe have done something that deserves death. Yet, they refuse to allow someone to plan their own death.
This country was founded on nonsectarian principles, but the present day Christians, most notably, the evangelicals have destroyed those ideals. Their bigotry is destroying this country.
We need to take back our country and give people control of their own lives without evangelical interference. Our own deaths are our own business and no one should have any influence over it.
80
@Carlos: How do you plan to do it? If you cannot say, as a guide to others can you tell us how you arrived at that solution?
4
@Richard Schumacher
Personally, I plan to use a very sharp razor. I cut myself on one accidentally. The pain didn't happen until a few seconds later, and it was minor, unlike the devastating menstrual pain I used to have, or the pain after I had a hysterectomy and my doctor refused to allow me sufficient opiates. Besides the razor, all I need are the knowledge of where my carotid artery is, approximately 5 minutes alone, and the willingness to traumatize the unfortunate souls who have to clean up the mess. The problem is not finding a way to kill yourself--that's easy. The problem is finding a method that does not traumatize others.
2
This is a nice article, but it misses the basic point that if you want to control your last years, your assets, your medical costs, and your relations with family and friends you have to make the death decision while you have competence and others can't interfere.
39
@barrie a wigmore You make an excellent point but in your competent state, be prepared for a fight. Loved ones tend to be that way. I suggest copying this article and its comments and having it handy to show the doubters.
7
@Cone But other "loved ones," the ones having trouble paying their bills, will be thrilled to see you go sooner rather than later.
Of course suicide can be rational. If we are fortunate, many of us will reach a point where we have accomplished nearly everything of value to ourselves or to others we will ever be able to accomplish, while the ultimate cause of death our death is still unseeable. We may at the same time arrive at a point where unwanted decline, incapacity, and frank suffering are nearly all of what lies before us. If you have done North of 95% of all you ever will, and your future is almost entirely a burden, given that the end is the same now as down the road - death has only one sequel - oblivion - it is entirely rational to end your life.
Life - that is the mere fact of physiological function - is not what is precious it is the ability to contribute and to still be part of the future that makes life worth living.
18
@Steve Demuth Thanks for the thought that physiological function is not what is precious, it is the ability to contribute and be a part of life that makes life worth living. Suicide is on my bucket list.
10
Modern medicine seems to have a solution for every problem. However, many times the solutions are worse than the problems themselves. Today, medicine cares about “aliveness,” not wellness...there’s just more money in aliveness.
If you’ve ever experienced a hospice, it’s really just a slow dragged out death, albeit, very profitable I’m sure. Some adults are slowly figuring this out.
17
That's not a fair or accurate description of hospice.
7
Suicide involves a risk that the chosen means is not successful and the individual is left in a worse situation. Assisted death is far more humane.
48
The more I think about this the more blank my mind becomes.
1
If you're going for balanced reporting, along with the bold italic 'suicide prevention' links, you should include directions to the thoughtful end-of-life resources such as 'Final Exit'.
I do not see implicit value in this state we call 'living' - I would not take life from another but do not understand why others feel their valuation of my life should override my own whether good or bad.
I'm one of the people who have considered my accomplishments and responsibilities and concluded that I'm not in a hurry to die, but there is no pressing need to continue, so if my health or life circumstances became poor I have plans for my 'Final Exit'.
71
You express my sentinemts and views exactly. The article states, as an argument against the right to control ones own death, that the decision is not a rational process because the decision is a "teeter-totter" and that counseling frequently results is some people changing their minds. Both are silly arguments. Almost all serious decisions in our lives are "teeter-totters". How many men struggle with the issue of deciding whether to propose marriage? Does that make proposing an irrational process? With respect to changing one's mind, it should be elemental that a person contemplating such a serious decision should get counseling. But it is a non sequitur that those who decide not to end life should be denied the right because others change their minds in the process.
24
To my way of thinking one of the worst aspects of the entire discussion is not a moral one but rather the lack of humane means to end ones life should that be the path that an individual feels passionately is the right choice. How utterly brutal that many people like my wife of 37 years had no options as she reached the last days of her fight with ovarian cancer. Hospice is deeply flawed and not working for many many patients and families. We are left with guns, lethal homemade cocktails, ropes, tall structures, exhaust fumes and endlessly brutal and cruel alternatives. Shame on us as a society for failing to even teach our children to talk about death and dying. We will all die and we better find an avenue to opening the discussion. Health care professionals are not going to do it for us.
115
@Mark Smith
Would like to know why you say "Hospice is deeply flawed ...".
1
It seems to me that thoughts of suicide are too quickly linked to clinical depression. He killed himself. Therefore he must have been clinically depressed. Maybe not. Maybe those thoughts are reactions to the realities of life and particularly of death. I had planned to kill myself when I was 18. Almost by accident I did not, and I came to the realization that life was not insupportable. Yet. I could always do that deed later. I did not rescind my decision. Here I am almost 80 and it still stands. And life is still worth living. But at some point that may change. I mean really: at my age who would want to put up with some of the possibilities in our collective future. I've always considered myself one who if I knew the asteroid would hit at 3 a.m. would set my alarm for2 to catch the fireworks. I'm a curious sort, interested in what will happen next. But at my age would I want to endure the nuisances of the futures suggested by The Walking Dead or The Road or the blowup of the Yellowstone Caldera or the Fascification of the US by present administration in Washington? Suicide or concentration camp: I'd take option one.
34
As with many other issues (abortion rights, the me2 arguments etc.), this also comes down to control. Who makes my decisions for me?
Do I, or does someone else?
Answer: I do - with or without advice from family, doctors, clergy, whatever. At the end of the day, I do!
“I am the master of my fate, I am the captain of my soul.”
63
You are the Captain of your soul. Just don’t expect any deckhands to follow your orders. If you want the ship to travel in a different direction, you better man the helm yourself and rig the sails yourself. You have a crew of one if you choose that path.
1
Beautiful illustration
4
I have always felt that I want to end my life before cognitive or physical deterioration takes hold. I also had a feeling that many in my generation (b. 1955) would be the force that would change the stigma of suicide as a rational choice. I am very glad to see this happening and to read this article. Many times I have said that I wish we just had an OFF switch, because religious and legal fears seem to keep us from figuring out how to make rational suicide possible. I hope it happens, and soon.
52
We need a better terminology in the debate of suicide. I suggest to use involuntary suicide to describe anyone who kills himself out of desperation brought on by extreme depression and hopelessness. But anybody who wants to end her life based on a rational choice such as prevention of suffering, or physical decline or having lived just long enough would commit voluntary suicide.
Involuntary suicide is the last (and often preventable) step in a disease process, voluntary suicide the last step in a rational process of self determination.
82
@Oliver Herfort - I really like your last line in your post.
4
@Oliver Herfort
Extreme depression is a mental disease. Disease. Illness. When chronic unrelenting depression takes hold, when your doctors don’t know what meds will work, when you’ve fought and fought, why is it not rational to want to die? Why the disparity between mental and physical illness? And hope? Why be hopeful? Sometimes there’s no magic pill for extreme depression, just as there isn’t for stage 4 cancer. Please, this is not the pain Olympics. Pain is pain.
3
My only concern is that people will commit suicide based on financial problems, rather than mental or physical problems. It’s very difficult to support yourself in old age and I don’t want older people feeling obligated to end their lives based on money.
46
@Kacy M
I would be interested in hearing how you address that problem.
My experience with people in their mid 80's is that comfortable and familiar surroundings, seeing a familiar medical care giver, having food they like that tastes good, the ability to sleep when and as long as they like and not at someone else's schedule goes a very long way to the quality of life.
Those things are available in some degree to people with means but not to those in Medicaid nursing homes ( where the most assets you can have is $2000, meaning you are poor).
Our lives are always governed by our means, and to some the quality outweighs teh duration. To suggest that end of life decisions should not be financially motivated in some way is a tad naive . Where will the money come from so people don't as you put it feel obligated to end their lives based on money?
I
20
@Kacy M
Vote for people who support Universal health care, Social Security and Medicare. Do not support people who want to jerk the financial security blanket from seniors.
29
@Kacy M
Point taken, Kacy, but depending on the individual, if a lack of supporting resources leaves only a difficult future to survive, how is this any less debilitating than an incurable disease or the prospects of dementia? Each person has their limits.
12
Yes, I can understand that there is such a thing as rational suicide. That being granted I also think that the resort to suicide is an indictment against our society's failure at providing palliative care for the ill (not only the medical technology but also the economic access); company for the alone; and care for the prior generation(s) and our common civic responsiblities. Please don't accuse me of claiming moral superiority because I can point out these moral failures.
20
This is where the cult of longevity, especially in the medical community, has gotten us. We’ve gotten to the point where something that would have ended life in the past now causes years, or even decades, of helpless suffering.
138
Whether suicide is a sane option depends on why the person commits it. Discussing it or threatening it are a long way from doing it.
I know exactly how to commit suicide with as little stress as possible for my wife. When the time comes, if it does come, she has agreed to help me if I can't do it myself.
I've had incurable immune system cancer since I was 49 and I am 68 now. I have little immune function. I also have 9 other serious chronic illnesses, mostly due to the ravaging effects that repeated chemotherapy has had on my body. I have had to be treated surgically for two other types of cancer in the last ten years.
I have an idiopathic degenerative nerve disease that is similar to MS, but worse because there is nothing that can be done for something that is too rare to have a name.
My spine is collapsing and causes intense pain. I am bipolar - have been for fifty years. I have a clotting disease that has caused so many blood clots I have lost count - one of them a pulmonary embolism that nearly killed me.
In the last 18 months I have been in septic shock TWICE! Again, I nearly died with it.
BUT, I am nowhere near ready to commit suicide. I have little sympathy for people who kill themselves who are not in hopeless pain.
Those who are weak in spirit gladly leave life. I have seen it time and again. It irritates me when I hear of the BS reasons people in this article spew for committing suicide. It is such a shame not to love whatever life you have.
7
You have a wife who supports you in your illnesses and will assist you in suicide when the time comes. What about those of us who have no one? No spouse. No children. No siblings. Just a couple far flung cousins who are not in a position to jump in and help? When my chronic medical issues become impossible for me to deal with alone what then. Your judgmental attitude is borne of naïveté.
38
@Troutchoker
With all due respect for your experiences, who are you to question the choices of others?
31
@Troutchoker Congratulations on your superior stamina.
