What do I need to consider if I’m thinking of medically assisted dying?

It depends on who you're telling and maybe on how you're dying. A conversation I would have with my with my son and my daughter looks completely different than a conversation than I would have with the board of my organization which looks completely different than the one I'd have at the community center. I might by that point be like, "All right, let's party". And looking at my kids, I'd be like, "No, wait a minute. Get over here. Let me hold on". And it would be totally different right now than it might be if I get to live another 40 or 50 years. 

I think it's important to be as honest as you can be; giving people all the information just helps their grieving process. It's not necessarily about other people, but, people love you and when you are dying and that physical bond here is going to be gone, it is a thing. Being death positive isn't death happy. We can just be realists about death; it's not a positive or a negative. It's just something that happens. It can be hard and ugly and it can be beautiful. It can be all of the things. But starting with as much honesty as you can muster is a good spot.

First consider whether you're in a place where this is legal, because that will determine how you go about it. I live in Oregon, where it’s legal, but our law has a lot of checks and balances built in that can hamper the process. Don't wait too long; it can take weeks or even months.

Most laws require people to be capable of taking the medication themselves, or capable of consenting in the moment. This means you cannot wait until you're physically unable to do it or mentally unable to consent. The second most common diagnosis in Oregon for assisted death is ALS—amyotrophic lateral sclerosis, Lou Gehrig's disease. It eventually causes an inability to swallow, so a person with ALS, who wants to control the time of their death has to do it before, sometimes well before, their natural death. Somebody who has cancer may be noticing that they're going to begin to lose cognitive control so they will need to make the decision before that happens.

I do not believe that anyone who partakes of physician-assisted death wants to die. They're not committing suicide, and I reject the term “assisted suicide.” These are not people who are sick of life and want to die. These are people who have to die and are trying to exert some autonomy in the process.

I think the next evolution of these laws, which we are seeing in in Europe, is the ability to lay this out ahead of time for oneself and give that power to somebody else. It's the very definition of a slippery slope. I just don't think it's very slippery, and it’s not a very steep slope. People get pretty worked up about where this is going to go, but after many years in Oregon now, we've seen nothing of the dire predictions coming true. I'm okay moving toward these more open gateways for it.