IAMA person that helped my (then) terminally ill best friend die via physician assisted suicide earlier this year. AMA.

I have no question. I just wanted to say that you're incredible. The world needs more people with your kind of compassion and understanding.

Thank you so much.

Would you do it again if you had to?

Yes. I don't regret anything, other than having to watch someone I loved deteriorate so dramatically. Her death itself was very peaceful, and I knew she was 100% ready. It's what she wanted, so if I had to, then yes. I just hope I never have to again.

You should know that for the entire existence of human kind this moral dilemma has been questioned. Don't ever think it was wrong, because NOBODY has ever been able to decide that. You are a great person.

Thank you, friend.

You are a good person for helping your friend whom you obviously loved very much. We should all be so lucky to have someone we can trust to care about us that much.

Thank you for your beautiful comment.

I didn't see any mention of it in other comments so I apologize if it has already been said, but for people curious about the process I would highly recommend watching "How to Die in Oregon". It is a really great documentary about the Death with Dignity organization, and it follows several people who have made the choice to go with assisted suicide.

What really struck me about the film was how ready people seem to be when the time comes. It looks much more peaceful than having to waste away in a hospital, and the fact that you get to go with your friends/family present, in my opinion, would make it feel more like a sweet release than an eternal goodbye.

I think that being a part of your friends escape from the pain was a very tough, yet noble thing for you to do.

I watched "How to Die in Oregon" a few weeks after my friend's death.

I agree that it was very moving, and I strongly encourage anyone who isn't sure about their feelings on physician assisted suicide should definitely watch it.

I really appreciate your comment.

Any reason for Shaun of the Dead? (Apart from it being awesome)

We watched Shaun of the Dead together for the very first time back when she was taking care of me after an awful breakup. We laughed our asses off, and when she came to my house that day, it's what she chose. She had a very difficult time speaking her last few months of life due to her tumor, but I got the clear impression she wanted something to remind us all of happier times. :)

man-tears.....ugh so deep in the feels

It's Monday morning, Who the fuck is cutting onions!!!

Damn turds.

Tis true, but in all seriousness. I witnessed a good friend pass from cancer just out of high school. It was my high school GFs Aunt. She was an amazing person loved animals and everyone she met. Meets no strangers kind of person. While her death was not assisted we knew the exact day she would pass. We all could see her body and mind giving up. So we stayed with her the entire day. Friends came by to talk with her and show her things she loved. It was a very hard day, she eventually pass around midnight and we all broke down and spent a few more hours waiting for the ems to come and take her. Onions man, fucking onions.

I'm truly sorry for the loss of your friend.

Thank you and I am truly sorry for the loss of your friend. I am sure she was a beautiful person and you are equally as beautiful. Thank you for sharing your story, I love you both as one human to another. Chin up and one foot in front of the other.

Thanks so much. That means a lot to me.

How long did it take her to past and what were her last words?

After taking the medication, she was able to keep her eyes open for 9 minutes, which I'm told is extraordinary. Most people close their eyes after only a minute or two. She slipped into a coma, but she continued breathing and her heart continued beating (albeit very, very weakly) for another 40 minutes or so.

Before taking the lethal dose of seco-barbitol, patients are given an anti-nausea pill to help keep the dose down. After she took her dose and a few minutes had passed, I asked her if she felt nauseated at all.

Her last word(s) was: "No."

You're a great friend. You have my respect. What is the first thing you did after those 40 minutes, the moment you knew she had passed away. It must've been hell. I've never been in such a situation but I think I would go crazy and cry, cry a lot.

Drank a thousand glasses of wine and made some very difficult phone calls.

Were you the only one with her in the end? Did she have any family present? I hope the question isn't out of line, but I find it interesting that she passed in your home.

I am married and have a 13 year old daughter, so I asked my husband to find some fun father / daughter thing for them to do, outside of the house, all day. My daughter knows my friend passed, but does not know the details or that it was in our home. Present for her death was myself, another close friend, and a social worker from Compassion and Choices, which is a non-profit organization to assist families through the Death with Dignity (assisted suicide) program. My friend had family who live outside of the country, and are extremely Catholic. It was for that reason that she did not wish for them to know her exit strategy. She was divorced, and had a son from that marriage, but who also does not know the specific details of her passing. She instructed me to be honest with him, if ever approached.

Thanks for the answer. You sound like a wonderful friend.

Thank you. :)

I was wondering the same thing. I always imagined assisted suicide to happen in a hospital, it sounds amazing that she was able to be with you in your home. I'm assuming there was hospital staff there?

