We have the power to reimagine how we die and how we mourn

— We live queer lives—and we can die queer deaths too

By Zena Sharman

At the funeral for Jamie Lee Hamilton, a trans Two-Spirit and Métis Cree activist and sex worker advocate, her community sang and danced to “Respect” and “Sisters Are Doing It for Themselves” during the church service and ate cupcakes decorated with rainbows and red umbrellas. When disabled queer Korean activist and organizer Stacey Park Milbern died, her community organized and livestreamed a 150-car caravan in Oakland and shared tributes under the hashtag #StaceyTaughtUs. Shatzi Weisberger, a Jewish dyke, death educator and activist known to many as the People’s Bubbie, died in 2022 at age 92. She got a head start on her funeral four years earlier by hosting her own FUN-eral, a death-themed party where her friends decorated a biodegradable coffin with glitter and got temporary tattoos while being serenaded by the Brooklyn Women’s Chorus.

What would you picture if I invited you to imagine your own gloriously queer funeral? Maybe it wouldn’t be a funeral at all, but a celebration of life, or a drag show, a brunch, a protest or a rave. Maybe it would be all of these things and more. Would there be sequins and glitter? Dapper suits and splendid hats? Leather and denim? Cozy onesies? No clothes at all? My ideal scenario is a cross between a potluck, a magic ritual and a dance party; I like to imagine my beloved people dressed in whatever they feel most comfortable in. I hope they sing, dance, eat, laugh and cry together, resplendent in their many expressions of queerness as they gather in remembrance and celebration.

Instead of a single event, you might want several gatherings reflecting different facets of your life: a religious service by day, followed by a raucous night at a dungeon, or an intimate ceremony for only your polycule, before a larger memorial open to all of the people who knew and loved you. For some, it might feel good for your chosen and families of origin to mourn together; for others, it will be important to create protected spaces that intentionally keep out your estranged parents or your transphobic aunt. You might choose rituals, traditions or ceremonies that are part of your cultural, spiritual or ancestral practices, or want something completely secular. Maybe you’ll want a virtual memorial so your friends and loved ones from all over can remember you together, or invite people to mourn you privately in whatever ways feel right to them. What we imagine can be as unique as we are.

Our wildest imaginings likely differ from stereotypical depictions of funerals as formal, sombre events where black-clad mourners stand sadly around a heavy wooden coffin. Queerness offers us ways of perceiving and being in the world around us while making and remaking it through a distinctly queer lens. While the conditions of LGBTQ2S+ people’s lives often push us into unwanted proximity with death, we have the power to reimagine how we die and how we mourn. This includes active resistance to the violence and oppression that cuts short too many LGBTQ2S+ people’s lives and an invitation to subvert the beliefs and practices getting in the way of dying queerly, on our own terms. When we queer death, dying and mourning, they become sites of creativity, self-determination, collective care and resisting oppression, creating opportunities to challenge dominant ideas, practices and narratives that limit our ability to express who we are at every stage of our lives, including when we die.

As a death doula and self-identified death nerd, I talk about death a lot, and I’ve noticed that people tend to have one of two instinctive reactions when I bring it up: they recoil, regarding me strangely—or they lean in, wanting to know more. These leaning-in moments feel intimate to me. They often come with stories about a beloved person who died, questions about grief and death and the kinship of knowing it’s safe to talk about something that can feel unsayable. I’ve had these tender exchanges with friends, co-workers and strangers, which shows me how hungry many of us are for spaces where we can talk openly about death. There’s something about these interactions that feels inherently queer to me: holding space for each other while we share a raw or vulnerable truth, or reveal parts of ourselves that we’ve learned to keep hidden away.

Many of us have internalized a tendency to avoid talking about death, an instinct that can be accompanied by feelings of fear, anxiety or denial. When we do think about it, we may keep our thoughts to ourselves because we don’t feel ready to start a conversation about death with the people around us, or because we’ve consistently received messages that talking candidly about death or grief is risky or off-limits. For some of us—especially racialized, Mad and disabled people—talking openly about death or freely expressing grief can lead to pathologization or criminalization.

It can feel overwhelming to confront our mortality or that of the people we love, and many of us haven’t been taught the basics of what the dying process looks like, or what to do when someone dies. Before my oldest child was born, we went to a prenatal class to learn what happens during and after a birth. I wish I’d had a similar opportunity to learn about death a decade ago when I was caring for my mom at the end of her life. “We’re hungry to understand our own death and our own mortality and the death that surrounds us all the time, in a more real way,” Santa Fe, New Mexico-based death educator and host of the Death Curious podcast, Alexandra “Aries” Jo, tells me. They attribute this hunger to the stripping away of death from our everyday, mundane lives.

It hasn’t always been this way. It used to be more common in North America to experience death as a collective, community event. Deaths were more likely to happen at home, where family and community members—often women—cared for their own dead. Some communities have kept these traditions alive as part of their faith or cultural practices, and a growing number of people are accessing home hospice care. But for many of us, the past century has brought with it the increasing medicalization and professionalization of death and death care, transforming it into something that happens behind closed doors in settings such as hospitals or funeral homes. As a result, historian Katherine Arnup explains in a Vanier Institute report on death and dying in Canada, the experience of death has become “very foreign and frightening” for many people.

Yet it feels like an oversimplification to speak about death avoidance or the place of death in our everyday lives without acknowledging that many people and communities live and die in contexts saturated with death and grief, experiences that are tied to systemic oppression. “Loss is a part of life. Bereavement is natural. Grief is natural,” Oakland, California-based author and media justice activist Malkia Devich-Cyril tells me, “but mechanized loss, racialized loss, loss that comes as a result of inequality—that’s not natural. It is unnatural and it is the direct result of groups of people [in power] refusing to lose.” Devich-Cyril, author of a forthcoming book on Black grief and radical loss, points to how these forms of loss produce “an undue burden on those of us who have less power in the world. Grief becomes not only a consequence of disadvantage, but a cause of disadvantage and of disproportionate experiences of grief.”

