A terminally ill Hopkins woman shares her plans to die with dignity

Voluntarily stopping eating and drinking (VSED) will allow a woman with Alzheimer’s to die on her own terms.

Cheryl Harms Hauser with her husband, David McNally, at their home in Hopkins.

By Kevyn Burger

Warm and lively, Cheryl Harms Hauser relished her hostess duties when a visitor arrived at her Hopkins home, telling the back stories of the art hanging on the walls, selecting the perfect color of mug for coffee.

Despite her outgoing personality and fashionable appearance, Hauser, 75, did not dress herself. She can’t dial a phone, set a table or follow the plot line in a television series.

Two years ago she was diagnosed as having Alzheimer’s disease. Now this wife, mother and grandmother is planning a way to die before dementia claims her.

Hauser has decided that at an as yet unnamed date, she will hasten her death through a process called VSED: she will voluntarily stop eating and drinking.

“When the day comes when nothing matters anymore, I’ll begin,” she said. “My brother died of this disease and it was torture. I don’t want that for me and my family.”

In the past few years, VSED has emerged as a possible course of action for people diagnosed with terminal illnesses or progressive diseases. In the face of great suffering or a long, irreversible deterioration, the people who choose VSED refuse to swallow food or sip liquids. It typically takes 10 days to two weeks for them to die.

“Some people want to go out fighting to the end, but that’s not for everyone,” said Dr. Timothy Quill, a Rochester, N.Y., palliative care physician who has provided medical support to VSED patients. Quill also co-authored “Voluntarily Stopping Eating and Drinking: A Compassionate, Widely-Available Option for Hastening Death,” which was published earlier this year.

“Of what I call the ‘last resort’ options, VSED is the most available and least well described,” he said. “It appeals to people on the sicker end of the spectrum. They’re prepared for the end of their life and want to speed things up. It’s not dissimilar to someone who chooses to end life-sustaining treatments.”

Humans have informally chosen VSED for centuries. But carrying it out today is no simple act. People opting for this method need a doctor’s supervision that includes medication, symptom management and hospice care, Quill said.

They also need family support.

“They need a partner with some sophistication who is willing to go through this process with them,” Quill said. “They need to share the same values and have many conversations to make sure everyone is on the same page.”

For Hauser, that partner is her husband, David McNally.

Friends introduced the pair in 2007. A mother of three, Hauser was thrice divorced and McNally was a widower whose first wife and the mother of his five children had died of ovarian cancer.

“We crawled into love,” Hauser said, smiling at her husband. “With my track record, I resisted for a long time before I succumbed.”

Four years into their relationship, Hauser was by McNally’s side as he faced a debilitating form of throat cancer. His radiation treatments left him thin, weakened and dependent on a feeding tube for a time.

“We didn’t need to get married, but when we bought this house together [in 2016], I turned a corner. Something bubbled up,” McNally said. “I told Cheryl, ‘I wouldn’t mind being married. Actually, I would love it.'”

But within a few years of exchanging their vows, they both noticed changes in Hauser’s behavior and memory. That led to her being diagnosed with the fatal disease.

“Cheryl’s level of self-awareness is high. She observes things and can talk about them because she is not in denial or frightened. This side of her brain is dying,” said McNally, touching his wife’s styled hair. “We have seen the MRIs.”

A leadership consultant, speaker and author of five bestselling business books, McNally has put his career on hold while he assumes duties as his wife’s full-time caregiver.

Because Hauser is no longer comfortable being alone, her daughter Wendy Longacre Brown creates a weekly Google calendar and shares it with her sister and a few of Hauser’s friends so they can sign up to be on duty when McNally needs a break.

“My mom prides herself on being dignified,” Brown said. “She’s the person who always showed up with lipstick, sent the handwritten cards. She’s losing the values she’s held closely, the ones that identify who she is. She’s begun mourning that person and I mourn with her.”

Brown is a trained and certified death doula whose work focuses on providing emotional and spiritual support, rather than medical care, for the dying and their families. She’s now using her knowledge to help her mother with end-of-life decisions.

“Mom has tremendous courage and clarity. She’s decided she doesn’t want her life to end in a nursing home, unable to recognize her loved ones or herself in the mirror,” said Brown. “I’m so proud of her. She gets up every day to live the best life she can.”