It's actually illegal for it to take place in a hospital. I'm told (by the Compassion and Choices social worker) that 99 times out of 100, it happens in hospice. No hospital staff were present, and again, I'm not even sure if it's legal for them to be there. It's a pretty tricky process.

That's really strange! I always imagined otherwise. Do you happen to know why?

My best guess is because of the hippocratic oath to do no harm, but I'm probably not the best person to answer that. I know there was at least one physician on this thread, so maybe he or she can answer.

If you were in her shoes, would you choose the same?

I honestly don't know. I feel some comfort knowing I live in a state where this is an option, but I don't know if I'd have the sack to do it. Watching her drink the medication that would end her life was definitely a "holy shit" moment for me. She was incredibly strong and brave, and I feel like a pansy. But honestly, since the day she was diagnosed, I felt like there was no way I would be able to deal as gracefully as she did. Great question. I realize I haven't answered it, and it's because I don't honestly know what I would do unless I was actually in her shoes.

I see, I understand what you're saying. I'm sorry you had to lose a friend this way.

Thank you.

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We'd been friends for 6 years when she was diagnosed, 11 years by the time she passed away. It had never occurred to me before now that 1/2 of the time we were friends, she had cancer. Wow.

Geez. 6 years fighting a brain tumor. What a beast! I am terribly sorry for your loss.

Thanks so much. :)

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Great question. Yes, in Washington, a person has to:

1. be diagnosed as terminal, with fewer than 6 months to live
2. Request verbally to her physician to become a candidate
3. Request in writing to a different physician to become a candidate
4. Undergo an intense psych screening
5. Have two witnesses sign a notarized intent (one of which cannot be a family member)
6. Self-administer the lethal dose.

(edited because I forgot #5)

The psych screening seems ridiculous if all the other five are fulfilled.

I can see your point. Ironically, the psych screening is put in place to eliminate anyone who is depressed or suicidal (ha).

Well if they have less than six months to live what difference does it make?

I honestly don't know why the law was written the way it was. It's a very valid question.

If it is so much trouble, why does one go through it to do it legally?

That's a really good question.

I think in Oregon, who has had legal assisted suicide since 1994, it's not nearly as difficult as what my friend experienced trying to navigate through the process. Here in Washington, our law is much more new and there are more details that need to be ironed out.

In the end, I think people desire to go through the legal channels because it's much less scary to consider taking a lethal dose of medication that has a proven track record of being effective. The thought of swallowing a bottle of pills chased by a fifth of vodka has a much higher likelihood of being vomited back up, and other more violent methods are, well...much more violent.

There is also a stigma associated with SUICIDE, as opposed to a physician attended suicide. I think it's probably easier on loved ones when a professional is overseeing the process. I don't know. Just my thoughts.

Do you know what they do if someone has become so ill they could not take the dose by their self?

It's not legal for someone to help them take it so I imagine someone could be charged with a crime if they did.

If someone requests to die via this manner but for some reason would not be able to self administer, they are out of luck and will be denied. At least that is the case here in Washington and I believe Oregon as well.

That's interesting. So the law simply serves to allow patients to get medical advice on how to do it/obtain drugs from a pharmacy?

I suppose that is a way of looking at it. In the end it is indeed the terminally ill patient who is taking a lethal dose as opposed to a physician.

You sound like an amazing friend to be there for her during all that.

My question is how comfortable was she when she took the lethal dose?

My grandmother had a massive stroke when I was 18 and I was her power of attorney and executor of her living will. When I came home from work and noticed that she was not responsive I called 911 and they took her to the ER. I had told them that she had a strict DNR in her living will but they decided to medi-flight her to a better hospital anyway, so I can relate to the emergency response team giving you hell over it. From there I had to make the call to bring her off life support and take her home to pass. It was probably the hardest thing ever because it took about 2 1/2 weeks for her to pass. I know that if it were legal to have AS where we are from she would have wanted it.

Thank you for the kind words, and I am deeply sorry about the pain you experienced with your grandmother. I cannot stress it enough: everyone please get a living will / DNR (if that's your thing) in place ASAP.

She seemed very comfortable when she took the lethal dose, other than the fact that she said it tasted like hell. She actually had some miraclefruit before the medication which is supposed to make everything taste sweet but she reported still that it was disgusting. She still drank it down like a boss.

Your friend sounds like an incredibly strong woman.

The thing is that my grandmother had a living will that specifically said DNR. We nearly sued the hospital for going against it.

She really was a viking.