Stefanie Lyn Kaufman-Mthimkhulu, a Providence, Rhode Island-based disability justice educator and organizer, challenges the idea that the COVID-19 pandemic prompted many people to confront death for the first time. When faced with this sentiment, Kaufman-Mthimkhulu tells me, “So many disabled folks I’m in community with are like, ‘Okay yeah, maybe for you, but not for us.’” Kaufman-Mthimkhulu’s own relationship with death and dying is shaped by being a younger disabled person who has experienced shifts in their body’s capacity and access needs while grappling with medical ableism. It’s also been influenced by their experiences of navigating chronic suicidality. When reckoning with their own mortality, Kaufman-Mthimkhulu draws on the “lessons in impermanence” that come with the “dynamics of living and dying on crip time.”

While I’ve read lots of books and taken several courses to learn more about death, dying and grief, the first people to teach me important lessons about collective care for dying people and how to come together in mourning were leatherdykes a generation older than me who’d lived through the AIDS crisis. It was they who showed me how to organize end-of-life care outside of inadequate and inaccessible state-run systems. They showed me it was possible to stop traffic to sing our beloved dead through the street into their memorial celebration. In these ways, they were part of a lineage of LGBTQ2S+ people who cared for their own dying and dead community members as part of a wider response to the state abandonment and systemic discrimination characteristic of the AIDS crisis in the 1980s and 1990s. Our lineages include experiences of immense loss and collective grief and trauma; they also include organized resistance, collective care and a refusal to abandon each other during and after death.

Today, in my own circles as a queer person, more than one friend has expressed surprise to me at having lived into their thirties or forties, ages they were convinced they’d never live to see. With waves of anti-trans legislation and fascist violence currently sweeping North America, many trans people are fearful of increased violence and risk of harm, prompting some to hold protest signs with the message: “The trans agenda is an average life expectancy.” While supportive of the larger death positive movement, Los Angeles, California-based end-of-life doula, writer and educator Vanessa Carlisle, who is queer and non-binary, tells me they prefer to think of themself as “death accepting” because “I don’t need to be death positive about how much death is happening in my community.” Carlisle, who has deep roots in LGBTQ2S+ and sex worker communities, emphasizes their commitment to fighting for community survival as part of their work in end-of-life care. They want the communities they’re part of “to survive and be happy and well in a world that seems hell bent on destroying us.”

Sarah Chavez, the Los Angeles, California-based executive director of the death education and advocacy non-profit The Order of the Good Death and a founding member of The Collective for Radical Death Studies, affirms that this spirit of resistance and solidarity is integral to death positivity. Chavez, who co-founded the modern death positive movement in 2011, tells me that death positivity is fundamentally “about engaging and talking about death in an honest and open way, without shame.” She emphasizes that we cannot do this “without engaging with the systems and conditions that lead to unacceptable or bad deaths that result from violence, a lack of care, and all forms of systemic oppression.” 

“Queering death is also an opportunity to challenge narrow and limiting understandings of what constitutes a good death.”

How we die is intimately interwoven with how we live, Chavez points out, and “the exact same experiences and barriers that individuals encounter in life typically follow them right into death,” shaping our end-of-life experiences and what happens to our bodies after we die. She cites the example of the added stressors a dying person who is undocumented and their loved ones might face at end of life, like fear of deportation, family separation, language barriers, lack of access to cultural practices and the added costs associated with repatriation of someone’s body to their home or ancestral country. These barriers are systemic: a third of U.S. hospice programs limit access or outright refuse to care for undocumented people at end of life. This is why, for me, queering death demands the transformation of our health and end-of-life care systems and is wholly aligned with an abolitionist politic that includes border abolition.

Queering death is also an opportunity to challenge narrow and limiting understandings of what constitutes a good death. As researchers Cindy L. Cain and Sara McLesky write in an academic article on expanding definitions of the “good death,” qualities often associated with a “good” death—like not being a burden to others or mending familial relationships—“de-individualize the experience of death and disregard diversity within definitions of what is good.” These mainstream understandings, which shape the design of everything from our end-of-life care systems to the laws and policies governing death and dying to the training of hospice and palliative care providers, prioritize “a vision of dying that may not be achievable” or desirable to all patients and function as “a form of social control that seeks to discipline patients and their family members.”

An example of this is the ableism often inherent in stereotypical ideas of a good death. Kaufman-Mthimkhulu tells me they’ve often heard people describe a good death as “someone who’s died silently in their sleep at night, who’s a burden on no one and nothing.” They connect this to the “tremendous amount of fear” many of us internalize about “losing capacity, becoming more interdependent or more reliant on other people, or entering into new kinds of relationship dynamics where power might be shifting.” This is a very real fear for the disabled Canadians being systemically denied the supports they need to live while the government expands their access to medical aid in dying. At the same time, the ability to maintain our independence shouldn’t be the foundation on which we build our ideas of a good death. As in all facets of our lives, death is an opportunity to embrace interdependence as a foundational principle of disability justice. That’s why Kaufman-Mthimkhulu’s idea of a good death is “somebody who is able to move through the process of dying in a way that adheres to their values and beliefs and is met with compassionate, competent, self-determined care.”

In a blog post on what the death positive movement isn’t, Caitlin Doughty, the mortician and advocate who founded The Order of the Good Death, writes that it’s imperative to support communities to define “what a ‘good death’ means to them” and to work alongside each other to dismantle the barriers that get in the way of such deaths. When I think of how I might define what a good death means to me, I’m reminded of the consent practices I’ve learned from being part of sex-positive queer communities for the past twenty years. What feels good in the context of my embodied experiences, my identities, my relationships and my history might not feel good to you, and vice versa. When I contemplate this more broadly in relation to queering death and dying, I return to the themes of creativity, self-determination, collective care and resisting oppression.

