August 5, 2013

"One of the few advantages of dying from Grade 3, Stage IIIC endometrial cancer, recurrent and metastasized to the liver and abdomen..."

"... is that you have time to write your own obituary. (The other advantages are no longer bothering with sunscreen and no longer worrying about your cholesterol.)"

It was a paid obituary, but The New York Times noticed and ran a story about Jane Lotter. That was enough — along with the adorable photo booth pictures of her and the man she married — to make me begin this blog post. As I go along — you have to get to the last third — I see what I think is the real goal of the article: presenting a postcard picture of suicide.
Ms. Lotter took advantage of [Washington state's] Death With Dignity Act.... On July 18, the couple and their two children gathered in the parents’ bedroom. Ms. Lotter asked to keep in her contact lenses, in case a hummingbird came to the feeder [her husband] had hung outside their window.

The last song she heard before pouring powdered barbiturates, provided by hospice officials, into a glass of grape juice was George Gershwin’s “Lullaby.” Then she hugged and kissed them all goodbye, swallowed the drink and, within minutes, lapsed into a coma and died.
Does this picture make you more likely to take the barbiturate way out if you knew you were dying? Would you dissolve the powder in grape juice or some other liquid? Would you play Gershwin's "Lullaby" or something else? Would you be in your own bedroom, hoping to see a hummingbird one last time? Would you include only your closest family — hugging them in a planned sequence — only your most loved one, or would you go alone? As you imagine the theater of a controlled departure — with details corresponding to Lotter's details — are you more favorably disposed to the "Death With Dignity" approach or not? Are you still thinking about yourself, or did you, at some point in reading this paragraph, shift to picturing other people getting enthusiastic about early check-out time and thinking of yourself as one of the taxpayers and insurance buyers — us the living —  who stand to benefit?


raf said...

I can imagine an eventually (and expensively) terminal patient having access to pain medications restricted and being "counselled" about the barbiturate option.

Hagar said...

Hedy Lamarr said she wanted to make it into the 21st century, which she did, then cleaned the house, dressed in her Sunday best, put her last will and testament on her bed and herself on top of it, and passed away - independent to the last.

Unknown said...

"Death With Dignity" is not an option in my religion as it is considered a mortal sin. That being said, The only time I would contemplate this option were if I were diagnosed with Alzheimer's. In my opinion, when the brain is gone we have lost everything that makes us human. The story is poignant and I would only make that type of decision with my loved one's input.
C Colter

Dr.D said...

For a Christian, this is not an acceptable option. Only God our Creator has the right to determine the length of our lives. He has put us here, and He will decide when we have been here long enough.

To many, this will sound cruel, lacking in compassion for those suffering the awful pains of a dreaded disease. But the Christian must reply that those pains are there for our benefit (strange as that may sound!), to notify us that death is coming, and that we must repent and make our peace with God very soon. They are a final warning, a notice that our particular judgment is very near. We must simply offer our suffering to Jesus Christ, remembering that He is with us to the end, and that He has previously suffered a horrible death for our sakes, before His glorious resurrection.

I certainly do not condemn this woman for what she did. God will be the judge of that, and it is not up to me in any way to be her judge. I must, however, discourage others from taking this route.

Fr. D+
Anglican Priest

Amichel said...

I always worry about journalism like this. Now it's all gauzy stories, humingbirds and Gershwin. "What joy, to be able to choose your own death! See, you can be surrounded by your family, and maybe even see a hummingbrid outside your window as you fade away!"

There will come a day when it will be no choice at all. How much easier it would be if we could just euthanize the elderly past a certain point. Think of the savings! No expensive end of life care, no taxing conversations with the old and demented, just mix up some barbituates in the grape juice and be done with it. I mean, don't you think that's less selfish, making yourself less of a burden to all of us?

Ugh, gives me shivers.

Brian said...

"Ms. Lotter asked to keep in her contact lenses, in case a hummingbird came to the feeder [her husband] had hung outside their window."

There might've been a hummingbird the next day, of course, or even the next hour. What a thing to give away.

Jane the Actuary said...

Leaves you wondering -- how did she decided when to kill herself? The article doesn't say. Was she in intractable pain? It sounds like it was fear -- fear of suffering in the future.

Seeing Red said...

I have 2 thoughts:

1. How does this affect the death sentence - it's so peaceful, "Death with Dignity."

2. Reminds me of the ST:TNG episode with David Ogden Stiers.

The planet was dying, he was a scientist trying to save it, but their law was death by 60. His struggle was he wanted to live because he met Troi's mom and had more to give but it was again societal custom.

SteveR said...

This is too Soylent Green for me, Why not a 3d IMAX or a visit from Sir Paul?

Christy said...

I've wondered why no new Old Man of the Mountain has organized a new Order of Assassins from terminal, but functioning, cancer patients. Hashashin who actually use hashish to function. (Apparently the hashish eaters was a mistranslation encouraged by their enemies.)

Mark O said...

Messiah: O Death, Where is Thy Sting? (Handel)

Birches said...