A good death

Brown became familiar with VSED through the influential book “Choosing to Die” by Phyllis Shacter, which she shared with her mother.

“That got the conversation started,” Brown said. “We talked and talked and Mom said right away, ‘I think this is for me.'”

Part memoir, part how-to manual, it tells how Shacter helped Alan, her husband of 26 years, carry out his wish to use VSED to hasten his death.

“That was in 2011. We had no guidance at the time on how to do this,” she said. “We were the guinea pigs, the forerunners. When we heard about it, it sounded horrible. After we investigated, it didn’t.”

Like Hauser, Alan was diagnosed with Alzheimer’s. When he was in the early stages of the disease, he signed a health care directive and authorized his wife to carry out his wishes.

“We understood what lay ahead,” she said. “Alan had to stop eating and drinking while he was still mentally competent. One day he told me, ‘I’m ready. It’s time.'”

To start the process, Alan consumed only 500 calories a day for five days. He said his goodbyes to his daughter and friends, then he settled into his bed and soon was mostly sleeping.

“We played music, I massaged him. He wasn’t hungry, but he was thirsty and I sprayed mist into his mouth,” she said. “On the last day he was comatose, but when I said, ‘Blink your eyes if you are comfortable,’ he did. He had taken care of his business and I knew he was all right.”

Shacter relied on medical supervision. In the nine days that it took Alan to die, he received ongoing care and medication from hospice caregivers and a physician.

“These are not suicides, but rather elective deaths,” she said. “We made a conscious decision to go outside the natural order to bring death on.”

A little known option

Quill explained that hunger quickly diminishes in VSED patients, but they remain thirsty, which is treated with oral swabs, mists or swishing and spitting. Once they become dehydrated, their blood pressure drops, resulting in organ failure. That’s when medical and hospice providers begin administering stronger painkillers. Most patients experience agitation, delirium and/or hallucinations in the 24 hours before death and are sedated with anti-anxiety drugs and tranquilizers.

By the time death nears, patients have fallen into unconsciousness. Then they stop breathing and their heart stops.

“There’s no suffering in the last hours. They appear to be sleeping,” said Quill. “If you view death as part of the life cycle, which is how I see it, it’s a quiet process.”

Thaddeus Pope, a professor at Mitchell Hamline School of Law who has spent 20 years writing and teaching about end-of-life precedents,contributed the legal perspectives of VSED as co-editor of Quill’s book. He said the topic often remains taboo among both medical practitioners and individuals at the end of life.

“This is a legitimate option for those in late stage disease, but it’s not on the menu,” Pope said.”It’s almost invisible, underground. You have to know to ask for it. People don’t know how to talk to their doctor about VSED.”

Leading the ship

Hauser has signed an advance care directive, which has an attachment that spells out her desire to use VSED to hasten her death. It asks for the process to begin when, among other things, “I lose my ability to have logical conversations,” and “When I get lost in familiar locations.”

The document also asks that she receive her care at home with no life-prolonging procedures so that she can die with “dignity and grace.”

In March of 2020, Brown shot a video of her mother stating her wishes. Brown plans to record another video when the time to execute the VSED plan begins “so if there is an authority who questions whose idea this was, the source will be in front of them,” Brown said.

Brown talks to her mother and stepfather every day and visits frequently to track the small cues that mark the progression of the disease in her mother.

“My job is to support my mom and her wishes and to know when she is still able to make the decision on her own so we can fulfill that wish,” she said.

Harms said she wants to spend her final days in the den of the home she shares with McNally. She’s also specified the songs she wants playing and the people she hopes will stop by. But she understands that there’s always an out.

“If, three days in, she says, ‘This is too scary. I want a meal,’ we will remind her of her words and show her the video. But if she decides she’s not willing to do it anymore, we will honor that, no question,” Brown said. “It will be a big surprise to me if she says stop. No one is leading this ship but my mom.”

Finding joy

For now, Hauser and McNally remain socially active. Hauser regularly attends her grandchildren’s sporting events (although she sometimes needs to be reminded about which team to root for).

In the past year, she has taken up a new pastime — and earned a nickname.She dances to music while painting, dabbing and dashing acrylic paint onto canvases to create one-of-a-kind colorful abstracts. McNally calls her Picassorina.