You have assigned an implicit value to 'life' that suits you - but it is not the same value others may. 'Shaming' people for having different perspectives than your own suggests to me a lack of empathy.
35
I often wonder.......is this active euthanasia going down a slippery slope if it is placed as an article of the Constitution and becomes settled law of the land?
The congress wants to have a constitutional convention to change and eliminate and add many articles.
If we decide to vote in active euthanasia I am afraid folks .....older i hope!!! Will be cutoff from all government and social aid and told to report to the Hospice for an eval of viability . A government entity will create algorithms for criteria and decide when older folk die.
Just look at the patterns .......legal euthanasia and legal abortion will decrease the population world wide and healthy
younger folk will have great productivity at ?? the GIG econ.
Site.
Please lets improve the skills of hospice professionals and increase their salaries and numbers to offer pain free support.
When i cared for my mother ( Pancreatic cancer,@64)
Over 20 years ago as she struggled a bit as her lungs filled with fluid on the day she passed ,i gave her final dose of morphine.
She was dosing on amounts that would kill a horse by that time
She wasn’t swallowing and really in a coma with lots
of brainstem activity causing the “ lingering at the door”effect.
The morphine was given PR. Thirty minutes later as we turned her in bed she passed with one giant last breath in my arms.
So with good care the transition is easier.
Nurses and Doctors .......do not stop pain med in the dying.
Passive euthanasia is acceptable to me .
12
Ms Shoot makes for a good example of an informed patient taking the necessary steps to ensure there is no question or doubt of her chosen end.
I might borrow her tattoo idea. DNR is already rubber-stamped all over my hospital notes, but best to have it there for paramedics and ambulance crews too.
11
In the real world one takes action either too early or too late. Very seldom does an inevitable event occur at exactly the desired time.
So, when one considers their own demise they implicitly deal with the ‘too early-too late’ continuum. And, given the potentially horrible consequences, ‘too early’ is a very reasonable decision.
I find rational suicide completely rational.
43
Only in the selfish west could we seriously believe we have a choice in this.
In the east, death, whether by suicide or by natural causes, happens exactly when it is supposed to, by exactly the means it is meant to.
Acceptance of existence as is, of the evolution of our individual lives, of the evolution of our planet, and us as a species. Acceptance brings peace, no matter how death finds you.
6
@laura m Please post again after you've spent a month in an assisted living facility -- one that you are in because you can no longer function on your own, and so your family and/or the government has decided that, for your own good, you must live out the rest of your life in one of these hell holes.
13
If an individual's right to life is the foundation of all his other rights, then surely he has a right to death as well. If he doesn't own his own body, who does? Having complete control over one's own death is the ultimate freedom that few experience.
42
When Christ promised his followers that his father had many mansions and that they would be in heaven with him after death, many suffering Christians opted to end their lives to be with him.
With true belief this was not irrational. But the church leaders were appalled at losing their members and made suicide an unforgivable act, denying suicides a burial "at the foot of the cross." (in the churchyard). Some cultures have found suicide reasonable and even honorable. Some Christian martyrs have chosen suicide and been honored for it, often as resistance to rape. But! The difference between suicide and homicide is free and rational choice. We must not go down the path of homicide.
But choosing to refuse medical treatment and choosing to refuse artificial hydration and artificial sustenance can be accepted.
4
I need no on'e approval if and when I decide to kill myself. I'm an old man, I'm not afraid of dying, and I do not believe in an invisible man in the sky.
42
My father committed suicide 12 years ago at 81 in urine-soaked squalor.
I will follow him, but not waiting to 81, and doing it before I am at incompetent mess.
I have no children, no spouse and no money and no property and I know what's waiting for me if I live. My Dad was a combat veteran - if he couldn't get help from the VA, what chance to I have?
50
I like the idea of giving myself an expiration date. I have thought about it and hypothetically, for now anyway, think a max of age 86 sounds about right. That will allow me to to think about the next 20 years in easily quantifiable terms...The bucket list becomes more "real". I am no fan of skilled nursing, long term care, or assisted living environments. Human warehousing for lack of a better term for the infirm.
47
@Harley Leiber
Well said a best before date so to speak!
4
The difficulty in reaching a consensus on the acceptance of normalizing suicide and particularly assisted suicide is that the range of circumstances is so broad. Usually these conversations concern the old and infirm, the end-of-life situation. This is the easiest case. A loved one is terminally ill and has had enough.
If you allow assistance here how about for the suffering 40 year old? Or the teenager who has been bullied and is hopelessly despondent? Survival instinct in humans being what it is, most of us I think have difficulty with these issues at a visceral level, whether we have been influenced by the centuries of religious proscriptions or not. Just as I am not eager to ever come upon a loved one hanging from a doorway or with their head blown off, I am uncomfortable about playing a part in anyone's demise even if the act is essentially merciful.
7
The defenders of the Second Amendment have ensured the wide availability of the most reliable tool there is for suicide, and from what I've read, many older men who commit suicide use it. The biggest negative is that it's a violent and grisly method both for the user and those who discover the aftermath. It that context, "death by auto in a garage" is apparently a superior method though also full of complications.
Perhaps freely available and legal access to less violent means of "rational suicide" such as the drugs used to euthanize pets would neatly address the "right to die" issue as long as the person has the physical and mental capability to follow through. As for all the caring people who don't want someone to end their life this way, thank you for your concern, but don't let your compassion be confused with a sense of moral superiority so great that it robs people of their freedom to make such a fundamental decision.
52
I have raised two sons who were my joy and life. Now they are extremely successful and have their own young families and busy lives. As it is, they have no time for us, so it would be naive to think they would be of any assistance or comfort to my husband and me as aging diminishes us. We made sure they had the best we could provide morally, spiritually, physically, and educationally. I want to finish the job right and not be a burden to them, especially if our dwindling finances run out.
43
@Keaton: as you have very accurately expressed here… it is a short, very troubling leap from "I want to kill myself because I am in pain, and terminally ill" to "I HAVE TO kill myself, because I am a burden to others….costly to society….have no intrinsic value if I do not have a job or make money….and must relieve the onerous burden to my adult children of having to bother with me as I age".
2
The slippery slope arguments have been in public view for nearly a century: https://en.wikipedia.org/wiki/Euthanasia_and_the_slippery_slope .
We should use some of the evidence we have, including decades of experience in The Netherlands: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2733179/ ("Two Decades of Research on Euthanasia from the Netherlands. What Have We Learnt and What Questions Remain?," Sept. 2009). There was little evidence of a slippery slope, as long as policies were carefully implemented.
The whole idea of the slippery slope has problems, not just confined to discussions over death with dignity concerns: https://plato.stanford.edu/entries/fallacies/ . From that latter discussion: "...it is unclear at what point piling scattered stones together makes them a heap of stones: if it is not a heap to begin with, adding one more stone will not make it a heap, etc. In both these cases apparently good reasoning leads to a false conclusion."
Although I am in favor of death with dignity options, it will be nearly impossible to convince conservative legislators, never mind the nearly 3/4 of US citizens who think this should be an option (June 2017 Gallup poll).
We can thousands of personal testimonials on either side of this divide--they will not help resolve the public policy concerns. The will only reinforce the divide, even in the face of strong public support.
9
@JSK “....as long as policies were carefully implemented.”
NO policy in the United States is carefully implemented. We are not the Netherlands. Compare the structural soundness of their levees to ours. We’re a sloppy country where everything is ruled so much by money and prejudice that we’ve been brainwashed into thinking that some lives are more valuable than others.
I am neither conservative nor religious and am not opposed to euthanasia on philosophical or moral grounds. But I am extremely worried about how it would play out in the reality of the present-day United States. We don’t need convincing that death is more convenient and cheaper than life; our culture celebrates a cavalier attitude toward death, when an execution by the state isn’t front page news, we deploy drones to antiseptically kill enemy combatants along with “collateral damage”, we call the police brave for killing anyone they feel like, and it’s easier to buy a gun than a smartphone. We have made death very easy. What we should be doing is making it easier for those of us who want to live. And by making suicide more convenient we are on the way towards making it expected.
Old age should not be considered a luxury.
15
@James Jacobs
1. There are states who have already carefully implemented death with dignity laws: https://www.deathwithdignity.org/learn/access/ .
2. You conflate too many things.
3. Your assertions do not hold under scrutiny.
7
I too, have thought about how I will die. I am a healthy 67 year old women who is very active. What horrifies me is going in to a rest home or similar facility and being taken care of by an underpaid staff. I have observed adults who are in these facilities, pretty much waiting rooms for death, being talked to like children, as if they had no existence before. When I visited a friend in an highly rated assisted care facility in the twin cities I saw what he was fed. Canned watery tomato soup, grilled cheese on while bread and apple juice, a meal void of any nutritional value. No wonder he was painfully waiting to die. This is what I call torture to live. I plan on having a choice.
96
@Sophia
Plus the horrors of having a blaring television in front of your face; nincompoop games a toddler would reject; "cheerful songs" warbled by tone-deaf volunteers; and the reek of swamp and decay everywhere.
Ghastly.
55
That slippery slope mentioned in the article is already happening; in states in which assisted suicide is legal, insurance companies are offering suicide pills in lieu of payment for life-saving procedures, and there are stories of children encouraging their parents to kill themselves because caring for them has gotten too inexpensive and inconvenient. And besides, suicide being illegal is not really an obstacle for those determined to kill themselves.
It seems to me that the fact that this issue is getting this kind of serious consideration represents a massive failure on the part of our society. We have unlimited money to wage war and prosecute anyone suspected of being a criminal but we are unwilling to do what it takes to keep people alive. What’s infuriating about this is that there are major advances being made in the realm of disease treatment and anti-aging procedures but the leap from the private lab to the public hospital isn’t happening because no one wants to pay for it. This is particularly ironic now that the politically dominant party used its supposed pro-life values to suppress access to abortion clinics and to smear the ACA by saying it would lead to “death panels”.
I know, I’m missing the point; it’s all about individual choice. Well, if that’s your choice no one is stopping you. But if you try to make that choice easier legally and economically, then that will inevitably lead to many poorer people committing suicide because they won’t have a choice.
10
@James Jacobs
This extreme view is a predictable part of an ongoing right-wing disinformation campaign: https://www.deathwithdignity.org/refuting-misinformation/ . The circumstances are--no surprise--far more nuanced that what is presented by @JamesJacobs.
