(The author is retired, lives in Brandon, Mississippi, and has degrees in science, social work, and theology. – Jay Niver, editor)
C&C, DWD, FEN, WFRTDS.
Those are the initials of the following four national or international organizations totally unknown to me until recently: Compassion & Choices, Death with Dignity, Final Exit Network, and World Federation of Right to Die Societies. Their purpose is to help guide us and secure choices as we near life’s end, so we and our loved ones do not have to needlessly suffer when death is imminent.
There are currently 10 states and the District of Columbia where Medical Aid in Dying (MAiD) legally offers an end-of-life option to terminally ill adults of sound mind. Unfortunately, there are 40 states, including Mississippi, where there is no such choice.
Before we consider those organizations, we should squarely, maturely look life and death in the face. There are two inarguable facts: We were all born and we shall all die; everyone, soon or late, regardless! Some of us will become octogenarians and pass peacefully in our sleep; some will die at a younger age, and some later. But die we shall, so why not plan for our deaths beyond simply going to a funeral home and purchasing a burial policy?
Especially, as we grow older, shouldn’t we plan for the unpleasant possibility that we might slumber fitfully for weeks, months, even years – totally unaware of our existence while our loved ones and others must care for us and clean up the mess? Why not recognize that possibility and ensure it doesn’t happen?
Almost everyone, at some time, has owned (or been owned by) a beloved pet, be it a cat, dog, horse, etc. And most of us, upon that pet’s impending departure because of injury, illness, or old age have relied on our veterinarian to end its suffering and ours.
That invaluable service is legally available in all 50 states. But in the greater part of America, we cannot legally do for ourselves what we can do for our pets, were we also at the end of our lives.
A recent survey by LifeWay Research found that 67% of Americans responded positively to the following question: “When persons are facing a painful, terminal disease, is it morally acceptable for them to ask for a physician’s aid in taking their own life?”
The following is an assumption on my part, but I think it is both rational and justified. Upon reflection, it seems to me that I seldom hear of a doctor or veterinarian – or, come to think of it, any member of a medical family – who died a prolonged death. I am usually surprised to learn of that person’s sudden passing, and I inevitably respond that I didn’t even know he or she was seriously ill.
If you or I were a trained EMT, nurse, physician, or veterinarian with the knowledge of and access to the necessary equipment and medicines that end life, and if we or our loved one were suffering while facing an inevitable death, wouldn’t we make the passing shorter and less painful, regardless of laws to the contrary?
During medical treatment, there may be a time when we become aware that the terminal nature of the illness is inevitable. To continue to artificially keep a terminally ill person alive, against his or her will, violates the Hippocratic Oath to first “do no harm.” That usually increases the physical, emotional, and financial suffering of that individual, and probably all who are closely related or involved.
Is that the most loving, most moral thing to do?
Humans are living longer. The average American lifespan for women is now 81 years, and it is 76 for men. Heart problems cause 23% of all deaths, cancer comes in second at 21%, and suicides have just fallen out of the top 10, now less than 2%.
Sixty percent of all firearms-related deaths in the United States are suicides. In most of those cases, the firearm was a good and faithful servant doing the bidding of its master. But the result is violent and disturbing for first-responders and certainly for that person’s relatives and friends. It also gives the gun an undeservedly bad reputation.
Following is a very personal anecdote to illustrate that point:
At Mississippi State in 1960, one of my good friends and a fellow student was also a pilot who had made a few parachute jumps, so he and I went to Camps Airport north of campus where he took me up on my first airplane ride and let me jump. Over the years, he accumulated more than 1,000 jumps.
A year ago he died, and I went to his funeral. Neither reading nor hearing the cause of death, I asked his son, who privately told me that his dad knew he had dementia, so he shot himself in the head with his .357 Magnum to keep from becoming an emotional and financial burden on his family.
There should be a more graceful transition method, and there is. The trick is to make it legal and available.
If you research the four organizations I introduced earlier, you will become aware of additional terms relevant to the right-to-die discussion, such as PAD (Physician Assisted Death); VSED (Voluntarily Stopping Eating and Drinking); Advance Directives; Healthcare Power of Attorney; surrogate, and MAiD.
For additional information, Google to find if your state has an active right-to-die organization, or contact:
Well done, Clyde! Sorry about your friend and sad he did not know about the Final Exit Network, their Exit Guide program, and SADD, their dementia addendum. You are right about medical people having access to drugs to end their suffering; it happens more than we know. FEN offers viable options for suffering people. Very few people qualify for MAID even where its available.
