Compassion & Choices is trying to do more for those with a dementia diagnosis through a new online “Dementia Values & Priorities Tool.” This post is the first part of an exploration of C&C’s approach to dementia advance planning.
A recent article in the Washington Post produced by Kaiser Health News and written by Melissa Bailey asserts that openly discussing a self-controlled death, no matter how rational the discussion, is viewed by some people as “subversive” or, at least, out of the ordinary or suspect.
Thanks to everyone who made suggestions to deal with Jane’s presumptive problems (see previous post). If Jane had an independent social worker–one not in her healthcare system–that person might respond to Jane’s difficulties with something like the following:
Lamar Hankins shares his notes taken from a lecture by Professor Thaddeus Pope, who spoke on the topic “Avoiding Advanced Dementia with a VSED Directive” for the Hemlock Society of San Diego.
This post lays out a process for making a dementia directive to be used when or if we become unable to make our own views known because of mental incapacity. If you are willing to live with dementia through the end of the disease, this post will not be of use to you.
The idea suggested by some disability rights advocates, that most of us will be disabled in one way or another by the time we reach the end of our lives, has been borne out in my experience. Virtually everyone I have known who has died has met, days or weeks or months before their deaths, the definition of disability under the Americans with Disabilities Act. How can we assure that those who are disabled are not coerced into ending their lives too soon?
Developments since 1997 in accepted medical practice regarding voluntarily stopping eating and drinking (VSED) and terminal sedation (TS) warrant fresh claims that state exclusion of lethal assistance to a competent, fatally stricken patient is so arbitrary as to violate equal protection of the laws under state and federal constitutions. While the prevailing jurisprudence for the past 20 years has upheld state bans on lethal poisons as a mode of protecting a vulnerable population (dying patients) against abuse or mistake, there are at least 2 cogent counter arguments in any renewed constitutional debate.
In my last post, I discussed some general propositions about Voluntarily Stopping Eating and Drinking (VSED). In this post, I look at some VSED issues in greater detail.
I learned that VSED doesn’t have to be a horrible way to hasten one’s death. With proper care, it can be done without pain or distress. The first two or three days are sometimes the most difficult because of hunger pangs and thirst. The hunger is easy to control if one has access to pain medication. The thirst can be ameliorated with proper oral care, such as judicious use of ice chips, rinses, and lubricating gels.
As I have stated previously in these posts, I do not intend to allow myself to live far into the condition we term dementia, should that fate befall me. However, we never know what might happen to thwart our intentions, which is why I have chosen to use advance directives as creatively as possible to prevent being forced to live a life that I find intolerable and inhumane. This is why I welcome any efforts to create the circumstances that allow everyone to have the lives and deaths they want.
