No option for dying with dignity
Laurie Falco wants to die soon. She isn’t sure exactly when, but soon. She underlined the word on the sheet of notebook paper on which she answered my questions recently. Her writing is light and spidery, making it difficult to read. But it is her only means of communicating. Amyotrophic lateral sclerosis, ALS, has taken her voice, just as it has taken her ability to swallow food, to walk more than a few feet, to breathe on her own at night.
She doesn’t fear death. She fears being trapped inside a silent, useless shell that was once her body. She knows, no matter what her church friends say, that life can be worse than death. Falco watched her mother descend into the tumultuous fog of Alzheimer’s, slowly losing her mind, her bowel control, her ability to tame her abusive language and violent outbursts.
But assisted suicide is illegal in California, as it is in every state except Oregon. Falco cannot be prescribed a lethal dose of medication to bring about her own death. She could order the medicine over the Internet, but she would need her children’s help to do so, putting them at risk of prosecution.
So when she decides the time is right — soon — she will have to end her life by starving because it is one of the few legal options open to her. We live in a society that understands the compassion in ending a beloved pet’s painful life through lethal overdose, but still can’t see why people should be afforded the same loving option.
Hospice can give Falco enough morphine or barbiturates to keep her comfortable as she starves, but death can take days. It will be serene and painless, though not as dignified and controlled as she would wish. If Falco lived in Oregon, she could fill out a request for physician-assisted death. Two doctors would verify her terminal status and her competency. Then she would make a second written request 15 days after the first, both signed by two witnesses.
Then at the time she chose, in her own bed surrounded by her family and her two adoring dogs, Falco could consume a lethal dose of prescription medicine. She would slip away in 15 or 20 minutes.
Oregon voters passed the Death with Dignity Act in 1994 and again in 1997, triumphing over those who warned of state-sanctioned killings of vulnerable elders at the hands of their heirs and of severely disabled people whose care had become too burdensome. But after nearly seven years, Oregon has seen none of the predicted abuses.
Falco’s children called Compassion in Dying, a national organization that provides counseling to terminally ill people about end-of-life choices, last spring at their mother’s request. A Bay Area caseworker has been counseling the family in thinking through the decision and considering the options.
What Falco wants isn’t immoral or unreasonable. People get to make choices in everything from how to give birth to whether to have a cosmetic surgeon slice them up in the name of beauty. Falco simply wants the freedom to decide for herself when her life is no longer worth living. She wants her exit, unlike her horrible disease, to be on her own terms. She wants, as much as possible, to make her death a loving and powerful experience for her and her family instead of a lingering, wrenching disintegration.
“I think she’ll decide the time is right when she’s ready to say goodbye to her family,” said her eldest daughter, Stacie Lautrup, whom I reached by phone in Sacramento, where she lives with her husband and children. “But at this point, I can still think of lots of things she can cackle about. She still loves being around everybody.”
Falco knows her family will let her go when she asks. She won’t ask today and probably not tomorrow. But, as she wrote in her notebook Thursday, soon, before ALS takes away everything but her beating heart.
Joan Ryan is a columnist for the San Francisco Chronicle. Her e-mail is [email protected].