She’s asked that her paintings be offered for sale at the reception that will follow her memorial service, and that the proceeds go to an as yet unnamed end-of-life nonprofit.

“I’ve always loved art and creating like this is very therapeutic. It makes me feel good,” Hauser said. “My mantra is, I will not do anything that doesn’t bring me joy.”

Hauser and McNally have been transparent with their family and friends about their decisions and consider sharing their part of Hauser’s final mission — and her legacy.

“We talk openly about VSED and we want to encourage people to have these conversations about death and how they want to die,” she said. “I have had time to get to acceptance and I want to share my journey. This is what I have to give.”

Complete Article HERE!

‘It is about being in control’: how New Zealand’s assisted dying law is bringing comfort to one family

Steve Smith may be the first person in the country to qualify for the euthanasia procedure. He says it’s a ‘solution’ and a ‘choice’

Steve Smith with his wife, Kate Reilly. Smith, who has brain cancer, may be the first New Zealander to become eligible for a medically assisted death under the country’s End of Life Choice law.

By

When Steve Smith dies, he wants to be at home, in the arms of his beloved wife. He wants it to be a moment he chooses, before the aggressive tumour in his brain takes hold. He may get his wish.

Smith, who was diagnosed with glioblastoma in May, might be the first New Zealander to become eligible for a medically assisted death, after the country’s End of Life Choice law came into force this week.

The legalisation of assisted dying in New Zealand has been the culmination of years of activism. Perhaps most prominent of the campaigners was Lecretia Seales, a lawyer diagnosed with a terminal brain tumour who, alongside her husband, Matt Vickers, began a legal battle for her own assisted dying in 2015. Seales died that year, before the legal challenge was settled and before the act brought before parliament, but she became one of the key public figureheads of the campaign, which pushed on for another five years and gradually shifted public sentiment.

The bill was voted in in 2019, with the proviso that it be approved by referendum.

In the referendum last year, 65% of voting-age New Zealanders voted in favour of legalising assisted dying, joining a handful of countries that allow it. To qualify for the procedure, a person must have a terminal illness expected to be fatal within six months, be in an advanced state of irreversible decline, be undergoing “unbearable” suffering, be mentally able enough to make an informed decision and be aged 18 or over, while two doctors need to sign it off.

Speaking from his home in Raumati, north of Wellington, Smith, 66, said his diagnosis came as an enormous shock, but when he reflects back to the end of last year, there were little signs something was off – dropping his keys; writing nonsense in emails. When the migraines became unbearable, he sought medical advice.

Kate Reilly and Steve Smith walking
Kate Reilly and Steve Smith. ‘I think it’s a good choice for people to have because it is a choice,’ he says.

Glioblastoma is the most common and aggressive form of malignant brain tumour. Smith’s doctors told him that without treatment, he would have roughly five to eight months to live. It is difficult to know how the tumour will affect an individual, he says, but he understands the last weeks of life can be extremely painful and, in some cases, intensive medication is not enough to dull the pain.

Opponents to the law have pushed for better resourcing of palliative care for this period, and are worried the law opens up vulnerable people to abuse.

But the ability to choose a medically assisted death before the disease becomes unbearable is a choice Smith is glad to have. “I think it’s a good choice for people to have because it is a choice. It’s not something you have to do or need to do. It’s just something that you can do.

“The jobs I’ve had in my world are all about providing solutions. And here’s another solution that I can add to my current choices. Really, it is about being in control of my autonomy.”

Smith supported the referendum, not knowing then that it would become a part of his own reality so soon. His latest brain scan results are due back soon and will indicate whether he can apply for a medically assisted death. He can change his mind at any point in the process.

Smith sounds remarkably upbeat as he discusses his future, a state of being he credits to his relationship with his wife, Kate Reilly.

“From my perspective, we’re doing very well working with it at the moment,” he says with a laugh. “For us, it’s our relationship, the thing that holds it together. We’ve got a very strong relationship, and we’ve got a very good way of communicating with each other when things aren’t going right.”

Having the conversations about his death with his family and those close to him has been a tough process, he says, but people have been incredibly supportive. None more so than Kate.

“It’s heartbreaking,” Reilly says.

