“Why is euthanasia almost always considered the appropriate end point for our animal companions, but not for our human loved ones?”

— Jessica Pierce in Psychology Today


Neil Gaiman’s “Death of the Endless,” drawn by Chris Bachalo in Death: The Time of Your Life #1, DC Comics. (Lo-res version qualifies as fair use under United States copyright law.)

The March issue of our local Senior News (published by the Humboldt Senior Resource Center) was dedicated to what the editor called “a difficult topic” which “may sound grim.” I was heartened that he took on this topic, one of universal relevance, although I’ve never been comfortable with the idea of death being difficult or grim, as in The Grim Reaper. Neil Gaiman’s “Death” character in his Sandman series — a kind, ankh-wearing goth girl — is more to my taste. In fact, the wealth of contributions in that issue of Senior News belie pessimism around the topic, many of which I found inspiring and compassionate.

I guess, at least at this point in my life, I’m in Kant’s kamp, so to speak: “The meaning of life is that it ends,” he wrote. Not just the meaning, either. Isn’t the certainty of death the whole justification for getting up in the morning and doing anything—writing a weekly rant, for instance? The only thing worse than dying, imho, is not dying—an awful eternity, day after day, century after century, whether on Earth or in some monotonous Barbieland, aka Heaven. Shudder.

How’s it going up there?” The Assumption of the Virgin with three hierarchies and nine orders of angels by Francesco Botticini, painted around 1475. (Public domain)

(Practically speaking, we are virtually immortal, in a sense. Our “germ plasm,” as the late biologist George Wald called it, represents an unbroken line stretching over three billion years, all the way back to the first primitive organism to appear on our planet. The other part of us, what Wald called the “soma,” is merely the vehicle for the germ plasm to get from one generation to the next. He writes, “Death is the casting aside of the body, of the soma, after it has done its work. That work is to carry the germ plasm, to feed it, to protect it, to warm it in a warmblooded organism, and finally to mingle it with the germ plasm of the opposite sex. With that, it has completed its function and can be discarded.”)

Philosophy aside, in my dotage I follow legislation relating to MAID, Medical Assistance in Dying, which currently, in California and a handful of other states, glosses over the problem of dementia. As the law now stands, MAID permits assisted death if two physicians confirm that death is likely to occur within six months, and that, absent intervention, the period between now and then is likely to be painful — not just for the dying person, but for their caregivers.

However, dementia, including Alzheimer’s, is rarely fatal in the short term (i.e. six months), typically taking years from onset of the disease to death. I dread the possibility that I might live a life in which I’m no longer conscious, behaving in ways that I wouldn’t want my wife Louisa, my family or friends to deal with. I believe that if someone with dementia meets the criteria for MAID — mental capacity for informed consent, intolerable suffering, and a foreseeable death, even if not within six months — they should be eligible.

Louisa and I already have advance directives, but we wish we could add that if, for instance, we became verbally or physically abusive, required physical restraint/locked door facility, or couldn’t feed ourselves — we’d want MAID. Unfortunately that’s not an option under California law, nor in any of the other nine states with MAID laws. We would like to see the legislation liberalized so that dementia, as defined under clear guidelines, would be a permissible reason for allowing a medically assisted death with dignity.