To me, queering death is part of a larger liberatory project encompassing our efforts to fight for the survival and thriving of all communities experiencing systemic oppression. As a longtime LGBTQ2S+ health advocate, the more I look at death, the more I think about how we live our lives, what enables our individual and collective flourishing, and what gets in the way, at every stage of our lives. Queering death is about when, where and how we die, the care, support and options we have access to during this process, and what happens to us and our loved ones after our deaths. It’s also about actively working for a world where all LGBTQ2S+ people—especially those who experience the most significant and harmful impacts of systemic oppression, like people who are trans, racialized, Indigenous, disabled, Mad, poor, incarcerated, unhoused and/or undocumented—have what they need to live long, full, joyful lives free from violence and harm. Queering death is not about hastening the inevitable; it’s about fighting for us all to live and die in ways that respect, honour and celebrate every aspect of who we are.

Complete Article HERE!

Former Archbishop of Canterbury advocates for assisted suicide law

George Carey, the former Archbishop of Canterbury, leads a ceremony of prayer in the Crypt Chapel at his official residence in central London on Oct. 5, 2001.

By Anugrah Kumar

Lord George Carey, former Archbishop of Canterbury, has challenged the official stance of the Church of England on assisted suicide, urging the British government to set aside time for debate on the law governing assisted dying. A Christian group is warning that it would be “a very dangerous thing” to do, however.

Carey, who served as archbishop from 1991 to 2002, framed this issue as being “profoundly Christian,” asserting that it’s crucial to prevent individuals from suffering against their will, The Telegraph reported Monday.

The former archbishop diverged significantly from the position of the Anglican Church, ignoring its warnings that such legislation could pressurize vulnerable individuals, particularly among the half-million elderly people mistreated annually, to end their lives prematurely.

The Church of England has also cautioned that nations that have legalized assisted dying have experienced a “slippery slope,” with the process becoming progressively easier over time.

Carey has been calling for assisted dying since 2014, when he lent his support to a bill introduced in the House of Lords by Labour’s Lord Falconer. Although the bill did not pass, the issue has resurfaced as lawmakers on the health select committee are reconsidering assisted suicide and euthanasia.

The proposal includes an evaluation of safeguards needed to prevent coercion and the requirements for an individual to consent to the termination of their life.

In his submission to the inquiry, Carey emphasized his belief that one of the many Christian values is to ensure no one endures suffering against their will. He stressed that assisted dying should only be an option for those expressing a clear, persistent wish for it and suggested it was an “act of great generosity, kindness and human love” to aid those wanting to end their suffering.

Carey also contended there is a need for laws reflecting the “compassionate society” we live in, encouraging the government to gather evidence from a variety of sources and ensure an appropriate debate to facilitate law change.

He pointed to evidence from Oregon, California, Australia and New Zealand, asserting that laws allowing choice over the manner of death, with adequate safeguards, can be enacted successfully.

However, the CofE’s submission contradicts his perspective, noting that evidence from the same regions indicated a “slippery slope in operation.” It contended that no systems could effectively rule out coercion in such scenarios.

The CofE has raised concerns over “improper psychiatric testing” in places like Oregon and the prevalence of “doctor shopping,” with patients looking for medical professionals willing to administer lethal drugs. It further warned about challenges to the original law, expanding the definition of assisted dying to include those with non-terminal but “grievous and irremediable” medical conditions.

In an op-ed, Christian Concern Communications Manager, Paul Huxley, reinforced the CofE’s position, asserting that legalizing assisted suicide would be “dangerous, unnecessary and wrong.”

He cited evidence from other jurisdictions where vulnerable people felt pressured into ending their lives prematurely, and highlighted the Christian perspective that views death as an enemy and noted that suffering is an opportunity to strengthen one’s faith in God.

“It would be a very dangerous thing to do. … Assisted suicide changes the way doctors think about how they care for people. They think, ‘oh well, we can offer you euthanasia’ rather than thinking about how can we look after this person…,” Huxley wrote. “I think it’s a very concerning message that we are sending to people.”

He pointed out that “the most dominant symbol of Christianity is the cross – a man dying,” and, therefore, “life and death are put right at the center of the Christian message (the Gospel) as Jesus died for our sins and was raised for our justification.”

Complete Article HERE!

What is medical aid in dying, when is it done and is it legal?

— Here’s an update on the end-of-life debate.

A 2020 Gallup poll showed 74% of Americans surveyed said doctors should be allowed to end the life of a patient with an incurable disease “by some painless means” if the patient and the patient’s family requests.

More states and countries are enacting laws to let terminally ill patients in great pain decide when to die

By Donna Apidone

In January, just a few days after the start of 2023, a woman walked into the Daytona Beach, Florida, hospital where her terminally ill husband was a patient and shot him. She said she intended to kill herself as well, but hospital staff stopped her before she could carry out the second part of her plan.

Ellen Gilland told police the shooting was by mutual consent, that she and her husband agreed that it was the best way for them to handle his decline in health. He was too weak to take his own life.

Only 10 states and the District of Columbia have laws that allow medical assistance in dying by making a lethal dose of medication available to adult patients who request one. The practice also is legal in Montana because of a court ruling.

Medically assisted deaths are illegal in all other states and U.S. territories, including Florida. No jurisdiction permits the use of firearms to end a human life.

Words matter

Medical aid in dying is not euthanasia. The latter term includes the act of one person killing another who is terminally ill or hopelessly injured and suffering great pain. Euthanasia is illegal throughout the United States. However, if the person who is dying self-administers, the act is not considered euthanasia.

In the U.S., terminology has evolved. The current acceptable wording is “medical aid in dying” or “medical assistance in dying” indicating that a medical professional will make a lethal dose of one or more drugs available to the patient but leave it to the patient to decide whether to take it. The terms are abbreviated as MAID.

The word “suicide” is not accurate, although is it sometimes incorrectly applied. Death certificates state a patient’s underlying illness as cause of death.

