EXIT would you consider being a member?

Family, Education, Health and Pets
81
I think people are seeing EXIT just at the end point. To me it's about discussing with your family what you and they would want, in an environment without the added emotion and pressure of an actual terminal or traumatic event.

For somebody who becomes a member of EXIT, they have made their wishes clear and they have given the tools to their family members to carry out those wishes. Without something like EXIT there is no choice but to suffer until the natural end.

I can see and fully understand the feelings of the "life is precious" and the "slippery slope" objectors. I agree that there has to be great oversight to prevent abuse. But in the end, it's my life and that of my family, and we should be able to choose to end that life with dignity.

We put our pets to sleep so that they do not suffer, even though they have no voice to express their destiny. I am no more important than any other animal, though I can declare my wishes. I want my right to choose my fate too.

82
I think this hits the nail on the head... We do it for our pets for reasons of compassion. Why can't we make this decision for ourselves.

We spend incredible amounts of money to preserve life, but it seems we spend very few resources on preparing for or facing death. I actually applaud the Swiss for what they are doing!

fduvall

83
Yes, of course.

84
Exactly, and it depends on the time of life too. My mum was the most intelligent and vivacious woman. She had a fantastic life until she was about 80- then she became totally blind, combination of glaucoma and cataracts. Cataracts could have been operated on, but she would still have had minor tunnel vision due to glaucoma. Her knee replacement was a disaster, and she had narrowing of the arteries in her legs, and was crippled from top to toe in very painful arthritis. She tried hard to keep going, but then broke her hip and femur in a fall- and just gave up. She had been a founder member of Exit- and asked many a time to die- but my dad begged her and begged her not to- and anyhow the OAP home where she was wouldn't allow it anyhow. She was trapped and hated it. She tried to stop eating and drinking, but they would more or less force feed her. She lived that miserable life for another 14 years- whenever we visited, she would put her hand above her head and make the sign of scissors- cut the string she kept saying, just cut the string. She didn't have cancer, or motor neurone, or parkinsons, or any disease as such. She had exactly what Meloncollie described 'Lebensmüde' -tired of life and just did not want to spend more time being turned in bed every 2 hours, wearing pampers and having to be washed by staff- in pain, unable to read when she was a verocious reader... she just had enough. She was forced to live 14 years of misery- and she should have been allowed to die quietly and peacefully.

I totally agree that many cancers can be cured and allow for many many long years of enjoyable life afterwards. But sometimes, the fight cannot be fought anymore, and especially if very old and without any joy in life- then the choice should be there for those who don't want to go on. With Motor Neurone disease, morphine or palliative care will not really help- and the patient knows that they will die slowly of suffocation. Should they be forced to go through this, like Debbie Purdy had to?

I just love life, and I hope to have many many more years ahead of me to enjoy my grand-children, daughters, friends and the wonderful nature around me. I am a fighter, and I am sure if I was struck by some disease, I would fight like hell. But being a member of EXIT is hugely re-assuring- knowing that, if ever- I feel I just can't go on fighting the debilitating effects of some dreaful disease or disability- the choice is mine. As someone said before, for many people, knowing that the choice is available is so reassuring- that it gives them more strength to continue to fight- and many choose, at the end, not to use EXIT. It is a charity and only gets funding from member subscriptions, and to insinuate that they get funding from health insurances is just wrong.

The reason this thread was opened was because it was wrong to discuss this on a thread about retiring to Switzerland. Although for me- it was very much part of the decision process- as the Debbie Purdy case really made me think, And so did the wonderful Dimbleby lecture, written by Terry Pratchett and read by the wonderful Tony Robinson- about the lack of choice in the UK.

But also, even if we disagree, it si good to talk openly and to exchange views - and also to work out for ourselves, frankly, what we want in 'case' we are faced with a situation which is unbearable. Thanks for your views- those that I agree with, those that made me re-consider and look at the subject differently, and even those I truly disagree with.

Here is the link to the Terry Pratchett Dimbleby lecture if anyone wants to watch it:

http://youtu.be/90b1MBwnEHM

85
I see many similarities between this thread and the thread on assisted suicide stats - in a good way

86
VERY intelligent, enlightening post. In fact, it's the direction Exit is trying to take at this moment. Read here .

87
So are you saying that my mother should have had to live in pain, blind, totally dependent and hating every minute of it- because she was not fortunate enough to have a 'terminal disease'? And forced to live 14 years she did no longer want to live, to age 94? Because her choice would make YOU uncomfortable?