“It’s been very tough. But my love for Steven means that I will support him and what he needs, not what I think should happen or what I need.”

Their three adult children have been part of the conversations and also support their father. Reilly says the children are still unsure whether they will be there for the moment he dies.

“But I know for me, he will die in my arms, and that’s my choice.”

Complete Article HERE!

Another choice in choosing how to die

A friend of a friend chose to die via VSED (voluntarily stopping eating and drinking) recently. I guess there is an acronym for everything these days. But I had never before heard of this one. There are, apparently, many books, videos, and podcasts describing this method of choosing to die. As a hospice person for decades, of course I have known of people choosing to die this way. It does happen from time to time. I did not realize that this very personal choice had both a formal name and a movement to support it.

We live in a state with a death-with-dignity option. However, the processes and the hoops a dying person must jump through in order to fulfill that wish are so very complicated that, in my experience, most folks die before all the red tape has been completed. That law allows a person to self-administer a lethal drug. However, to obtain the required drug, a person must be seen to be mentally qualified and within the last six months of life. That effectively excludes a person with progressing dementia. By the time you have only six months to live your mental capacity will likely be severely compromised.

VSED, on the other hand, is entirely within the control of the individual if they decide on that route. A caveat: they must have a caretaker willing to assist them and that person is agreeing to a very challenging role.

Is VSED the same as suicide? Those who champion it say it is elective death (at a time of their own choice) since most of these people know already that they are dying of some illness that over time will rob them of any dignity. If you have witnessed a parent declining into dementia and you, too, have been diagnosed with the same disease, VSED might look like a possible option. Degenerative diseases like multiple sclerosis or ALS conceivably might make VSED look attractive.

What is the process like? It appears that there are lots of moving parts to consider before the person actually ceases to eat and drink. First and foremost, good medical supervision is imperative. If your local hospice and/or palliative care physician will assume that role, that would be ideal. Those professionals are specially trained to provide medical aid and support to the dying and they know their stuff when it comes to keeping someone comfortable. The partner/caretaker is probably the cook, nurse, driver, case manager, liaison with doctors, and full-time support person for the patient who is dying. They, too, must get their own needs met and be taken care of. So, likely, paid caregivers who understand the process must be interviewed and hired.

There is no one way that all this occurs. In general, the person who wishes to die makes the decision to stop eating, and most critically, drinking, and sets a date to start. We can go quite a while without food. But liquid is a whole other story. There are people who regularly do intermittent fasting as a way to diet. There is a real “high” that humans experience after fasting for a length of time, which is the result of our bodies going into ketosis.

After a few days, hunger is not such a big issue, but the need for liquid is. The caregivers have a humidifier running in the patient’s room, swab their mouth with damp swab sticks, put drops in their eyes, and later squirt a fine mist into the mouth. The doctor prescribes low dose morphine and/or a fentanyl patch to keep the person calm and comfortable. As the days go by someone needs to turn the patient regularly to avoid bed sores. Bed baths and peri-wash, changing of clothes and bed linens are a daily regimen. Eventually, the patient slips into a coma. Consciousness is gone but the body ticks on longer until it can no more.

The caretaker has to watch all this, and it cannot be easy. You would have to love someone an awful lot to endure it.

Complete Article ↪HERE↩!

4 ways that older people can bolster or improve their mental health

By Jelena Kecmanovic

Older people generally have fewer psychological problems than the rest of the population. They also have shown the least increase in anxiety and depression during the pandemic, despite being most vulnerable to covid-19.

Resilience among the elderly has been attributed to their ability to better regulate emotions, higher acceptance of the ups and downs of life, and wisdom that comes from having learned to see the big picture.

But old age brings many challenges that can harm mental health.

Even after she lost her second husband to cancer, she kept engaged by providing relationship coaching, gardening, walking her dogs, hiking and doing house repairs. “But when my left knee started giving me more and more trouble, so that eventually I could hardly walk, I felt really discouraged and depressed,” Landrum said.

Many older people do suffer from considerable mental health problems. Among those living outside group settings, the rate of clinically significant depressive symptoms is 8 to 16 percent and anxiety disorders is 10 to 15 percent. The elderly living in nursing homes fare worse. Most older adults with depression and anxiety do not receive treatment for it.

