A Designed Death - Part 1

Choice - Across the Life Course

The Last Supper, circa 2024

As the UK debates assisted dying legislation, here’s an article I published in FORBES in 2022 when my mother used Canadian legislation to peacefully depart at the ripe old age of 97. It takes a look at the state of legislation on end of life choices around the world. Where do you stand on this issue? What do you want for your parents - and yourself?

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4th Quarter Choices - Medically Assisted Dying

Medically assisted dying is hotly debated in an ever-expanding number of countries. Advocates and opponents proffer powerful and passionately held arguments for and against. From early-adopting Switzerland to latest-to-the-table Australia, more and more countries are legalising the practice. It is now available to over 280 million people in 11 countries around the world. It was on offer to my mother, who recently (and gratefully) used Canada’s legislation to orchestrate her own wise demise.

As a writer and researcher who studies the implications of longevity on life and careers, I have focused in these columns mostly on the 3rd Quarter, the years from 50 to 75. But because so many of us in this stage of life accompany our parents to their 4th Quarter ends, it is worth exploring how we can best support them. And learn from them how to (better) plan and prepare for our own ends. Having just gone through this personally, it seems an essential task of Q3. And a gift to our children in Q4. What have I learnt? If we don’t claim the design of our own deaths, it’s likely someone else will. Cede this space if you will, but read this first.

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For Boomers used to planning and controlling many of life’s choices, from when to have children to what kind of milk in their coffee, defining a good death seems like something they may want to discuss with their families – and decide for themselves. Sooner rather than later. It is likely to become an integral part of planning a good life and legacy. Clear choices, clearly communicated, help families navigate today’s end of life smorgasbord of a multiplicity of medical options. For most, it isn’t an appetising meal. Read Atul Gawande’s Being Mortal for an urgent wake-up call on the painful, protracted, medicalised end that currently awaits so many of us.

Two years ago, in September 2022, I witnessed my mother calmly and resolutely end her life with the help of Canada’s Medical Assistance In Dying (MAID) program. She was suffering from chronic spinal stenosis and, after an accident and months in hospital, had deteriorated to a state where she was wheelchair-bound, incontinent and dependent on 24/7 care. After decades of supporting Dying With Dignity in Canada, she decided it was time to use the legislation she had long hoped would be legal by the time she needed it. The law was six years old. She was 97.

The experience elicited a mass of mixed emotions among her loved ones and friends. Mostly relief at the serenity of a planned end, at home, surrounded by her family, with ample time to say goodbye, express love, and mindfully share newly-finite time. Yet it made both me and my husband Tim, who co-authored this piece, do much research and more soul searching to think more deeply about all sides of the ongoing debate. After my mother’s departure, we remain aligned in support of the practice, carefully regulated and monitored. Personally, we both harbor a wish to emulate my mother’s courageous role modelling and die in a country where we too will have exit options on call. Will we use it? Who knows, but we hope it will be available.

Yet we recognise the validity of many of the questions and concerns being raised. It needs debating. Anyone advocating assisted dying - or discussing options with family members – will want to think through them. What follows is what one might call a considered advocate’s assessment of the state of medically assisted dying around the world. A second, follow-up article, will explore – and consider – the many objections to its spread.