Julia Brancaccio died on Feb. 15 at 11:17 PM after a five-month battle with End-Stage Liver Disease (ESLD). She was my grandmother and an integral part of my daily life for the past twenty-odd years.
In the months leading up to her death, she endured a host of health issues that are commonplace among 91-year-olds: urinary tract infections (UTIs), diabetes, depression and bedsores. As her health care proxy, my mother was tasked with the unenviable responsibility of answering some of the most difficult questions about my grandmother’s health and well-being. If she stops eating, do you want the medical staff to insert a feeding tube? If she stops breathing, do you want her to be put on a ventilator? Do you want the medical staff to administer antibiotics if she develops an infection?
Luckily, my grandmother had already answered some of these questions by signing a Do Not Resuscitate (DNR) before her cognitive abilities deteriorated. Still, there were so many end-of-life decisions that she had not made. In the midst of confusing medical jargon and stacks of Medicaid paperwork, one thing became increasingly clear to me: she should have been given the right to end her life medically and die with dignity.
American men and women are living longer than ever before. The average life expectancy for men and women in the U.S. was 78.6 years in 2016. That being said, rates of chronic illnesses are also increasing across the country, putting a new burden on long-term care facilities.
The U.S. Department of Health and Human Services estimates that more than two thirds of people who reach the age of 65 today will need long-term care services at some point. Those individuals have roughly a 35-percent chance of spending time in a nursing home, which comes with its own risk of depression from loss of independence.
In cases like these, physician-assisted dying can oftentimes be the most compassionate option a person has in the face of unremitting physical and mental suffering.
As of this writing, six states and Washington D.C. have enacted death with dignity statutes, and more states, including New York, are on their way to passing their own laws. Outside of the U.S., right-to-die legislation has been codified in countries like Canada, Belgium, the Netherlands, Luxembourg and Colombia.
Since the first American right-to-die law was codified in Oregon in 1997, 1,459 patients have died ingesting the medications prescribed under the Act. The 249 Oregonians who received that medication in 2018 cited reasons like loss of autonomy, decreasing ability to participate in activities that made life enjoyable and loss of dignity for pursuing death on their own terms. Nearly 80 percent were over 65, nearly 63 percent had cancer.
One of the biggest concerns people have over passing right-to-die laws is the potential for abuse of vulnerable patients. The U.S. health care system values cost-effectiveness, and some worry that right-to-die legislation could be used as a cost-containment strategy, especially in cases where individuals are suffering from costly chronic illnesses. But the states with right-to-die laws have set up strict eligibility criteria. Furthermore, in cases in which physicians are unsure of a patient’s motivations to die, they are referred for psychiatric evaluation.
Right-to-die laws give competent adults the ability to decide what happens to their bodies in the face of old age and illnesses. When patients are able to control when and how they die, their family and friends are given the opportunity to say their goodbyes on their own terms. We should all the right to leave this life with dignity if we so choose.