Although 22% of Americans have access to medical aid in dying, fewer than 1% of people in the 10 states and Washington, D.C., where this option is legal actually obtain the medication, and only two-thirds of them ultimately decide to take it, according to Compassion and Choices, a nonprofit group that advocates for end-of-life options including, but not limited to, medical aid in dying.

Where it is legal in the U.S.

In addition to reaching a consensus on the language describing medical aid in dying, the 11 jurisdictions that authorize the practice are consistent in their intent, said Kim Callinan, president and CEO of Compassion and Choices.

“Most of the laws across the states are very similar,” she said. “The eligibility criteria are the same. And the safeguards are the same.”

Geoff Sugerman, who served as campaign manager for Oregon’s Death with Dignity law, which was enacted in 2012, and works closely with the national organization called Death with Dignity, laid out the four cornerstones of the laws in in the 11 jurisdictions:

  • Patients must be adults with a terminal illness and a prognosis of six months or less to live.
  • Attending physicians must verify patients are acting voluntarily.
  • Patients must be able to make and communicate their decision to healthcare providers.
  • Patients must be able to self-administer (ingest) the medication.

Differences among laws

There are some differences in the laws. Where it is legal, a common waiting period for approval of medical assistance in dying is 15 days. Hawaii mandates 20 days. New Mexico and Oregon are less than 15 days. In California, a 2022 adjustment to the law reduced the time from 15 days to 48 hours.

Most medically assisted deaths are limited to residents of states that have legalized the procedure. However, the Vermont legislature in April passed a bill that would eliminate the residency requirement; Gov. Phil Scott has said he would sign it into law. Meanwhile, Oregon officials have said the state will not prosecute nonresident cases.

The number of states considering medically assisted death continues to grow. Minnesota and Florida have bills in their legislatures.

From the archives (June 2019): How ‘death with dignity’ laws allow terminally ill patients to take back control — sometimes at a price

Fine-tuning legislation

While some states debate new MAID laws, others are weighing changes to existing laws. As public opinion adjusts and data is collected, legislators in several states are considering amendments. Some details in the original laws may have “served as barriers to the patient,” Sugerman explained.

Changes to legislation may include the length of the waiting period and expanding the definition of “medical professional” to include Physician Assistants and Nurse Practitioners. Some states may remove their residency requirements so that patients can travel from other jurisdictions for the process.

Details and updates about state legislation are available through Compassion and Choices and Death with Dignity.

Healthcare systems

A patient’s first consideration of medical aid in dying may come in a conversation with a primary care physician or specialist when treatment options have been exhausted.

Dr. Nathan Fairman is a physician with UC Davis Health in California. He was selected to provide medical information to the state’s legislators as they prepared wording for the End of Life Option Act, enacted in 2015. Fairman explained how the process might go in his health system.

A UC Davis Health patient sees a primary care physician until a diagnosis necessitates care from a specialist. If treatment of a disease or condition is no longer beneficial, the specialist is likely to discuss end-of-life options with the patient.

Depending on the illness, medical aid in dying may be one of several options. Others may include palliative care and cessation of eating and drinking. Each option comes with its own set of considerations.

The patient makes the choice. A team is put in place to help the patient and doctors through the qualification process. “We employ navigators,” Fairman explained. These are two trained professionals who “make sure the patient has gone through all of the required steps — and there are a lot of them” — to qualify for medical aid in dying, if that is the choice.

“We were intentional about having a clinical social worker in this role,” he said. “It requires a high degree of advocacy and health system literacy. You need to have someone who is jumping through those hoops.”

Doctors may opt out

Doctors may disagree with the state law or their system’s policy. Professionals are not required to participate in aid in dying. Depending on personal beliefs, a doctor may refer a patient to a colleague in the same system.

In California, although referrals are allowed, they are not guaranteed. In the region served by UC Davis Health, most of the major health systems have policies for the process. The exception is Dignity Health, a Catholic healthcare system. A patient may have to change health systems to have access to aid in dying.

On the other side of the country, Providence St. Joseph Health is a Catholic healthcare system serving residents of Maine and Vermont, two states that have legalized medical aid in dying. The healthcare system has published its end-of-life policy. “PSJH considers intentionally hastening death to fall outside the scope of legitimate medical practice,” according to the document.

The PSJH policy acknowledges its patients may request a service it will not provide. “Providers and caregivers must not actively obstruct eligible patients from discussing, exploring or pursuing legal avenues to hastening death. Within the context of a therapeutic relationship, providers and caregivers should discuss with the patient why they may be inquiring about hastened death and what unmet needs there may be.”

Final exit network

A nonmedical end-of-life option is available through the Final Exit Network (FEN), a nonprofit organization based in Tallahassee, Florida, with about 20 “exit guides” who volunteer in all 50 states.

Wendell Stephenson lives in California and is a member of FEN’s board of directors. He said the organization is “devoted to providing information to people about how they can end their lives in a peaceful manner.”

FEN volunteers may be present at a death, but that is not required. Because physicians are not a part of the Final Exit Network process, medications are not used. Instead, FEN volunteers suggest using an inert gas and explain how to obtain and use it. Family members also receive guidance on observing the process but not helping, to avoid criminal charges.

Do patients measure up?

FEN has a medical evaluation committee consider applications from patients seeking to end their lives. The committee (composed of MDs and others with medical and mental health backgrounds) review applicants’ medical records with a couple of key considerations.

One of FEN’s rules is that applicants have conditions that “cannot be cured,” Stephenson said. They must have an intractable medical condition that seriously impairs quality of life. Most of these can be expected to shorten the applicant’s life, but death does not have to be imminent.

Another requirement is that applicants be physically able to manipulate the equipment that delivers the gas, Stephenson explained.

FEN does not provide the inert gas or related equipment, nor does it publicly discuss the content of the information they provide. For details, they refer to “Final Exit,” one of the books written by the organization’s founder, Derek Humphry.

