by Rohin Francis, MBBS, Medlife Crisis Modern technology has blurred the lines of life and…
BASICS: Make sure those who are involved in your care know your wishes. Document this in your Advance Directive. Appoint someone to speak for you who knows and agrees with your wishes — your Health Care Agent, who can speak for you if you cannot speak for yourself.
See The Conversation Project and California Advance Directive.
You may want to have a POLST (some states call it a MOLST) – a valid medical order specifying what level of treatment you wish. It is designed for those for whom it would not be a surprise if they died within 1 year. Not every state recognizes these forms. They must be signed by a medical professional to be valid. Inquire with your medical provider.
REFUSAL OF TREATMENT: You, or your Agent, can refuse or withdraw life-sustaining
treatment and request Comfort Care Only.
VSED: This involves withholding food and fluid. This method, VSED (Voluntary Stopping Eating and Drinking) requires medical or nursing assistance to make sure you are comfortable and may take up to two weeks after stopping fluids and food. Death is by dehydration, not starvation.
HOSPICE: Most hospice care is provided in your home. Hospice can usually make you comfortable, talk with your family, bring medical supplies, and relieve pain. It cannot make all end of life symptoms better and usually will neither prolong nor hasten death. There are many hospices in San Diego. Call and ask about their attitude toward the End of Life Option Act (EOLOA) and VSED. They can be helpful or obstructive.
End of Life Option Act (EOLOA) It is now legal in California to ask a physician to prescribe a lethal drug(s) to end your life. You must be 18, a CA resident, and have two doctors certify that you are mentally competent and be diagnosed with a terminal illness; defined as having six months or less to live.
FINAL EXIT NETWORK (FEN). Members can request personalized information and support if they have produced evidence of a severe chronic or terminal condition or early dementia and wish to hasten their death.
Switzerland: There are two reliable organizations in Switzerland, Dignitas and Life Circle, that will provide aid in dying.
Paperwork is required and the cost can be around $10,000 plus transport and lodging.
Do it Yourself Methods: There are several books on methods you can use yourself. The classic is Final Exit by Derek Humphry, 3rd addition, with the Addendum. If you considering a Do It Yourself method you should: follow all instructions precisely, find a buddy that can be with you, but NOT assist. Keep quiet about doing this.
See also: Dignified Dying, by Boudewijn Chabot or Five Last Acts by Chris Docker
There are many mortuaries around. These are two suggestions:
San Diego Memorial Society: A non-profit that can get you a discounted burial or cremation at a local mortuary.
UCSD Body Donation Program: They can use your body for teaching and research and arrange some organ donations.