Legal Death with Dignity Now an Option

It’s been just over a year since a unique Redding individual implemented his decision for “Death with Dignity”. He was a deeply spiritual man. He did not fear death. But neither was this a decision taken lightly or based on clinical depression. It was a practical decision to choose his own destiny.

After four years of chasing a diagnosis for his odd symptoms, he was finally diagnosed in 2012 with Frontotemporal Degeneration – Behavioral Variant Type (bvFTD). He learned that it was a fatal disease for which there was no cure. It would progress with decline in 3 categories: Behavior/personality, language and motor skills. For this “Renaissance Man” (Attorney/child advocate, Harley Rider, Musician) there could be no more cruel diagnosis.

He knew that he wanted to cherish all that life had left for him. He also wanted to protect himself and his family from a gruesome death. He knew that in addition to possibly being totally incapacitated and without motor skills or his true personality, it was equally possible that he could harm a family member when in a disease-symptomatic rage. He and his devoted wife did everything they could to live with the disease. As the disease progressed, he would spend hours locked in his own pain in a fetal position, sobbing uncontrollably unable to function.

Life is most certainly a gift. A life well-lived is a profound gift to the recipient as well as those who are touched by that life. There are those that believe only their god has the right to choose when life ends. I do not argue that point. I only submit that perhaps this god has also given us the gift of free will to make choices. My goal today is simply to provide information about options.

When ABX2-15 was passed on 10/5/2015, it followed 25 years of efforts to make it legal to end your own life in California. Prior, most folks considered going to Oregon where there was a legal option.

According to the CA Death with Dignity website the new law allows “qualified individuals” to “legally request and obtain medications from their physician to end their life in a peaceful, humane, and dignified manner”.

Qualifications are:

  • a resident of California 18 years of age or older;
  • mentally competent,
  • diagnosed with a terminal illness that will, within reasonable medical judgment, lead to death within six months
  • able to self-administer and ingest the prescribed medication

These requirements must be met and verified by two physicians. There are no exceptions. There is a minimum 15 day waiting periods between the two required requests that the patient must make. More information for physicians can be found at: http://www.familydocs.org/eol/end-of-life-option-act.

This individual was a lawyer and careful to protect his family from any repercussions. He made sure to have the requisite documents in place and readily available. It was 9 years since the onset of symptoms that he completed his transition. He was confident that it was time.

Currently the documents needed are:

The medications were self-administered (following a tequila shot to calm himself). The needed materials had been locked in a safe and never touched by anyone else in the family. Like most stories I have heard, he was reported to have had a deep sense of peace as he made this transition.

The aftermath was not as peaceful. Since he was not under hospice care and the death was not physician attended, 911 was called. This resulted in a much more chaotic scene than his wife expected to experience. It is my understanding that much of this will be avoided when qualifying under the new law.

It’s interesting to note that in Oregon since 1998, 1545 patients received prescriptions, but only 991 (64.1%) actually ingested them and died. The three most frequently mentioned end-of-life concerns were a decreasing ability to participate in activities that made life enjoyable (96.2%), loss of autonomy (92.4%), and loss of dignity (75.4%).

Discussing your decision with loved ones and family is critical to the success of this process. While we might feel it is really no one’s business but our own, it clearly impacts those closest to us. A further piece of advice from one survivor: “Be very careful who you choose to walk this path with you. It is a sacred experience and a sacred trust”. They must be 100% supportive or there can be painful and damaging results after all is finally complete. That is the last thing the survivors need as they work through their own personal grief.

Note: Covered CA has extended the application date for 2/1/2017 effective dates to 1/20/2017.

Margaret R. Beck
Margaret Beck  CLU, ChFC, CEBS started her insurance practice in Redding in 1978. As an insurance broker/consultant,  she represents businesses and individuals as their advocate.  She assists in choosing proper products, compliance with complex benefit laws and claims issues once coverage is placed. All information in her column is provided to the best of her knowledge, subject to final regulation by the respective agencies. Questions to be answered in this column can be submitted to info@insuranceredding.com. Beck's column is also published in the Redding Record Searchlight.
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9 Responses

  1. Hollyn Chase says:

    Thank you Marge–this is extremely valuable information. I appreciate your taking the effort in putting together such a coherent and detailed article. I have made a copy of it and put it with my papers.

  2. Richard Christoph says:

    Marge,

    Many thanks for this informative, poignant, and beautifully written column.

  3. Beverly Stafford says:

    Thank goodness California has joined other forward-thinking states and has passed this law.  My beloved father-in-law who suffered for years with emphysema once said that if he were a dog, his family could put him out of is misery, but as a human, he had to wait painfully for death.  Thank you, Margaret, for this information.

