We need better Death with Dignity laws

When the End of Life Option Act went into effect in California in 2016, then-Gov. Jerry Brown commented that he felt the state shouldn’t deny anyone seeking a dignified death.

The pandemic has forced too many American families to consider what this means for their loved ones’ own contexts, as the virus ravages the bodies of a third of the country’s assisted living population, murderously left unchecked by a void in leadership at all levels, including in Orange County, Calif. Too many elderly residents have likely been forced to make the ultimate choice, alone in hospital beds, with lucid minds and broken bodies, opting for death instead of a few twilight years of incapacitation, trapped in bodies reliant on oxygen machines and strapped into beds where their biggest daily achievement would be being rolled over for a different view every 12 hours.

This piece first appeared in my newsletter, Sex, Drugs, and Biotech.

My grandmother, Charlotte Hesz Erdely, 92, made such a choice on a sunny Sunday afternoon in Feb. from her hospital bed, where she had been quickly deteriorating from Covid-19 for only three and half weeks. She asked us over the phone not to be angry with her for doing so. “Ne haragudj,” she said feebly in Hungarian, as my mother and I listened together, with my sister dialed in from her home in San Francisco. “I want to go to sleep. Good night.”

After she hung up, nurses administered morphine and finally removed the oxygen masks that had been piled onto her face, keeping her alive but miserable. She had been told that to continue her life, she would be moved to an acute care facility where continuous oxygen would be necessary to survive. She didn’t want that — and chose to die instead.

The longtime Cypress, Calif. resident and leader in the local Hungarian refugee community ultimately passed peacefully at 12:53 am the next morning, without her family by her side.

The small blessing of the pandemic may be that other families will be forced to grapple with the nebulous cloud around euthanasia—a concept often coupled to related ideas like doctor-assisted suicide or death with dignity—and come to the same conclusion that we did: that it was, without a doubt, the correct course of action for her, and for our family. We respect her wish despite the pain we are now experiencing.

Death with dignity has long been an ethical and legal minefield, fraught with political and religious controversy. But, the pandemic demands we shift our attention to the ways death with dignity laws can create room for compassion and personal autonomy, even and especially when the person themselves is unable to administer the treatment that would kill them.

California’s law clearly states that a person must be capable of self-administering their own lethal drugs, and a recent article pointed out that people who contract Covid are ineligible under the law. But with so many Covid patients, many of whom can no longer breathe on their own or don’t want to suffer, it’s the removal of a lifesaving medical device that ultimately, mercifully, kills them. This is illegal in too many places in this country, and that must be rectified.

As we adjust to a change in leadership at the federal level that will steward a path toward a post-Covid “new normal,” we should also begin to consider what it really means to advocate for “pro-choice” policies.

If we argue that we have a right to make medical decisions about our own bodies and if we believe that autonomy is a strongly-held American value, we must also become more comfortable with applying that value where it matters most: in the choices of the dying to choose a dignified death.

My grandmother was a dignified woman. She always wore a hat and carried a butterfly clasp handbag. She was a survivor of wars, revolutions, and she embodied the American refugee story, ultimately raising a family in her beloved adopted country. I am so grateful for the front-line workers who smudged the law, just a little, to allow her the peace she deserved at the end. May others receive the same care and benevolence.

A logo for Alex’s newsletter, Sex Drugs and Biotech.
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Reporter. Bioethicist. Publishing on the intersection of ethics and policy with emerging science and tech. Sorry for the recipes if you’re here for news.