Should she not have been able to decide for herself- after a rich and wonderful life of 80 years?

88
The movie "After Jimmy" gives heartbreaking insight into a family whose eldest completed suicide, how the family doesn't 'get' why he killed himself, and how the parents start guilt-tripping each other, which just results in more pain for those affected by the death. It's on YouTube.

I wonder why trying to find out who could be responsible for a death is so important to some? Why is it hard to accept that sometimes death is indeed wanted? How does judging ways of death help with closure?

89
I think closure is a little bit more difficult if you know those who you love and need, check out earlier by their own decision. I know what the counter arguments are and would always respect people's decision, and will do so. Still. One thing is to rationally know it, one thing is how human heart actually works. Not much to do with our reason. Knowing that, I think I will not opt for this. I know my kin.

Imagine you are a doctor and your own parent decides for no treatment. I am still processing this, since we had it in my environment. It's unimaginably hard.

Love makes some want to die early, to not cause pain watching you suffer. Another one decides to put up with suffering to not cause pain to loved ones by exiting early. It's tough, and there is no moral judgment that should be aplied. But if people think they are automatically destined to suffer, because there would be no EXIT, it is wrong. And they should not think this way, and pay just in case. I think the issue of EXIT is big now, there will be cases like these.

That's the thing. EXIT exists and will. I don't have a problem with something existing discretely, to help people end their suffering in a dignified way. Just like I know there are medical professionals who are always put every now and then in front of this dilemma. I am from a strange environment where this fight to improve people's quality of life, by improving their health, is on a daily agenda. Including discussing the situations where the value of human life had to be accepted as it was presented by the actual patient, ie no more value. No more will to fight. There is a moment where the doctor, caretaker, family, has to decide to back off. It is more common than just these moments of terminal deterioration. I am afraid that this moment to back off, them knowing the patients have checked in the EXIT anyways, will not motivate to help to improve, and will let the weak patient off the hook. Palliative care is so expensive. Shrinks are, meds, and elderly need them more than we do. It's cheaper to treat one's anxieties and fearing death (isn't it a social phenomenon) with this insurance. Hospitalisation is really expensive, it causes some hospitals here to have major financial troubles. EXIT is cost efficient.

This issue is not private and discrete at all. That's what's bugging me. It's like organ donation issue. It is campaigned for, popularized, it's all over the media...It's not a discrete moment at a docs office. A quiet suggestion. It's discussed and judged, flyers printed, special IDs will be put in people's wallets. There are opinions pushed, just like this "how can you be so selfish" to want to live (keep your organs intact), we have read in here, too. I think the min it becomes an issue to have mass population judgment tag added, it will automatically push some lonely and desperate folks towards this, that would not maybe opt for it. I am afraid if this will later on enable other ways to view elderly. Then those mentally ill. Then those who are a bit not normal. We as a society are not ready for this, I think. Especially where cash and investments hold high value.

Ok.

It's interesting when people assert their yes-no without coming with some interpretation. I will delete this poster's comment if he does not chip in, looks like post count harvest..

Considering the anecdotes here, as per individual members plans for future, I understand. EF is a platform of folks who have already learned to fight. These people will make their choices, assertively, also based on comparison more than not, with whatever they have experienced elsewhere, where healthcare is different, etc. I think the demographics are different than what is present in reg society here, their behavior, assertivity, ambitions, etc.

The Harakiri comment was done on purpose. This issue reminds me stats on suicide, which are quite high here. If I remember well, it was lonely elderly, unemployed, kids who failed exams. Vulnerable social groups. To enable one of these groups with an esier way to dissappear, is strange for me. It's like marking an area, on my way to work where all those ICN train jumpers operate to end their lives - "here, please, do it here, since you won't make a mess, we have infrastructure to service you, just pay to be a member". I just think by helping those who do not want to live, we might be facilitating shrugging off any responsibility we as a community or family really have for them, and not the opposite.

Of course I do think people will decide on their own whatever they want and it should be respected. I need to put these disclaimers all over, I know.