Late life depression, in turn, has been found by researchers to increase self-neglect, cardiovascular problems, morbidity, and risk of suicide. It also leads to worse social and cognitive functioning and compromised quality of life. And geriatric anxiety has been linked to heart problems and high blood pressure, among other problems.

Studies have illuminated some risk factors for geriatric depression and anxiety.

Elderly people who deal with significant physical problems or cognitive decline, who are lonely, or who are grieving or dealing with multiple losses are more likely to experience psychological problems, especially depression. So are older people who have a lot of regret about a life not well-lived and who struggle to find meaning in their lives.

Many existential concerns come to the forefront of people’s minds as they near the end of their lives.

They confront questions such as, “Have I led a meaningful life?” “What has my role been in this world?” or “Am I leaving something behind?” How people perceive, explore, process, and talk about these questions can affect their emotional well-being.

Here are four approaches that psychologists like me find can facilitate these explorations and consequently bolster or improve mental health.

Engage in life review

It is a truism that the older people get, the more they reminisce about the events that took place in the past, sometimes very long ago. Psychologically, there is a purpose to looking back.

One of the most influential psychologists of the 20th century, Erik Erikson, considered the last stage of life to be focused on reviewing life, integrating positive and negative memories, and coming away with a coherent sense of a purposeful life. He postulated that people who had a particularly hard time with this process could end up feeling despair.

“In my work with older patients, we often engage with the question, ‘What has it all been about?’ ” said Herbert Rappaport, a clinical psychologist in the Philadelphia area and the author of “Marking Time.” “It is powerful to help them construct their life stories and to witness how this leads to a sense of peace and acceptance of whatever comes next.”

Research shows that life review improves mental health.

But depressed individuals have a hard time recalling positive events or reflecting back on their lives in ways that are not negative and self-critical. They also tend to remember things in a more general, abstract way, without much detail.

A strategy that counteracts this tendency is to intentionally remember positive situations and times in your life, recalling as much concrete and sensory information as possible.

“I worked with an older woman in my practice who was worried about her daughter’s well-being once she’s gone, and she questioned if she’s done anything to help the next generation, and now it was too late,” said Jason M. Holland, a clinical psychologist in Gallatin, Tenn. “Writing about and discussing these feelings and reviewing her life in totality helped her realize that it’s not all negative and that she’s leaving an important legacy with her grandkid.”

Autobiographical writing or recording, storytelling, scrapbooking, making art that honors your life, family genealogy, oral history interviews, arranging old photographs and creating legacy projects are all ways that promote life review.

Consider sources of meaning

Much of popular psychology and self-help urges us to discover or create meaning in life. “I fear that this just adds more pressure for people, that this can become another reason to feel guilty and ashamed — ‘I’ve failed because I haven’t found the meaning of my life,’ ” said psychologist Joel Vos, author of “Meaning in Life: An Evidence-Based Handbook for Practitioners.”

He suggested that people engage instead with the meaningful activities that they are already doing.

In my own psychology practice, I have found that, during the pandemic, many people have gained more clarity about what really matters in their lives. This often centers on going beyond oneself: connecting with others, with the past and future, with God or spiritual concepts, or with nature. Another source of transcendence includes creating something in the world, from a tenderly tended garden to a painting to a nonprofit organization.

“It is never too late to orient yourself toward what’s meaningful. At 90 years old, I am a living example,” said Irvin Yalom, emeritus professor of psychiatry at Stanford University and the author of “Existential Psychotherapy” and “Staring at the Sun: Overcoming the Terror of Death.

“I still see some patients, but just for a session each because my memory and energy are not what they used to be,” he said. “I connect with my children and play chess and talk with friends. Human connections make life worth living.”

Accept limitations

A common misconception I hear is that acceptance equals passive resignation or giving up. It actually means the opposite; it’s an active process of facing the limitations that come with age, employing courage and wisdom.

“One of the best predictors of successful aging is the ability to disengage from unattainable goals,” said Carsten Wrosch, a psychology professor at Concordia University in Montreal. “While grit and perseverance might be most important for younger people, the elderly with the best psychological outcomes let go of things they can’t do any more and shift toward things they can still do that are purposeful.”

