Wednesday, January 25, 2023

Of Dad, Death, and Dying With Dignity (Or the Lack Thereof)

 By Eric Segall

My Father Maurice Segall died a little over a week ago in the middle of the night in his sleep at the age of 93. Tragically, that was the only peace my father found over the last few months of his life. His death has been very difficult for all of his family but I wanted to write this blog post because of what I saw towards the end of his life. 

My father was a successful businessman who always took enormous pride in his ability to take care of himself. He left home at 14 because he lived in a small town in Canada where there was no high school that was satisfactory for what he wanted to learn. So he moved to Montreal where he could get a real education. 

He lived with an aunt who was pretty rough but at least he got the education that he so badly wanted. He supported himself in high school by playing pool and poker. He eventually went to McGill University and then Columbia and the London School of Economics. Among his jobs, he ran the credit card division at American Express (spoiling me rotten with house seats to sports and theater when I was a teen).

Throughout his life, my father repeatedly told us that if he ever got to the point where he needed someone to "wipe his butt," as he would so bluntly put it, he wanted his children to find a way to end his life. A few months ago, his lungs filled with fluid because of a faulty heart valve (as I understand it) and he had to be hospitalized for five days. He was never the same after that visit. Before he went into the hospital, he and I played on-line bridge together two or three times a week. We never played again after he left the hospital.

For the last few months of his life, he couldn't feed himself, clothe himself, get out of bed himself, or go to the bathroom by himself. I am not a skilled enough writer to convey how painful this was to watch. His decline happened quickly and harshly.

Shortly after he came home from the hospital, now with moderate dementia, he would ask us, "where is the pill?" We didn't know what pill he meant but we knew what he was asking for; he wanted to die. He repeatedly asked us to find a way that he could take his own life. He tried unsuccessfully to starve himself to death several times. 

My family is very lucky to have the means that allowed us to take care of my dad in the most humane way possible. I can't even imagine what it would have been like to not have had around-the-clock assistance to help take care of him. But most Americans aren't that fortunate. We have to find a way to do better.

Euthanasia is illegal under Massachusetts law, as it is in all states. Even where physician-assisted suicide is legal, such as in Oregon, the law's requirements probably didn't apply to my father because it was unclear if he was terminal. He was not in great pain physically but he was in mental anguish. Again, he had no way to take care of himself and he was often very uncomfortable but probably not enough to clearly qualify for a lethal prescription even in those few states that allow it. We, of course, did nothing to hasten his death as painful as that decision was for his entire family.

I've always had mixed feelings about euthanasia and physician-assisted suicide. On the one hand, of course people should be able to die with dignity and shouldn't be forced to suffer through great pain physically and/or psychologically. I also understand, of course, the slippery slope problem. Some bad actors might choose to promote hastening death in circumstances that don't call for it, and that too would be tragic.

We do, however, have laws for that kind of criminal behavior that would likely deter most bad actors. Having said that, I do not believe this is an issue that courts should resolve. In fact, the highest court in Massachusetts recently refused to resolve this question, saying it was a legislative, not a judicial issue. I agree with that decision but that in no way means we as a country do not need to figure out a way, given advanced technology keeping people alive so much longer, to deal much better with end-of-life issues. 

Having seen what happened to my dad, I would like to see legislative fixes for this problem, as they have in some other countries. Whatever the solution, I believe we have the tools to allow people to die with dignity without risking undue pressure on the old and infirm to end their lives prematurely. And I'd be less than honest if I didn't say that I am aware that the biggest obstacle to such a system is organized religion. Many (not all of course) folks who are religious believe death should be in God's hands. I feel the same way about that issue as I do about abortion. If you don't want one, don't have one, but you shouldn't impose that value on others; same with voluntary euthanasia and physician-assisted suicide.

In any event, I'm still in mourning, but I also know my dad would have wanted me to take a few days and then get back to work, which is what I am trying to do. Frankly, it is what all of us here at Dorf on Law have been trying to do for the last six months as Mike and Neil have also suffered terrible losses. It is not easy but it is, I guess, part of life. And life does go on, even when it is so very, very difficult.

I love you Dad.

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