25
@James Jacobs
The right to die is and should be a decision for each individual to make for themselves, without any interference from any moralizing by others. How long a life is long enough must be the right of the individual, not the the right of interfering busybodies to decide. Not being dead is not quite the same thing as living a good life.
20
@James Jacobs
insurance companies are offering suicide pills in lieu of payment for life-saving procedures,
_________
This is a wild, inflammatory statement, worse even than the term "death panels". Some citation or proof should have been provided.
35
Just turned 70 two days ago. My first thught was of all the people in their 60s who have died and that I'd (surprisingly) outlived. Doctors have been foretelling my imminent demise for several decades in order to get me to take medications that I refuse to consider. So I am realistically looking at my final decade -- without much of a financial cushion. Actually I dread the idea of turning 80 with my dwindling health and limited means, particularly with the gop threatening Medicare and Social Security. Thankfully I live in California with some legal relief for such an eventuality which I intend to pursue at an aappropriate moment. As to current life, I just bought myself a Rachel Maddow Show hoodie. There are things in life to hold on to, even in the era of Trump.
63
@Joann DiNova
Love your spirit. Go for what you want, Girl!!
16
It is so important to discuss this topic--the quality of death. One of my grandmothers died after decades of Alzheimers. For many years, she was basically a lump of flesh with a brainstem that wouldn't give up even though all other functions had. Her brainstem kept going long after she had become unable to recognize anyone, unable to hear, unable to see much, unable to walk or talk, unable to feed herself, unable to care for herself or interact with others in any way. She was spoon-fed mush, rolled around to prevent bed sores, sponge bathed, wearing diapers, wasting away, unable to interact with the world. I would much rather kill myself than live condemned to that kind of deterioration. This is not an article about young, healthy people killing themselves because they can't deal with x, y, or z temporary situation in their lives. This is about aging and dying by choice rather than, say, by Alzheimers or Parkinson's or cancer, or who knows what else. For some of us, living is about more than a brainstem that won't quit.
182
Death is inevitable , it is the direct consequence of life .
It should be painless .
It is immoral to force the terminally ill to live a few extra weeks using any medical mean , as it is to impose life to someone whose life has been fulfilled but it has become a burden for lack of interests , loneliness and for having had “ enough “ of it .
If one is clinically depressed should be treated , but if one has reached “ satiety “ with life , he/she/it should be helped to painlessly achieve the destiny that Mother Nature has anyway always planned for us .
51
Of course it is rational, now this individual seems to have jumped the gun. Nobody should share such information since the law might get them into trouble, and your elderly relatives should have a relationship with you that is fine with an unexpected death. After all it can happen in the middle of the night.
5
I'm almost 75 and in good health (as far as I know -- I do have annual physicals, etc.). I've always been single, I have no children and I'm an introvert so although I have a fair number of acquaintances, I don't have many close friends. My only sibling -- a brother -- is now married to a much younger woman and is deeply involved with her close family. My nephews and niece live far away and are immersed in their own lives and families. I live in my own home and participate in some social activities. Life is OK. What frightens me -- and I haven't read any other mention of it here -- is running out of money to support myself. I don't have a lot and I live in terror of another 2008-type event that wipes out what little I do have. I have a living will and have made my decisions about what course to take if/when my health deteriorates. But what if I run out of money? At this point I'm convinced the U.S. government won't do anything to help me out. Is it selfish/materialistic/short-sighted to take my life when my money runs out? I don't think so. I don't have anyone to take care of me and I don't want to be a burden anyway, so why not? I have vestiges of religious belief that nag at me about this, but that's all. And BTW I lost a younger brother to suicide almost 45 years ago so I do know what it's like to have that happen in a family. However, my situation is not comparable in the least.
267
@karen b. I have a similar situation, but am 40. I have always supported suicide as a personal decision that is acceptable when life is not worth living. Certainly, young people who are just going through growing pains should not consider it and need help to recognize they can drastically improve their future, but I feel it is perfectly moral to take ones life once the bad outweighs the good in adulthood. As we get older and our bodies and minds deteriorate, I do not believe it is enough to suffer through life. Nor, do I believe anyone else should take on the burden of taking care of us. I also do not believe society should be supporting people for 10-plus years of retirement. If people cannot support themselves through savings, i'm sorry, but they should not burden others. I have every intention of taking my own life when the time comes...in a painless and planned manner. Hopefully not having a stroke while on the toilet or in pain from some horrible disease or in a bed having lost my memory. I think those who oppose suicide are forcing their religious beliefs on the rest of us, which is illegal.
21
@De
Unfortunately, De, your post lends support to those who fear the slippery slope. Did you actually just say that society should not be supporting people for 10-plus years of retirement? Any concerns at all about where such a thought process leads? What are you really suggesting? After the 10-year mark, check in to be put to sleep?
I am quite curious at how many of those who insist the elderly are a terrible burden, will still hold these beliefs when YOU reach this stage of life. At 40 it's easy to insist you'll simply kill yourself, decades from now. I think it's a safe bet that most of you insisting this, WON'T.
16
@karen b. Karen, you are not a burden. Your life has value—on its own and it is not dependent on your bank account. You say you are an introvert, but I want to kindly ask if maybe you lack the energy to interact with others because of some level of depression? Introverts gain energy by withdrawing to their personal space each day. But, all of us need social contact. Acquaintances can become close friends with time and effort. I urge you reach out to your family. Maybe meet for dinner once a month to start. Offer to babysit. Volunteer in your community. Also consider researching intentional communities where everyone contributes and cares for each other. You have so much to give and live for. You are valued and can be a blessing to others. Please don’t give up. Much love to you.
2
• ...some believe suicide ought to be considered a reasonable option.
ALWAYS.
“Suicide is man's way of telling God, 'You can't fire me - I quit.”
~ BILL MAHER
49
(1) What happens when people with life insurance commit assisted suicide where it's legal, or rational suicide? Does the life insurance pay up or not? If you have had the policy for several years / decades what then?
(2) I would like to read articles on this topic that include the perspective of Asian religions and philosophies.
Jainism has a form of voluntary stop of eating and drinking that leads to death, only the most spiritually advanced people undertake this under specific conditions, to reduce the burden of karma (Sallekhana or Santhara).
Ancient Hindu life cycle patterns and stories say that elderly people are encouraged to withdraw from society and live in seclusion in a forest, cutting bonds of attachment and allowing the younger generation to fulfill their duties without interference (Vanaprastha). The next step is to accept or seek death when when all responsibilities are complete, through stopping food, or entering a river or a fire, etc (Prayopavesa).
None of these forms of voluntary deaths are acts of despair or passion or violence or attachment. These are not 'death before dishonor' acts of desperation. Though these religions disapprove of suicide, they do allow for ending one's life in specific situations.
To what extent do current legal and medical frameworks allow for these perspectives?
20
@S
Most (if not all) life insurance policies only have a 1 or 2 year period after taking out the policy, during which they would not pay out for death by suicide.
2
Suicide only became taboo in the West when wealthy land owners, including religious communities, were losing their oppressed laborers. The Church agreed.
I have the right to end my life at a time and place of my choosing, as long as I do not cause PHYSICAL harm to another.
57
@Chris
I have my plans made to end my life in a few years -- or next year...depending. As you said, "at a time and place of my choosing."
But, I'm keeping myself upbeat about it by considering taking a couple of my enemies with me. (Just kidding.)
9
i'm 63. i have spinal stenosis. i had surgery this year and had 2 implants put in my spine. my dad is 86 and is suffering at a home after my mom died. i am not going to wait for this. i have a a suicide kit ready that will put me to sleep, like they did to my pets.
i remember soylent green where you went to die peacefully when you were ready. this is what we need. with the gop ready to decimate health care and medicare, i see no reason to get to this point. also, i see signs of the earth dying everyday, in many ways. i ready to check out.
40
It seems we have more compassion for animals at the end of their lives than we have for humans. As a country we are completely unprepared for the wave of aging baby boomers who will need end of life care as many do not have children, partners or extended family who are able to provide care. In my community, at home hospice care is not available if you live alone and there is no in hospital hospice option. I would like the right to die with dignity at a time and place of my choosing.
69
Some people want to eke out every second of life, no matter how grim, and that is their right. But others do not. And that should be their right.
165
The only occasion on which I seriously thought about suicide is far behind me now, thirty years behind, and I still marvel at my belief, at that time, that the problem I was facing was insoluble. What made me desperate then is now a source of rueful laughter--nothing hilarious, but a sense of the absurd turns that life can take. Here I am, in my early sixties, delighted with my life, wanting only more. Another absurd turn: I have metastatic breast cancer. If the stuff the oncologist is giving me works as planned, I could live "many years." But cancer's tricky, so I could find myself dying much sooner. Although I can imagine the urge some have to bow out of life sooner than nature dictates, I think the culture, the society as a whole, is best loving and protecting life--assisted suicide, if condoned, should be for end of life conditions, not the healthy, but frightened, old.
http://www.thecriticalmom.blogspot.com
8
For me, it's not so much an issue of dignity as it is choice. I believe I am the best judge of how much suffering I am willing to endure during my life, and most definitely at my life's end. My only hope is to be able to face that end on my own terms, dignified or not.
Without other options, some may feel suicide is the only choice. And unlike many others here, I don't believe suicide is the ultimate act of selfishness. I think people just genuinely feel they've run out of options.
59
@FRITZ
I think, like most human actions, suicide is not one thing. It is fruitless to try to pin down whether it is "selfish" or not. It might be in some cases, amd not in others. There is no point in denying it often leaves family and friends in terrible pain. But there is also no denying that for some it appears to be the only way out of terrible pain.
13
@FRITZ
You put it perfectly and succinctly, my thoughts exactly.
3
Our fear of suffering leads us to blame the victims. We under-treat pain because some addicts choose opioids, but the real reason is that we don't want to admit that some people have terrible pain that is not helped by massage and meditation. We object to suicide with all kinds of rationalizations because we don't want to admit that there are things worse than death, and especially when they are looming on a family member, that we might be the next victim.
My body. My choice. Why do only pregnant women get such consideration?
64
@Dan Ari
The same people who are against assisted suicide are also against abortion. Both things are none of their business.
20
What is dead is humility. We cannot bear to reach a state where we must be humble and accept the help of others. We not only accept their help, but we help those others to learn to give help as well.
One must learn to accept humility as one ages or ones health diminishes. Humility is not a bad thing at all. Humility is when we give up pride and give ourselves to God and his will.
