At 2 AM on March 15, 1988, I received a phone call from my mother in Winter Park, Florida, telling me that my father, who was dying of prostate cancer, had taken a pistol from his bedside table and shot himself, preferring to die instantly from the bullet instead of slowly from cancer. He had undergone a series of treatments over several years that held the disease at bay, but now there were no more treatments to be had, and he was rapidly becoming incapacitated. A man of almost obsessive independence, he was unwilling to become helpless and die by inches. Since then, I’ve often thought about the loneliness of his last few moments as he mustered the courage to shoot himself. My mother was sleeping in the next room, and I also think of her shock upon finding his body.
Twenty-three years after my father’s death, Lee Johnson, a man similar to my father in many ways, ended his life quite differently. He was also dying of cancer, but as a resident of Oregon, he used that state’s Death with Dignity law to obtain from his doctor a prescription for an overdose of barbiturates that he could keep on hand and use to hasten his death if he chose. When he decided the time had come, his daughter, Heather Clish, who lives in Massachusetts, joined her mother and sisters at her father’s bedside. Lee Johnson died while holding his wife in his arms, with his family around him.
This form of physician-assisted dying, often called physician-assisted suicide, has been legal in Oregon for fifteen years and in Washington for four years, as a result of voter referendums. As I described in a recent essay in these pages,* the law permits doctors to honor the requests of terminally ill patients whose life expectancy is less than six months for medication to end their lives at a time and under circumstances of their own choosing.
Over the years, the Oregon law has been used sparingly, accounting for at most 0.2 percent of deaths in any year, and it is overwhelmingly supported by the public. More than 80 percent of patients who have died in this manner were suffering from disseminated cancer; most of the others had either late amyotrophic lateral sclerosis (“Lou Gehrig’s disease”) or end-stage emphysema. Nearly all received hospice care (as did my father)—Oregon’s is now among the best in the country—but found it was not enough. As reported by their doctors to the Oregon Public Health Division, their suffering stemmed not so much from pain as from the loss of autonomy. (The experience in the state of Washington, although shorter, is much the same.)
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