THE ONE-MONTH-LESS CLUB
LIVE WELL NOW, OMIT THE LAST MONTH
SYNOPSIS:
When we declare our membership in the One-Month-Less
Club,
we are affirming that we will live so well during the healthy
years of
our lives
that we will not miss the last month of life in the hospital.
We are declaring our option to
shorten the process of dying
if the last days would be more burdensome than beneficial.
OUTLINE:
1.
CHOOSING THE BEST TIME TO DIE
—NOT
TOO SOON, NOT TOO LATE.
2.
WHAT IF WE COULD OMIT THE WORST MONTH?
3.
IF LIFE CONTINUES TO BE MEANINGFUL,
WE CAN
POSTPONE OUR DEATHS.
4. DECIDING WHEN THE LAST MONTH IS
BEGINNING.
5.
WE WILL LIVE BETTER NOW BECAUSE WE
HAVE
DECIDED TO
LIVE ONE MONTH
LESS.
6.
MEDICAL ADVICE FOR CHOOSING THE BEST TIME TO DIE.
RESULT:
This
chapter is an open invitation to the reader
to become a member of a club with no meetings, etc.
Joining requires making a specific declaration
in one's Advance Directive for Medical Care
or some other end-of-life planning document.
THE
ONE-MONTH-LESS CLUB
LIVE
WELL NOW, OMIT THE LAST MONTH
by
James Leonard Park
We become members of the One-Month-Less Club
by declaring our
membership in our Advance Directives for Medical Care.
We are the people
who plan to live so
well
during the years
of our lives when we are in good health
that we will not
miss the last month in the hospital,
which would be the
normal way to end our days
if we accept standard medical care.
1. CHOOSING THE BEST TIME
TO
DIE
—NOT TOO SOON, NOT TOO LATE.
If we select the best times for our individual deaths,
we will avoid both
dying too soon and dying too late.
In
the midst of life, we cannot decide the best time.
But if we begin to
imagine making such a decision for ourselves,
we will prepare
our minds for putting our end-of-life choices into action.
Being ready
to die in every way
—intellectually,
emotionally, interpersonally, & spiritually—
will empower us to live
better every day
and to make it easier to
shorten the process of our dying.
2. WHAT IF WE COULD
OMIT
THE
WORST MONTH?
Here is a thought-experiment that might be helpful:
Think of someone
you knew well who died at least 10 years ago.
(Ten years might
be needed to get proper perspective on that life.)
Did this person
die too soon or too late? (Or at the right
time?)
Whatever the
particular circumstances of a specific death,
we can at least
imagine deaths that were premature
and processes of dying that
were prolonged beyond
benefit to anyone.
Perhaps age 50 should be a membership requirement
for joining the
One-Month-Less Club.
Up to that age, we
will probably worry about dying
too soon.
But we might join
the One-Month-Less Club
when we shift from worrying about premature death
to worrying about unreasonably
prolonged dying.
As the 21st
century unfolds, advances in medical science
might make prolonged dying
more
common
than premature death.
Here's another way to imagine our lives one month shorter:
Have we ever been
very sick for a month?
Have we been in
the hospital for a week or more?
If we had the
option of omitting
that time in the hospital
from our lives,
what would we have lost?
Perhaps the only
good result we can specify
from such a time
in the hospital is that it enabled us to survive.
We are alive now
because we received that medical treatment then.
But if there had been some way to skip that month in
the hospital
and still be alive and healthy today,
we would probably not lament the loss of that month of life.
Our lives would be none the worse for that omission.
If we agree that little would lost
from our lives
if we had skipped the worst
month,
we might be open
to omitting the last
month of our lives
since our last
month of life might be the worst month.
And what about the people closest to us who will observe our dying?
How will they remember
that last month in the hospital?
3. IF LIFE
CONTINUES TO BE
MEANINGFUL,
WE CAN
POSTPONE OUR DEATHS.
However, joining the
One-Month-Less Club
does not mean that we want our lives to end prematurely.