13
@India
Well you can give yourself to God and his will. For me, I am not a believer and want to decide for myself when to go. I am certain that my loved ones will agree if I ever get to that point. They will be sad, but will understand.
31
@India
I do not agree.
12
@India
Your attitude -- your religion -- is what led me to decide on ending my life before I fell into the hands of someone with an attitude such as yours.
17
I’m 60 years old and have metastatic breast cancer. The cancer has spread to my bones, liver and brain. I expect to die within the next couple of years. I experience some pain, generally not extreme, intermittently. When the pain becomes too great, or the cancer in my brain starts to befuddle me, I plan to reach into my cache of opioids and end my life. I think that that is a reasonable choice, I hope to be able to make the decision for myself. Alternatively, I am open to dying in my sleep peacefully before I reach that point.
330
@Laura
Wishing you the very best.
33
@Laura
I'm in the same boat, but I'd prefer to keep going. If I were in excruciating pain, I might think differently though.
7
@Laura Thank you for your honesty and insight. my best to you.
11
Self-Euthanasia is not suicide. It is a rational choice by a person who no longer wants to live their life under certain circumstances (pain, loss of sight, bedridden, etc). We must stop infantilizing older people. They still have rights.
124
@Sara K
When you kill yourself, it's suicide. When you kill someone else, it's homicide. I see no point in redefining terms.
10
@DW That is very black and white thinking. Motivation matters. Suicide may be more associated with depression or psychosis, and self euthanasia a rational option near the end of a productive life
17
@eqnp
Honestly, it's just the dictionary. I don't think the issue is black and white at all, but taking words with simple meanings and twisting them does not bring further clarity.
4
Ms. Shoot's avoidance of mammograms and colonoscopies with the object of not treating the disease that they discover could cause her to suffer a slow, awful death. The tests can reveal pre-disease conditions that can be successfully and simply treated. When my mother was 61, a test revealed that she had colon cancer. Minimal surgery cured her, no further treatment was required, the cancer never returned, and she lived a fulfilled life until she died at 94. That might not be everyone's fate, but prevention is a good thing.
25
@Nativetex Metastatic Breast Cancer isn't the same, and many patients with either will not make a full recovery, or as in the case of one relative, any real recovery. Unless you consider 2 years of increasing hospital visits, extra illnesses and bedsores as a recovery.
22
@Nativetex I believe Ms Shoots said she was 70. Current evidence does not show any benefit to mammograms after age 70
26
While I agree with commenters that we have the right to decide the circumstances surrounding our deaths when we reach a state in which the suffering and degree of debilitation is no longer endurable, I do have a fear of the unintended consequences of developing into a society in which elderly are "expected" to choose suicide.
We already live in a world which marginalizes older people. A society in which old age is not respected for its experience or wisdom. A society that overemphasizes the importance of youth and beauty.
What happens when we "evolve" into a society in which the "right" to suicide unexpectedly morphs into the "duty" to commit suicide?
We are now witnessing the unexpectedly toxic consequences of other inventions of our society, such as social media and technology. They were also meant to be a boon to civilization.
How do we avoid the well-meaning act of a mercy suicide devolving into the expectation that most people past a certain age should just let go?
If that prediction sounds far-fetched, consider how brutal our society has already become.
87
@TM The only people, mostly young, who seem to think older have an “obligation” to terminate their lives are safely ignored.
13
@TM Anything can and has been abused. Witness the problems by the “right to bear arms”, alcohol consumption and driving vehicles. Does that mean they should be banned? Obviously not.
I watched my 88 year-old father suffer a prolonged, painful death while in care at a facility. During his last days - as his swallowing reflex disintegrated - he slowly drowned in his own saliva. The facility staff kept him alive (mitigating his pain with opiates) despite his obvious agony and death’s inevitability.
As a society we give our suffering pets better end of life consideration.
You say you’re are concerned about the potential for abuse with the ‘right to die’ concept. As I've witnessed first-hand, there is already abuse/agony caused by Society’s obsession with extending “life” as long as possible.
Rather than wait for society to see the light re:self-directed mortality, I’ll make my own plans, thank you.
And it’s absolutely none of your business.
94
@TM I'm afraid I disagree. Our society most emphatically does not 'marginalize' the elderly, nor are seniors disrespected. Quite the opposite in fact. The men and women who dominate all three branches of our Federal government are disproportionately seniors. Both major party candidates in 2016 were over 70. Paul Ryan is an outlier as House Speaker because he's under 60. And many pundits have pointed out that Bernie Sanders, an octogenarian, is most popular among the under 30 crowd. That pattern is not limited to government. The most recognized names in corporate America are typically over 70. Sex sells in Hollywood - always has - so it's no accident that youth and beauty are venerated in pop culture. But that isn't uniform: Betty White is in her 90s but her career is still going strong. Larry David is pushing 70 and millions hang on the next season of "Curb."
Seniors are in no danger in our society of ever being "expected" to off themselves. They are the nation's most powerful demographic. Given current fertility rates, will continue to be well into the future.
10
Before I say this, I need to state that I am not Blonde Guy; I'm just using his account. I'm in my 70s. I have a kind of cancer that is, at present, incurable. And I have already planned my suicide. I have no intention of doing this any time soon, but if it becomes necessary, I won't waffle. I'm in a state where "physician assisted" suicide is legal, but I intend to do it myself. Again, only if necessary. It's my life. I think I'm entitled to decide how much pain I am willing to bear.
286
@Blonde Guy
Know that there are those who stand with you and your decision
14
For those of you considering DNR tattoos...
A retired nurse suggested putting it on the roof of your mouth... and then there’s the reality
https://www.washingtonpost.com/news/to-your-health/wp/2017/12/01/a-man-c...
@Q.
"Page not found" at WaPo
4
This article treats suicide advocates, religious opponents, and disability rights advocates who oppose suicide as if they were ethically the same. They are not. Suicide advocates are not trying to force their views on anyone else. The other two groups are.
87
The conventional wisdom (which is usually always wrong) goes that anyone thinking of suicide is automatically depressed and needs intervention to stop it. This is not always the case. Some people are quite calm and logical about these decisions.
Additionally - especially if someone is older or ill in some way that they personally can't deal with - why can't they make their own decision on when and how to leave? I'm certainly not advocating that anyone who is sad or having some tough times should just kill themselves - absolutely not - there should be help for people that are looking at suicide in a depressed or desperate way.
This is really such a barbaric country - lacking in any kind of true personal freedom. People can freely walk around with guns and shoot each other. Die from lack of shelter and medical care every day. You're on your own, Jack, in just about every conceivable way. Drowning in student loan debt - your fault! Bad mortgage deal - suffer the results! Bad health - stop smoking or eating so much - your fault! But if you want to leave this mortal coil on your own terms - someone in authority or the commenters on this page want to step in and tell you what to do and why and who you are and how you feel. No matter your pain or suffering or rational mind. They all know better. Barbaric and cold country, this is.
196
Death itself does not scare me, but the process of dying does. I no longer have any responsibilities to anyone else. If the day comes that I feel like I am doing more dying than living I'll make a choice about what's best for me. My greatest wish is that I'll die naturally without ever experiencing a day where I don't want to live.
51
Favorite quotes that seem applicable here:
"You can think of death bitterly or with resignation ... and take every possible measure to postpone it. Or, more realistically, you can think of life as an interruption of an eternity of personal nonexistence, and seize it as a brief opportunity to observe and interact with the living, ever-surprising world around us.”
Natural Causes, Barbara Ehrenreich
On the other hand:
"I don't mind dying, I just don't want to be there when it happens." - Woody Allen
15
As I ease into old age and the medications multiply, what I realize more and more is that the deterioration I am experiencing is not "wear and tear", it is rather programmed disintegration, and the drugs are not so much curing disease as antagonizing that natural process. If we can artificially prolong life in this way, what's so different about artificially shortening it? To my mind, when you become too weak to carry out the normal tasks of everyday living on your own, it's time to check out. Eventually it will be legal to do so, it's only a question of time.
58
@Larry
I believe, after a quick check, that attempting suicide is no longer a crime in the U.S. (Or maybe just in most of the States.)
Now we have to fight the nomenclature: "Depressed;" "impaired;" "impulsive;" "deranged;" "socially disconnected," and "mentally ill." And -- the worst thinking of all -- "against god's will."
5
@Larry
Well said.
3
Many of these comments state “I will do this” or “I will take action to end my life.” Make your own choice and take the consequences. Check out any time you want. We won’t extradite you back for trial. Just do not ask anyone to help you check out. In most states they will go to trial.
1
Depression can also be caused by life's circumstances, which may not be able to be changed. Depression can be like which came first the chicken or the egg. there is a certain power and dignity to choosing one's demise. For myself I'm not a Wild Turkey man, a growler of IPA, will do when my turn comes.
14
Personally, when I cease to be me, when I cannot even remember my own name, have zero independence in any physical or biological function, it is time to flip the switch and end the biological processes. That despite the fact that medical science has developed all the requisite tools to keep all of the biological functions working despite there not being a functioning human remaining.
Sadly, when the money runs out, the MD's finally relent, but not before every possible penny has been extracted and deposited in the accounts of the medical establishment.
52
@George N. Wells: By the time you have arrived at the state you describe in your post, you will no longer be able to end your own life. If you don't want to end up in that state, you'll need to end your life sooner.
11
@George N. Wells however, when you cease to be the person you are now, the new you may feel very differently.
2
I am of the age where I understand and appreciate why someone decides to stop living due to impending illness and wanting to choose the way to die. Dr. Balasubramaniam has a good point that there are treatable conditions that may change a person's mind that not everyone knows about. Alzheimer's disease is one of the leading reasons a person might choose suicide, therefore it's important to learn about new treatments for cognitive impairment and early Alzheimer's that improve memory for many of those who use them. Anyone who's planning methods of death and refusing to read about Alzheimer's because it seems like there are no options should learn about such methods as the Bredesen Protocol. THough not mainline medicine, these are new and being tested and I hope they grow enormously in use.
3
@Elizabeth Miller
Here's what one recent Amazon reviewer had to say about the Bredesen Protocol.
"This book does not contain accurate information about the number of people who have participated in the protocol, supervised by a trained doctor and the outcome rates. We paid 30k be part of the official immersion training program and have spent thousands more implementing the protocol. We have not had success and none of the other patients we are in touch with have either. We are not getting any answers. I fear this is more about making money than sharing a scientific discovery. Buyer beware! This has been a bitter disappointment."