@ Amichel

Exactly right. The only people taking advantage of these die with dignity laws are the better off right now. If they became commonplace, the less well off would probably be advised to use them in entirely different ways. So while I understand the point of the laws, I think I'd rather just live with lax enforcement instead of enshrined laws protecting a right to die.

David said...

I would do without the lullabies and the terminal hugs and all the theater of the last farewells. Especially the lullaby. If others want to hug me, have a hug, but I don't want them to feel obligated. Death is about giving up control, not exercising it.

cold pizza said...

We all face a physical mortality. Everything passes. Does this mean we should give up and kill ourselves because it's all moot?

From whence and whither consciousness?

If you believe consciousness continues after death of the physical host, where did that consciousness spring from? Can an immaterial (and essentially immortal) being be created by mortal means?

My intellect marvels at the miracle we call life, that such wonders as matter can exist at all. (really, if you ponder, what is matter but a form of bounded energy?)

My faith leads me to believe in an existance pre-dating the creation of this cosmos and that this journey through the mortal realm is but one step on a path teaching me how to be a responsible and essentially good being. Mortal life provides lessons that a spiritual creature could not otherwise comprehend. It allows each of us the exhibition of our individual and unique true nature.

I feel sorrow for the family but I do not judge the woman. Fear is... powerful. When there is no hope, there can only be fear.

I also sincerely believe there are a lot of rather confused ex-athiests maundering through the afterlife. -CP

RunningFromCancer said...

While it sounds glorious, controlled, peaceful and picture perfect, I am not sure I would or could do it. Obviously you never know for sure until something happens and then as the article said, paraphrasing - the timing is tricky. Too soon and you miss out on joys and too late . . . is too late.
Having been diagnosed with Stage 3b breast cancer 9 years ago, I certainly thought / think about death probably more than the "average" person. I also understand being so sick from treatments that you just want it to end - the treatments / not life.
I enjoy life too much. And it sounded like Jane enjoyed life - so maybe she wasn't that different than me - but she was at a point where she was done fighting - the outcome was inevitable and only she can understand that point and make that decision.
So as much as we would like to "know" what we would do - we can't because we can't possibly understand where she was - and can't know what we would do.
But to answer some of the ?'s
Music: Aaron Copland - Appalachian Spring or Fanfare for the Comman Man
Family: I would want my immediate family near by
Location: Outside, somewhere I love, with only the sky above - - it sounds sort of sappy as I reread this!

Richard Dolan said...

What was missing from the article (and the obit) was an explanation about why she needed to die when she did. No mention of unrelieved pain, no suggestion that some suffering made death a longed-for release. Just a passing statement that a person in her position choosing 'death with dignity' needs to act before they fall into a coma naturally, and then can't drink the poison. But all the poison did was put her into an induced coma, followed shortly by death. Perhaps she was so weakened by the disease that she could barely move, but (for whatever reason) the subject is ignored. Strange omission for a person saying that she loved life, and was sad to have to take her exit.

Anonymous said...

I'm visiting my sister in western Wisconsin and whilst enjoying a late morning coffee we discussed our reactions to this story. We have agreed that a dignified death is optimal, but are in diametrical opposition as to dying alone or surrounded by loved ones.

While my sister feels that being born alone and dying alone are something that one must do alone and have no knowledge of the event so as to ensure that they never second guess themselves and their decision making is out of the equation. My sister feels that I would be kinder to let the children and loved ones think that the death was a natural one in ones sleep. That they would never know.

I however, feel that it would be giving one's loved ones the option to be present at the event and their presence at my bedside would be welcoming and supportive and a less lonely way to leave this world. I appreciated the hand given in support and love by my husband during giving birth and would appreciate the hands of any of my children who chose to be there at the moment of my death.

MadisonMan said...

Death is about giving up control, not exercising it.

Exactly. Control to the end simply means you are a control freak.

Anonymous said...

Me, I'd go with Faure's Pavane.

My mother spent the last 2 months of her life in a coma (was a stroke), and it tore my father up something fierce. He'd find himself walking into a room, forgetting why he went there and burst into tears. My recommendation was that he write down on a piece of paper what he was doing, so that when he walked into a room and the emotions overwhelmed him, he could later look at the paper and remember what he was doing. It wasn't alzheimers, it was grief that was crashing over him.

John Lynch said...

We all die, but some people quit.

RecChief said...

no one can say for sure what they will do when the time comes. However, I hope to keep fighting to the bitter end.

LYNNDH said...

Single Malt Scotch

Smilin' Jack said...

For a Christian, this is not an acceptable option. Only God our Creator has the right to determine the length of our lives....I must, however, discourage others from taking this route.

God seems to have become rather shy the past few thousand years. He's lucky that so many brave souls are willing to step up and speak in His place.

Kirk Parker said...

Cole Colter,

In my experience with person with Alzheimer's doesn't retain enough short-term knowledge of their situation to be that focussed.

Anonymous said...

"What joy, to be able to choose your own death! See, you can be surrounded by your family, and maybe even see a hummingbird outside your window as you fade away!"
Reminds me of Edward G Robinson's death scene in "Soylent Green".

Dr.D said...

Dear Smilin' Jack,

God has spoken quite clearly, and I doubt that He thinks He needs to repeat Himself. He has given us His word written (which is quite clear to those who time the time to really study it), and He has also sent His Son, Jesus Christ.