  4. A. Jacoby says:

    So grateful that you wrote this column. I have absolutely no idea how I would face such a diagnosis, but I find it extremely comforting to know that the option is viable. I have always thought that it was an interesting comment on our culture that we allowed our pets more compassion and dignity in death that we allowed each other.

  5. Joanne Lobeski Snyder says:

    This is good information.  The family you referred to made their decision based on all of the data about this horrible disease.  The man was going to die for sure, but he and his wife took control of how and when this event would happen.  They both wanted to avoid the absolutely certain horrific end stages of this disease.  They are my heroes.

    The wording of this law is so well crafted.  An individual of sound mind can make a decision based on all of the data about their terminal medical condition.  The possibility  of indefinitely  being kept alive in a hospital because of new technologies is not an option.

    Thank you for a great article.

  6. K. Beck says:

    I have heard many very disappointing things about DNR (Do Not Resuscitate) orders. They are often not followed. Or followed in some manner not intended by the signer. Do you think it would be advisable to have a legal document written by a lawyer instead if a standard DNR form? That might be more binding on the person who gets involved with people when they may be incapacitated? Personally, I have already spent way more hours than I ever want to spend in “convalescent” hospitals. We had a DNR for my dad. He ended up in a hospital with pneumonia. The hospital released him to a convalescent hospital without telling anyone, not me, not my brother, not the convalescent hospital, that he still needed antibiotics. Maybe they decided he would not recover even with continued antibiotics? Maybe they thought the DNR included withholding antibiotics when they decided they would do no good? So, they did not discuss this with anyone?  Within a few days he died. This was not what anyone intended! I was not living in the same city, so I didn’t know what was going on and was quite shocked when my brother called me to tell me our dad was deceased. I have all the forms, but have not filled them out because of what happened to my dad. I don’t want to be kept alive, but I also don’t want to be dumped by some MD who decided I don’t need meds without discussing it with me or my family!

  7. Joanne Lobeski Snyder says:

    K. Beck, I had a similar experience with an older friend who had a DNR order.  His family wasn’t involved in his life.  Another friend of his and I were his unofficial medical advocates.   He was fairly deaf and couldn’t hear my voice on the phone.  He would disappear out of the hospital and I would try to guess where he would end up next.  At any rate, he was moved from place to place and ended up in a convalescent hospital where we would visit.  He got a lung infection and ended up in the hospital.   The reason I mention this is that it seemed as though he was being “housed”.   He wasn’t getting a lot of attention.  When my co-advocate asked why he didn’t seem to be getting treated, we were only told that he was getting palliative care.  It was confusing.  It felt like everyone was waiting for my friend to throw in the towel.   He looked good and was in good spirits.  Did I mention he was a WWII veteran so he wasn’t used to giving up on anything?

    He was released to the convalescent home and died shortly afterwards.

    I though a DNR had to do with avoiding efforts to revive a heart that has stopped.

     

  8. JeffG says:

    Not only is California laying the groundwork to regulate cow flatulence, you now need a permit to commit suicide — ah, what progress!

  9. DNR orders can, and should be, exactly what you want them to be. Whether or not emergency personnel or medical professionals follow your orders can be a whole other issue. You can clearly state that you want pain medications, supplemental feeding, antibiotics, hospitalization and more. You can also clearly state that you want ZERO extroidinary means, except being kept comfortable with pain medications. Remember that DNR orders are going to be carried out during high crisis situations. Your family will be distraught, EMT’s will be following orders to “always strive to save the life,” doctors and nurses may not have time to carefully read some paper stuck before them. It is always best to clearly inform several family members of exactly what you do and do not want and charge them with communicating your desires to the medical professionals. Be sure to include a trusted person who is not so close as to far apart during the crisis.

    Legal documents for health directives, power of attorney and DNR’s were drawn up for both of my elderly parents. I delivered those documents to both hospitals and they were scanned into my parents’ medical records. During subsequent emergency room visits, those records were easily accessed by the staff. I was grateful not to have to gather up legal documents AND try to get someone to the emergency room.

    When my husband of 36 years, the amazing man of whom Margaret Beck speaks of in her article, arranged his Death With Dignity, he was meticulous in his planning. This was not just because he was an attorney, but because he was adamant that EVERYONE knew it was clearly his choice and his desires. First and foremost it was to relieve his incredible suffering from his terminal brain disease, but also to keep his terminal illness from taking me out with him. He wanted to die with dignity, but mostly he wanted to LIVE as long as he could squeak out any semblance of  life. It was his desire to stay just as long as he could possibly tolerate his pain. He was incredibly brave right up to his very last breath.

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