Monday, October 28, 2024

Sarco? I think not.

The older I get, the more my thoughts turn to mortality in general, and my personal mortality in particular.

I'll "only" closing in on 75, so I certainly hope that the end game is not nigh. Still, sooner or later it happens to the best of us. 

Like everyone else in the world who thinks about their own death, I hope that when the time comes, I check out quickly and painlessly. My father died at 58 after a seven year battle with kidney disease. His death was neither quick nor painless. My mother, age 81, had two miserable weeks in the ICU before she died of heart disease, but I'd take those two miserable weeks of wind-down vs. the long goodbye slog. But as long as I'm healthy and with it - as my mother was: when she died, she was still volunteering, still taking courses, and had three trips planned -  I'd sure like more than 81 years, even though when my mother died it seemed pretty old to me.

My Aunt Mary (my mother's sister) made it well into her 90's, and up until her early 90's she was independent and vigorous. If you saw or spoke with her, you'd think you were with someone a decade - maybe even two decades - younger. And then she wasn't so independent and vigorous, but still doing more or less okay. And then, sadly, for the last long months of her long life Mary was bedridden, crying, praying to die. This from a woman who was so strong, tough as nails, not one scintilla of self-pity running through her veins. Sigh. 

My Aunt Margaret (my father's sister) didn't make it to Aunt Mary's great old age. She died at 85, but it was quick and, as far as we know, painless. And Peg died with her boots on. The evening before her death, she'd hosted members of her family for dinner, including a new great-grandchild. On the day of her death, she went to Mass, went to the Star Market, went to the library. And came home, took a nap, and died on the same daybed my grandmother had died on seventeen years before, under the same yellow-and-brown afghan (crocheted by my mother) that Nanny had died under. 

We all want a Peg death, that's for sure. Maybe a Mary death, with the trade off of suffering through a final bad spell in exchange for a decade more of good enough years. Maybe even a Nanny death, although she had tremendous mobility issues for years and her final years were pretty constrained. (Of course, I don't have a daughter to take me in and take care of me for the final half-decade of my life.)

My husband died too young - at 70 - and his last couple of years were on the cancer rollercoaster, with periods of misery interspersed with periods of mostly okay. Not a great way to go. But Jim approached his death with equanimity and good humor, and, in the end, refused a last chance to prolong his life for a few months (a few months of mostly chemo suffering). While I hope for a Peg death, if I get a Jim death, I hope I go out with the same equanimity, good humor, and practical wisdom.

During Jim's final months, we did vaguely explore a move to Vermont, a right-to-die state. More than once, Jim told me that even if he wanted out, he would never ask me to give him morphine - which we had (but never used) throughout his time in home hostice - because he wouldn't want me to get in any trouble. So, we looked a bit at Vermont, where Jim was born and grew up, but nothing came of it. 

I'm a believer in right-to-die, and have voted in favor of it when it's been a ballot initiative. Not that I'm a 100% believer. What I do believe is that there need to be slippery slope safeguards in place so that it doesn't turn in to a convenient way to get rid of folks who are no longer quite as convenient as once they were.

But if I'm actively dying and miserable, in hospice, nearing the end, please hold off on the intubation, the invasive problem fixing, the forced feeding. Just up the morphine dose, keep me out of pain, and let me drift off into the oblivion of The Big Sleep.

Would I be more pro-active in terms of a planned exit, as in our non-transfer to the great state of Vermont for Jim? I doubt it. I've always been more of a let's just see what happens kind of guy.

My end-of-life meditations pretty much presume I'm compos mentis. So far, I avoid going down the path of thinking about what to do if I get Alzheimer's - other than the stray is this it? thoughts that intrude when I can't remember the word for poncho, or when I leave my keys on the kitchen counter rather than on the credenza.  

Anyway, there's apparently another end-of-life option on the horizon, the Sarco death capsule, which was recently tried out in Switzerland.  

The “Sarco” capsule, which has never been used before, is designed to allow the person sitting in a reclining seat inside to push a button that injects nitrogen gas into the sealed chamber. The person is then supposed to fall asleep and die by suffocation in a few minutes. (Source: The Boston Globe)

Several people were detained by the police on "suspicion of incitement and accessory to suicide" after a 64 year-old American woman checked into the Sarco, a 3D-printed device developed by Exit International, a Dutch assisted suicide group. 

Switzerland is a logical place to beta-test the Sarco.

Swiss law allows assisted suicide so long as the person takes his or her life with no “external assistance” and those who help the person die do not do so for “any self-serving motive,” according to a government website.
Unlike some other countries, including the Netherlands, Switzerland does not allow euthanasia, which involves health care practitioners killing patients with a lethal injection at their request and in specific circumstances.

Switzerland is among the only countries in the world where foreigners can travel to legally end their lives, and is home to a number of organizations that are dedicated to helping people kill themselves.

Despite Switzerland's generally positive attitude towards right-to-die, and the country's becoming a destination for suicide tourism, there are some who take issue with the Sarco, questioning its legality in terms of product safety and use of nitrogen. 

The product safety concern is interesting. Is the Sarco safe if it safely kills someone? Unsafe if the person takes too long to die?

I don't know about you, but the Sarco is not how I want to "slip the surly bonds of earth." I want to die in a comfy bed or relaxer chair, not in a 3-D printed device that looks like it belongs in a modernized, souped up version of an amusement park Bump'em Car ride. Or on the bobsled course in the Olympics.

Still, it's something worth thinking about. 

What's the right way to go????

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