I think I have a problem with possible consequences if the popularisation of this issue is done insensitively. Some of the reactions I have encountered have alrady made me think.

90
You make some very thoughtful points here, MusicChick. There is definitely the risk that outside forces will influence what should be an individual and extremely personal process and decision. And it is true that, as a society, our care of the elderly or otherwise vulnerable leaves much to be desired (I'm referring to nursing homes, etc). Even though, from what little I've seen, Switzerland does much better than other places. However, if this process of self-determination regarding whether to end ones life gets taken over or is overly influenced by groups that have a stake in the economics of health care then it would be very, very frightening.

That said, I still thank my lucky stars that I live (and hopefully will grow old) in a place where I have the right to determine when and if I want to end my life. And can do so at home without worrying that I'll screw it up and be in an even worse position than when I started.

91
There is one thing I'm curious about. Why is EXIT different from euthanasia? Is it because euthanasia is administered by someone else and EXIT is self administered with the help of a volunteer? I ask because i had a friend in the Netherlands who planned her own euthanasia - the doctor came to her home and administered the drugs, but she choose the time and place, etc. She was dying of cancer. But it sounds very similar to the service EXIT provides. Is the distinction more to do with specific law in Switzerland, i.e., suicide is not a crime but euthanasia is?

And one more thing... Lots of medical folk dealing with the dying say that in people expressing a desire for suicide, treating pain and depression decrease the desire. But you could say that if the individual doesn't want to be assessed for pain or depression, that's part of individual autonomy. I guess i need to read more about EXIT, but is it possible that a person could go ahead and die without an assessment (where treatment might have changed the individual's mind about suicide)?

92
There are several types of euthanasia, with differeing legal status.

Assisted suicide is where the patient expresses a wish to die, consents to the act, and performs the act himself, with the assistance of another person. Legal status, including the action of the other person, varies by country.

Voluntary euthanasia is where the patient expresses a wish to die, consents to the act, and another performs it without involvement of the patient in the act itself. Legal status, including the action of the other person, varies by country.

Non-voluntary euthanasia is where the patient is unable to express the wish to die or consent to the act, such as when the patient is a child, an adult lacking the capacity for understanding or consent, or in a coma. The legal status of non-voluntary euthanasia varies in different countries - and in those where it is legal, the person allowed to do so varies as well. In some countries, a medical power of attorney is needed, where a patient as specifically designated someone to make such decisions. In others, the next of kin or a third party, such as a doctor, may make the decision unilaterally without appointment from the patient.

Involuntary euthanasia is where the patient has the understanding and capacity for decision but does not give consent - it is performed against the wishes of the patient or without obtaining his consent. Involuntary euthanasia, differing from murder in the intent of the person committing it, is a crime in most countries.

To my understanding, EXIT is only involved in assisted suicide. Non-voluntary and involuntary euthanasia remain illegal in Switzerland.

I'm a little hazy as to the status of voluntary euthanasia in Switzerland - can somebody clarify?

ETA:

Actually, come to think of it I'm also unsure if non-voluntary euthanasia is still illegal in Switzerland. Haven't there been cases of in the news recently? Or am I thinking of cases in another country?)

93
Thanks MC for your sensistive comments. It is of course so true that our own experiences will hugely infulence how we feel about this and other issues.

For me, it is totally the opposite about closure. I find it much harder to get closure because I know my mother was not able to make the choice she wanted to make- and was forced to live another 14 years of misery, and that I was not strong enough to help her (and lived a busy professional and family life in another country).

And again, I know many medics who clearly chose NOT to have treatment for aggressive forms of treatment at a good age. It is their professional experience which make them take that choice- they want to enjoy the time left to them without chemo and radiotherapy, which would rob them of that time. And then when the fight is over, go quickly. I totally understand and respect that. I've known older people spend their last few years going from operation to operation, chemo, radiotherapy- feeling dreadful- when they could have had a much shorter time enjyoing their family. Personally I'd feel much worse if I had pushed them to have all the treatment and as such, 'waste' such little time they had left. Depends of the stage of life too.

One of my ex students is in a terminal phase of recurring cancer, a single mum with 2 young daughters- so very different.