Supporters and opponents

The Pew Charitable Trusts, a nonprofit research organization, issued a report summarizing the viewpoints of several of the world’s major spiritual groups regarding medical aid in dying. The report, published in 2012, provides more perspective from each religion than a simple “yea” or “nay.” Many faiths do not approve of MAID, a few allow for it, none endorse it. Some acknowledge the request for reduction of lifesaving techniques at the end of life.

In a Gallup poll in 2020, 74% of the 1,028 Americans surveyed said doctors should be allowed to end the life of a patient with an incurable disease “by some painless means” if the patient and the patient’s family requests it.

Activists are often family members of patients who have died painful deaths.

The Catholic Church has called MAID “morally impermissible.” Some Christian medical associations have also spoken out against medical aid in dying. The National Hospital and Palliative Care Organization is opposed, as is the American Association of People with Disabilities.

Will insurers cover it?

Will insurance cover medical aid in dying? “Sometimes,” Fairman said. “Many private insurances will cover it. MediCal [California’s version of Medicaid] will cover it for the state portion. Any federal insurance will not cover it.”

The Compassion and Choices website reports, “Regardless of whether a state has authorized medical aid in dying, insurance providers cover treatments that are deemed effective and proven, and not those considered unnecessary, experimental or below the standard of care.”

Countries outside the U.S. allow different end-of-life options. Callinan, CEO of Compassion and Choices, warns against comparisons “because the healthcare systems, the political systems, the economic systems, the cultures are entirely different.”

Canada passed its MAID law in 2016, covering residents eligible for Canadian healthcare. It has been updated several times. By 2024, a decision will be made regarding the inclusion of mental illness as a criterion.

Outside the U.S.

While euthanasia — medically assisted death performed by someone other than the patient — is illegal throughout the U.S., it is allowed in some other countries.

End-of-life options vary around the world. The practice is legal in Belgium, Luxembourg, Netherlands, Switzerland, Austria and Spain. Some processes resemble medical aid in dying and others are closer to euthanasia, though at the request of the patient.

Several Swiss organizations offer medical aid in dying to nonresidents. The oldest and best known is Dignitas, which has been featured in BBC and PBS documentaries. In addition to a membership fee, a patient pays a considerable sum for the end-of-life procedure.

Medical aid in dying is legal in New Zealand. In Australia, five of the six states either allow medical aid in dying or will by the end of 2023. Colombia allows the practice, while Chile, Uruguay and Argentina have introduced bills to decriminalize the procedure.

Several other countries have laws that allow patients to decline treatment and/or nourishment that would sustain life, according to World Population Review.

Complete Article HERE!

The parting gift from my dying friend was an extraordinary act of selfless compassion

— In the hospital room I lost it. I stood there awkwardly with wet eyes. And then something incredible happened

We are raised to be stoic in the presence of the dying, when our instinct is the opposite.’


The word that our old friend was about to die travelled as quickly as a Mallee scrub fire. He’d been medically evacuated home from overseas a week or so earlier. He was now in hospital with his family about him, not very responsive and unable to talk.

“You should get there quickly. He might only have a day or two.”

There was disbelief and shock. I’d last seen him across a cafe table in Glebe three months earlier where he was characteristically ebullient. He enthused about his plans overseas for the years ahead, and spoke of his love for his children and grandchildren.

He gave me four boxes of antique books.

“I don’t need stuff where I’m going,’’ he said. He meant overseas. His words now seem unintentionally prescient.

The sadness I felt when I heard of his terminal decline was largely about his now unrealised – and cruelly thwarted – plans. Also, I just couldn’t – still can’t – foresee a world without this man, one of the bravest, most forthright, irreverent, passionate and generous people I’ve known.

Last year in this space I wrote about the importance – and occasional fickleness – of “mateship’’ and male friendship. I wrote how “two of my most important friendships have been with men who are both 20 years older than me’’.

“Both are intensely creative and passionate, have done amazing things while continuing, as their 80s approach, to live compelling lives that have been marked by courage and iconoclasm, sensitivity, tragedy, devastating loss, success, disappointment and, not least, a desire to do good. They’ve gently guided me and been there (each with a sixth sense, almost, that told them I was troubled) when life has cut up rough.’’

This was one of the men I had referred to. He’d long been around for me as a mentor – on how to be genuine, how to be true to your beliefs and art, and especially on how to learn to not give a damn about the critics and the knockers. He’d been there to counsel me through the grief associated with my parents’ deaths. He’s the type of bloke who texts when your team wins – or loses – big. Who always asks after – even offers to mind – your dogs.

When serious illness struck my family a few years ago, never a week passed without him checking in. Urging me to hope. For hope and optimism were always his propellants. Publicly at least.

And so I drove out of Sydney on one of those glorious, crisp autumn mornings under a crystalline sky of the gentle blue you might find on a bolt of shirt cotton in the tailor’s window. It was an air-punch morning. One on which to celebrate life. And I was driving to a regional hospital to say goodbye to a dear friend who, although 77, was Peter Pan incarnate to me and so many others. I was counselling myself as I drove to keep it together. For him. For how much do the dying fear what’s next and become even more afraid when their anguish is reflected in our eyes and responses? We are raised to be stoic in their presence, when our instinct is the opposite.

It was on a day like this, 25 years earlier, we’d first met over a long lunch in Sydney where I’d come, as a newspaper reporter, to write a profile about him. We’d been true mates ever since. Although I do wonder at the equality of our friendship; he always seemed more there for me than I for him. Yes, we talked often about the tragic death of his adult son. But I could offer him nothing, then, because I had never experienced any such loss. I could not reciprocate the hope he’d always urged in me. For it was already hopeless. I could only lend a caring, passive ear to his pain. I don’t know how he survived that. Testimony to an old soldier’s resilience, perhaps.

