When you think about a doctor, you usually think about someone who tries to do whatever it takes to extend life.
But sometimes caring for people as a doctor means being there for them at the end of their life, and helping to make the transition easier.
In my medical practice, Integrated MD Care, we take care of patients and families who are facing complex and (often) terminal illnesses. My mission is to help improve people’s quality of life—whatever challenges they are facing. When the quality of a person’s life is no longer acceptable, I’m committed to ensuring their that the final phase of their life is as peaceful and dignified as possible.
In June 2016, through the End of Life Option Act, it became legal for an adult resident of California with a terminal condition to request a lethal dose of medication from their physician and allow their life to end in a peaceful and dignified manner.
California became the fith state to pass such a law, joining Montana, Vermont, Washington, and Oregon. Colorado and Washington DC have since passed similar laws. Other states are sure to follow suit.
Rather than being forced to allow a disease to ravage and consume the body or mind to the point of unconsciousness or death, people in California with a terminal illness and a prognosis of six months or less now have the option of determining when, where, and how they will die. I believe this is a blessing.
Instead of having to live with the fear of struggle, of an undignified and helpless end of life, people can now be in control of their future–confident that if the quality of their life no longer justifies the struggle, there is a painless and quick way out. This is not suicide. These people are dying from a disease that will claim their life within a short time. They are merely accelerating the course.
Shortly after the aid in dying law came into effect in California, people began contacting me to request my help. They wanted a way to leave their struggle behind, and it was now legal for them to do so, but they couldn’t find a doctor who would support them. This was both surprising and maddening.
I discovered that most physicians are unable or unwilling to provide this type of care. Either they work for an organization that won’t allow them to, they believe it takes too much time and effort, or they are morally opposed. Since I have a small, private practice and am not part of a larger organization, I am free to choose which stance to take on this critical issue.
As a physician who is passionate about helping people experience more joy and quality in life, and more peace and comfort in dying, I decided that I am comfortable doing my part to navigate people through this complex and emotionally tumultuous process. More than comfortable—I am honored.
I carefully look at each request and evaluate, in a compassionate and non-judgmental way, whether the individual meets the requirements and is making a carefully considered and well-thought-out decision. If so, I am ready and willing to help.
I have now prescribed medication for a number of patients, and have been present for many of their deaths. All of these patients were completely resolute and at peace with their decision. All of them took the medication without any hesitation. Every one of them died peacefully, without struggle, with their loved ones at their side.
Still, with the end of life, I do have very mixed emotions.
I am honored, privileged, and disturbed at the same time, even though I believe in my heart that what these people are doing is the best option for them. Because I’m intimately involved in the process, it still pains me. I know the feeling of losing someone very dear to me.
With each patient who has chosen this path, I’ve worried about what they would experience and how peaceful the death would actually be. This was especially true for the earlier patients. Now that I have more experience I am better able to anticipate exactly what is likely to take place.
Early on, I feared that they might take the medication and then struggle or, worse, that the medication would fail, and their loved ones would have to endure a terribly stressful situation.
I’d done plenty of my own research and collaborated with medical experts in Oregon and Washington with quite a bit of experience in this arena, so I was confident that the medication and dosing were appropriate, but that lurking fear remained.
To my great relief, I can confidently report that none of my patients has experienced any suffering or struggle at all.
Everything has gone as smoothly as anyone could hope for and a beautiful transition from this world into another has occurred each time, just as my patients would wish for.
The profound sense of relief and gratitude that my patients and their loved ones experience when they learn that I can, and will help them, has been almost overwhelming for me.
When terminally ill patients know they can have a more peaceful and dignified death, they are empowered in a way that is truly beautiful to behold. Their fear drops away and they are allowed to live out their final days in peace.
This knowing gives them back the control that their disease has taken from them.
To be honest, I never imagined that as a doctor I would be practicing this kind of care.
In fact, prior to last year it never even occurred to me. But I now know that without my services these patients would struggle much more, and some might still be agonizing as they search for a way to escape a life of suffering. And their loved ones would have the permanent emotional scars that come from watching those they love suffer and not being able to stop it.
Over the past three decades, I’ve learned much about the healing power of excellent medical care. It’s amazing to me what we can do to overcome certain diseases and challenges.
Over the past year, I’ve learned about the incredible healing power of being allowed to choose the time and manner of one’s own death when faced with a terminal illness.
Every life should be rewarded with a peaceful and dignified death. There is no reason why this shouldn’t be possible for everyone. I’m truly honored to be able to ensure that this is possible when I am called upon to do so.