And I understood what you meant about your grandmother...my comment was directed at anyone else that doesn't have a living will / DNR in place. I'm sorry that I wasn't more clear, and very sorry you had to experience that. It's really the last thing you need when navigating the torture of losing a loved one.

I think dealing with my family was worse than dealing with the doctors. Once they medi-flighted her, as soon as I got there I went into total dick mode and got up in some faces about it. My mother and aunt (her two daughters) were both trying to make me sway and give them the power to call the shots. I didn't and so they basically tried to guilt me into believing that I killed her. That was a pretty big blow to my psyche even though I know that it is what my grandmother wanted, and made me promise to her while she was still alive.

You are a wonderful grandson and you definitely did the right thing. So many people do not understand that being another person's medical Power of Attorney does not mean operating as the decision-maker on their behalf...it is so that their own wishes are carried out. You stood fast, and it was your mother and aunt who were operating selfishly. I can give them a pass, though, because people are not in their right mind when grieving. Telling you that you killed her though...not so much.

Take care.

Do you ever get any negative comments for what you did?

Also, I'm sorry you had to go through that. It seems like your friend loved you very much and you can know that she doesn't have to suffer anymore.

Thank you. In general I have been blown away with kindness and support. The only really judgy comments I've received have been from my own Christian parents who begged me to share Jesus with her before she died. They made it very clear that this was Not. OK. but even still, told me they were proud of me. Her mother suspected foul play and ambushed me over the phone the next day, begging me to tell her if she would see her daughter in heaven because if she had done this to herself, she never would. That has actually been the hardest part of this whole thing - the moral dilemma of whether to be honest with this woman, or spare her by lying.

hello. I do not mean to be presumptuous and assume that you need help with this situation (your friend's mother). I realize you didn't ask for advice, so I mean no offense.

but, I am a hospital chaplain, pastor, and theologian well-versed in issues of end-of-life care, death with dignity, etc. I have specialized in working with families who are diverse in their beliefs. feel free to PM me if you'd like any counsel regarding your friend's family and/or your own parents.

peace.

That is very kind, thank you.

Unfortunately, her mother has returned to her home country, and I have lost contact with her.

I do appreciate the offer and kindness.

How was she ready for the afterlife? I know the question may be a little odd, but since she knew her death was coming. Was she ready? What were her thoughts?

Well, on the surface, she claimed to not believe in the afterlife. Of course I have no way of knowing if that is how she truly felt. She certainly didn't romanticize her own impending death though. There were no tears whatsoever. In fact, I never once saw her shed a tear throughout her entire illness.

Do you feel it was unfair that her mother missed the "occasion"?

In some regards, yeah, I do. Her mom loved her and was her MOM, for fuck's sake. But I also understood that her mom would never accept her choice, so I respected my friend's choice to exclude her, regardless of how uncomfortable it made me.

Reading through this thread, you are the best friend a person could ever want or need, she was very lucky to have you. Being a 250lb, 6'4" "manly man" this really brought me to tears. Not in sadness, more so because of the relationship you two shared and the strength of your bond. This is the most touching thread I have ever read. Thank you for sharing.

Thank you for your comment. I am honored that it has touched some of you, and overwhelmed by the number of kind comments and support this thread has received.

How did your friend approach you about the issue? Is it something that she discussed with you before making her decision or was her mind already made up before she spoke with you about it?

She began having frequent seizures, and we made several trips to the ER. After a few weeks of these seizures, she emailed me to let me know she wanted me to accompany her to her next doctor's appointment to "discuss options". Her doctor sat down with me and explained that this was the path she had chosen, so yes, her mind was made up. She just didn't exactly know when she wanted to go through with it. It was 3 months later that she actually obtained the lethal dose, and several weeks after that before she took it.

It was 3 months later that she actually obtained the lethal dose, and several weeks after that before she took it.

How does this work? Does she hold onto the dose and take it whenever she's ready? Do you have to call doctors/police/undertaker etc. before/during/after?

I was spending time with her one day when she shoved a business card into my hand, for the University of Washington Pharmacy Director. After asking her a series of yes and no questions, I figured out that she wanted me to call and get the medication for her since her ability to speak was way too degraded to make that phone call.

Once a patient has met all of the criteria to qualify for the DWDA, then yes, it's up to them to obtain the medication and they can take it whenever they choose. I'm told that statistically, 45 - 50% go all the way through the process and obtain the medication, and then never take it. I guess it's just a safety net for them to utilize if they decide to. Some never do.

We had to meet with the Pharmacy Director for the UW Medical Center when she received the medication to make sure we fully understood how it needed to be ingested, etc. Then I had a few meetings with the DWD Coordinator at the hospital who asked me to keep her apprised before, during, after.

