My pet would never die this way. Why did my father? – Orange County Register
Pops died on St. Patrick’s Day in Delray Beach, Florida — a traumatizing, agonizing, slow-motion catastrophe. Even with absolutely angelic hospice care — and round-the-clock morphine — his was a brutal, violent, vicious exit from this world that left me sputtering with rage.
How to forget that desperate rattle and hiss as he gasped for air? His repeated attempts to get out of the hospital bed despite skeletal legs that could no longer hold him? His shrieks when the nurse inserted the catheter?
“Give me the needle!” he cried repeatedly over the last several months, pleading with God to take him. “I want to be with my wife!”
I had to bite my tongue to keep from saying, “There are no needles, actually. But if you had moved to California, near me, instead of to Florida, where it’s cheap, a dignified exit would actually be an option.“
Game-changer
That’s thanks to Anaheim-born Brittany Maynard. A decade ago, she became the brave, beautiful, tragic posterchild for medically assisted suicide in California.
Maynard had earned a bachelor’s degree in psychology from UC Berkeley and a master’s in education from UC Irvine. She was passionate about the world and eager to make it a better place, teaching at orphanages in Kathmandu, working in Costa Rica, visiting Vietnam, Cambodia, Laos, Singapore and Thailand, summitting Kilimanjaro in Tanzania a month before her wedding. She took ice-climbing courses in Ecuador. Went diving in the Galapagos, Zanzibar and the Caymans.
In 2012, about the time she got married, Maynard began to get severe headaches. On Jan. 1, 2014, she was diagnosed with brain cancer. There were surgeries, but the cancer returned. She was told she had just six months to live.
“Because my tumor is so large, doctors prescribed full brain radiation,” Maynard wrote in an essay for CNN. “I read about the side effects: The hair on my scalp would have been singed off. My scalp would be left covered with first-degree burns. My quality of life, as I knew it, would be gone.
“After months of research, my family and I reached a heartbreaking conclusion: There is no treatment that would save my life, and the recommended treatments would have destroyed the time I had left.”
Maynard rejected the idea of dying in hospice care at home. She feared pain, personality changes “and verbal, cognitive and motor loss” even with palliative medication. “Because the rest of my body is young and healthy, I am likely to physically hang on for a long time even though cancer is eating my mind,” she wrote. “I probably would have suffered in hospice care for weeks or even months. And my family would have had to watch that.”
She wanted to die on her own terms in her home state, but California had repeatedly rejected death with dignity proposals. So Maynard and her family moved to Oregon, where patients who were sound of mind and had less than six months to live could legally seize control of their final days.
On Nov. 1, 2014, Maynard drank a potion that put her into a deep sleep from which she never awoke. She was 29. But she was not done changing the world.
“I’m heartbroken that I had to leave behind my home, my community and my friends in California, but I am dying, and I refuse to lose my dignity,” she said in a video released after her death. “I refuse to subject myself and my family to purposeless, prolonged pain and suffering.”
Her mom, Deborah Ziegler, continued her fight to bring death with dignity to her home state. In October 2015, Gov. Jerry Brown signed the California End of Life Option Act into law.
Options
Opponents warned darkly of coerced deaths. Of insurers denying patients expensive life-saving treatments and pushing cheap end-of-life drugs instead. Of abuse and coercion by rapacious family members eager to get their hands on an inheritance.
After nearly a decade of legal assisted suicide, the law is indeed used more frequently — but assisted suicides still represent a tiny fraction of all deaths in California, according to data from the California Department of Public Health.
In 2023, the most recent year for which data is available, there were 290,511 deaths among California residents. Only 884 of them took aid-in-dying drugs, fewer than 1% of all deaths (a tiny 0.30%, to be exact).
Of those 884 people, 92.8% were age 60 or older; 97.1% had health insurance; and 93.8% were receiving hospice and/or palliative care when they died.
Somewhat stunningly, 85.4% of them were White. About 77% had at least some college education. Nearly 88% of the deaths happened in folks’ private homes. And most of them were suffering from cancer.
Interestingly, there are many more prescriptions written for the drugs than there are deaths; people obviously want to keep their options open. In 2023, there were 1,281 prescriptions under the EOLA.
The most common prescription (98.4%) was for a combination of a cardiotonic, opioid and sedative drugs, according to the CDPH. Not every doctor writes them, however: There are more than 125,000 licensed physicians in California, and the end-of-life prescriptions came from just 337 of them.
All told, over the first 7 1/2 years of the law’s life (June 9, 2016, through December 31, 2023), there have been 6,516 prescriptions written and 4,287 deaths after ingesting the medications. Of those deaths, the overwhelming majority (91.2%) were among people receiving hospice and/or palliative care, according to the CDPH.
Next year, the death of my friend Monica Edwards will be included in the annual report. After fighting cancer for nearly three years, it became clear it was a battle she couldn’t win. Like Maynard, she wanted to go on her own terms. With dignity. Edwards died on Oct. 31, in her backyard, surrounded by family and friends. She was 62.
“It’s been a good life,” she wrote in her final Facebook post. “I trust I am flowing into the one thing that makes us all tick, makes us all harmonize when operating on our purest state. I’ll be there. And if I’m fortunate enough to be able to come say hello, you’ll know it’s me. I wish you all love, light, sweetness and harmony. And just enough of the opposite to be grateful for every other day you’re alive.”
More dignity?
Right now, only 10 states and the District of Columbia have “death with dignity” laws. In addition to California, there’s Colorado, Maine, Montana, New Jersey, New Mexico, Oregon, Vermont and Washington.
Glaringly absent here is Florida, the state with one of the greatest concentrations of people over age 65 (22%, beaten out only by Maine at 23%).
That seems unconscionable.
I’m not clear if my father would have actually chosen this option had it been presented to him. But what a relief it would have been to have an option at all. With the morphine, he was reaching his arms out for things unseen. “Where did all these children come from?” he asked as I sat next to him — just the two of us, alone in the room.
When he entered “crisis care” and his morphine dosage more than doubled, he was mostly unconscious — but there was jerking and twitching and shuddering, sometimes moaning. The excellent hospice nurses from Trust Bridge assured us that he was feeling no pain, but it still was an agonizing thing to watch (and, as death nears, an agonizing thing to hear). I will forever be grateful to the nurse who was there on the last night, who urged me to lay down for a while because I’d need my strength. A half-hour later, she woke me. It was time. Pops was 97.
1 of 4
This year, more than a dozen states are considering death with dignity laws, according to DeathWithDignity.org, including Arizona, Connecticut, Delaware, Illinois, Indiana, Kentucky, Maryland, Massachusetts, Missouri, Nevada, New Hampshire, New York, North Carolina, Rhode Island, Tennessee and Florida.
“Terminally-ill patients are increasingly asking why anyone – the state or federal government, the medical community, religious entities – would presume to tell someone else that they must continue to die slowly, painfully, inch by inch against their will,” Maynard’s mom, Ziegler, recently posted on Facebook. “Brittany’s choice to make her decision public took more courage than I can imagine. Ten years later her grit and determination have changed the face of the Death with Dignity movement in a big way.”
Please, other states, let California’s experience guide you. At the end of life, people deserve a choice. I’m grateful to Maynard for helping ensure that’s an option for all of us.
Originally Published:
Post Comment
You must be logged in to post a comment.