In the traditional understanding, for a man to send his son to represent him in dealing with others was considered to be the final stroke, the last choice and not to be exceeded. The Lord God has done this, therefore, I think it extremely unlikely that He will do anything like that again.

The Son, however, also sent the Holy Ghost to work in the hearts of believers, to lead them into all TRUTH. The Holy Ghost is at work yet today in the hearts and minds of those who truly believe. For those who do not believe, there is nothing left but the witness of Christians.

Many say that is a very mixed bag, and there is some truth to that. Lots of people, claiming to act in the Name of Christ have done many evil actions, but then, many others have done great things for the benefit of mankind. It is only God who knows who the true Christians are. You cannot tell for certain about another person, but, as Jesus said, "Ye shall know them by their fruits." The good ones are recognized by the good that they do, while the bad ones clearly are not Christians, whether they think that they are or not.

Fr. D+
Anglican Priest

Badger Pundit said...

Following up on the comment about how similar this is to Soylent Green (1973), here's a clip of Sol (played by Edward G. Robinson) ordering up classical music and dying to the strains of Beethoven's Sixth:

Interestingly, Robinson WAS in fact terminally ill, and died of cancer 12 days after the death scene was filmed. Personally I'd take Beethoven's Sixth over Gershwin's Lullaby any day.

30yearProf said...

It's a matter of choice. It's MY body.

If I can (were I female) kill a living child (i.e., the fetus in my womb), why not myself.

As long as I control the decision, I want the option.

Carl said...

I dunno, she sounds like a drama queen. I understand, one of the very biggest problems of dying is that as soon as that is known you get shunted off on this side track, away from the main hurly-burly of humanity. People treat you differently, like you're a temporary visitor from another planet. We'll talk about that later, know... They make you feel like you're not quite human anymore. About the only way you can get their attention again, be part of the family, is to actually die. So this lady wanted to stage that herself, make sure they all paid attention. As I said, kind of a drama queen.

Of course, the whole problem is rooted in a great denial. We are all of us temporary visitors. We just pretend, most of the time, that we're not, that we are all rushing together into the indefinite future on the unending main line forevermore. It is presumably this great pretense of daily life that makes the shock of its forceful end, when we find ourselves hurtling down the siding with the buffer and end of track comin' right up, more brutal, painful to all concerns.

The Stoics had a way with this. You were supposed to meditate in a daily way upon the impermanence of not only others, but yourself, and to appreciate how remarkable but temporary was what you had now -- like a roller coaster ride that is amazingly fun but the end of which you can see coming up pretty quick. Christianity, particularly in the Middle Ages, was also good about this (although in our smug superiority now we just think they were morbid, dwelling on death all the time, or it was all just to enrich the Pope.)

But being cleverly modern and all, we've largely put that aside, and instead of meditating on our own impermanence we seek (bogus) immortality in our passionate cults and movements, and then when the hour strikes unlooked-for, we stage scenes so we get the spotlight one more time. Not really an improvement.

Lori said...

Interesting story, but I call bullshit.

NYT could not even get the quote on the button correct. "Happy to have been here"? or "Happy to be here"?

Verb tense - writing - truth -makes a difference.

Dr.D said...

30YearProf said, "It's a matter of choice. It's MY body."

This goes to the heart of the matter. Is it really HIS body, something of his own creation and over which he should have sole control, or is he a created being, put here by something greater? If the latter, it is NOT HIS body, but the property of its creator, God.

To assert "It is my body," is to deny that we are, in fact, the creations of God, the creator of Heaven and earth. God give us the freedom to make that denial, but then we will have to pay for our choice later. It is definitely a choice that 30YearProf is allowed to make, but it is not one that I can recommend to anyone.

Fr. D+
Anglican Priest

Mark Trade said...

I didn't think any of those things, Ann. None of those questions even occurred to me. I thought it was simply too grim to think about choices made just before death at this moment in my day. Besides it is not my business how people choose to live, and it is certainly not my business how they choose to die.

Unless they have some kind of fiduciary responsibility, contractual arrangement, or anything for which their health still legally demands their attention, what ground do I have to say that someone's liberty must be infringed?

PWS said...

I really like Carl's post. I think whether you plan your death or it comes another way is not the central question.

The central question is "Are you ready to face your own death?"

On some level, that question makes most of us squirm figuratively, if not literally.

If you can accept your own death, having a plan or on nature's time is not that big a difference--except perhaps to spare some suffering by you and your close friends and family.

William said...

Someone dear to me died of cancer in a hospice. The hospice was a very nice place. Didn't matter. Her death was ghastly and prolonged. She had lots of morphine but it didn't work. The nurse rubbed some kind of morphine ointment on her. The nurse said that thin people didn't retain the morphine. (Do fat people die of terminal cancer?). She was in and out of consciousness and lucidity. It took a couple of weeks. It was all pointless suffering.

Hazy Dave said...

I missed the turning back, I walked on by
Old situations can make you want to lie down and die
I want you to stay
You search for a worthwhile need
But why not do the searching around here and try to involve me?