There were also several phone calls between myself and funeral homes re: post-mortem arrangements beforehand, but once her mother got involved after she died, it was out of my hands.

Wow, I'm really surprised they're allowed to hand out a pill that will kill someone when ingested. Seems like there would be liability issues. Thanks for the response.

It is actually 90 capsules that have to be pulled apart and dissolved in 4 oz. of fluid. It would be pretty tough to accidentally swallow it and die - its a very deliberate act.

Ok that makes way more sense than a single pill. Is there a horrible taste/odor? I was thinking more along the lines of liability in case it was used to murder, as opposed to accidental ingestion.

She said it tasted absolutely unholy.

Do you ever feel regret for doing it?

I feel sad that it had to come to that, but watching a vibrant, beautiful woman be crippled by her disease was heartbreaking. I guess to properly address your question, I feel haunted by the fact that I helped her and watched her die, but I also feel like I did the right thing. It was truly what she wanted.

Wow. Haunted by it. I know just what you mean. I don't believe in supernatural phenomena, but the word "haunted" sure hits it on the head. I'm about 2 years past my last experience of sitting with a loved one in their last hours, and I don't feel that way anymore, but I sure did for quite awhile. A few sessions with a grief counselor helped, but I think time passing is what helped the most. Best wishes.

Thank you. Take care.

How did you feel about the whole decision process to do physician assisted suicide? Do you feel like it is something that should be legalized through out the US?

I absolutely believe that it should be a legal right for anyone, although I found the particulars of getting her through all of the hoops she needed to jump through to be incredibly tedious and frustrating. Further still, we encountered some ugliness with the emergency response team after she died which made things extremely interesting. I am so happy to live in a state where this is a legal process, but there are some definite kinks that need to be ironed out still.

Could you expand on the ugliness from the emergency response crew?

I was unaware this was legal in any state, so I'm very intrigued. After she had passed, do you call 9/11 like any other death? If it is perfectly legal, why would they be ugly about it?

Also, I saw where you said the family didn't know of the exit strategy, so do they think she just passed from the disease?

Thanks for doing this AMA. I would like to see this legalized everywhere so people who don't want to suffer when they know they're about to die can have a more peaceful option.

I had been instructed to contact her physician after her death (he was well aware of her decision to end her life via DWD), who was apparently on the golf course that day, and asked me to page the Medical Examiner directly for an NJA number. The Medical Examiner called back and told me to dial 911 and report an "expected death".

The next thing I know, two fire trucks, an ambulance and two police cars come hauling ass up to my doorstep. Six firemen came in with all of their gear, prepared to resuscitate her to which we responded HELL TO THE NO. They felt for a pulse and began shouting that she was still warm, and it was their job to resuscitate. We went 14 rounds with them while I pulled out Medical Power of Attorney paperwork, etc. and having them literally tell me that how do they know that I didn't bust into the house to rob and murder her?

It took over four hours with my friend dead on my couch for them to back off and allow the funeral home to remove her body.

An interesting footnote is that as a result of that experience, policy in WA State has actually been set in place that legally requires the Medical Examiner to issue a NJA number for all DWD cases. Hooray.

Her family does not know 100% that she chose to end her life, but her mother strongly suspected it. I haven't heard from her since a few days after she passed, so I don't know if she ever came to terms or what. That part still very much haunts me.

Well, as rough as that is, they were just doing their job. Can't blame them for the state not having better procedures for the aftermath. I wonder if the "expected death" got sort of "telephoned" through the next couple calls so they sent all these people for a different reason. Although, to think you broke in and murdered someone who just so happened to have those papers, and then stuck around for the cops seems a touch ridiculous lol.

I'm glad they have something in place to make things easier now. It had to be hard to sit and deal with things with your friends body just on the couch :(

I'm also 100% glad my parents would support my decision and wouldn't have to be lied to about my way off of this Earth. My mother would hold my hand if it ever came to it.

I agree with you, and they were just doing their job. It was unfortunate timing that it directly corresponded with a very heightened emotional state for myself and my other friend. After all was said and done, the fire chief or whatever he was apologized and made nice. And the SPD was absolutely beyond compassionate and wonderful. It just really highlighted how grossly uninformed emergency response teams were at the time (none of them had ever even heard of Death with Dignity in Washington) and so now they are required to complete training for these cases. It's all good stuff. :)

It's very unfortunate this needed to happen, but on the brighter side your friend and yourself have just ensured that future cases of assisted suicide will gain the appropriate reaction so nobody needs to go through that added pain and trouble. Internet hugs - Thanks on behalf of those future people and thanks for being a lovely and supportive friend all the way to the end. You did good.

