A Conversation About the End

Published: Apr 11, 2019

Photo by Arvin Chingcuangco on Unsplash
Photo by Arvin Chingcuangco on Unsplash (Photo by Arvin Chingcuangco on Unsplash)

March of this year marked an important month for Marylanders— it saw the passing of a bill that would have put terminally ill patients in control of their own fate. Passed through the House of Delegates on March 7th before a highly amended version met its defeat on March 27th, the End-of-Life Act would have allowed terminal patients to peacefully end their lives at a time and place of their choosing.

Over the years, my own personal experience with death has helped to create my strong and continued support of the laws which give and protect a terminal person’s right to choose how they live and end their life. With only six states and Washington, D.C. recognizing physician-assisted dying as law, it’s clear the idea is a controversial one, but one I, and many others, believe deserves more attention.

Mark’s story

I was eighteen when my father passed away unexpectedly. He was there and then he wasn’t –  his heart attack leaving behind a trail of confusion, along with a desire to understand why. A few years later, my closest friend from high school lost her father Mark*, but for her family, his death was preceded by years of suffering.

Although diagnosed with Multiple Sclerosis (MS) while we were still in high school, Mark did not pass until we were in our early twenties. MS causes the body’s immune system to attack the central nervous system, and while some may have mild or moderate symptoms, easily managed through medications, others deal with a monstrous disease which progressively robs both the body of its ability to function normally and the afflicted person of their independence. Mark experienced the latter. MS may not take your life directly, but it will deteriorate the body, causing a host of other issues that can.

Over the life of his diagnosis, I watched Mark go from a healthy, vital man to someone who could no longer walk or feed himself without assistance, someone who lived with daily pain. Barely able to function without support from those around him, slowly losing his awareness, I witnessed his quality of life drastically diminish in his final months while those around him struggled to see their father, husband, best friend, lose his life. Losing a parent, regardless of circumstance, leaves a hollowness inside of you. While the death of my father still hurts and confuses me to this day, I can’t help but feel grateful that his pain was short-lived. My father was brought swiftly to peace, something many have shared they wished for Mark.

Because MS by itself is not terminal, it’s considered a chronic disease and is not covered under the physician-assisted dying umbrella of illnesses, although many advocates are currently attempting to add certain degenerative diseases, such as the late stage MS and Parkinson’s, to the approved list. Knowing if an end-of-life option would have been the right choice for Mark and his family is impossible, but having the option is a right I wish had been granted not only to Mark but other terminally ill patient’s living outside of the scope of physician-assisted dying laws.

Death with dignity

Until Mark’s passing in 2009, I was unaware that these laws existed within the United States. It wasn’t until I stumbled across the documentary How to Die in Oregon that I was introduced to the first approved Death with Dignity Act passed in that state back in 1994. While watching the documentary, it became clear that those considering end-of-life options are not doing so rashly – a common misconception.

Often missing among legal rhetoric surrounding the various physician-assisted-dying laws is the viewpoint of the patient and their families, a crucial perspective. Death with Dignity laws are not about wanting to escape life — they’re about putting power back into the hands of the terminally ill, giving them options and control. Those who choose physician-assisted-dying desire to end life on their own terms, in a physical and mental state that offers peace to themselves, as well as to their families. 

The passing of the Maryland End of Life Act through the House of Delegates generated a great deal of criticism over the past weeks. Viewing them as a “slippery slope,” those in opposition of laws believe they are likely to erode our society. Misinformed about of how physician-assisted-dying functions, many are unaware that there are safeguards which protect from abuse.

What it is

Maryland’s Richard E. Israel and Roger “Pip” Moyer End-of-Life Option Act allowed residents 18 years or older and diagnosed with a terminal illness to request aid-in-dying medication from a physician. Seeking this end of life option would have required residents to ask their physician on three separate occasions (once in writing and witnessed by two other individuals) to prescribe a lethal dose of medicine that would end their lives peacefully, in a place and time of the patient’s choosing.

What it isn’t

End-of-life acts are not euthanasia. While a physician must perform a mental health assessment, as well as provide a prescription, they do not administer any medication. To comply with the act, the patient requesting the prescription must ingest the medication themselves and often does so surrounded by family and under the guidance of an end-of-life counselor.

Why the conversation matters

This is the fourth time an attempt to bring physician-assisted dying to Maryland has been defeated, but many still hold hope. As Del. Shane Pendergrass said, “Every person is one bad death away from supporting the bill.” For me, that death was Mark’s.  Currently awaiting the expected signature of Governor Murphy, New Jersey recently passed their own version of death with dignity, a fact which I applaud.

I understand the uncomfortable nature of discussing the end of life. Often, our unwillingness to explore this sensitive topic has much to do with our own relationship to death and the loneliness that goes along with it. Allowing the terminally ill to leave this earth gracefully and with dignity is not selfish. We owe it to each other, to the ones we love, to exhaust every option in pursuit of a peaceful and comfortable end. We owe it to each other to keep the conversation going.

*Name has been changed

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Briana Franco ’19 is an editorial intern for UMBC Magazine. These are her opinions.

Header image courtesy of Arvin Chingcuangco on Unsplash.

Video courtesy of Capital News Service.

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