25
It is a slippery slope.
I lean in favor of not allowing assisted suicides unless the person is in a very poor semi vegetive state and is terminal and can rationally want it.
However, you can also not lock up rational people forever who threaten suicide. If somebody really wants to do it they will do it.
Most people who attempt suicide and are not successful end up finding out they really don't want to do it and live a normal life.
Also medical/therapy and other aids should be made available to the person.
Last but not least, I believe in the basic right to own a gun but subject to regulation, responsibility and non promotion.
A gun owner who threatens suicide should have their gun temporary taken away.
4
@Paul
You have no more right to the method of suicide than you do to person's choice to commit suicide.
Would you take away one's gas stove? How about keeping us away from lakes and oceans? Don't let us own rope or knives?
And who, exactly, is going to pay for my medical help or therapy and other aids?
7
The feeling that the best years life has to offer are in the past knows no age limits. We start flirting with the idea in our teens, and it reemerges to haunt us periodically until we die. If this feeling provides a rational basis for suicide in the elderly, as this article suggests some so-called experts believe, why not with the young?
Hopelessness (the kind unaccompanied by terminal illness) cannot provide a rational basis for suicide at any age. Whether a decision is indeed rational depends in large part on the probability of the assumed outcome and perceived benefits. Humans, however, have proven themselves poor predictors of their futures. People who once saw themselves as gods find themselves crawling humiliated from prison, as Jeffrey Skilling did recently, while others whose lives may seem objectively intolerable often transform themselves and their circumstances into heroic tales of success.
Our adaptability forecloses any attempt to justify suicide by reference to an unknown, unknowable and, thus, uncertain future.
1
@GBarry
You exaggerate. It's not that hard to stay out of prison.
9
@GBarry I would say that our adaptability is exactly what justifies suicide when ones understanding of the future includes pain, physical/mental deterioration and financial collapse. We adapt by choosing to control our demise rather than leave it to fate.
12
@GBarry
Rubbish!
4
Everybody dies.
When you pass a certain age you see how little time is left. As you age your perception of time changes. Each year becomes a smaller percentage of your total accumulated experience. To a 20 year old a decade is half a lifetime; to a 60 year old it is only one sixth of their life.
You also know that the last few years will be hard, very hard. Friends are gone, children can be remote while control and dignity are slipping away. And then there is outliving your money in the face of mounting care costs.
So if I reach, say, 75 and I were struggling and decided to end my life what is the real loss? Would another five or ten years matter in the face of diminishing capacity?
221
@D Priest May I ask how old you are now? If you are young, it is easier to make such a statement, I think.
2
@Ken. Actually, I think it's easier to "make such a statement" if you're old. Days fly by quicker, and there is lots of illness. Even if something is treatable (and take a closer look, depression may be "treatable" but the treatment often does not work), it's still illness. Drugs have side effects that often make you feel worse than you started out. We all die. As we get closer to the deadline and living becomes harder, why shouldn't the person affected have the right to call it quits when he/she thinks it's best? Why should anyone be forced to lie in a bed and just wish for death when the physical breaks down?
58
@Ken
I'm 81 in a few weeks. I say D Priest has it right. There's very little loss. In my case, it's going to be just on the cusp of nothing lost when I die at my own friendly and capable hands.
12
Suicide used to be an art form. Consider Socrates and his drinking the hemlock while with a gathering of friends. And then there was the ancient Roman Senator who was informed by Nero that he had to leave Rome forever before dawn. And instead of weeping, the Senator called all his closet friends to a party, where the Senator would drink wine while opening a vein and let the blood flow until it and he was gone. Today we look at suicide as criminal, sinful, and unreasonable when it should be considered as a personal right with no government, church, or family getting in the way of a human to end their lives.
51
Personally I can't accept suicide as an "art form." I find that repellent, and it gives some heft to the "slippery slope" fear that some express - where once it becomes "okay," it starts to move toward "good idea," then "advisable past a certain age or with a certain diagnosis" and ultimately, "What are you still doing here? You're old."
Today's front page features an article by a woman whose mother asked her to kill her, and she ALMOST did it - couldn't quite bring herself. I don't think it's a stretch to suspect there are plenty of others who CAN do it and will be getting … ideas from this.
I think your post shows the limited thinking we still confront on this topic. Surely there is some other way to view this that is not "criminal" or "sinful" etc., yet also avoids romanticizing suicide.
How about "sad"? How about tough - usually traumatic - for the survivors? A person may have his or her reasons, and I've certainly never understood the point of considering it criminal (it just makes no sense). But an art form? That's encouraging and enabling to people with problems that might be solved some other way, and that's a bit sinister in my view.
4
@Jim Dwyer
Were we not subjects - slaves, peasants, tenant farmers - assets! - to be used by those who own us we wouldn't have deep religious restrictions against suicide.
We own our lives. Whether assisted, accepted or not, many will choose the manner of their departure. Debate all we want we will not change those who seek it nor those who avoid it.
18
Arthritis. It doesn't kill you, but can destroy your life. Oddly the media ignores this plague, which is on the increase due to the obesity epidemic. It's the underlying cause of the opioid epidemic, which started as a chronic pain epidemic.
29
@Anne
from a retired attorney for the AMA:
I was suicidal when Merck pulled my highly-effective Vioxx from world markets. My FP said some of his patients from the UK moved seamlessly to Arcoxia for their severe osteoarthritis (OA) and I should figure out a legal way to get this drug from the UK or Europe.
While a lawyer for the AMA in 1983, I helped to write and Congress passed a "personal use" importation exemption that individuals can use to bring to their home prescription drugs not approved by the FDA for U.S. dispensing. Maximum of one year's supply at a time. Need a U.S. physician script and matching physician script from the country where the drug is dispensed and shipped or brought by friends, as I do with a London MD and Pharmacy. And a signed/dated letter saying only this drug works for you, as I do with a London MD and pharmacy.
Go to fda.gov + Presciption Drugs + personal use importation for details.
This is not hard to set up, but your local physician likely will require a trial of Celebrex, approved for use in this country. No dose of to Celebrex works on severe OA pain for about 2/3 of patients. So I and a cadre of pain physicians are working on a petition -- totally apart from Merck -- to get FDA expedited approval of Arcoxia. Soon.
This approval by the FDA could take as many as 7M patients for whom Vioxx worked, many now on opioids that cannot control OA pain, and provide low-cost highly-effective pain relief. Stay tuned.
2
Everybody needs an exit plan. Be it from a lousy job, a lousy marriage, a boring business meeting, a relationship that's no longer working, or a life that's no longer working.
44
@Unconvinced These are all temporary things that can be changed. Poor health at the end of life is different
5
I think more older people would be committing suicide if they could be 100 percent certain that there is no existence after death. The problem is,neither devout religious people or atheists can prove what they sincerely believe. Religious people have an advantage in that, if what they believe is a myth, they will never know. Atheists, on the other hand, may be in for a shock.
1
@Aaron Adams
Also, some of those who believe there's an afterlife aren't sure which place they're going.
3
@Aaron Adams - So you are saying that because atheists do not believe, when/if they come across the god that may exist, he/she/it will punish them for not believing in said god entity?
6
@Aaron Adams
Your post made me chuckle, and caused me to think of the waiting room scene in Beetlejuice:
https://www.youtube.com/watch?v=cZwdCa0ynEw
If I am surprised by an afterlife, I hope it is as entertaining as that one.
3
seems silly to me that it's controversial.
i'm getting out of here if i get a bad cold...
but seriously, at some point it's just obvious that the remaining time will not be worth enduring the indignities that accompany it.
38
"Depression" isn't an illness. It's a description of a state of mind. There can be lots of _rational_ reasons for being depressed, so it's illogical to say "'depression' needs to be treated before a person can make a rational decision.
52
@Chelmian
Depression is not an illness and why does someone have to take "happy pills" if they are cognizant of what they are doing. One doesn't suddenly make a decision to end their life......usually they have made preparations which means they are aware of what their decision involves and it is a personal decision. We have so many things removed from our palette and this personal decision should be theirs alone and the reasons for it is theirs alone. we don't owe anyone an explanation and as long as you are not putting anyone else at risk wny should anyone else care.
R
16
@MK Belive me, Your people do care
I have known since 1971 when I first saw 'Harold and Maude' at the age of 10, that of course suicide is a rational option -- as Maude tells Harold, "couldn't imagine a lovelier farewell" -- and I have not changed my mind since -- and after all, isn't freedom of suicide the only rational reason for preserving the 2nd amendment? -- "If you want to sing out, sing out"...
50
I was wondering who determined that Robert Shoots showed no signs of depression. Did a mental health professional determine this or was it just his family?
Depression can be a subtle illness and people can hide signs of it from family members and friends.
One other thing. I am a physician and have treated many terminally ill patients. Unfortunately, many have preconceived notions about what the final months of life will be like based on experiences they had with relatives years ago and that in no way reflects where modern medicine is today.
And in a country where access to healthcare is a privilege and not a right and even those with insurance can end up with bills of tens of thousands of dollars from end of life care, we face the problem, like that of the recent article on the man with cancer in China who tried to save his family from the bills for his care by disappearing, that people may choose suicide because of fear of burdening loved ones with bills.
9
@Steve
You lost me at "modern medicine"- why can't the aged die with dignity without doctors running around them, doing tests, tube feeding? Oh right, doctors wouldn't make as much money. I am certainly going to leave my money to my children, not doctors that insist that lying in bed all day in pain with little cognitive function is a life.
41
@Steve If you read earlier reporting by Paula Span you will see numerous instances of elderly, demented people being kept "alive" with feeding tubes, over family objections, or with the family not even being asked. Sure, some people die well, especially when supported by hospice, but I wouldn't count on it!
32
@Steve
I have no plans to consult a mental health professional before I kill myself when I decide it's time.
Now what, Doctor?
10
Thank you for making this important subject public, Paula Span. I live in California where physician aid in dying is legal, and as a hospice chaplain have helped a number of people end their own lives with dignity. I am more in favor of this with every case. I see too many people parked in wheelchairs in front of daytime television to believe that the goal of living as long as possible is desirable. Old age and sickness mean losing control, and a planned death -- not a decision made in a moment of despair, but one made rationally and calmly -- can mean taking that control back.
