Conscious Dying: The Right to Choose

It’s time to talk about physician-assisted suicide as a conscious choice.

We’re used to talking about choice. The choice to have a child, eat meat, recycle, marry. As responsible, conscious people we make decisions every day. But when it comes to end of life choices, as a society we’re a bit behind.

Jack Kevorkian’s recent death brought back a flood of memories for me. He was my grandmother’s hero. While she was admittedly—and quite proudly—a touch twisted, I happen to agree with her and Jack: We should have a choice when it comes to end of life decisions. Growing up with her in my life, it was impossible not to see suicide as an option. Our first conversation about this took place when I was four. She explained to me that it would be up to her, that made sense to me then and it makes sense to me today.

In my early twenties, well before I met and married my husband, I made my own plans for when I get old. They involve: assisted living, water aerobics and my best friend of 30+ years, Bevin. We have since opened the circle, inviting our men, our hairdresser and other friends to join us. We have scoped out a facility—we haven’t gone so far as a tour, which I assume would raise some eyebrows—it’s close to the lake, a movie theater, Walgreens and a grocery store. These are the things we assume will be important.

Bevin and I took ballet together. We learned to swim together. We take yoga together. We were married in a Jewish ceremony at a square dance—and while I stepped on a PBR tallboy at the end, the state of Illinois doesn’t recognize our union. The idea that if our spouses die before us—or better yet, they don’t—I may be lucky enough to spend my old lady years with her and members of my circle of people is comforting.

The stats on women outliving men support the idea that when the shit comes down, many of us might be relying on female friends as we age. It’s not pleasant to think about, but if you consider the popularity of The Golden Girls and articles like Jezebel’s recent “Are Friends the New Husbands?” it’s clear that women out there are thinking about aging differently than earlier generations, which, I think, means it’s a great time to talk about assisted suicide as a real, legal option.

More than just the specifics of the Old People Dorm Plan, the idea that I will have a say in my own fate is, at the core, what is appealing.

Suicide, assisted or otherwise, is a hard sell. I’m in no way saying it should be mandatory, based on one’s ability to afford care or based on anything other than personal choice. It’s about asking the big questions: How much pain can I endure? How much of myself, or my freedom, can I stand to lose? Has my life been fulfilling? Does the good outweigh the bad? What does my God say about suicide?

For many people, religion might be the deciding factor. And that’s fine. I’m not saying that anyone should break from a religion that has filled their lives with tradition, comfort and joy.

End of life decision-making should be intense and it should be personal. But it should be a decision.

Author Libby Lowe’s grandmother in the prime of youth

In the U.S., Oregon is the only state where assisted suicide is not a crime. The Death With Dignity Act, passed in 1997, allows terminally-ill adult Oregonians to obtain and use prescriptions from their physicians for self-administered, lethal doses of medications. Meaning, the assistance is defined as the ability to write a prescription. How and when to use the medication is up to the individual. In 2010, 65 people—of the nearly four million residents in the state—chose to end their lives.

In the rest of this country we have DNR orders (do not resuscitate) and hospice care for those deemed terminally ill, but we have no legal, dignified way to choose to die. Well ahead of his time, Jack Kevorkian fought to change that. His work on death and dying started back in the 1950s when he presented a paper suggesting that death row prisoners have the right to choose to die by anesthesia so that their organs could be harvested to save lives. It didn’t go anywhere in the 50s, or in the late 80s when he revisited the idea. I still don’t get why.

In 1987 Kevorkian studied in Netherlands, focusing on how Dutch physicians assisted in the suicides of terminally ill patients without interference from the legal authorities. During the 1990s, he assisted in about 130 suicides, ultimately spending eight years in jail. He was released in 2007 and died earlier this month in a hospital.

The progress he made is, in tangible terms, small. But the conversations he started are essential to our country becoming a place where conscious living extends to become conscious dying.

My end of life plan is, in theory, fairly sunny: Me and Bevin and our husbands walking to Walgreens and taking in a movie before going back to the home for 4pm dinner. I realize I may not be that lucky, or that even if I am, I may end up very sick and alone at the end. I can’t say for sure that I would choose assisted suicide if I had the option, but I know I would want the choice to talk honestly with my doctor and my loved ones and then make an informed decision.

The choice to end her own life with dignity is a luxury my own grandmother didn’t have, but it’s one I feel is fundamental to creating a conscious, kind society.

Top image of author Libby Lowe with her grandmother

Update: Libby Lowe (@LibbyLowe) is sharing this post as part of XX in Health Week 2013, a celebration of gender diversity in health leadership.