Many thanks, Clyde, for sharing your perspective and recommendations. Given that you have seen and faced death on the battleground and the fact that you live in a very conservative community, make your blog post especially noteworthy. I appreciate your service to our nation and your courage in speaking out on what is likely to be a controversial topic to your friends and neighbors.
Thanks to Clyde Morgan for his well-reasoned post. I have only one suggestion to make, though his comment was more of an aside than a substantive point. He writes, “. . .why not plan for our deaths beyond simply going to a funeral home and purchasing a burial policy?” As a consumer activist regarding the funeral industry for thirty years, I have found only very limited circumstances when paying in advance for a funeral or cremation is a wise consumer choice. If there is someone to take care of your arrangements, it is seldom useful to give the funeral industry your money years in advance. Contrary to the false assertions of that industry, I have identified 21 goods or services that cannot be included in prepaid funeral plans. Some of those goods and services may be needed; others not. And prices often go up and usually are not guaranteed. Putting your money in a Pay on Death account to pay for your final arrangements works for many people who want to be sure that expense is paid for.
Firstly, thank you for your service, and thanks for writing this. We are going through this with my 88 year old mother and it is heartbreaking. Something has to change.
What are the goods and services that cannot be prepaid? I prepaid everything for my late husband’s funeral except for opening/closing the gravesite, a floral arrangement, refreshments for the visitation at our church, a luncheon for close family and friends after the burial, and a headstone (five items). Out of a total of around $20K, I only had to pay about $2600. Most of that $2700 was for opening and closing his grave. The remainder included extra charges for obituaries (I wrote more than what was budgeted), a larger musician honorarium than was budgeted (found out after the fact that what I was told was a usual honorarium was too low).
Prepaid funeral contracts use either an insurance-funding mechanism or a prescribed percentage of the money paid is put in a trust fund and held in that fund until death occurs, when the funeral service can access it to carry out a person’s wishes.
The following items cannot be included in the contracts for two reasons:
1. They cannot be anticipated in advance of need, or
2. They are purchased from third party vendors or others whose prices for the items cannot be known since the date of the consumer’s death is not known at the time the preneed contract is purchased.
Here is the list that I began to put together in 1998. Not all items will pertain to any one body disposition, but it will not be known until one’s death whether any apply, though direct cremation or immediate burial avoid most of these potential extra costs:
1. Charges for extra embalming procedures made necessary because of an autopsy
2. Extra embalming charges made by the funeral home after organ or tissue donation
3. Costs of restoration after disfiguring deaths
4. Special cosmetic procedures needed because of the condition of the body
5. Extra refrigeration costs when there are delays
6. Expenses of an outside funeral director when death occurs away from home
7. Receiving remains from another funeral that first picked up the body
Items Purchased From Third-party Vendors and Others:
8. Opening and closing the grave
9. Police escorts
10. Obituary publication costs
11. Crematory fees
12. Floral arrangements for the casket
13. Clergy honoraria
14. Costs of an outside facility for the service
15. Cemetery charges for setup of chairs and awning
16. Government-required permits
17. Vault installation at the cemetery or mausoleum
18. Charges for an interment service at a columbarium
19. Charges for extra certified copies of the death certificate
20. Charges for music and/or for musicians
21. Beautician charges
I think the key to pre-paid services is whether you cremate. When living in British Columbia, we used a flat-rate, pre-paid arrangement for my mother-in-law. The man who owned the company came personally to meet with us in our home to discuss everything. He seemed very sincere and caring. We picked the cheapest bamboo urn for Granny’s ashes; her body was picked up at the nursing home; and he handled required paperwork with the province.
I can’t recall a single surprise, and no cost beyond what we paid in advance. It worked so well, my wife insisted on using the same outfit for her death, which we did. The only other cost (in both cases) was for space in the columbarium where mother’s and daughter’s ashes are now interred. That, too, was paid up front.
I’m 75 and want to be able to chose myself, when I’m ready to go either from terminal illness or simply having had a good life and feeling the time is up and I’m ready to leave..like leaving a good party, but you’re just ready to go home.
But since this is not allowed in the US except in those few states and under strict terminal circumstances, it leaves this to the individual to handle in private. Not everyone can afford to fly to Switzerland for assistance…if only.
So that is why suicide becomes the go to solution here. It’s terrible that it is this way and I blame religious overreach, money the nursing homes and hospitals make from keeping you alive, and our culture looking at death as a horror, instead of a natural process that is in everything.