Choosing When and Where to Die
September 14, 2017
What would you do if you had a terminal illness that would become excruciatingly painful, and incapacitate you, so that you would have to depend on others to the point of losing all dignity? What would you do if you had a disease that would slowly rob you of your mind, making the simplest of tasks impossible to do so that you would have to rely on caregivers 24 hours a day?
Richard had Parkinson's disease and he knew what he wanted to do, but he couldn't do it. He was on Hospice and he simply wanted to die. He had been an active strong man all of his life, who exercised and did all the right things, but now he was a man who needed help for everything. Parkinson's had robbed Richard of his ability to do the most basic things in life, such as walking, standing up, sitting down, showering, going to the bathroom and the many other things we do that are so automatic that they require little or no thought.
Although Richard wanted to die, he had to wait for time to take its toll and for his body to quit living. The end finally did come for him, but not until 24-hour care was needed, not until he had taken multiple falls (sometimes three in one day) and not until his body had become beaten and bruised after each fall with skin tears and broken ribs.
Until a year ago, in California the terminally ill had to wait for their illness to take its toll, and often death was a long, painful process, as it was in Richard's case. However, a dying person in California can now choose when and where to die by using California's End of Life Option Act.
The act, which became effective in California in June 2016, allows someone who is terminally ill, but mentally competent, to choose when and where they are going to die by self-administering a prescribed medication. The law requires that two physicians confirm that a patient is eligible.
The patient must also have the ability to request the medication orally in person two times and in writing one time. Forty-eight hours before taking the medication, the patient must sign an attestation form declaring that he or she is taking the medication voluntarily. The law states that this is not suicide.
Not only does the act allow a patient to choose when and where to die, it gives the patient comfort in knowing that the medication is available. Only about 30 percent of people requesting to use the act actually use the medication to facilitate their death, but knowing that one has the option is a great comfort and relief.
However, there are some caveats that come with the act. It's important to know that the medication cannot be ordered at the last minute. Recently, Akhila Murphy, a death care midwife and co-founder of Full Circle Living and Dying Collective, was contacted by a member of the community who had elected to use the act. "He came forward to tell us," explains Murphy "that although he had permission from his doctor, it still took several months to find a second doctor who would agree that he was eligible to obtain the aid in dying medication." Once two doctors were on board with the patient's plan, it took additional time to find a pharmacy to fill the prescription. The last problem was the cost of the prescription, which ran from $350 to $3,500, depending on the medication ordered.
Dying can be a difficult process and facilitating one's own death can be challenging. Advance planning is key; knowing the eligibility requirements for the End of Life Option Act and the process required to facilitate one's death can make the process relatively smooth. For more information on Full Circle's next event on this topic or on Full Circle's services, contact Akhila Murphy at (530) 432-6929.
By Linda Chaiko-Lepley
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