405
I am deeply disturbed by the sheer number of comments here that are endorsing suicide as casually as might endorse chemotherapy.
Suicide isn't a cure for anyrhing. As someone who has attempted suicide in the past, and who has lost family members to suicide, what more one seems to consider is the impact that suicide has on everyone around them. My uncle killed himself when I was a tot and she still cries for him on the anniversary of his death. I grew up having to watch her weep every holiday as well as on my Sister's birthday (he shared the same birthday as her).
No matter much you suffer now, your family will suffer just as much for decades if you commit suicide. My mother still blames herself for not seeing it sooner, and I hate myself even more than I did before I tried to kill myself today for nearly putting her though that kind of pain again.
It doesn't matter how much you discuss it with your family first, they will suffer and you'll be to blame.
As for whether you should have the right end your own life... yeah if you are sane you probably should. Just know that suicide is the ultimate act of selfishness. You are declaring that the feelings of others have no value, and that to you the world is not worth experiencing anymore in a permanent finalizing gesture.
18
@Devon: You've got it backwards. Everyone gets to make their own decisions about their life, including how and when to end it. If another relative has been grieving about it all their life, they're the one who needs help.
84
@Devon You say that other peoples' feelings - and in some cases religious ideologies - are more important than one's my own feelings. That is as offensive as the former communist regimes who outlawed suicide on grounds that you were 'state property' and had no right to deprive the state.
71
@Devon
Yes, but what if you've outlived all your family members, friends, and anyone else who might miss you or otherwise have feelings about you? That's an increasingly common scenario for older Americans. It's also and also a plausible reason someone might consider suicide preferable to a continued "undead" existence of loneliness and uselessness, especially if they're in a nursing home with nobody to advocate for them or even to visit them.
Would the absence of family members, or anyone else who has any feelings about you, affect your view of suicide as "the ultimate act of selfishness"?
37
There simply is no way to know whether your suicidal thoughts will dissipate. Whether or not you feel like living today, there is no way to know how you will feel tomorrow. So the decision to commit suicide is always a crap shoot.
5
@michjas
So is the decision to get out of bed every morning. We all have different risk tolerances.
9
@michjas
If I'm suffering with pain and loss of ability to think clearly, tomorrow is not going to bring me back to health and happiness. Suicide, then, is a "natural."
10
@Rea Tarr: if you have dementia... you won't be able to think or plan clearly enough to end your own life.
I recommend to everyone the brutally frank film, "Still Alice". The protagonist has early stage dementia and tries to end her life before it hits rock bottom. But she can't, because the dementia has left her unable to follow even simple instructions.
I think you are asking the wrong question Perhaps the increase in suicidal ideation in the elderly is directly because of our health care system. Hospitals, Hospices may be pushing people towards suicide as we rightly fear what will happen to us when we end up ill, old and hospitalized. We are failing our elderly by frightening them into choosing suicide as the only option for a sane ,painless, death. I know of no one wishes to die in a hospital bed .
Doctor K. Ross brought the hospice system to this country when she was horrified at how people died in America. Hospice was supposed to be a great system to help people die pain free and in control of how they die. Big business has taken over hospice care and largely its just a money maker. The ridiculous "opioid" epidemic fear has made it impossible( no injectable opioids now) to keep people pain free at home. This situation now leaves people no choice but to check out while they are still able to or they may end up trapped in the health care system.
All the people I know intend to take their lives before they end up in this trap. Of course the trick is knowing when its the right time as a stroke will remove any chance of a easy death.
105
Witnessing a loved one impeding death is horrible. I can't get it out of my head the night my Dad wanted to commit suicide on Thanksgiving night. My Mom and I are crying as it was my husband who talked him out of this. My Dad had Alzheimer's and it was another 4 years of decline, no longer the man we all knew but he did have the loving support from his family till the end of his life.
5
My MD advises me:
"Die Old! Die Fast! Die Cheap!"
51
Such a well written and interesting view point on death in the midst of physical / mental decline.
I've mentioned before some ways to avoid or broach the subject of how you wish to be treated for disease or rather treated with aggressive comfort are:
"Five Wishes," a "MOLST" or "POLST,"-
(https://fivewishes.org/docs/default-source/default-document-library/prod...
documents that spell out exactly how you want to be treated - for example yes or no to "tubes and machines." Also appoint appropriate health care proxy(ies) - people you know who will advocate for you when you can't for yourself.
Palliative care, while not hastening death is a way to seek aggressive comfort and not prolonging life longer than god/the universe/nature/your body intended. It is a way to treat the horrible symptoms of a disease while avoiding things like mechanical ventilation, hospitals or other unpleasant uncomfortable processes of cure-oriented medical care while preserving dignity.
Take a minute RIGHT NOW to discuss the FIVE WISHES or other advanced care planning thoughts with your loved ones and friends. Do it now!
15
@John Galt
While you have this discussion, remember that if you are in a facility, including a nursing home, assisted living facility or even a hospital, your MOLST. POLST or other directive may not be honored.
I know, because a family member had one and was in a NH in hospice. I was told directly that their policies trumped the MOLST and when I signed her in, I signed an agreement to that effect.
Oh, and then there was the admission to a hospital where the MOLST was lost in the back of the chart. The hospitalist asked me "Have you ever thought of a DNR?" I nearly lost it right then and there.
Do not think for a minute that all that advance planning is going to make it a certainty that you get the death you want. A lot can go wrong.
65
@Cathy Did your family member still have assets and was self-pay? Nursing homes do fairly well financially from self pay, but not very well from Medicaid. IS there a difference in the nursing home industry in how they regard MOLST for self-pay vs Medicaid pay? That is a very interesting question.
3
@Cathy
My friend donot be so naive that anything is certain. In my facility it is policy to review these documents each time a patient is brought to us. My point is that these are ways to make your needs known. And frankly a MOLST would never be meant to be "lost in the back of a chart" in a hospital. A MOLST is meant to be secured on a fridge or some other visible place in a home or nursing home so other providers know what to do or not to do with the patient.
3
Having a way to exit the body with sound mind and dignity intact is necessary for the good death, but most options seem to include drugs or violence. Here is an excerpt from an article titled, "When, if ever, is conscious dying not suicide?" which shows another perspective.
"William Dalrymple talked to a nun about the Jain custom of gently starving yourself to death, a process she firmly distinguishes from suicide.
“Sallekhana is a beautiful thing. There is no distress or cruelty. As nuns our lives are peaceful, and giving up the body should also be peaceful . . . First you fast one day a week, then you eat only on alternate days: one day you take food, the next you fast. One by one, you give up different types of foodstuffs. You give up rice, then fruits, then vegetables, then juice, then buttermilk. Finally you take only water, and then you have that only on alternate days. Eventually, when you are ready, you give up on that too. If you do it very gradually, there is no suffering at all. The body is cooled down, so that you can concentrate inside on the soul and on erasing all your bad karma.”"
(https://www.exopermaculture.com/2013/10/31/when-if-ever-is-conscious-dyi...
16
I can't imagine too many cruelties worse than being forced to live one's last years in a miserable state. Isn't life hard enough as it is? Why be forced to endure longer than you want?
99
The phrase in the article that some older people feel that "their life is without value" rang a bell with me. 87 years old, recently widowed, and having accomplished most of my life's aims, I seriously contemplate suicide. Especially after watching my father slowly decline in a nursing home, sadly fully aware of what was happening to him. Not for me; suicide seems perfectly rational to avoid a degrading end.
212
@Renaissance Man Bob Kruszyna
I'm so sorry.
6
@Renaissance Man Bob Kruszyna
Good for you. Hope you go out well!
10
@Renaissance Man Bob Kruszyna : I am sorry for your loss but you should definitely talk to a therapist.
If you are in OK health...there is no reason to die yet.
It is very common for widowed folks to feel this way. I can only imagine the terrible loss of a life partner...but over time, you will come to terms with the loss.
Please try to live for your children and grandchildren. They need you!
I'm wondering why there has to be an insipid message at the end of this (and every) article about suicide basically stating "if you're feeling depressed, blah, blah, just "talk" to someone and all your problems will magically be solved and you'll want to live--guaranteed."
Right. It's insulting. People, especially older people, who have lived a lifetime of bad health, tragedies, anguish, pain, bad luck, homelessness, etc. are not going to be "cured" or talked out of their choice to end their lives by some stranger's voice on the phone.
Time to stop the mixed messages. If you're done with life, you're done. Do you honestly think "talking" will do any good or change someone's mind? I'm not saying I'm in favor of suicide, just that I understand why someone would want to discontinue living when their life consists of nothing but pain.
86
I'm 65, enjoy my life, and would happily live forever if I could. However, I'm not afraid to be dead, and once my health goes, I will not prolong the dying process. A quick and simple death on my own terms is far more preferable than the humiliating, agonizing, and expensive death that modern medicine offers.
139
@Noodles: you cannot know that in advance.
You could feel fine and then have a massive stroke tomorrow and be too incapacitated to end your own life.
You might also live to 99 and die in your sleep.
LIFE is a system you cannot "game".
1
I strongly support Doctor assisted suicide for people who want to die with dignity in their Old Age. Most people are afraid of death so they submit themselves to the Hospital System when they become seriously ill. What awaits them are horrifying and degrading experiences which can go on for years. Hospitals make Billions of dollars keeping dying patients alive for as long as possible.
79
@Art Ambient: there is a lot of misunderstanding over this.
In the US... in those 7 states that permit Physician Assisted Suicide....the patient must be 100% in their right mind AT THE TIME of death...have a terminal illness with less than six months to live.
It is absolutely NOT for those with dementia, as they are NOT in their "right minds".
1
Some people do suicide for the wrong reasons- like treatable depression. I say 'wrong' because in some cases when the depression is treated the person states they are glad they are alive and didn't suicide. So knowing when to intervene versus respecting one's right to follow through with suicide is tricky. Physician assisted suicide requires a terminal condition- what would a general right to suicide require?
7
@Stephen Offord
And, as the article notes, most non-psychiatrist physician no little about diagnosing mental illness and, even if they did, wouldn't want to take the time to do so, we may condemn people with treatable conditions to death.
I wonder how people would feel if someone with treatable cancer committed suicide but never saw an oncologist because his doctor failed to suspect the illness or thought there was no treatment for it.