And in the hospital, now, there he was in bed, diminutive now for such a robust man and wearing the pallor of imminent death. His beautiful children were about him, the room brimming with love. His eyes and his smile sparkled as they always had. He grinned as we held hands. There was time alone. I thanked him for it all. And yes, I lost it. I could do nothing but stand there awkwardly, with wet eyes, when his kids re-entered the room. I felt like an intruder.

And then something extraordinary happened.

Helped by his son, he stood on unsteady legs upon a mobility device to visit the bathroom. I gave him a stoic two-handed thumbs-up. He smiled and gestured for me to come forward. As we hugged in silence he patted me on the back as if to sooth my earlier evident distress.

It was an extraordinary act of selfless compassion, a perpetual gift if you like, from a mate who had already imparted so much to me about life and humanity. He was making sure I was OK.

He died a week later.

Complete Article HERE!

Paul Simon Confronts Death, Profoundly, on ‘Seven Psalms’

— The 81-year-old songwriter ruminates on mortality, faith and meaning in an album that could be a farewell.

On a new album, Paul Simon is thinking about time, love, culture, family, music, eternity and God, striving to balance skepticism and something like faith.

By Jon Pareles

What do songwriters do when they feel death approaching? As time runs out, some choose to spend it by determinedly creating music to outlive them.

“Seven Psalms” sounds like a last testament from the 81-year-old Paul Simon. It’s an album akin to David Bowie’s “Blackstar” and Leonard Cohen’s “You Want It Darker,” which those songwriters made as mortality loomed; they each died days after the albums were released.

Their generation of singer-songwriters has dedicated itself to chronicling their entire lives, biographically and metaphorically, from youth through last words. “Blackstar” was turbulent and exploratory; “You Want It Darker” was stoically bleak. “Seven Psalms” stays true to Simon’s own instincts: observant, elliptical, perpetually questioning and quietly encompassing.

The album is constructed as a nearly unbroken 33-minute suite, nominally divided into seven songs that circle back to recurring refrains. It has places of lingering contemplation and it has sudden, startling changes; its informality is exactingly planned.

Simon begins the album in his most casual tone. Over calmly precise and rhythmically flexible guitar picking, he sings, “I’ve been thinking about the great migration.”

Almost immediately, it becomes clear that the migration is from life to death, a transition the singer is preparing to make himself. He’s thinking about time, love, culture, family, music, eternity and God, striving to balance skepticism and something like faith. “I have my reasons to doubt/A white light eases the pain,” Simon sings in “Your Forgiveness.” “Two billion heartbeats and out/Or does it all begin again?”

Simon’s songwriting has never been particularly religious. Over the years, he has drawn on gospel music for songs like “Bridge Over Troubled Water” and “Loves Me Like a Rock,” which bring religious imagery to secular relationships, and his 2011 album, “So Beautiful or So What,” had touches of Christian imagery — but also imagined “The Afterlife” as one last bureaucracy, where arrivals have to “Fill out a form first/And then you wait in a line.”

“Seven Psalms” is more humble and awe-struck. Its refrains return to, and work variations on, the album’s opening song, “The Lord.” As in the psalms of the Bible — which, as Simon notes in “Sacred Harp,” were songs — Simon portrays the Lord in sweeping ways: wondrous and terrifying, both protector and destroyer, sometimes benign and sometimes wrathful. The Lord, Simon sings, is “a meal for the poorest, a welcome door to the stranger.” Then he turns to naming 21st-century perils: “The Covid virus is the Lord/The Lord is the ocean rising.”

Much of the music sounds like solitary ruminations: Simon communing with his guitar, which has been the subtly virtuosic underpinning of most of his lifetime of songs. As his fingers sketch patterns, he latches onto melody phrases and then lets them go, teasing at pop structures but soon dissolving them. And around him, at any moment, sounds can float out of the background: additional supportive guitars, the eerie microtonal bell tones of Harry Partch’s cloud-chamber bowls, the jaunty huffing of a bass harmonica and, in the album’s final moments, the voice of his wife, Edie Brickell.

In the course of the album, Simon sings about personal distress and societal tensions. In “Love Is Like a Braid,” a song of gratitude and vulnerability, he sings, “I lived a life of pleasant sorrows until the real deal came/Broke me like a twig in a winter gale.” In “Trail of Volcanoes,” he juxtaposes youthful exploits with adult realities: “The pity is the damage that’s done/Leaves so little for amends”

Meanwhile, Simon’s tartly aphoristic side reappears in “My Professional Opinion,” a swipe at social media context collapse set to a country-blues shuffle. “All rise to the occasion/Or all sink into despair,” he sings. “In my professional opinion/We’re better off not going there.”

He ends the album — possibly his last — with a song called “Wait.” He protests, “My hand’s steady/My mind is still clear.” Brickell’s voice arrives to tell him, “Life is a meteor” and “Heaven is beautiful/It’s almost like home.” At the end, he harmonizes with her on one word, extended into five musical syllables: “Amen.” It sounds like he’s accepting the inevitable.

Complete Article HERE!

‘I have my life in my own hands’

— A filmmaker spent three years with Paralympian and triathlete Marieke Vervoort to explore her wish to die by euthanasia

By Amy Woodyatt

Throughout her storied career, triathlete and Paralympian Marieke Vervoort captured the imagination of her native Belgium and the wider world.

But it wasn’t just her stack of sporting achievements that drew attention.

Vervoort lived with a degenerative spinal and muscle condition and had long been vocal about how one day she wanted to – and would – end her life by euthanasia.

Euthanasia involves a physician administering a drug to end the life of a patient who is suffering, usually with a debilitating or life-limiting condition.

“Everyone is pushing me and asking me, ‘When are you going to die? Do you know already the date that you’re going to die?’” she told documentary maker Pola Rapaport, who last year directed the film “Addicted to Life” about Vervoort.

“I said, ‘F**k you.’ … You don’t know when you want to die. When the time comes, when I feel it’s enough, then I will decide.”

