I have been getting ready to let go of my cat Dorothy for two years now. By let go, I mean that as she fails, I will be arranging for the vet tech to come to my house and euthanize her. I take my responsibilities as a pet companion seriously; pets depend on us to take care of them when they can no longer sustain a quality of life. To sustain life beyond an excellent quality is more cruel than compassionate. We have figured this out with pets.
I was reminded of how different it is for us humans when we would like to choose to end our life because the quality of it is no longer sustainable. I recently attended a training regarding Medical Aid in Dying. Dr. Rebecca Thoman from the Compassion and Choices, a national not for profit organization presented to the MN Death Collaborative on the state of Medical Aid in Dying. It is not currently an option in Minnesota, but I wanted to make my readers aware of it so that when the legislature considers it again, you can be informed. It is an important emerging concern for those of us who believe that choice is essential as we determine our life’s end.
As a doula, my job is to be centered on the needs of my clients; what they want as they die and how they want that process to go. I want them to have as many options as possible, even those they will never use. That is what sparked my interest in medical aid in dying.
You may have heard of the term “death with dignity.” That is what this used to be called. But this term is falling out of favor; the truth is that sometimes death does not include dignity and we want to be as authentic as possible in how we talk about this topic.
You may have also heard the term “assisted suicide.” Medical aid in dying is also not that and patients in other states who use the medical aid in dying option do not have suicide listed on their death certificate. Instead, the cause of death is named “Natural Causes.”
This is also not euthanasia. No injections are given or taken by the person who is dying.
Medical aid in dying is defined as a medical practice in which a terminally ill adult with decision making capacity receives a medication that they can use by taking themselves to end their life.
There is data being collected in the states and Washington DC and here is what we know so far:
- Two of every three people who got the medication used it. In 2021, 383 people received the medication and 238 ingested it.
- There is a palliative effect by this type of statute; it gives people comfort to have this option, especially for people who are very fearful of a painful, long death process.
- Most people who have chosen this option have cancer, followed by ALS, heart and lung disease.
- The participants tend to be white, educated and insured (the medication is currently expensive).
Ten states and Washington DC allow medical aid in dying. In most of them, there is a residency requirement, generally at least 6 months. That is being challenged in courts but points to why it is important for this option to be available in all fifty states. As it stands now, medical aid in dying is available to only 22% of the population. In the absence of national legislation, this must be legislated by each state legislature.
The Minnesota statute which was opposed by the Republican dominated legislature and therefore not passed, had the following elements:
- Adults only (18 or over)
- Resident of the state
- Must be terminally ill with 6 months or less to live
- Must be mentally sound (that means this is not an option for people with dementia or Alzheimer’s)
- Must be able to self-administer the medication
- There must be a second opinion confirming the medical situation
- No one is required to participate in this program
- There is liability protection for the physician prescribing the medication
- On the death certificate, the cause of death will be listed as natural causes
As we move toward a de-medicalization of death in our culture, as we try to honor the wishes of most patients that they die at home, we need to give the dying as much choice as possible. They need resources, the ability to be surrounded by loved ones as they exercise their self-determination. It is part of the evolution of our societal approach to death and dying. Therefore, this legislation is important. For more information on the legislation and on what you can do to support it, check out their website: https://compassionandchoices.org/in-your-state/minnesota