Woman’s end-of-life decision sparks controversial debate

Shortly after posting a video rescinding her plans to end her own life Nov. 1, 29-year-old Brittany Maynard followed through with her original plans and ingested the prescription that ended her life that Saturday evening.

“Goodbye to all my dear friends and family that I love,” Maynard wrote on her private Facebook page and released to People Magazine. “Today is the day I have chosen to pass away with dignity in the face of my terminal illness, this terrible brain cancer that has taken so much from me… but would have taken so much more. The world is a beautiful place, travel has been my greatest teacher, my close friends and folks are the greatest givers. I even have a ring of support around my bed as I type … Goodbye world. Spread good energy. Pay it forward!”

Maynard was diagnosed in January with a stage IV glioblastoma multiforme, an aggressive brain tumor that takes the lives of its victims within months of its diagnosis.

Glioblastoma multiforme, also known as a Grade IV Astrocytoma, is one of the most aggressive brain cancers. Its cells reproduce at a very high rate, making treatment difficult. The American Brain Tumor Association reports that patients who are diagnosed with a glioblastoma multiforme tumor have a median survival time of 14.6 months.

Knowing that her disease was terminal and would lead to headaches, fatigue, neurological deficits, epileptic seizures, confusion, delirium and dysphasia, Maynard and her family uprooted from their San Francisco Bay Area home this spring and relocated to Portland to utilize the state’s Death with Dignity Act (DWDA).

In 1997, Oregon became the first state to implement the DWDA, followed shortly after by Washington, Vermont, Montana and New Mexico. Many other states are in the campaigning stage. In Oregon, the DWDA requires that the patient be at least 18 years of age, have a diagnosis of a terminal illness with a prognosis of less than six months to live, be an Oregon resident, be capable of self-ingesting the medication, have the mental capabilities to understand the diagnosis, alternative treatments and the results of the life-ending medication, and the patient must take the medication voluntarily.

A January 2014 report by the Oregon Health Authority reports that since DWDA was legalized in the state in 1997, 1,173 Oregon residents requested DWDA prescriptions, with 752 patients choosing to take the medication. The average age of patients in Oregon who died through DWDA in 2013 was 71 years old, with the youngest age being 42 and the oldest being 96.

Maynard chose Nov. 1 as her end-of-life date in anticipation of how quickly her type of cancer would progress.

“If November 2nd comes along and I’ve passed, I hope my family is still proud of me and the choices I’ve made,” Maynard said in an Oct. 30 video released by CNN. “If November 2nd comes along and I’m still alive, I know that we’ll still be moving forward as a family out of love for each other, and that decision will come later.”

Organizations that support the DWDA, such as the Death with Dignity National Center and Compassion and Choices, are fighting to shed light on DWDA to ensure that the residents of each state are given end-of-life choices.

“I support DWD not primarily for the few who actually take the medication, but for the many, many who know that that is their option, if they choose,” said Dave Mayo, board member of the Death with Dignity Political Action Fund. “In the interview that’s aired the most often, Brittany has talked about how much better she feels knowing that she is in charge of when her life will end. She will not be at the mercy of her disease.”

There are organizations that do not see a difference between physicians-assisted suicide and suicide. Texas Right to Life believes that society is failing the terminally ill by offering them expedited death over a cure or more extensive end-of-life care.

“There needs to be a real conversation about the dangers of adopting a policy that allows a patient to be killed rather than treated as a solution to a physical or psychological condition,” said John Seago, legislative director for Texas Right to Life, in an interview shortly before Maynard’s death. “Similar to the pressure Mrs. Maynard may now be feeling, there will be an unjust pressure on all patients with complex and difficult health conditions if assisted suicide is legalized.”

Maynard brought the DWDA into the spotlight by spending her last weeks alive advocating with Compassion with Choices, the leading advocate for laws like Death with Dignity. Her message has reached millions of people and has people across the country talking about this controversial topic.

“I think her case drives home the point that we all die at some point, and the young and attractive are not immune to the possibility of being confronted with an illness that may carry with it a grim death,” Mayo said.

Texas Right to Life worries that public expectation and opinion may have played a role in Maynard’s death.

“Texas Right to Life is very concerned for Mrs. Maynard now that she has become a poster child and commercial for this ideology,” Seago said, before the news of Maynard’s death had been announced. “She seems to have doubts about actually ending her life, yet with the publicity of her story, we are afraid she will feel the pressure to end her life, whether or not she believes that is really in her best interest.”

Click here to read The Signal reporter Maria Lara’s commentary on the issue.