LIFE VOL.1, NO.3 – WHERE WILL I DIE?

End of Life No. 3 – My uncle Al died eating at Binion’s Casino in Las Vegas, Nevada. I don’t know if he was in the Steakhouse, Benny’s Bullpen or eating somewhere else in the casino, probably the café. I’m told he choked on steak and had a heart attack, or maybe it was the other way around. The news stuck with me. Uncle Al had a great war record and a long history of caring for his kids. I’m told he was an avid golfer. If he’d had a choice, I assume he would have picked somewhere other than a crowded Las Vegas eatery to die, but we don’t always get to choose.

My golf partner died the week before the final round of one of our seasons together. He was on his Harley when he went through a stop sign hidden in the blinding setting sun. He died instantly a few weeks before 9/11. If I die in a motor vehicle, the leading cause of accidental death by at least 20 points, I’ll most likely experience hemorrhage or cerebral injury. If I die by cancer, I will expire under palliative care at my home. Who knows where a heart attack could kill me, a golf course I hope, playing alone, tired and resting under an oak tree.

At death I hope I’ll surrender consciously, never to look back. We don’t easily surrender to anything, some of us. We want control. So much so that we are willing, even anxious to get things over with by whatever means, when we see there is no escaping difficulty. Nearly all religion says that suicide is not allowed. After all, murder, even of the self, is like a free pass to hell or low rebirth. Choosing suicide might seem more logical to someone who doesn’t live by religion, but it’s never a desirable outcome, and most people choose to ride out their final scene no matter the circumstance. If debating this is important to you, join the discussion at euthanasia.procon.org.

In the US, as far as this author knows, only Oregon recognizes physician-assisted suicide to be legal. The “Death With Dignity Act,” was enacted on October 27, 1997. It allows terminally-ill Oregonians to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose. Here are the reported figures for assisted suicide in Oregon for the first five years:

• 1998 – 16 deaths, or about 6/10,000 total deaths
• 1999 – 27 deaths, or about 9/10,000 total deaths
• 2000 – 27 deaths, or about 9/10,000 total deaths
• 2001 – 21 deaths, or about 7/10,000 total deaths
• 2002 – 38 deaths, or about 13/10,000 total deaths

According to an article at Seattlepi.com, “Deaths attributed to Oregon’s law in its first decade totaled 341*, an average of 34 a year, with a high of 49 in 2007. Compassion & Choices volunteers have served as witnesses to deaths in about 85 percent of the cases.”

* TIME magazine has different facts and comes to a different conclusion. They put the figure at 292 suicides over 13 years. See; Legal Euthanasia: No Spur to Suicide.

Many elderly worry that they will become a burden to those around them. They can’t afford long-term care. They think the medical community is insensitive. But ultimately, those who seriously consider euthanasia can no longer take the pain and misery that can accompany certain diseases. Some have applied for assistance and been denied due to psychological disorders. In other cases, individuals have bypassed the medical community all together.

People commit suicide all across the globe, for different reasons, using different methods. Even those who choose not to commit suicide formally, often choose not to eat or drink near the end. Discontinuing life support is a common practice as well, not suicide, but often prescribed in living wills or by family members or physicians. We all die. We would all prefer to have some sense of control, but it’s not always possible.

I will undoubtedly return to this subject later, but the end of life series I’m engaged in is not the ‘end my life’ series. Below are some links that might help you evaluate the issues for yourself:

Want to prevent suicide and euthanasia?*

Suicide.org is a site devoted to suicide prevention. You can find help here if you are considering suicide, or know someone who you suspect is considering the act. Suicide.org also provides links to suicide survivor groups.

Euthenasia.com actively fights legalization of suicide in Oregon and wherever else it has been instituted (Netherlands) or is being considered as a legal practice.

National Right to Life site offers essays and arguments against euthanasia.

GlobalChange.com thinks palliative care will win out in the end. They argue that modern medicine can eliminate suffering.

Euthanasia Prevention Coalition seeks to join all forces working against euthanasia and assisted suicide.

Want to fight for legal options at end of life?*

Compassion and Choices devotes itself to creative legal and legislative initiatives to secure comprehensive and compassionate options at the end of life. This organization also handles all Hemlock Society membership functions.

Death with Dignity National Center has been a force in defense of the Oregon legislation and other initiatives for fourteen years.

*Author’s note: Our culture is has reduced to sound bites. The resulting and often embarrassing polarization we see in politics and nearly every other aspect of our life is arguably driven by the media, but it is also driven by our own lack of willingness to be open, honest with ourselves and our friends, and willing to investigate before we commit to a point of view.

More articles and deep dives

Can suicide be culturally scripted? Read this posting by Laura Blue for TIME.

A collection of articles on euthanasia can be found at the New York Times site.

Philosophers and ethicists will already know the name Margaret Pabst Battin. Margaret is author of something like 14 books. In 1994 The Least Worst Death was published (ISBN-10: 0195082656 ) Her sequel, Ethics and the Way We Die (ISBN-10: 0195140273), covers everything I will discuss in this series and much more. If you are interested in topics like suicide prevention, death in the AIDS community, suicide bombing, serpent-handling and other religious practices that pose a risk of death, genetic prognostication, suicide in old age, global justice and the “duty to die” (I’ll write on this bizarre thought later), then this book, a combination of scholarly research and fiction, will be of interest.

There are dozens of book on these subjects and thousands of articles. Some search terms that may not initially come to mind are ‘bioethics’ and ‘rational suicide’.