The decision of 29 year old Brittany Maynard to move from California to Oregon in order to legally confront glioblastoma cancer and die on her own terms-- with dignity-- as she did on November 1, 2014 triggered a national debate. Her death came almost a year after PEW Internet research found that more than 50% of Americans now believe terminally ill patients should be allowed to hasten end of life and access compassionate assistance. What do you think and how likely is it that your state will adopt a Death With Dignity policy?
Seven states, Oregon, Washington, California, Colorado, Vermont, Hawaii and the District of Columbia now allow Death with Dignity and have clear procedures and tracking in place. Montana overturned bans on aid in dying making it accessible through the courts. In total, 10% of states permit end of life choice. With more than half the nation supporting aid in dying laws one may wonder why more states don't allow it? The answer starts with politics. Legislators are reluctant to pass assisted dying acts. Both Washington and Oregon used the initiative process to pass laws by popular vote thereby avoiding the complexities involved in a House or Senate bill. Vermont legislators are so far alone in finding the will to vote. They enacted The Patient Choice and Control at End of Life Act in 2013. Will Brittany Maynard's decision prompt action in other states?
In the New York Times article Aid in Dying Movement Takes Hold in Some States they note recent momentum suggesting that Baby Boomers' experiences with aging/dying parents is reshaping public opinion and driving new debate on Death With Dignity. A Harris Poll in 2011 however found that 18-54 year-olds had a more favorable view of aid in dying then the Boomers. Across all age groups more than 2/3rds of respondents thought that terminally ill people had a right to choose to end their own life. If you watched television the night of Maynard's death, you saw an America ready to take on the question: Is it time for Death With Dignity?
Every major network carried the story. Public Broadcasting focused their thoughtful segment (above) on two Oregonian's perspectives and their journey with terminally ill partners. In it, Pam Wald, whose husband used the law, concludes, "No one wants to talk about dying and death but once we get into that it really becomes an act of love." How that love manifests is highly individual. For Dr Bill Toffler, also featured in the segment, love meant riding it out. "Every day we lived differently because we knew that we had a limited amount of time," he said. Neither Toffler nor his wife believed in hastening death so they opted for medicine and end of life care.
In Seattle, Washington, KIRO 7 television featured Kate Lounsbury and Nancy Niedzielski. Lounsbury, a former dancer and caregiver, elected aid in dying when her lymphoma returned. Her story, first featured in social media at the blogs A Personal Look At Death With Dignity and San Diego Story, reawakened spirited discussion sparking over 700 Facebook comments about KIRO's story content.
Niedzielski's husband battled brain cancer before Washington State passed Death With Dignity in 2008. His painful ordeal motivated her to advocate for the law and volunteer for End of Life Washington as she explains, along with others, in their powerful video.
Compassion and Choices, a national organization with state chapters, stewards Death With Dignity laws, provides end of life consultation, and promotes policy and advance planning. Interested in the history of this movement? Bills are introduced in many states but often get tangled in politics thus failing to advance however the Death With Dignity National Center notes that legislative bills supporting aid in dying are on the increase. What's happening in your state?
Death With Dignity laws, advocates tell us, respect individual choice by legalizing and providing needed support and tracking for end of life acts that currently operate in the shadows. Privately, doctors and patients have been practicing aid in dying for years without the support of law. According to an article in Vox.com, a survey in 2000 found that 1 in 7 oncologists have helped their patients end their lives. Not everyone finds that cooperation though which pushes people toward suicide or ending their suffering by refusing food and water. That stark choice is motivating terminally ill patients, like Brittany Maynard, to use their last energies to become strong vocal educators and advocates for aid in dying. 77 year old realtor, Charles Selsberg, suffering from ALS, penned an op-ed (with assistance) asking legislators in Colorado to "have mercy on the terminally ill." Selsberg stopped taking nutrition because, lacking legal and compassionate aid it dying, it was the only way to end his ordeal. "The literature I read said it wouldn't be hard, and it isn't — it's brutal.," he wrote. "My loved ones support me, but this is as difficult on them to watch as it is for me to execute." Talk show host, Diane Rehm, publicly described her heartbreak watching her husband of 54 years refuse food and water when his doctor declined to help him with a compassionate death. That experience shaped her into a national advocate for end of life choice. She dedicated a show to the topic of aid in dying. "Everybody has a right to an opinion but we, humans, have a right to do what we want with our bodies," explained 66 year old Barbara Coffin who struggled with Ovarian cancer for 12 years before dying with dignity in Washington state earlier this year.
American attitudes about aid in dying are changing. Understanding the feelings and perspectives of people whose lives have been touched or altered by terminal illness is key in settling indecision or debate about Death With Dignity. It's possible, however, that you may never really know how you feel about the law unless you encounter terminal illness or someone making the choice to hasten death. More than likely, in the years to come, you'll be asked to vote on the matter or be challenged to form an opinion because Death With Dying is a movement gaining momentum.
Update October 2015: California adopts Death With Dignity making it legal up and down the west coast. In signing the bill California's Jesuit educated Governor Jerry Brown said, "I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn't deny that right to others." Keep up to date on states where Death With Dignity is legal by using this map.
Update: June 2016: Canada votes for physician assisted dying. Justice Minister Jody Wilson-Raybould and Canada's Attorney General and Minister of Health are quoted in this article from NPR as saying, it "strikes the right balance between personal autonomy for those seeking access to medically assisted dying and protecting the vulnerable." But the law emerged from hot debate and will likely be challenged in court.
Update: August 2016: A young artist afflicted with ALS throws a rebirth party in Ojai California before becoming one of the first people in that state to use the new right to die law.
Update Jan 2019: Hawaii adapts to new Our Care Our Choice law