She was a Paralympic gold medalist at London 2012, winner of silver medals at Rio and holder of a European record for the T52 100 meters, but Vervoort’s condition caused her near-constant pain and made sleeping very difficult.

She received euthanasia approval in her native Belgium in 2008, but far from signaling the end of her life, Vervoort was very vocal about how the ability to control her own destiny empowered her to continue to compete at the highest level and make the most of her remaining days.

Documentary maker Rapaport, who encountered Vervoort’s story after reading a news report about her, says she was instantly captivated by the athlete and how the “paradoxical” permission to die “had given her a kind of liberation of spirit.”

“Her knowing that she could choose her date of dying and the conditions under which she would die, and whom she would have with her. … The fact that that had given her so much mental liberation and spiritual liberation, I thought, was a fantastic story,” Rapaport told CNN Sport.

Vervoort had been living with her illness, which caused paraplegia, since her teens, and as she got older, she became involved in wheelchair basketball, swimming and triathlons. By the time she applied for euthanasia, she had already considered and planned to die by suicide.

“I no longer have a fear of death,” she explained. “I see it as an operation, where you go to sleep and never wake up. For me, it’s something peaceful. I don’t want to suffer when I’m dying … When it becomes too much for me to handle then I have my life in my own hands.”

Rapaport added: “She told us on day one, ‘The time is not here for me to call my doctor and tell him that I want to go now. But when the bad days outweigh the good days, that’s when I will do it.’”

Ultimately, that moment ended up coming over a decade after she was granted the approval for the procedure.

A love for life

Vervoort won gold in the T52 100m wheelchair race and silver in the 200m race at the London 2012 Paralympics, then claimed two further medals at Rio 2016.

Apart from her athletic endeavors and achievements, Vervoort made sure to live to the fullest toward the end of her life, making time for wheelchair bungee jumps, Lamborghini racing with driver Niels Lagrange, trips abroad and time with her close friends.

Vervoort’s continued enthusiasm for living in spite of her suffering was the result of being granted the choice to do what she wanted with her life, Rapaport said.

“The most important central theme of the film is that when a person has control over their personal body, mind, spirit, that it gives them freedom to live. And in this case, having control over decision-making about the end of your life,” Rapaport explained.

“She had incredible highs and really amazing successes that still astonish me and I think astonished her fans and the Belgian public and the royal family. And she also had horrendous lows,” Rapaport said.

Vervoort was named a Grand Officer of the Order of the Crown by Belgium’s King Philippe, whom she met in a ceremony in 2013, along with Queen Mathilde.

By the end of her life, seizures and excruciating pain had become almost daily for Vervoort, which also understandably contributed to a decline in her athletic ability.

The day Rapaport and her husband, Wolfgang Held, who is also a filmmaker, met Vervoort, the athlete experienced a seizure, which at the time led them to believe she was dying in front of them.

“It was grueling to watch. It was very upsetting to watch when Marieke would go into the seizures, and over the three years that we shot with her on and off, it happened more and more frequently,” Rapaport added.

“I didn’t want it to be a film only about this marvelous Paralympic athlete who triumphs in the face of incredible odds. I really wanted the audience to get the sense of what this young woman goes through on a regular basis,” she explained.

An ongoing conversation

In 2019, after a small party with friends and family, Vervoort died through euthanasia at her home in Diest, Belgium, at the age of 40 – and although it has now been some four years since her passing, conversations around euthanasia are still as relevant now as they were then.

Although a few European countries including Belgium, Luxembourg, the Netherlands and, recently, Portugal allow euthanasia under certain conditions, euthanasia and assisted suicide are not legal in most countries, and assisting a suicide, or providing a means to die by suicide, is punishable with jail time in many places.

The Vatican condemned euthanasia in its strongest language yet in 2020, calling it an “act of homicide” that can never be justified.

Meanwhile, debates resurface in Belgium over patients who have died by euthanasia on the grounds of psychiatric reasons.

Last year, the European Court of Human Rights ruled that Belgium didn’t violate the rights of a person with depression when it accepted her decision to go ahead with a euthanasia procedure after her son, with support from Christian advocacy organization ADF International, mounted a court case that was highly publicized in the country.

In Belgium, 2,966 people died by euthanasia in 2022, comprising 2.5% of all deaths in the country that year, according to the country’s Federal Commission for the Control and Evaluation of Euthanasia.

Of euthanasia performed in 2022, nearly 90% of patients were over the age of 60, with almost 60% of the 2,966 who died having cancer, about 20% affected by multiple diseases and about 9% affected by nervous system diseases.

Rapaport told CNN Sport she wanted Vervoort’s experience – shown through shots of the athlete grimacing and crying out in pain, as well as footage of her seizures – to help people to understand why people would decide to die by euthanasia.

“It’s not an advocacy film. It doesn’t have any statistics. There’s no politicking in it. I felt that the more you can enter into this young woman’s experience, the more you will understand the arguments for assisted dying, no matter what country you’re in,” Rapaport added.

“Her story does expand the conversation, and you see what a person goes through and her case: how [the right to die as she wanted] improved her life immeasurably.

“That’s what I thought was so beautiful about her story, that this permission made her life so much better in the meantime, and it really allowed her to live to the maximum. And that was just unbelievably inspiring,” she added.

Rapaport hopes the film will keep conversations around death ongoing.

“It’s something generally people don’t want to talk about until they absolutely have to; even then, they don’t want to talk about it. But having control over that really can transform the rest of a person’s life and that is all we have.

“That’s all we have because we’re all going there,” Rapaport added. “It’s just a matter of when, how and how it will be handled.”

Who should have the ‘right to die’

What’s happening

Three decades ago, Dr. Jack Kevorkian became the face of the incredibly contentious debate over medically assisted death. Dubbed “Dr. Death” in the media, he claimed to have helped at least 130 patients die before being convicted of second-degree murder in 1998.

