On Saturday, Brittany Maynard may end her life in her Oregon home. Or she may choose not to, at least on that day.
The 29-year-old, who has stage 4 malignant brain tumor, has obtained a prescription for a fast-acting barbiturate under Oregon’s right-to-die laws. She had planned to use it Saturday to end her suffering, surrounded by family. But days before she intended to take her own life, Maynard released a new video indicating that she may postpone her own death until after her intended date of Nov. 1.
“It doesn’t seem like the right time … right now,” she says in the video. “But it will come, because I feel myself getting sicker.”
Oregon is one of a handful of states with right-to-die laws, which allow terminally-ill patients to end their own lives. Earlier this month, Maynard chose to discuss her decision in public, becoming a national spokesperson for advocates of these laws.
In the more recent video, she again provides an explanation, but this time, on why she may choose to postpone taking her life.
“If Nov. 2 comes along and I’ve passed, I hope my family is still proud of me and the choices I made,” she said in a video released Wednesday by Compassion & Choices, an advocacy organization for the terminally-ill. “And if Nov. 2 comes along and I’m still alive, I know that we’ll just still be moving forward as a family, like, out of love for each other and that that decision will come later.”
However, she said, she knows the day will come.
“It will come because I feel myself getting sicker,” she said. “It’s happening each week.”
Maynard isn’t the first to choose this route — and she won’t be the last.
In Oregon, a potential death-with-dignity candidate is slightly more often a man in his 60s or 70s. He’s likely white, married and college educated. And he likely has terminal cancer.
He chooses to die in his home because he’s worried about losing control of his mind and body, according to statistics from Oregon’s 2013 Death With Dignity Act report. Since Oregon enacted the law in 1997, more than 750 terminally-ill patients in the state have died by taking a lethal doctor-prescribed drug. In most cases, it’s secobarbital, sometimes pentobarbital, both of which are barbiturates.
When a patient is ready to die, he’s instructed to take an anti-nausea drug first to reduce the risk of vomiting. (Three such cases have been reported in Washington.) Once he takes the barbiturate, he’ll likely be unconscious within 25 minutes, but death could linger as long as about 100 minutes.
No matter how smooth the exit, doctor-assisted suicide faces scrutiny. Opponents cite moral or religious concerns. Some say patients who are depressed will use the laws to commit suicide. Others worry lives could end in abuse.
“Assisted suicide always looks justified if you look at the situation of the individual who wishes to use it, but when we look broadly, we see how significant the dangers and risks are,” Marilyn Golden, senior policy analyst at the Disability Rights Education and Defense Fund in Berkeley, Calif., told the San Francisco Chronicle. “Where assisted suicide is legal, some people’s lives will be ended without their consent through mistakes and abuse. No safeguards have ever been enacted or proposed that can prevent this outcome, which can never be undone.”
Surveys on the subject vary. In a poll conducted by the New England Journal of Medicine last year, 67 percent of more than 1,700 medical experts surveyed in the United States were against the practice. That same year, a Pew Research survey showed public opinion was split, with 47 percent of U.S. adults supporting physician-assisted suicide and 49 percent opposing it. A Gallup poll suggested results varied according to how the question was presented: Some 70 percent of Americans were in favor of allowing physicians to “end the patient’s life by some painless means,” but only 51 percent were in support of allowing doctors to help a patient “commit suicide.”
But states that have death-with-dignity legislation also have narrow guidelines for who qualifies. A patient who wants to end his life through doctor-assisted death must be an adult. He must be diagnosed with a terminal illness that gives him less than six months to live. He must be mentally capable. And he must live in a participating state — Oregon is one of five states with such legal protections.
California is not among them. That’s why Maynard uprooted her life in San Francisco earlier this year and moved to Portland with her husband.
“The amount of sacrifice and change my family had to go through in order to get me to legal access to death with dignity – changing our residency, establishing a team of doctors, having a place to live – was profound,” she told People.
Like Maynard, a terminal patient who opts to die this way must meet the qualifications. Then, after he requests the medication from his physician, he must wait 15 days and then request it again — both orally as well as in writing.
“Now that I’ve had the prescription filled and it’s in my possession, I have experienced a tremendous sense of relief,” Maynard wrote in an op-ed for CNN. “And if I decide to change my mind about taking the medication, I will not take it.”
It’s a sentiment that has been expressed by others in her situation. Although more than 750 in Oregon have died from taking the drug, more than 1,170 in the state have filled the prescription under its death-with-dignity law.
Part of dying with dignity, it seems, is in the freedom to choose — whether or not the choice is made.
“Both patients and families frequently express gratitude after the patient receives the prescription, regardless of whether it is ever filled or ingested, typically referencing an important sense of control in an uncertain situation,” according to a study published last year in the New England Journal of Medicine.
Come Saturday, Maynard may choose to take the drug another day — or not at all.
“Having this choice at the end of my life has become incredibly important,” she wrote for CNN. “It has given me a sense of peace during a tumultuous time that otherwise would be dominated by fear, uncertainty and pain.”