On March 11 2012 Dr. Peter Goodwin ended his life under the law he helped create—the Oregon Death With Dignity Act. A short video interview with him is available here.
Self-directed dying, for those diagnosed by several physicians as terminal with 6 months or less to live, offers a peaceful demise to those who are dying from debilitating diseases that guarantee a languished, anguished end if taken to their bitter end. Dr. Goodwin did not go without regrets, but he did go peacefully—an outcome virtually all of us say we want, very few of us achieve, and fewer of us know how to increase the likelihood of attaining no matter where we live. This because we’re all too scared, or cowed, to talk, to think, to choose. So we wait. And wait…beyond the several late life hospitalizations and debilitations likely in store, until events grab us like the existential tornados I’ve experienced them to be during the hospitalized demises of each of my parents, despite advance directives suggesting they’d have rather experienced peace at their life’s close. Extracting oneself or a loved one from a late-life terminal medical crucible is difficult at best; it was impossible for my patient-family. The crucible is particularly awful when the patient-family is the subject of medical error and other systemic maltreatment.
Euphemisms abound for self-directed dying. The American right uses “death panels”. The press uses “physician assisted suicide” (although that third word is inaccurate once one is diagnosed as terminal). Doctors (be they curative, palliative, or hospice docs) who provide palliative sedation in sufficient doses to end life use the cover of St. Thomas Acquinas’s Principle of Double Effect, which says that dying is an acceptable outcome if the doctor’s primary intent is to relieve suffering. Dr. Tom Preston uses “patient-directed dying” in his book of the same name. I use “self-directed dying” because that places the ownership on how we close our lives where it rightfully belongs: in each our own hands.
That’s as it should be. And it’s a truly brave act to hold that choice close.