Thanks so much for the kind words. :)

Can you explain what happened with the emergency response team? I'm sorry if I sound a little straight forward.

edit - Ninja'ed

No problem - and I actually just did. Let me know if the comment was buried and I can recap. :)

What a great friend. I'm sure that meant so much to her.

Thank you for the kind words.

I had a dream last week that my best friend had died, and remember sobbing in my sleep. I can't imagine being in your shoes, but I commend you for being there for her.

I know you say it was the right thing to do, but are you OK?

Thank you for the kind words. I am OK. There have definitely been ups and downs and every once in a while, the reality of it comes from out of nowhere and kicks my ass, but it's beginning to settle in that she's gone. The hardest part has been little things, like accidentally butt-dialing her with my phone and seeing her name on my screen. Or running across some piece of art she designed (she was incredibly talented). Also, I miss her son but don't know his dad at all so I've been struggling with how to approach him or reach out.

How long ago was this?

As for contacting the dad... seems the best course of action would be straight up and honest.

This was the beginning of March of this year.

I did try to call her ex-husband that night and did not receive a phone call in return. I keep meaning to call, but keep pussing out.

hugs. The right time will present itself, when you're ready.

I hope this AMA has been cathartic for you. I've lost many friends over the years, starting 14 years ago, averaging about 1 a year ever since.. the most recent in May of this year. It never gets easier, but I think talking about them is the best thing you can do. That's what keeps them alive.

Thank you, and it has been interesting and cathartic. Sometimes I think I would like to get involved in this cause but haven't quite found the right momentum just yet.

Thank you for the kind words.

Did you and your friend ever talk about your/her thoughts regarding death and what comes next? What are your beliefs? What were hers?

She was a recovering Catholic who had abandoned all religious beliefs and wanted no part of religion. She wasn't thrilled about dying, but she didn't seem scared or uncertain about what is to come next.

My beliefs are a bit ambiguous, but I feel very strongly that if there is a loving, compassionate creator, he would not require us to suffer senselessly. I don't know what comes next either, and I will fully admit that death scares me, as irrational as that may sound.

That's comforting that she didn't seem scared or uncertain! Death is indeed a scary thought. Seems that she was a strong person making this decision. You did a very caring and loving thing :)

Thank you. :)

Did you have EMS there to take her away after she passed? Or did you have to call someone? And do you feel uncomfortable knowing someone died in your house?

First I paged her doctor. He called back right away and gave me a number to the Medical Examiner. Called the ME, who told me to call 911 and report an "expected death", under the Wa State Death With Dignity Act.

Two fire trucks and two police cars came screeching up to my house. Six fireman, and two police officers came in, and the firemen felt for a pulse and began reaching for what I assumed was defibrillators and such to revive her. We told them she had taken a self-administered lethal dose of seco-barbitol in accordance with the DWDA and they insisted that they were there to resuscitate the "victim", otherwise there was no reason to involve the fire department.

We pushed back that this was a legal act and she absolutely did NOT want to be revived at which point things got heated. I produced medical power of attorney paperwork to show that I could speak for her re: medical issues on her behalf, the fire chief told me these were useless documents to him without a POLST (Physician Orders for Life Sustaining Treatment). I had begged my friend to always carry a copy of her POLST with her, but after digging in her bag, it wasn't there. That was probably my fault for not checking to see if she had that on her first The more you know.

The fire department finally relented and packed up, apologized and left. I imagine they were there arguing with me for about an hour, and at one point essentially accused me of breaking in to rob and murder her. He presented it as a hypothetical but that's when I came a bit unhinged.

The police stuck around while we waited for the funeral home to come get her. While we were waiting, her cell phone rang, and I saw that it was her mom. I couldn't bring myself to answer the phone and tell her that her daughter was gone, so I let it go to voicemail. One of the police officers asked if I would like for her to call the mom and break the news to her, and I told her yes.

Finally the funeral home showed up and took her away. Between the time of death and the time the minivan (not a hearse by the way) rolled away and the cops left? Four hours.

Called my husband and told him he could bring my daughter back home.

Made a bunch of phone calls to friends.

Got very drunk.

Your friend was strong. I don't know if I could do that even though I know all lives end eventually.

I, no words... Just feelings is all I have...

I don't know if I could either my friend. She was a brave girl. Hugs.

How old we're you and what did her family say?

I'm 42. She was 39 and a day.