1
@Stephen Offord
For many of us who plan to kill ourselves, anyone who would try to "intervene" would be very unwelcome. There's either a general right to commit suicide or there's no right. Just as we have the right to drink excessively or overeat or mistreat -- or coddle -- ourselves in dozens of other ways.
12
@Stephen Offord: People who do not suffer with serious, intractable depression seem to overestimate depression's amenability to treatment. Note that, although people often glibly point to someone who is glad they didn't die, many people whose suicide attempts are thwarted just go on to try again later.
10
Suicide rights are like abortion rights. It's a personal choice. If you don't want to do it, fine, don't do it. But don't stop other people from making a different choice.
Both are types of individual rights and freedoms we should have; freedom from religious influences in our laws.
It's absurd that people who want to have gun rights often stand in the way of other kinds of rights....
314
I would invite anyone who trusts the medical system to care for them in the end stages of dementia and/or multiple chronic degenerative illnesses to visit a local nursing home.
Any of them. Stay for a few hours. If you can bear it.
Or ask a med/surg nurse about her "regulars"; the elderly patients that come in every month or two in a new crisis as they slowly deteriorate.
Even with the most loving of families, the best medical care and the most comfortable surroundings, people with dementia and progressively incapacitating illnesses can live a long time in pain, fear, and indignity. Maybe professors of medicine should do a few night shifts to see what is really happening.
Nothing cures a rigid philosophical stance like spending some time with people at the end stage of dementia. Your eyes open wide very fast indeed.
334
@Cathy: Indeed. The so-called "bioethicicists" especially need to spend a few days on the night shift. Then they might stop trying to control other people's decisions.
58
@Cathy
I lived through the ravages of dementia--that which my Mother (of 8 kids) experienced. At the end, standing in front of her when she looked up at me then looked down, not recognizing me, was crushing.
I am not going that route--saving my daughter and loved ones the agony of my decline--not to mention the huge expense of care. To what end?
Not for me.
24
@Cathy: I have both a mother in law AND a friend (age 95!) in dementia care as I write this.
So I see loved ones and facilities at least once a week. I've been doing that now for over 6 years, with different relatives.
It is VERY tough. Dementia is a horrible disease.
But it doesn't mean I would KILL either of these fine ladies. They are still in relatively good physical health other than dementia. They are NOT in any pain. They are still ambulatory -- still enjoy music, good food or a hug.
Of course I fear that kind of old age. Nobody wants to end up with dementia.
But the answer simply cannot be to MURDER our senior relatives, because their condition disgusts or frightens US.
1
This is timely. I'm in my 70s
Since I was 25, I've managed to beat three unrelated cancers, melanoma, bladder cancer and colon cancer. And I've been clean since 1998. But what I went through to beat those cancers was medieval. I've been through the traditional slash, burn, and poison treatments on multiple occasions. I got beat up pretty bad. But I was young and vital and had hardly lived when the ordeals began, and dealing with it was worth it.
I'm so glad I did it, but I'm not sure I could do it again. Something will eventually get me, and if I were facing a process like what I went through when my melanoma metastasized, I don't think the life extension would be worth it. I'll take the palliative care thank you.
I'm a grown man. And I've spent some time thinking through this.
And If I choose my time and method of passing, I can't see how that's anybody's business but my own.
366
@Slideguy: you can absolutely refuse any medical treatment. And you can absolutely commit suicide -- who could possibly stop you?
The ISSUES comes when you want "someone else" to do the dirty work, because you are too sick, weak, frail or have dementia or a stroke. And people here want it done, based on something they may have said or wished for or even written -- 20-30 years EARLIER.
This may not be a good comparison, but when I was learning to fly and practicing forced landings, I was told to always maintain airspeed and control of the aircraft, even if you were heading for the side of a mountain. It was better to plow in under control than otherwise. I see suicide in old age like that; just maintaining control of your destiny to the bitter end. We all don’t die peacefully in our sleep.
127
@Bubba Brown: Please explain your metaphor. Why would it be better to hit the side of a mountain under control than not?
2
Avoiding colonoscopy because she won't treat the disease? Does that mean that she would not allow the doctor to find a pre-cancerous polyp? With that test, colon cancer is largely preventable. How sad!
I was also struck by the doctor's statement that in a certain case, suicide might be "rational." Does that then mean that not to kill oneself would be irrational? Just asking - I'm almost certainly not going that route, but don't have a particular problem with people making their own choices.
8
@Anne-Marie Hislop
When you're 70 years old and have lived your life, it is perfectly rational to forgo the slim possibility of life extention, especially when those measures increase the odds that you will be sucked into the cancer industrial complex and suffer a pointless, debilitating, and extended dying process.
55
Well, it's her choice, but 70 seems a bit young to make that decision and yes, having the tests could mean catching something early enough that the treatment is relatively simple. Snicking out a potentially bad polyp during a colonoscopy is hardly a major physical burden and could yield many more years of good life.
8
As a "senior citizen" and looking at the comments I can see where age seems to make a big difference in how one feels about this.
I'm an organized and methodical individual, I have said for several years I need to outlive a handicapped and dependent son and my wife with dementia. If I last that long, my goals will have been met & I'm done.
85
This is something that MORE people ARE going to do, and at least folks my age do talk about it, BUT I don't think that it will be, what can we call it, a significant trend?
For those who dread years of dependence and loss of cognitive, and physical abilities - and who have witnessed all of this first hand: I think the bigger question remains: why can't I make certain binding decisions ahead of time, while I still think clearly? Before there's that Catch 22 of being found unable to make decisions for myself, of having no agency in your own life, at a time when you are miserable with the life you are left with.
I've lived with depression, which has been treated with reasonable effectiveness (intractable depression is a good enough reason for suicide, IMHO). I really believe in getting treatment. I also worry that some idiot will decide that being treated for depression means I am not able to reason sufficiently well to make decisions for myself.
As for being rational - why would a person who considers ending their life for private reasons be required to be100% rational, whatever that means, when most people do not make purely logical decisions about anything. We may move, marry or divorce - because we expect these things to make us happier. We're often wrong; moreover, oblivious to the subliminal impulses driving our 'decisions.' People who have lived to a reasonable age who consider ending their own life would draw from the same mix of experience, belief and emotion.
67
@cheryl
from a retired medically-trained attorney:
You can take control: write a one-page plain-English document that says you are suffering from . . .and list the pain sources (skip the mental health). Then direct that EMS and MDs not follow their SOPs and, instead, do NO diagnostic or treatment interventions. Comfort Care Only. Two witnesses and Notary Public. Works in every state under our SCOTUS' defined "right to refuse treatment."
Get a Medic Alert Foundation bracelet that has your advance directive contact information and do put your one-page advance directive into this database.
Hospice inpatient arrangement made in advance by interviewing inpatient Medical Directors to get to a "Yes" on IV Morphine & Methadone (methotrexate in Catholic facilities). As my father's very young inpatient hospice MD said after I got him to "Yes," . . ."three hours to three days of peace and no suffering until he finishes a quiet death."
That hospice now uses and adapts my POLST directive for its patients looking for a lawful way to a quiet death . . .soon.
3
Many of these comments keep talking about ventilators, feeding tubes and other extenders of life. A healthcare power of attorney, discussed with your designated relatives and primary care physician, eliminates those procedures. It costs $75 in TX with any attorney. It is very legal to not do anything to extend your life as long as everyone knows it to be your wish.
It is very illegal for any human being, in most places, to take action to introduce substances into your body to end your life. You cannot place the burden of ending your life on another person. Do not try to burden your spouse, children, siblings, etc. Do not ask them to try things with drugs that they do not understand. As you end your life, you will ruin their lives. Is that really how you want to be remembered?
1
I am 62. My husband is 69. My sister is 65. Of COURSE, we all intend to kill ourselves if our quality of life deteriorates beyond a certain point. Why on earth would we not? We have watched our parents, aunts, uncles, and family friends go through the depredations and degradations of extreme old age. We see no value in spending the last year or two of "life" bedridden, incontinent, confused, and agitated, as happened to our elders, who had been remarkably fit in their 80s, once they reached their 90s. We certainly see no value in spending weeks or months intubated and on IVs in hospitals or nursing homes. We dread the cutting or outright abolition of Social Security and Medicare, and ongoing climate change makes simply breathing in the summer months harder where we live (wildfire smoke). Deciding when we have had enough, and acting on it, is rational and reasonable, and we intend to do it.
549
@me
Amen !
26
@me: As one who is 88, I still am active, but dreading a future where, once incapacitated, I will not have the option of requesting the merciful euthanasia that even cats and dogs are afforded. This, in a more advanced society, would be available upon request, and without having to have physicians proclaim one a terminal case with only a few months left to live.
18
@me Lucky you to live in Oregon. I would like the same choice. My husband and I (at 82) are in fine health at the moment, mobile and most of our wits about us. But we know it all may stop on a dime. I'm afraid I'll have to just stop eating and drinking as Diane Rehm's husband had to. Not something I look forward to.
I lay the blame on this taboo on the power of religion or at least churches on our society. Just say "sacred" and you expect deference. Wake up folks. We want autonomy.
13
Just like abortion, suicide will very quickly move from being a choice to being something that you have no choice but to accept. Nobody asks a baby if it's ready to die and they will quickly quit asking granddad, too. Doctors, insurance companies and "loved ones" will all decide on suicide for someone else. Which, of course, makes it homicide, not suicide, but we will legislate our way right out of that. The most vulnerable people in our society are the unborn. Right behind them are the aged and infirm. If you can't rally votes, our society is indifferent to your humanity.
12
To use a word like "unborn" that assumes all fetuses will miraculously survive to term--in a magical world in which miscarriages never happen--is the height of cruelty to would-be parents who have suffered that loss.
47
@Working mom. We already have people acting on behalf of "God" working hard to protect the "unborn" from being legally aborted. So you do raise a valid point. It is often hard to protect individual choice. But at the same time do you think Grandad wants to continue living when his mental state approaches that of a baby? If you read a lot of the posts on here, it seems like he would not want that.
26
@Working mom
That's another point worth mentioning: In this country we have a unique medical-industrial complex that's focused on wealth care for executives and shareholders rather than health care for patients (which the insurance industry officially calls "medical loss"). Particularly if Republican ideologues realize their dream of destroying "socialist" Medicare in favor of vouchers for private insurance, it is conceivable that the oldest and sickest patients will be condemned to euthanasia by insurance companies whose executives regard their continued existence as inimical to the interests of shareholders. It's just as conceivable that insurers will demand euthanasia for younger patients whose conditions are deemed too costly a burden on investors.
