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The Massachusetts ballot initiative to give terminally ill, mentally competent adults with six months or less to live the freedom to obtain a prescription for aid in dying was defeated. The right to be at liberty to die should have been an election issue everywhere.  

Popular and professional media had been crammed with other “stories” and “reports” like Joe Klein’s June 11, 2012 Time magazine cover article, “How to Die,” in which he described the dramatic improvement in his parents’ care after they moved into a facility organized with an important distinction: no monetary incentives for unwarranted interventions.  

At Liberty to Die: The Battle for Death with Dignity in America, has just been published by New York University Press. It was borrowed for me from the San Francisco Public Library via the LINK, the taxpayer-library user’s lifeline. Standing next to me at Library Circulation was a proverbial little old lady who chimed in audibly “At liberty to die that’s good that’s needed that’s important!” (Old women are so often assumed to be little and ladies, or at least lady-like… My bad.)  

Author seventy-five year old Howard Ball is Professor Emeritus of political science at the University of Vermont. He has authored books about the Supreme Court, judicial policy and politics, and international justice, including The Supreme Court in the Intimate Lives of Americans (also published by NYU Press); and Genocide: A Reference Handbook.  

“Provocative and compelling” is Compassion & Choices magazine’s take on Ball’s latest book. It charts how end-of-life choice has become deeply embroiled in debates about the relationship amond religion, medicine, civil liberties, politics and law in American life. Ball explores the cases that built the constitutional framework and the legislative and ballot battles in state after state up through the 2011 legislative sessions. He also describes the legal rulings and media frenzies that accompanied the Terry Schiavo case and documents the growing number of Americans like my library ladyfriend who support a person’s right to aid in dying as well as “the continuing and vigorous opposition of the ‘sanctity of life’ organizations.” 

When a terminal illness is diagnosed, control of one’s own life ceases. Of every six hospital admissions, one is to a Catholic hospital, where aid in dying and other end-of-life choices are strictly forbidden. For many of those patients, a Catholic hospital is the only local “choice.” Supporters of the policy of allowing a physician to assist a terminally ill patient to die do not refer to “suicide.” Nor is the older phrase “physician-assisted suicide (PAS)” used by Ball. “Physician-assisted death” (PAD) is appropriate.  

Mental health specialists contend that there is great difference between suicide and the choice made by a dying patient to hasten impending death in a peaceful and dignified manner. The American Psychological Association has recognized that the reasoning on which a terminally ill person bases a decision to end her or his life is fundamentally different from the reasoning a clinically depressed person uses to justify suicide.  

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“The Suicide Tourist” documentary aired on PBS Frontline on March 2, 2010. (www.pbs.org). The DVD can be purchased and is in some libraries’ collections. It depicts one person’s travail and travel following diagnosis and onset of ALS. It is the account of Craig Ewert, his devoted wife Mary who enabled their trek, and their decision to journey to Switzerland, where assisted death is possible, albeit not easy. 

ALS is amyotrophic lateral sclerosis, also referred to as motor neurone disease in some British Commonwealth countries and as Lou Gehrig's disease in North America. It is a debilitating disease with varied etiology characterized by rapidly progressive weakness, muscle atrophy, difficulty speaking and swallowing, and d ecline in breathing ability.  

In 2007, Dignitas, a Switzerland-based organization, began an effort to gain legal permission for healthy foreigners, including married couples committed to suicide pacts, to end their lives in Switzerland. As of October 2008, approximately 100 British citizens had travelled to Switzerland to die at one of Dignitas' rented apartments in Zurich. Most of these people remain anonymous. In July 2009, British conductor Sir Edward Downes and his wife Joan died together at a suicide clinic outside Zürich "under circumstances of their own choosing." Sir Edward was not terminally ill although in great pain; his wife had been diagnosed with rapidly developing cancer. Read Anushka Asthana’s article in The Guardian Observer, Saturday, July 18, 2009. Right-wing politicians in Switzerland have repeatedly criticized “suicide assistance” for foreigners, branding it suicide tourism (Sterbetourismus in German). 

