Hastening one's death is doable without the aid of a doctor, with the help of an organization like Compassion & Choices (www.compasssionandchoices.org, or 1-800-247-7421). They can provide information and counseling in a discrete, loving, ethical, and legal manner to those who are terminally ill. But the imperative for action is yours alone. You must be mentally and physically capable of taking action -- making the decision (a true act of courage), planning, organizing. Fortunately, most people will never want or need to hasten their own deaths. Even in the three states where physician assistance is legal, only a relative handful have used the option. Most people find they can bear their final illnesses, making adjustments day by day, driven by the incredibly powerful will to live and man's phenomenal ability to adapt. Those who prepare for hastened death, but who don't ultimately take that step, still get great comfort from knowing they have an "out" if life is no longer liveable. But for the few who do choose that step -- for whom the quality of life has become unbearable -- there is hope. It requires the courage to act on your own while you have the mental, emotional and physical capacity to act -- to willingly give up a day or a week of miserable life at the very end. To say no to being kept alive to the last possible breath when all pleasure and quality of life is gone. To refuse being swept along in the great American death machine. No decision is more personal than how we choose to die. Why then do we let government, religion, society, friends and family bully us into dying the way they think we should, not even asking what we might want for ourselves?
- Make a will, even if you're young and healthy today. Dying without one leaves a terrible and costly mess for your heirs to clean up. Consider putting assets into a trust. That can greatly cut the "death tax," reduce the complications of probate, and leave more money for your heirs. If you want someone to have cash, put it into a joint account that immediately becomes their property upon your death.
- Complete an advanced directive stating your wishes about being kept alive with artificial nutrition and breathing if you have no prospect of ever waking up and regaining a decent quality of life. If you don't want tubes, talk about this frankly with those will have to make a decision for you. Take them off the hook. Let them know it's okay to pull the plug without guilt. I've prepared a letter for my "plug puller" telling him not to take a chance that I'll wake up into a horrifically debilitated existence. The choice is mine, and I choose the certainty of a peaceful death over the one-in-a-million chance of miracle recovery. If you do want the tubes, of course, that is your right.
- Name a health care proxy, someone who can make decisions for you if you're no longer able to make them for yourself.
- Give power-of-attorney to someone you trust to manage your finances and other affairs prior to your death if you're no longer able to do so.
- Educate yourself about the wonderful benefits of hospice care, usually given in the home, that can greatly ease the burden of your final days on both you and those close to you.
- If hastening your death interests you, do your research and prepare while you still have your strength and mental abilities. There's no harm in preparing "just in case," even if you never choose that course. If you wait, however, it's possible that when you desperately need relief, you won't even have the option (other than voluntarily stopping eating and drinking) -- and nobody else will be able or willing to make the arrangements you failed to make for yourself.
- Speak frankly with your doctor, family, friends, and loved ones about your end-of-life wishes and options. People don't know what to say to a dying person, so they say nothing at all, or avoid visiting and conversation altogether. They will likely welcome your bringing up the subject and taking the lead, guiding the discussion and rescuing them from a very awkward position. Discuss pain management and palliative care with your doctor. If they're unwilling or unable to keep you pain-free and comfortable, consider finding someone else.
- Clean up your affairs -- financial and otherwise -- while you have the chance. It is selfish and unkind to evade your responsibility to deal with your own "issues" (like a house full of junk) if you have the capacity to do so, shifting that burden to others after you're gone.
- Plan and pay for your own funeral, burial, or cremation.
In summary, there is no need to be a passive bystander at your own death, to sit idly by while events unfold around you. You can take control -- and must. Make no mistake, there is a giant industry out there waiting to profit from keeping you alive as long as your poor body can hold out, draining every penny you ever saved, ruthlessly and blindly putting quantity of life above quality. That is the "default" position in your society. If you do nothing, that's what you get. Please know there is another way, but only if you take charge and take responsibility for yourself.