That said, I do believe there are cases where suicide is an entirely rational option. For example, "fighting" cancer or other serious diseases requires significant family and social support. Someone who lacks that support (an increasingly common situation) may well find suicide preferable to "fighting" their disease alone or (worse) in a nursing home. Similarly, an older person who has outlived their family and friends may well consider suicide preferable to a lonely, useless existence.
But in our system that puts profit first and patients last, we need to make sure any right to suicide is not abused to further the interests of shareholders.
12
"Accordingly, she avoids tests like mammograms and colonoscopies because she won’t treat the diseases they reveal."
This is ridiculous. The purpose of a colonoscopy is not to detect treatable colon cancer (although it could do that). It's to detect and remove polyps, thus preventing colon cancer. Virtually all colon cancer begins as a polyp and most polyps take 10 years to become cancerous. Thus, removing polyps effectively prevents colon cancer. It would be supremely absurd she were to develop colon cancer because she refused to have a colonoscopy. Not "rational" at all. Does she also refuse to have her A1c or blood pressure measured?
18
@JerseyGirl
It doesn't matter what the "purpose" is. The effect is that if you are found to have colon cancer during a colonoscopy, there is no way to opt out at that point. You will be forced to enter the medical industrial cancer complex, like it or not. And the potential benefit is just not worth the risk for many older people.
37
@Noodles
Why is there no way to opt out? If a polyp is removed, but found to be cancerous, you decide whether to have further treatment or not. If you have a polyp that can be easily removed at age 70; that seems infinitely better than having a more advanced cancer discovered at 85.
6
@cheryl
Not everyone makes it to 85. And if you die at the current US life expectancy of 78.7 years (yes, it's declining), you may receive no benefit from having had that polyp removed at age 70. However, you will have exposed yourself to the not inconsiderable risks, expense and discomfort of the colonoscopy itself.
If you are, in fact, diagnosed with cancer during the procedure, you will subject yourself to the crushing anxiety of knowing you have a fatal disease and you will be strongly pressured, bullied, by the medical establishment to be treated. Many older people would prefer not to open that Pandora's box.
37
We allow competent people to be suicidal all the time, with legal substances - Tobacco and alcohol, just shower acting.
34
"Accordingly, she avoids tests like mammograms and colonoscopies because she won’t treat the diseases they reveal."
Ditto.
48
The morning sun becomes an oppressive light rather than the promise of another day. Tea, wine, and many foods lose their robust flavor and allure. Memories fade as inevitably as one's perceived usefulness to the outside world. Things hurt or need constant monitoring, regulating and/or medicating. Simple, previously taken for granted acts are irritatingly difficult to accomplish. Independence seems fleeting. Sure, we can fight through or adapt. But sometimes, it's understandable to just say, enough.
221
There is no more inalienable right than that of a conscious, competent, fully informed person to determine the time and circumstances of his or her own death. I cannot imagine anything more self-evident if one truly believes in individual freedom and self-determination, nor can I think of anything that is more essentially American.
241
Thank you. Well said.
11
@Mike Rupp: absolutely you can.
You just cannot get SOMEONE ELSE to do it.
You also cannot decide to kill your dementia-addled mother in law, because you don't want your future inheritance wasted on her nursing home costs.
But YOURSELF? you can check out any time you like.
1
Both by heredity and heritage our conviction that 'unquestionably life should always be cherished regardless of circumstaces', was formed in an environment where life expectancy was much shorter than it currently is. (While at the same time glorifying killing and being killed in wars.)
At 82 I am pretty healthy, have no financial worries, and live well. I only dread becoming disabled and dependent, living a burdensome life. It would grant me peace of mind if I could expect assistance to a good death at the time that I might desire it; unfortunately I do not foresee much of a chance that societal prejudice against suicide will be reversed in my lifetime.
231
In America there is big money to be made keeping people alive, so don't expect a rational political debate any time soon.
188
Meanwhile, some people must be losing money keeping people alive. Who are those people? It is equally important to know.
1
@Sean
True, and a lot of the money made here via the American system of health ends up in the Vatican, an organization that owns 600+ major hospitals and takes full advantage of Medicare and Medicaid.
If ever I'm terminal with cancer I will not rot in agony as my older generation had to do, I'll find a way to end my suffering on my terms. I'll be cremated and my ashes spread on the Chesapeake Bay as I will not enrich the funeral / burial rackets.
Factoid: Fully ONE THIRD of spending in the Medicare program occurs in the last 3 weeks of a person's life. When the other posters on here talk about intubation, ventilators and other measures to keep the elderly alive, it is a given that Medicare is paying that bill.
9
^ This.
3
It's as if Kipling's poem "If" needs one last stanza where he states that if one has lived the life described in the poem, and finally, fully realizes there's no one left who needs him/her, or would miss him/her .... plus many more personal reasons,... "Then, If . . . "
20
The real crime of suicide is that so many have to do it through ugly, often messy methods like hanging, walking in front of a train, jumping from a high building/bridge, etc. (PSA: CO poisoning from your car exhaust doesn't work very well now because car exhausts are really clean these days. Usually you just wind-up with a nasty headache).
If YOU decide that you do not want to live in this world any longer, that should be your choice and yours alone to make. This decision is ultimately yours to make regardless of how others among family, friends or clergy may feel that THEY should have a say in your choice.
Imagine if there were suicide medical services where you could go to end your life. Some counseling would be provided to ensure that this was not an impulse decision. Then the staff would help you end your life cleanly, after say, a 2/3-day waiting period. I think this is available to a degree in Switzerland.
You could even choose to donate your body or organs , thus helping others and adding value to your passing.
Even better, what if you were allowed to sell your organs on the open market and bequeath any revenues to charity or your family?
148
@Joseph I agree, Iy was a few weeks ado I had my end of life conversation with my doctor. It was painful, horrible to have to argue in defense of taking my life when I was reasonably infirm and perceived my life as no longer worth living. Had I the means I would have as my last travel destination Switzerland could pass in peace and dignity
52
@Joseph reminds me of ETHICAL SUICIDE in BETWEEN TIME AND TIMBKUTU, By, Kurt Vonnegut, Jr
1
@Joseph
PART A:
I agree with you that this should be a choice made by every individual for him/herself. Accurate information should be available to people so they can avoid not-quite-effective methods that may cause permanent damage & decrease their quality of life. (I wonder how many readers were surprised by the info you provided about car exhaust?)
I think there are web sites of varying accuracy & integrity which provide very specific "how to" info ranging from helpful to dangerous. And that makes it even more important that they be able to discuss their intentions & questions with their provider.
I do especially agree that these individuals should be able to arrange for their own organ donation! BUT... I disagree with the idea that they may sell their organs. Frightening idea to me!
As an RN, I've seen too many horrible children do terrible things to their parents for their own gain, or even just for convenience. A surprising # of adult children who share a home with an elderly parent routinely take that parent to the local ER on holidays, long weekends, & during vacation weeks so that they won't be burdened with the parent on vacation, etc. The parent is often confused (even with no previous Alzheimer symptoms), frightened, frustrated, angry, & lonely. Can you imagine how helpless you would feel? They suffer through all of this simply so the children can enjoy their holiday.
(Continued as PART B)
8
I've had a good life.
And I want a good death.
Not suffering in a hospital (or hospice).
Had to work for everything in my life.
Will also have to work to ensure peace at my end of life.
166
Augustine formulated theological arguments against suicide in the 6th Century. In more recent time, theological condemnation paved the view that suicidal behavior is symptomatic of emotional disturbance and mental illness.
Suicide hasn’t always been viewed so negatively. It has, at times, been viewed as a perfectly rational course of action.
Indiscriminate use of modern life-sustaining “medical advancements” has resulted in renewed interest in the possibility of rational suicide.
I’m not suggesting that greater, and earlier, use of out-patient palliative care would mitigate against the growing interest in suicide as a means to end one’s life when that life (by the rational individual) is deemed no longer worth living, but it could certainly improve the quality of one’s life in a serious or terminal illness.
We are a death defying, death denying country…it’s time we accepted that we’re all going to die, so we may as well talk about…and “have the conversation.”
https://www.youtube.com/watch?v=HCKSWNvhDhY
48
@Micki. Outpatient palliative care is often an impossibility. It is virtually never 24/7 hospice employees. Once patients become immobile, and the dying generally do, the ability to adequately care for them depends on the skill of family and maybe friends, the size of the patient, the patient's ability to be compliant, etc., etc.
I have seen this with my late father-in-law's experience at home before his last hospitalization (awful) and to a lesser extent with my mother who got her hospice services on top of care in her CCRC's very good SNF. Late on Good Friday I learned that her increasingly obvious pain and suffering was caused by the hospice nurse practitioner's having written her morphine prescription as "upon patient's request". Luckily, although the patient had no capacity to request, I as her health care proxy did, so I gladly more or less moved in over the Easter weekend until we could get the morphine order revised that Monday. (She died the next Friday.)
My late husband spent his last days in his native Brooklyn in a facility that is an outpost of a unique facility, a palliative care only acute care hospital. (Calgary in the Bronx is the mother ship.) One of the reasons he had reasonably comfortable last days was that intravenous morphine was available which would not have been possible outside of a hospital. It beat the fentanyl patches that he had been relying on at home, and once he was no longer able to walk I could not have possibly cared for him.
5
What if we handled it like we do for animals. People could opt in to be euthanized once they deteriorated to a certain degree. For example, many people choose to euthanize a pet when they can no longer eat on their own. I suppose this is the concept behind assisted suicide.
I feel that if we let people leave it to their own hand, they are leaving quality time on the table. But right now, assisted suicide isn't available for all.
At any rate, I don't think its a bad idea to have an alternative for the lingering suffering that so many people go thru before their bodies finally give out. We don't tend to do that to animals because it is "inhumane".
190
@MC
Who has the right in your proposal to decide whether or not the person who wants to commit suicide has "quality time on the table?" Isn't that the same as forcing a person to undergo mental illness treatment?
3
@Rea Tarr: What if the person who wants to commit suicide gives a power of attorney to someone they completely trust, along with a set of guidelines?
2
No power of attorney can authorize someone to break the law in another person’s name. Can a power of attorney authorize you to rob a bank or steal a car? You want to kill yourself? Go ahead. Just do not expect any help doing it.
1