Organisations like EXIT, and in the UK currently Dignity in Dying (btw did you watch the Dimbleby lecture? Hope you do)- cannot do their work quietly and discreetly. Especially in the UK where the Law totally prevents any assitance to be given without fearing ending up in prison. If people truly believe the Law must be changed, then they have to do so publicly. Even in CH, with EXIT, there are many fights still to be fought- like making it illegal for Old Peoples' Homes to forbid any resident from seeking EXIT assistance in the home- thus trapping people like my mother into enforced living with any quality. The care is great, warm, friendly- but it is NOT what every body wants, certainly NOT my mother. And also to find a way forward for those who are struck with Senile Dementia and Alzheimers- who currently cannot be helped by EXIT, unless they take that decision far too early at the onset of the disease, as one has to be of sound mind to ask for help. For people like my MIL, again a hugely intelligent woman who always used to joke when she was fit and healthy about the indignities of old age and senility. She always said that if she ever got to that stage, we just had to (her words) put a pillow over her head and not let go. She developed Alzheimers and a few years later her life turned into hell, especially during the protracted period when she was so aware she was becoming senile- and then the drugs turned her into a vegetable. If she had known the things she did during that time, which out of respect I want describe here- she would have been so sick and upset. She lived for another few years, first of misery, fear and anguish, and then of total loss of dignity. Seeing her makes me absolutely determined this will never ever happen to me. EXIT is now fighting to that people can make advance directives in case of Alzeimers or senility which will determine five clear criteria, of their own choice- by which time EXIT will come and help.

This fight will be long and very difficult- and publicity is essential- to change people's attitude to death, and to get more members, and yes therefore more funds- to continue to fight. That can't be done quietly.

94
No I wouldn't consider it.

I would like to think that I would be brave enough to make the most of life despite the situation I was in. I look at Stephen Hawking, he can't do anything for himself, but he still manages to enjoy life and make a huge contribution to science. Sir Frank Williams, quadriplegic, but still travels the world running his F1 team, and reportedly has only had one day off sick since returning after his accident - incredible!

The only situation would be if I couldn't use my brain anymore, maybe a situation like Michael Schumacher finds himself in, however, it's unlikely that I'd know anything about it if that was the case.

95
Mirfield lad.

96
That is the whole point, in the same situation I might want to live or I might not. I want to have that choice, only I can decide if I am enjoying my life or not.

97
Voluntary euthansia as you describe Meloncollie, is not legal in Switzerland. A retired doctor who is an EXIT volunteer was asked ba a member with motor neurone (I think- or some other debilitating disease) to help her die. From the time of the first visit, to the day chosen, the doctor visited several times, and the patient's condition deteriorated rapidly. the doctor devised a simple system that would allow the member to pull on a scarf to pour the lethal mixture, as she could not longer hold a cup or glass- but the next day, when she arrived for the final act, the member was unable to even to that- she expressed her total terror at the idea she would not be able to go through with her wish- and after some exchange, the doctor helped her.

She was taken to court but won the case.

Another case recently was when an elderly patient had rectal cancer- refused treatment and asked for help. The doctor was taken to court because he had not forced the member to let him make a rectal manual examination- which the member had refused. Again, he won the case. Two very important and key cases for EXIT. Common sense prevailed, even though the letter of the law was not followed- because the member's wishes were absolutely clear.

98

The point is with all of this - all people of sound mind should have the ability to choose the method and time of their own death. What's critical is that laws are in place to prevent any pressure or influence from outside regarding this.

99
Absolutely, which is why EXIT goes through a rigorous process of visits, talking to the member always on their own- to ensure that no doubt or outside pressure or cohersion is brought to bear.

100
My grandfather had Parkinson and at the end, he lost all his independence and couldn't do the most basic things by himself. At a certain point, he had enough and decided he didn't want to eat anymore. So the home care owner had to send him to the hospital that day.

After a day in the hospital, he was mad he wasn't dead yet from starving (that was very funny). Anyway, his doctor gave him morphine for his "pain" (he didn't have any with his meds) and he slowly increased the amount on my gran dad's wishes. After 3 days, it was over.

Suicide assistance isn't legal in Canada but is performed since a while already by some doctor under medical pretenses. I was very glad this doctor helped him when he asked for it.

I will certainly join EXiT and hope that if one day, I find myself in a situation where I can no longer live a life that hold me in a body that is a prison, I will be able to take this decision too and get the help to do it.