The documentary, “The Suicide Plan; Assisted Suicide in the United States,” aired locally on PBS Frontline in November 2012. (www.pbs.org). It depicts the travail of several persons as they attempt to experience or to facilitate death with dignity of a human being. “In this groundbreaking 90-minute film Frontline explores the shadow world of assisted suicide and takes viewers inside one of the most polarizing social issues of our time – told not only by the people choosing to die, but also by their ‘assisters,’ individuals and right-to-die organizations at risk of prosecution for their actions to hasten death.” Featured are nonprofit organizations Compassion & Choices and Final Exit Network as well as Derek Humphry’s Final Exit book. The video of "The Suicide Plan" video is available online; the DVD can be purchased at the website.  

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The leading cause of death in America differs by age group: 45-64 years – cancer, 65+ heart disease, dementia and cancer. Of the 1.4 million Americans who die each year, the vast majority are frail elders.  

The American Association of Suicidology reports that the elderly account for 12.5 % of the total population. In 2009 (the most recent year data were gathered), they accounted for 15.7% of all the suicides committed in the United States. Caucasian men age 65+ were at the highest risk for suicide; almost 85% of elderly suicides in 2009 were male.  

While the number of suicides among middle-aged Americans has gone up steadily since 2000, there has been a decline in geriatric suicides. Older adults take their own lives for a variety of reasons, including learning of an incurable illness. A new report from researchers has been published in the December issue of the American Journal of Preventive Medicine. 

Note that I avoid using the commit suicide phrase because I believe that ending one’s own life, with or without assistance, is not a crime, as in commit murder, and that PAD – physician assisted death – is the valid term. 

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NEWS: 

Services & Advocacy for GLBT Elders (SAGE) is the country's largest and oldest organization dedicated to improving the lives of lesbian, gay, bisexual and transgender (LGBT) older adults. SAGE is a national organization that offers supportive services and consumer resources for LGBT older adults and their caregivers, advocates for public policy changes that address the needs of LGBT older people, and provides training for aging providers and LGBT organizations, largely through its National Resource Center on LGBT Aging. With offices in Washington, DC, Chicago, and New York, SAGE coordinates a growing network of 23 local SAGE affiliates in 16 states and the District of Columbia.  

A maintenance worker at the Torrance, California Golden West Towers senior-living complex found three persons dead in an apparent murder-suicide. When he saw a man who lived in the facility holding a gun, he locked himself in the maintenance office and called 911. He heard one of the women victims say, "Please, no! Please!" and then two gunshots. A few minutes later, another shot. Officers found the bodies of two women and a man. Employees at the facility told the Los Angeles Times that the alleged perpetrator was a male resident of the facility, and that one of the victims was a manager of the complex and the other was a caregiver. One employee said the alleged shooter was prone to violent outbursts and had expressed anger toward those who were killed. Authorities confirmed that one of the victims was an employee at the apartment complex. They said none of the previous threats had been reported to Torrance police. [Los Angeles Times. November 20, 2012]  

A reliable source informs us in “a matter of public concern.” Strawberry Creek Lodge will be merged into Affordable Housing Associates. Affordable Housing Associates recently announced merger with Satellite Affordable Housing Housing to become Satellite Affordable Housing Associates. Informant wonders “if we are caught up in a non-profit version of Merger Mania? Merger manias are not a reassuring phenomenon… [Read Wikipedia article re the term merger.] One way of looking at this affair is that the possibility of getting $14 million blinded them to the obvious advantages of improving the Lodge slowly and gently, without risking our independent existence and without subjecting the tenants to a grueling accelerated program of demolition and reconstruction.” 

OWL, “the Voice of Midlife and Older Women,” reports that the median income for older women is $15,000.00 a year. Unemployment is much higher among older women – 20.5%, than men – 7.2%. Women are far more likely to serve as unpaid family caregivers. The notorious wage gap between women and men – 77 cents to the dollar – increases as women age. And gaps in life expectancy between rich and poor set to increase over the next 10 years.