I only spoke with her mom, who was reasonably distraught. She asked many, many questions about what had happened that day and whether or not she had taken something. It was pretty uncomfortable.

So her mother and her son still don't know that she decided to go with AS? Also, how long ago was this?

This was early March of this year.

I honestly do not know if they know the full details or not. I haven't spoken to her mother since a few days after she died.

I had to make a judgement call as to whether to be honest with her very Catholic mother and tell her exactly how her daughter died, and ruin her life, or keep it to myself.

I honestly couldn't think of a scenario where destroying the woman and her hopes to see her daughter in the afterlife made any sense, so I didn't disclose it. I don't know if that was the wrong thing to do or not. It was a shitty, shitty phone call and it will haunt me probably forever.

No questions. I just hope that when life comes to this, whichever role I'm in, I'm half as brave as you and your friend. Death seems less scary knowing it can be faced with so much love.

Thank you so much. I think we all have the capacity to surprise ourselves with things we don't necessarily think we can manage.

After reading all of this, I just want to hug everyone I care about :[

Yes you absolutely should. Every day even.

What was the turning point for her. Between fighting the tumor/being on painkillers and assisted suicide?

I'm not sure I completely understand the question. Do you mean at what point did death become the preferred option over living?

Her tumor was in her brain so she didn't experience any physical pain as a result. It was more the dramatically increased number of seizures (she went from one or two seizures ever few months to 20 or so per day), as well as the loss of her ability to speak, loss of dignity, and the fear of onset of paralysis, which her doctors explained would be the next chapter of her disease.

Per the Washington Death with Dignity act, the patient has to self-administer the lethal dose of medication, and she was beginning to fear that if she waited any longer, she may end up paralyzed and unable to do so. Her biggest fear was to end up in hospice with people caring for her basic needs. I distinctly remember her telling one social worker who suggested a live-in nurse "I want to be able to wipe my own ass".

I also think that after 5 years of dealing with chemo and radiation, she was just tired and sick of being sick.

I hope that answers the question. Please feel free to let me know if I totally misunderstood you.

How do you feel about assisted suicide? After watching it first hand if (god forbid) you were ever in that situation would you choose AS?

I sort of answered this upthread a bit, and my (non) answer is: I don't know. I just don't know if I would have the balls to do it. I think it would really depend on the disease and how my own daughter and husband felt about it. Well, probably just my daughter, because I'm pretty sure my husband would be completely supportive. If she felt like I was abandoning her, I don't think I would. If she was at peace with it, it seemed to me like a very peaceful, comfortable way to go.

I'm pretty sure my husband would be completely supportive

In the good way? Or bad way? :P

LOL. In the "I love you and don't want you to suffer but will of course never DREAM of dating after you're gone my love" kind of way. :)

This reminds me of the book Love Life by Ray Kluun which I read years ago, really liked it back then though. Anyway, I just wanted to ask you if you've ever considered euthanasia as a selfish act? If you think it's the easy way out and an option for the weak ones? Have you changed your idea on the subject since you and your friend went through this together? What are your thoughts about it? Thank you for a very interesting AMA.

Thanks for a very thought provoking question.

I really don't see this as being a selfish act. She was dying anyway, and had no quality of life. Her seizures were ravishing her brain, and she was functioning at the cognitive level of about an 8 year old. Asking her to live out the rest of her days paralyzed (which was coming) and unable to communicate would be selfish, in my opinion.

People that deal with assisted suicide on a daily basis do not even call it suicide or euthanasia - they call it "hastening". She hastened her death.

She got to choose the hows, whens, whos and wheres. I wish that she could have been open and honest with her family about her intentions, but I completely understood and supported her right not to.

Whether or not anyone agrees or disagrees, I urge everyone to have a living will in place. It seems like it's a million years away for the young and healthy, but it only takes a few minutes and you really truly never know when your number is up. It makes sense to get to do things on your terms. Sorry if I'm rambling. :)

Reading your answer got me thinking of another question, how did she choose the day she would go through with this? Did she make the decision the same day or was it decided weeks before? Also, if its not too personal, what was the atmosphere in the room like when she took the medicine? Did you feel uncomfortable? Mad? Relieved? Happy?

She initially chose a day that didn't work out. She had just seen her son (who lives with his dad in another state), but she didn't have all of her ducks in a row so then she pushed it back to the day after her birthday. A Saturday. She never (and probably couldn't due to compromised speech) explained how she decided that was the day, although I suspect she had just had it with the seizures.

