August 6, 1999 (Ira Pilgrim)

On Ending One's Life

Committing suicide shall be punishable by death.

On his death bed, writer Willam Saroyan said, "I know that everyone has to die; but in my case I thought that they would make an exception." As he well knew, there are no exceptions; everyone dies. Most people die quietly when an artery to some vital part, such as the heart or brain, plugs up. Some die of cancer; some die suddenly and violently. A few die in agony, a few kill themselves. For the vast majority of people, their death is not something that they or their physicians have much control over; it simply happens to them.

There is a bill before the California State Legislature called "The Death With Dignity Act." I have read the contents of the bill, which is now being considered by the judiciary committee of the State Assembly. It strikes me as a well crafted piece of legislation. That is, it is as well crafted as the legal and political mind is capable of. It is essentially the same as a similar initiative that was passed by the voters in Oregon.

If it passes and is approved by the governor, it will make it legal for a physician to prescribe a lethal amount of a drug, probably Nembutal(pentobarbital). The physician would not administer the drug.

When Derek Humphry's book Final Exit told the world that one way to end your life was to use Nembutal, and gave the dose that was needed, it changed the availability of Nembutal. When I needed some of that excellent sedative, my physician gave me a prescription for ten capsules which, if taken all at once would do little more than put me to sleep. If more was prescribed and I took it all and died, it might pose a problem for the doctor.

The Death With Dignity Act has all sorts of safeguards to try to insure that the person getting the prescription is terminally ill and "of sound mind" and is not just taking a lethal dose for the fun of it, or because of depression. Two doctors must certify to this.

This act has been tried for over a year in Oregon. It has not produced any wave of mercy killings as its opponents predicted. In fact, in its first year, very few people(23 out of about 10,000 people who died) had taken advantage of it. Of the 23 who got the prescription for the lethal dose of the drug, 15 used it. Eight of the people who received a prescription for lethal dose of a drug didn't use it, but allowed their lives to end naturally. In other words, for a few people, it was useful and for some it was probably a comfort to know that the drug was available. In short, the bill was far from being the boon that its advocates thought that it would be, nor the disaster that its opponents predicted.

One of the few things that a person can have power over is the power to end his own life. The power to prolong it also exists, but it is not the absolute power that is involved in ending it. I don't know about anyone else, but I am comforted by the thought that I can end my own life if and when it becomes intolerable, with no hope of it ever getting better. I know that emotionally intolerable times and pain are part of living and that things usually improve. It is unlikely that I would end my own life, but it is possible. If I do choose to end my own life, the method that I would use is painless, legal and neat. It would not be a bullet in my brain, which is sloppy and which would cause anguish to people I love. It would not be with the help of my physician, although I would expect my doctor to provide medicine to relieve my pain. I would like to die after saying goodbye to those I love. I would then stop eating and drinking and would, usually within a week, lapse into a coma and die not too long after that. It is uncomfortable in the beginning, but it is not painful.(More on this subject) Many people have found this out on their own, but they aren't around to testify to it in the legislature. To end my life in this way would require that others allow me to do it.

I may need a doctor to help to prolong my life, but I don't need one to help me to end it. The only thing required is that no one interfere. This is very difficult to find in a hospital where the philosophy usually is that their mission is preserving life, no matter how miserable that life may be. Often a person is kept alive regardless of how remote the chances are of his getting any better. Therefore, I would do my best to die at home.

A medical myth that has been perpetuated for some time is that a physician is necessary for a person to be born or die. With a few exceptions, this is just not so. Nor does a person need a lawyer or a politician to help him to live or die.

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