If our lives are still meaningful to us and those who love us,
then even if our terminal illness causes physical problems,
we will choose to continue
living.
If we are still able to pursue meaningful purposes,
to have meaningful relationships,
and to enjoy meaningful experiences,
we will not choose to end our
lives.
When we join the One-Month-Less Club in our Advance
Directives,
we will also explain what quality
of life we wish to preserve.
If we are still full persons
(with consciousness, memory, language, & autonomy),
then we will probably choose to continue living
even with the serious physical problems
that will eventually cause our deaths.
Another
chapter explores four dimensions of personhood:
"Losing
the
Marks of Personhood:
Discussing Degrees of Mental Decline".
4.
DECIDING
WHEN THE LAST MONTH IS BEGINNING.
How will we know when we are entering the last month
of our lives?
Unless we pick our own date of death, we will not know.
But by joining the One-Month-Less Club, we declare our choice
not
to follow the standard pathway
towards death.
And if we can no longer make our own medical decisions,
we are granting permission
for our proxies
to omit the final month under
standard medical care.
If it becomes clear that we have reached
the end of our lives,
—if,
for instance, we have a disease or condition that will only worsen—
then
we might want to shorten the
process of dying
rather than add a
few more days in the hospital.
Especially if we are suffering, we are declaring in advance
that we do not choose to
have our bodies kept alive as long as possible.
Of course, if we are still conscious and able to
discuss such matters,
we will consult with the people who are closest to us,
to see if they also agree that the time has come to wind-up our lives.
Because our loved ones will know our plans well in advance,
they should be able to agree when the final phase has begun.
And they should be ready for
us to shorten the process
of dying.
5. WE WILL LIVE BETTER
NOW BECAUSE
WE HAVE
DECIDED TO
LIVE
ONE MONTH LESS.
If the last month comes upon us sooner than we had expected,
we might easily
decide to endure a certain amount of suffering
if the additional
days allow us to accomplish something important
—some meaningful project we want to complete before we die,
some significant interpersonal matters we want to settle.
But if we have lived for a number of years
as members of the One-Month-Less Club,
we will put the most
important things
first.
This should result in fewer
regrets when death looms.
And if we are still conscious and capable,
we will have
every right to postpone
our deaths
because we are
still able to pursue meaningful
activities,
thoughts, feelings, relationships, etc.
At the end of our
lives,
each additional meaningful day might seem infinitely valuable.
But if we have lived well
during the healthy years of our lives,
when the time
comes to die, we might be completely ready.
If others are
inspired by our way of planning for our deaths,
they might also
consider joining the One-Month-Less Club.
And they will
support our choice to draw our lives to a close
at what we regard as
the best time and the
best methods.
We choose not to prolong the process of dying
just because the doctors can try one more
treatment
that might add a few days to our lives.
6. MEDICAL ADVICE FOR
CHOOSING
THE BEST TIME TO DIE.
We will certainly seek the best information
we can get
about the likely
length and quality of our remaining life.
And we will
remember that such projections can always be wrong.
But if we know
the most likely signs to watch for
—that mark the
beginning of the inevitable end—
then we know we
are approaching the natural end of our lives:
This is the final
illness. We will not survive it.
If we are dying from a disease well-understood by
medical science,
our doctors can provide a good description of our decline into death.
Some illnesses and conditions are known to be irreversible.
In such cases, our doctors can estimate how long we will live
if we accept standard medical care.
If medical science cannot save
us from death,
more time might mean worse suffering.
If we know that we are dying, the
question becomes:
Which pathway leading
to
death do we wish to follow?
If we affirm our option
of taking a shorter pathway
towards death,
we can explain
that choice in our Advance Directives for Medical Care.
If we are still
capable of deciding as we approach death,
we can choose exactly when
to 'pull the
plug' ourselves.
And if we can no
longer decide the best time to die,
our proxies need to
know when to terminate treatment
and when to shift to comfort-care for our last days.