The atmosphere in the room was as light as possible. It was a sunny gorgeous day. I made sure the house was nice and clean and a comfortable place to be. She stalled for a while and we just tried to keep it light, until she decided it was time. I held her hand and pretended to watch the movie while in reality my guts were in a knot. When she closed her eyes, I quietly let loose with a few hot tears, but for the most part, it was not dreary. She was relieved to put an end to the misery.

I meant to add that there is a very interesting documentary called "How to Die in Oregon" that covers this very topic. I highly recommend it.

Anyone who is curious about this should definitely track down "How To Die In Oregon"... It's fascinating and surprisingly uplifting.

OP, you're a good friend. Thanks for sharing with us.

Thank you. :)

physician here.

I'm curious. Who signs the death certificate? Does the case go to the medical examiner? Who pronounces the death...as in does 911 need to be called afterwards?

I'm a firm believer in dying with dignity. Your friend sounds awesome and someone I would have liked to meet.

We were bounced around quite a bit between her physician, the ME, then 911 and emergency response teams. It became a huge mess because from what I'm told, this type of death normally takes place in hospice. The fire department and the police department had NO idea how to handle a death of this nature, as it was the first case for all of them (at least the people that were standing in my living room yelling at me).

Eventually it was the ME that signed the death certificate, and because it was such a fiasco, policy in Washington has actually been set in place that legally requires the ME to issue an NJA.

Thank for the kind words. :)

What were the thoughts going through your head throughout the whole experience? What kind of emotions did you feel?

And as hard as this may be to answer: What did it feel like to watch (or feel) the life leave her body. I completely understand if you don't answer.

Thank you for this enlightening AMA

I suppose my feelings were all over the map if you take into consideration the time after her diagnosis and leading up to her death. Dread, sadness, and then I shifted into a "Mother Hen" type of a role where I helped her made decisions and actually moved her into my house for a while when she almost lost her healthcare (and then could afford it again after Obamacare but that's a whole other can of worms).

When I knew she planned to end her life I understood but was very depressed for days. Then dread waiting for her to decide when. Then a little bit of relief once it was all over. That probably makes me sound like a monster. Then, and now...I just miss her.

Seeing the life leave her body was a gradual, subtle thing. I sat and watched the tiniest pulse in her neck for what seemed like forever. None of that part of it really even seemed real.

Did you guys, before she lost her words, have the closure talk? Did you feel you had closure? Have you needed a therapist after this?

You are a good friend, and kudos to your husband for distracting your kid while it went down.

We had some logistical conversations - who to call, what to say, that type of thing. We never had a Terms of Endearment "You're my touchstone, Emma" type of tearful conversation. Lol.

As far as closure goes, I do feel like I got it, pretty much the moment she no longer had a pulse. It had been such a long illness (5 years) and then several months of uncertainty once I knew what her intentions were.

My husband is a really, really good guy. He has encouraged me to see a therapist but I haven't felt like I've needed to just yet. I probably will at some point.

I had a conversation with my grandmother before she died clearing the air of my teenagehood where i wasnt particularly nice to her. She forgave me and then watched more antique roadshow.

Did you guys have conversations like that?

Have you tried something new in honor of her memory? I read a previous comment she was a talented artist, have you tried to tap into her by painting? Have you felt the need to?

I just recently watched an episode of greys anatomy where they touched this subject. It intrigues me. Thank you for providing an ama.

We really didn't have any conversations like that to be honest. She wasn't a particularly sentimental person, and was fairly uncomfortable with touchy-feely stuff. The other component at play was, until she got really bad, she barely even seemed ill. It was a very dramatic shift when her tumor started growing and shutting her down. I don't know if that makes sense.

I keep thinking that I will at some point do something to memorialize her but haven't landed on exactly what yet. This in particular is what makes me believe I haven't properly dealt with losing her yet and the other shoe has yet to drop.

yet yet yet yet yet. I am apparently in love with the word yet. Lol.

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I'm so sorry to hear about your father, but I hope you realize (and I hope he does too!) how LUCKY you all are that you do live in a state that supports the right to die with dignity.

Please, if there is anything i can do, please do not hesitate to let me know. I would be happy to help in any way I can as well as put you in touch with the absolute angels at Compassion and Choices who started in Oregon.

I also recommend watching How to Die in Oregon, which you can get through Netflix (although not streaming). It isn't easy to watch, but I hope it will help bring you some comfort if that is what your father decides is best for him.

Hugs.

