Preparing for the End of Life
The Right To Die
As humans, probably our most-avoided topic of conversation is our own demise. Whether at work around the water cooler, or at home with friends and relatives, we simply don’t like to admit that fear is a major factor in preparing for our final moment on earth. It has been said that most of us would prefer, if we had our druthers, to just drift away to the other side while sleeping. After all, who wants to spend days, perhaps years, relentlessly suffering and waiting for the end?
Back in the 1990’s, ‘Dr. Death’, A.K.A. Jack Kevorkian, attempted to directly address this issue. He openly arranged for terminally ill patients to submit to his performances of what came to be known as ‘assisted suicides’. His practice morphed into a national debate regarding the legality of a person’s ‘Right-to-Die’, as the issue had come to be known. However, once he performed his act nationally on the television news program ’60 Minutes’, he was viewed by some as an executioner of sorts. As a result, in 1999 he was charged in Michigan with second degree murder and sentenced to 10 years behind bars.
But Kevorkian was not the first to raise the notion of euthanasia. As far back as 1906 the state of Ohio placed the issue on its statewide ballot. Although the initiative failed, the issue has raged on for a number of reasons. On the one hand, those in favor of euthanasia argue that it’s the most compassionate and inexpensive thing to do when a patient has been deemed terminally ill. Conversely, those opposing its use believe that doctors take the Hippocratic Oath for a reason, and that they should abide by it, no matter the circumstances. The oath prohibits medical professionals from intentionally allowing patients to die. Undoubtedly, the issue is complicated, at best.
The diversity of opinion around the country is perhaps one of the reasons Americans are sometimes confused as to what rules apply. It is obvious, as the map above illustrates, that the Right-To-Die is a freedom in some states, but not in others. Notably, states that are considered heavily Democratic have legalized the Right-to-Die. However, Republican dominated states have turned down the legislation, and many other states have remained neutral on the issue. The confusion seems to have much to do with politics and where one resides in the United States.
Finding solutions to the end of life decision-making is cloudy and difficult for most people for a variety of reasons. Religious and cultural beliefs and traditions, superstitions, along with the sadness and grief that come with planning for the end of life are among the reasons many of us fail to do so. For example, the Catholic faith teaches that planning ahead to ‘pull the plug’ is akin to suicide, which is considered a direct ticket to Hades and Satan. Others say they simply don’t have time to plan for the End of life, but that doesn’t explain away the importance of doing so. No one knows when that time will come, but everyone knows it will come sooner or later. And, everyone would prefer ‘later, much later'.
Fortunately, there are a guidelines to help prepare for that day. To avoid confusion and emergency decisions, many doctors and hospitals now offer their patients what’s known as an Advance Directive or a Living Will. These forms are legal documents in most states and can be leisurely completed, signed, notarized, and filed with doctors, relatives, and friends. The paperwork is simple and direct: do you want doctors to keep you artificially alive on a machine if you are terminal ill with no chance of recovery, or do you want doctors to let you die peacefully in hospice care if there is no chance of recovery, and who are you designating as the person(s) who will make those determinations if you are unable to do so. The importance of these documents cannot be overstated. Imagine for a moment the confusion that could erupt in this scenario, absent Advance Directives or a Living Will: a patient is admitted to a hospital in a coma and the doctors declare the patient brain-dead and will remain comatose. The Pastor of the patient’s church arrives to pray, insisting and believing the patient will recover, in spite of the medical opinions of the doctors. With the directives in place, this scenario has already been defined and the choices have already been determined in advance by the patient. Thus, no confusion, and a far better choice than dealing with an emergency situation facing gloom and doom at the End with no directions. No family of survivors of a decedent should have to tussle with this sort of issue during such a stressful moment in time. Of course, there are more decisions that should be made in conjunction with these.
Do you have a Advance Directive or a Living Will?
The Facts of Your Life
Decidedly, since no one is immortal, there are many others items to consider in the interest of any survivors. For example, documentation of people to contact like lawyers, insurance agents, accountants, or other trusted family advisors need to be noted. Also, legal documents such as contracts, adoption papers, marriage certificates, wills, medical records should be available. The importance of having this kind of information available for the surviving family is extremely valuable.
As with any life well-lived, there may be valuable assets that need to be distributed. Certain benefits such as a 401, a pension, or other work related assets, as well as insurance policies, vehicles, houses, etc. should be documented to avoid end-of-life confusion and despair. And certainly the administration of bank information such as PIN numbers, credit and debit cards should be supplied to trusted family or friends way ahead of the End.
Furthermore, confusion will be avoided if documentation is provided regarding any specific final wishes and arrangements. For example, a list should be provided indicating whether or not a normal burial or cremation is desired, disposal of the remains, type of casket, desired clothing, even the type of obituary may be important to some. All this information may be relevant end-of-life details that could avoid ill will or probate issues at the End. While no one can ever truly be prepared for the death of a loved one, following these and other guidelines in advance can make the process less stressful. Many hospitals, funeral homes, and even doctors can provide free guidebooks that can be useful in organizing the ‘business’ side of a life at the End.
For the survivors it is critical that all information be available and left in a secure location such as on a computer disc, or even in a bank lockbox. Additionally, survivors should avoid making any major financial decisions for at least a year following the transition. While in grief, scam artists seem to find a way to con survivors.
During the administration of the decedent’s estate, the information provided before the conclusion of life is critical. Probate Courts have the authority to decide the validity of various documents and assets. The notion of ‘probating’ has been around since the tenth century. At that time, any assets the decedent left behind went to either the king or the clergy. Of course, the king took any land, minus taxation, and the clergy administered whatever may have been left to assure that the decedent’s soul was taken care of properly. And since human beings have no known ‘shelf life’, it would be considered wise to have these crucial conversations---difficult they may be----prior to the End.
The Guardian, ‘Jack Kevorkian’, by Dominic Rushe, June, 2011
Wickipedia, ‘The Right To Die’, February 2018
Northeastern University, ‘The Right To Die In America: New Trends Explained’, With Map of the United States, by Allison Hanley, Ruggles Media, April 2016
‘Euthanasia in the United Sates’, 1906 Ohio Euthanasia Bill, Wikipedia, February, 2018
‘The Facts of Life’, Informational Brochure, Allstate Life Insurance Co., January 2016
Questions & Answers
© 2018 Dan Dildy