Our proxies will
know when to 'call it quits' for us
by reading our Advance Directives for Medical Care,
where we might address such questions as:
"Under
what
conditions would you request death?"
Joining the One-Month-Less Club
means that we have given serious thought to the timing of our deaths.
And if we slip beyond the possibility of deciding for ourselves,
our moral
permission will help our proxies decide when to end our lives.
We are saying that our
medical ethics includes choosing a timely death.
The One-Month-Less Club creates a new paradigm for planning death:
We are omitting useless
terminal care
—whether futile efforts last one day, one week, one month, or one year.
We are expressing our determination to choose a wise death:
at the best time, in
the best place, and
by the best methods.
Created 2-22-2007; revised 3-1-2007;
3-8-2007; 3-23-2007; 5-26-2007;
4-6-2008; 5-15-2009; 1-1-2010;
11-18-2010; 3-11-2011; 11-17-2011;
1-6-2012; 2-24-2012; 3-15-2012;
7-18-2012; 8-25-2012;
3-20-2013; 6-8-2013; 7-16-2013; 7-31-2014;
1-2-2015; 4-18-2015;
7-10-2015; 4-6-2016; 5-27-2016;
11-16-2017; 10-3-2018; 11-14-2019; 9-9-2020;
AUTHOR:
James Park is an independent philosopher
with deep interest in end-of-life issues.
The idea of the One-Month-Less Club
was first developed for his book on Advance Directives:
Your
Last
Year: Creating Your Own Advance Directive for Medical Care.
If you would like to read his personal declaration
of membership in the
One-Month-Less Club,
go to his Advance
Directive for Medical Care
and scroll down to Answer 18—The One-Month-Less Club.
Much more information about him will be found on his
personal website
—the last link below.
Here are a few related essays or chapters,
which might help you to think more deeply about your own death:
Choosing
Your Date of Death:
How to Achieve a Timely Death
—Not
too Soon,
Not too Late
Completed
Life
or Premature Death?
One
Million
Chosen Deaths per Year?
Taking
Death in
Stride: Practical Planning
Losing the Marks of Personhood:
Discussing Degrees of Mental Decline
Advance
Directives for Medical Care:
24 Important Questions to Answer
Fifteen
Safeguards
for Life-Ending Decisions
Will
this Death
be an "Irrational Suicide" or a "Voluntary Death"?
Will
this Death
be a "Mercy-Killing" or a "Merciful Death"?
<>Four
Medical
Methods of Managing Dying
Why
Giving Up
Water is Better than other Means of Voluntary Death
Voluntary
Death by Dehydration:
Safeguards to Make Sure it is a Wise Choice
Depressed?
Don't
Kill
Yourself !
WOULD
YOU LIKE TO MEET OTHER SUPPORTERS
OF
RIGHT-TO-DIE HOSPICE?
If
you are attracted to the possibility of shortening your process of
dying,
consider
joining a Facebook Group and Seminar called "Right-to-Die
Hospice".
This
discussion group is completely free of charge.
And
members are welcome to join from anywhere on Earth.
The
essay above has
become a chapter of Right-to-Die
Hospice.
Here
is a complete description of this on-line gathering:
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/ED-RTDH.html.
And
here is the direct link to our Facebook Group:
Right-to-Die
Hospice:
https://www.facebook.com/groups/145796889119091/
Further Reading:
Terminal
Medical Care from the Consumer's Point of View
Books
on Terminal Care
Books on Helping Patients to Die
Books
on
Medical Futility
Best
Books on Voluntary Death
Best
Books on Preparing for Death
Books
Supporting
the Right-to-Die
Books
Opposing
the Right-to-Die
Go to the Right-to-Die
Portal.
Return to the DEATH
page.
Go to the Medical
Ethics
index page.
Go to other
on-line
essays by James Park,
organized into 10 subject-areas.
Go to
the beginning of this website
James
Leonard Park—Free
Library