My great grandfather was not in a state with assisted suicide. this was also almost 30 years ago. since he couldnt get help from doctors he decided to use his pistol from WW1 instead. He called my grandmother moments before he pulled the trigger to say goodbye and that he "couldnt bare to have a nurse wipe his ass for the rest of his life." I find it very interesting that your friend had the same rationale regarding the choice. he was terminally ill with multiple cancers. the way he ended his life really affected my grandmother and was a big part of our family there after. I wish assisted suicide were legal because my great grandpa was a cowboy and wanted to go out with dignity. A fatal wound to the head with a gun isnt the best way to go but for him there were no other options. My family is forever different after that event. Youre an amazing person to be there for her and in my opinion feel very blessed to have her go in a peaceful way. Thank you on behalf of humanity Patricia.

I am so sorry to hear of your great grandfathers situation. This is precisely why I feel this is such an important issue. Thank you so much for sharing.

I recently saw the documentary "right to die?". If you're familiar with it, was this reasonably close to your experience?

What are the relative benefits to 'assisted' vs taking a bunch of sleeping pills? (sorry for the wording, I don't mean to offend in any way)

No offense taken whatsoever.

I think the main benefit is it is a medically supervised tried and true method. An anti-nausea pill is administered beforehand and it eliminates (for the most part) any chance of accidental survival although I hear it has been known to happen. And then those people wake up and are puh-hissed.

But to answer your question, there is nothing stopping anyone from chasing a bottle Xanax with a fifth of vodka. There's just a decreased risk of failure.

Forgot to add, I have not seen Right To Die but I will look for it. Thanks.

My mother has a terminal illness, diagnosed at 48. She was given the OK for medical assisted suicide (WA State) but has declined the offer. Could you give any advice for someone (anyone, really) who may be going to lose a loved one in the next few months to a year at most. Is there any way to really brace yourself beforehand? She is in a lot of pain, but doesn't want to go thru with the procedure. How do you feel about the people who decline the offer and deal with the daily suffering?

I'm sorry it's taken me so long to reply to you. I saw your comment yesterday, but I really wanted to think about this.

I think death is such a personal choice, and I respect your mom for not choosing it. If she's not comfortable with it, there isn't much more to say on the matter. It's her life, her death, and I think you should be as supportive as possible for whatever she decides.

As for what comes next, I think you should spend as much time with her creating memories as possible. Yes, you can brace yourself. And yeah, many of these memories will be made with you thinking to yourself the entire time, "She's dying, she's dying, she will be dead soon, wtf..." but SHE won't be thinking that. She will be having a marvelous time with her loved ones, and what is more important than that?

Take care, and I'm deeply sorry to hear about your mom's condition.

Apologies if this has already been asked... What did you guys do in the hours leading to her death, and how long were you with her leading up to taking the lethal cocktail? I imagine she told you what she had planned, and gave you reasonable notice, but what do you do with your best friend in the last few hours of their life? What did you tell your best friend knowing this would be the last time you spoke and you would be the last person to see her? What do you ask them? Has to be an indescribable amount of pressure.

I picked her up at her condo around 1 PM and we went back to my house and watched Shaun of the Dead, while we discussed a little bit of money she had set aside for her son, as well as funeral arrangements, etc. We didn't go get manicures or anything like that, it was really fairly strictly business aside from her unexpectedly wanting to watch a movie. She also wanted me to leave my dogs in the room...I was going to put them in another room, because they're big goofy Great Danes and I didn't want them in her face, but she wanted them there. She loved on them a bit.

We didn't have too much in the way of conversations, but by then it was so hard for her to speak. I did ask her a few times if she was 100% sure she wanted to go through with it, as well as gently let her know that if she changed her mind, no one would be upset with her and she shouldn't be embarrassed. Just tried to let her know she had my support whichever way she went.

I saw a few places where you said you had to deal with making a judgement call about what to say to her mother about the AS. Did you not speak with your friend beforehand about what you might say to her family after her passing? That way it wouldn't all have come down to you. Seems like something maybe she should have even taken care of before passing.

Yeah, I tried having that conversation with her a few times but never got a clear answer from her. One one occasion I gathered (mind you, her speech was so far gone that it was very "Is Timmy in the well!?" trying to get information out of her) that she wanted me to be honest with her mom after she was gone, and on another she indicated she never wanted her mom to know. So when it came down to it, I kind of panicked. Her mom caught me completely off guard when she called. I dind't recognize the number, and then shit just got real. I had to make a snap decision, and I chose to try and spare her feelings, ultimately.

Your friend was fortunate beyond words to have a friend like you who was willing to be there for her in such an impossible situation.

Thank you so much. I feel like I was the lucky one to have had her in my life.