Older adults often struggle with physical or cognitive limitations, with a loss of freedom, and with the ability to control their lives. “Losing control can be the most demoralizing. I suggest adjusting your expectations and finding anything, however small, that you can control,” Holland said.

Dealing with the hardships commonly faced in old age can even be a catalyst for growth. Illness, grief or another negative change sometimes results in an important reckoning. “Significant transition or change can lead to an existential crisis, a chance to reevaluate life and to eventually align it more with your values,” Rappaport said.

Deal with death anxiety

With the coronavirus death toll of at least 750,000 in the United States, many people here have faced death more immediately and more acutely than at any point in recent history. And yet, many still find it hard to talk about death and dying, avoiding news that could trigger death anxiety.

“Numerous studies show that people who have high death anxiety suffer from psychological problems and disorders,” said Rachel Menzies, clinical psychology postdoctoral research fellow at the University of Sydney and a co-author of “Mortals: How the Fear of Death Shaped Human Society.” “In general, death anxiety subsides later in life. But for some elderly, it can be very high and contribute to their depression and anxiety.”

To confront death anxiety, Menzies suggests reading obituaries or watching shows that involve death and dying, especially if these had been previously avoided.

“Visit cemeteries, nursing homes, or funeral homes — anything that will bring you in contact with death,” she said. “That way death becomes a normal part of life.”

Another often evaded topic is a discussion of one’s will and end-of-life preferences and directives. Tackling this now could decrease your fear of death, and provide a sense of dignity and control. And it will be a gift to the ones you are leaving behind.

An exercise I often use with patients, derived from Acceptance and Commitment therapy, a type of therapy which helps people to live with purpose and to stop being hostages of their anxiety and depression — is to have someone imagine their funeral and write their own eulogy and tombstone inscription. This may sound ghoulish, but it not only tends to reduce death anxiety, but also crystallizes the values that are important to people and urges them to put them in place before it is too late.

“Life well lived is the best antidote to death anxiety,” Yalom said.

Complete Article HERE!

Mum’s final moments with champagne and cigarette at assisted-dying clinic

Dawn Voice-Cooper, 76, who said her life had become an “unbearable” battle, slipped out of consciousness while surrounded by friends at an assisted-dying clinic in Switzerland

Dawn Voice-Cooper received her final wish at an assisted-dying clinic in Switzerland

By Amy-Clare Martin

A woman who spent the last few years of her life fighting for the right to die has been given her final wish after travelling to an assisted-dying clinic in Switzerland.

Dawn Voice-Cooper was surrounded by her friends while she sipped champagne, had a last cigarette and listened to her favourite song for the final time.

Facing a daily battle against a series of incurable health problems, including severe arthritis, brain bleeds and epilepsy, Dawn, 76, was determined to end her life on her own terms before the quality of her life, which she described as “at times unbearable”, deteriorated any further.

Dawn enjoying a glass of champagne on her final morning
Dawn enjoying a glass of champagne on her final morning

Her tearful last words to her emotional friends and the medical staff at her bedside were simply: “Thank you, thank you everyone.”

Minutes later she was dead, after receiving a fatal dose of ­barbiturates, reports the Mirror, which was invited along to cover her final journey.

The former mental health worker and mother of one had described her life as being the “endless, often difficult, and usually painful, daily management of several, incurable issues”.

Dr Erika Preisig with Dawn at the clinic
Dr Erika Preisig with Dawn at the clinic

She said: “People often tell me, ‘Oh you look fine, you look young, you’ve got a bit of a limp’. But they don’t know what’s really going on inside me, the pain and the difficulties – the daily management of my ailments and my injuries.”

Opponents of assisted dying fear any legalisation will push disabled and elderly people into ending their lives early out of fear of becoming a care burden.

Reporter Amy-Clare Martin with Dawn the day before she went to the clinic for the final time
Reporter Amy-Clare Martin with Dawn the day before she went to the clinic for the final time

But Dawn hoped that by sharing her journey she could show that rigorous safeguards can stop abuse.

The children’s writer, from Sevenoaks, Kent, began to consider assisted dying in 2017 and made her application to the Lifecircle clinic in Basel two years ago.

The application process required her to submit her medical history, explain her reasons for wanting an assisted death and prove she was mentally competent. Once in Switzerland, she was assessed by two doctors separately before being taken to the clinic.

