When Susan learned she had aggressive small cell lung cancer this past August, the first thing that crossed her mind was, “Thank goodness I live in a Death with Dignity state!” Living alone, and not wanting to spend her final days in a hospital hooked up to machines, or adding stress rather than peace for her friends and family, she found immediate comfort knowing she would have a way to die on her terms. “I have always been independent and taken care of myself. I view my death as a time to continue to take care of myself.”   

Along with the initial relief came much-needed courage to undergo treatment that could mitigate her cancer. “Having access to medical aid in dying gave me the strength to take on radiation and chemotherapy. I learned just after starting treatment that accessing that choice is not as straight forward as I thought.”  

Susan learned that her primary care physician (PCP), and all doctors within her health care establishment, were associated with a religiously restricted provider that does not support Death with Dignity services. This meant Susan could not rely on her current PCP and health care system to find two doctors to sign the order for medical aid in dying which is required by the law.   

 “Just when I needed to rely on my doctor the most, I was forced to find a new one if I wanted to have agency over my death. This seemed illogical in a state where medical aid in dying is legal.”   

Consequently, as Susan’s first round of treatment began, so also began her search for doctors who would support her use of the Death with Dignity law.  A task she felt pressure to quickly accomplish to overcome the 15-day waiting period (required in the law between the first and second request for the medication). “I knew I had to act fast. If my condition worsened, or I experienced side effects from the treatment, I could begin to suffer and need extreme measures to stay alive, measures I was adamantly against.”  To her surprise, this task was more daunting than treatment for her cancer. “When I learned that virtually none of the doctors nor the hospital in my area would facilitate my access to Death with Dignity, this was more distressing than my diagnosis and prognosis. I was terrified of what could be coming my way. I wanted all options legally available to me.” 

Unfortunately, Susan came face-to-face with these fears.  Side effects from her radiation treatment caused a high fever due to a drop in her white blood cell count, and esophagitis, which caused extreme pain and swelling in her throat making it nearly impossible to eat or drink. With the severity of her condition, she was admitted to her local hospital.  In the first 48 hours, while the hospital staff made attempts to control her pain and return her ability to swallow, Susan contemplated the possibility of a feeding tube to stay alive long enough to return home. This was the only way she could endure the 15-day waiting period and have time to find physicians who could support her wish to die with dignity.    

“I lay there in a position no one should have to face, having to accept extreme measures I didn’t want in order to die on my terms.  It’s hard to describe how impossible this felt.” 

Thankfully, with this hospital visit, Susan’s fears were abated. She was able to avoid a feeding tube.  Her blood cell counts improved, her pain was eventually under control, making her stable enough to return home. But her fear of another hospitalization, where she could once again face life-saving measures she did not want, weighed heavily on her mind. Knowing these risks, her quest to gain access to Death with Dignity gained new importance.    

Through conversations with friends and a bit of searching online, Susan found End of Life Washington.  With the help of our one-to-one volunteer guidance, she has identified doctors who can and will support her choice to have the option to use medical aid in dying. Once again, she feels the relief she initially felt – knowing when and if she feels her quality of life is diminished, she’ll have autonomy over her death.  

“Every day I weigh the risks of medical decisions to prolong my life, and the restrictions in the law that could prevent me from ending my life with autonomy, but I am not defeated. I am more resolute than ever. Even though there are more hoops to jump through than I anticipated — and the help of End of Life Washington is essential — it’s still my right, and my choice. I hope that I will be able to count on these facts to die on my terms.” 

End of Life Washington is the only organization in the state that provides the education, support, and advocacy necessary to help Washington residents exercise their choice to die with dignity and autonomy. More than ever we need to protect access to, awareness of, and support for a full range of end-of-life choices. Together, and with your financial support, we will have the ability to grow and adapt to support Susan and so many others like her to die as they choose.  

Help us protect and support the most important decisions of our life!