Kevorkian died in 2011, but the argument over whether it should be legal for doctors to aid people in ending their lives is still far from settled. Today, 10 states and Washington, D.C., allow medically assisted suicide — a process in which life-ending drugs are supplied to patients, who administer the dose themselves. The laws differ, but they generally state that individuals must have a terminal illness and a prognosis of less than six months to live to qualify. Only two states, Oregon and Vermont, allow medically assisted suicide for nonresidents.

While the U.S. is one of just a handful of countries to legalize what is often called medical assistance in dying (MAID), our laws are significantly more restrictive than those in some of our peer nations. For example, America is the only country to require a terminal diagnosis. All others allow people living with incurable illnesses that cause them “unbearable pain” to choose a medically administered death. Most permit both assisted suicide and euthanasia, in which doctors administer life-ending drugs directly. Several also permit MAID for people with severe mental illness and let individuals make “advance requests” in cases in which they’re expected to lose their capacity to make their own decisions in the future, such as from dementia.

Over the past few years, Canada has become the site of the highest number of medically assisted deaths in the world. There were more than 10,000 MAID cases in Canada in 2021. That’s more than the total number of assisted suicides estimated to have occurred in the U.S. since Oregon became the first state to legalize the practice in 1997.

Why there’s debate

At the most basic level, the debate over medically assisted death comes down to morality. Either you believe it’s categorically wrong for a doctor to help someone end their life or, like nearly three-quarters of Americans, you believe there are cases where people should be granted the “right to die” on their own terms.

The issue gets much more complicated when it comes to defining what those cases should be and what criteria people should have to meet before they’re allowed to choose a medically assisted death.

Advocates for expanding opportunities for MAID say that limiting access exclusively to terminally ill patients leaves countless people to suffer unnecessarily and denies them the ability to opt for a peaceful, pain-free death. They argue that a truly compassionate society would trust individuals to make their own choices, rather than insist that they die in a way that satisfies others’ sense of right and wrong.

But critics worry that more permissive assisted death laws could lead to a “death on demand” system or create circumstances in which people are pushed toward making the choice to die when that may not be necessary. There’s also concern that MAID could warp into a way for society to avoid the effort and expense of caring for its most vulnerable members, including the disabled, mentally ill and even the poor. Many critics point to troubling reports out of Canada — including one case in which a patient’s family claims he was “basically put to death” — as a sign of the slippery slope that can happen when there aren’t sufficient guardrails in place.

What’s next

Supporters of medically assisted death are hoping to expand the practice into more areas of the country. Bills that would legalize assisted suicide have been proposed in at least 10 states over the past year, though it’s unclear whether any of them will become law.


It’s inhumane to force people to suffer when they want to take a different path

“It is nothing less than cruel to prevent anyone from having some control in their most difficult hours as life comes to an end. Of course, there must be safeguards. … But for those who choose to end their suffering and for the families that support their decision, the death with dignity option should be available.” — Judy Kugel, Boston Globe

Assisted death should be available only in very limited circumstances

“Is it really more humane to deny a miserable person a clean assisted suicide than to grant it? Authorities should say yes: We won’t help you die because of your depression, poverty or unfit living conditions for the same reason we won’t take out your appendix if you have a broken leg, or prescribe lithium for a nasty case of psoriasis.” — Chris Selley, Wall Street Journal

Freedom to die should be treated as basic human right

“The ability to end one’s life is an important freedom. Our bodies belong to us, not the government. We should have the power to decide whether we wish to continue living, particularly if we are in constant pain or suffering debilitating or fatal illnesses.” — Scott Shackleford, Reason

The foundations of our humanity begin to crumble when life loses its value

“The idea that human rights encompass a right to self-destruction, the conceit that people in a state of terrible suffering and vulnerability are really ‘free’ to make a choice that ends all choices, the idea that a healing profession should include death in its battery of treatments — these are inherently destructive ideas.” — Ross Douthat, New York Times

Canada has shown how dangerous MAID can be for vulnerable people

“The introduction of euthanasia in Canada has become the slipperiest of all slippery slopes. Of course, the expansion of assisted suicide laws in the U.S. will produce the same troubling problems. … Canadians have the right to die, but do they have the right to live in the face of medical challenges?” — Valerie Hudson, Deseret News

We don’t have to choose between protecting the vulnerable and giving people the right to die with dignity

“Let’s be clear: It was always going to be complicated to find the proper balance between protecting patients and helping them die. Complicated but achievable. It should absolutely be possible to write laws that protect elderly, sick, disabled and otherwise vulnerable people from manipulation or coercion while still providing competent adults with options for relief from intolerable suffering or irremediable illness.” — Nicholas Goldberg, Los Angeles Times

The worst case scenario is a world where people can choose to die at any time for any reason

“The ultimate goal — or, at least, the consequence — of allowing assisted suicide/euthanasia is death on demand.” — Wesley J. Smith, National Review

Banning MAID leaves people to face, and often choose, death entirely on their own

“People facing the grim, painful finality of their lives are committing suicide right now, many without a physician present to ease their suffering — or to talk them out of it. Patients can’t be the primary decision maker on end-of-life options if the government refuses to permit the existence of a decision. Patients can’t consult with doctors or loved ones about their end-of-life preferences if the consultation itself is illegal.” — David Colborne, Nevada Independent

Current limits are so restrictive, the “right to die” largely exists only on paper

“The few places in the United States where assisted suicide is allowed impose restrictions so exacting they are difficult for people in state, and often nearly impossible for anyone out of state, to meet.” — Pamela Paul, New York Times

Sometimes life isn’t better than death

“The idea that any life is better than no life at all is largely unexamined and unchallenged, especially by the young and healthy. … But isn’t the principle itself — life at all costs — due for a reevaluation that pays more attention to the wishes of the individual? Wouldn’t more control of the time, place and circumstances of our deaths alleviate some of our fear of dying, if not of death itself?” — John M. Crisp, Tribune News Service

Complete Article HERE!