The emotional final goodbyes
The emotional final goodbyes

Unlike the better-known Dignitas, where patients drink a lethal cocktail of medication, Lifecircle sets an IV drip which recipients operate themselves.

Inside the clinic, Dawn signed her own death ­certificate. She hugged her friends, fellow campaigners Alex Pandolfo and Miranda Tuckett, before a nurse ­positioned her bed in front of the window to look out at the trees.

“It’s beautiful here surrounded by the trees. I think it must be the most beautiful place to die,” she said.

Dr Preisig helps prepare Dawn for her last moments
Dr Preisig helps prepare Dawn for her last moments

Lifecircle president Dr Erika Preisig asked Dawn four final questions on camera, to confirm she knew what she was doing and the consequences of taking the lethal drugs.

Then, listening to Nick Drake’s Day is Done, with her friends holding her hands, Dawn released a valve on the IV.

Following a police report, which takes place after every assisted death at Lifecircle, her body will be cremated and her ashes scattered by Dr Preisig.

Alex, who has early onset ­Alzheimer’s and who also plans to die at Lifecircle, said: “It was one of the most beautiful and loving deaths I have witnessed in contrast to the unacceptable and prolonged tortured deaths of my beloved mum and dad and the death my Alzheimer’s may bring to me.

“Dawn’s story and experience of both pain and then peace through the support of Lifecircle will be used as I continue to ask for an evidenced based parliamentary inquiry into humane voluntary assisted dying in the UK.”

Complete Article HERE!

‘Quick and painless death’

— Easier said than done

By Michael Cook

The central goal of right-to-die organisations has not changed much over the past 150 years. In 1872 a British writer, Samuel D. Williams, wrote a book advocating the use of the novel anaesthetic chloroform to give patients “a quick and painless death”. In 1931 the British eugenicist Dr Killick Millard proposed legalisation of euthanasia “to substitute for the slow and painful death a quick and painless one”.

Now that legalisation has arrived, however, doctors have realised that a Q&P death is easier said than done.

Writing in a recent issue of The Spectator (UK) Dr Joel Zivot, a Georgia physician, expresses his doubts about whether lethal medications are the way forward. He studied the autopsy reports of more than 200 prisoners executed with lethal injections and found that many may have died in great pain.

“The death penalty is not the same as assisted dying, of course. Executions are meant to be punishment; euthanasia is about relief from suffering. Yet for both euthanasia and executions, paralytic drugs are used. These drugs, given in high enough doses, mean that a patient cannot move a muscle, cannot express any outward or visible sign of pain. But that doesn’t mean that he or she is free from suffering.”

Dr Zivot believes that pentobarbital, which, it seems, is used in Oregon in 4 out of 5 assisted suicides, caused pulmonary oedema – the lungs fill with liquid secretions and the person can die in agony. “Advocates of assisted dying owe a duty to the public to be truthful about the details of killing and dying. People who want to die deserve to know that they may end up drowning, not just falling asleep,” he writes.

Nor is death necessarily quick.

In Oregon, where statistics are gathered about the mode of death, the median time to death throughout the 23 years of the Act is 30 minutes but the maximum time is 4 days and 8 hours. The median time for people to fall unconscious is 5 minutes, the maximum is 6 hours.

At least in the United States, doctors who participate in assisted suicides are aware of these issues. Dr Lonny Shavelson, a California physician who specialises in this novel field, has helped to organise the American Clinicians Academy on Medical Aid in Dying. This provides a forum for doctors to establish a best-practice for helping people to die.

It turns out that the very diseases from which the patients suffer can make the drugs less effective. Dr Shavelson spoke with Medical Xpress last year about some of the difficulties:

“Shavelson and [his colleague retired anesthesiologist Dr Carol] Parrot have identified which patients are more likely to linger, and can recommend adjustments. People with gastrointestinal cancer, for example, don’t absorb the drugs as well. Former opiate users often have resistance to some of the drugs. Young people and athletes tend to have stronger hearts and can survive longer with low respiration rates.

“We’re learning. Hypothesis, data and confirmation. This is what science is,” he said. “Our job is to stop the heart; that’s what they want us to do.”

Complete Article HERE!