CHOOSING YOUR DATE OF DEATH:
HOW TO ACHIEVE A TIMELY DEATH
—NOT TOO SOON, NOT TOO LATE

SYNOPSIS:

    We did not choose the dates of our births.
And usually we human beings do not choose the dates of our deaths.
But the advances of modern medicine and technology
make it increasingly possible and even necessary
for us to make meaningful decisions
about the timing and mode of our deaths.

    First we will want to avoid dying too soon.
Several practical safeguards can call upon others
in helping us to avoid premature death.

    Then, we will make provisions to prevent being treated-to-death
by a medical system that lacks organized methods for deciding
when medical treatments have become excessive and unreasonable.

OUTLINE:

1.  AVOIDING IRRATIONAL SUICIDE AND PREMATURE DEATH

    A.  CHOOSING APPROPRIATE PROXIES

    B.  SAFEGUARDS TO AVOID PREMATURE DEATH

2.  CHOOSING THE BEST TIME TO DIE—NOT TOO LATE


CHOOSING YOUR DATE OF DEATH:
HOW TO ACHIEVE A TIMELY DEATH
—NOT TOO SOON, NOT TOO LATE

by James Leonard Park

    A timely death is an ideal we can all aspire to achieve.
We do not want to die too soon,
when we can still have more days of meaningful living.
And we do not want to die too late,
after continued existence has become meaningless.

    So here we will consider some practical steps we can take
to assure ourselves and the people around us
that we will have a timely death.
Even tho in the midst of life, death will not be welcome,
there might come a time later in our lives when death at that season
would be better than prolonging our existence a few months more.
We can begin the process of preparing for
the ideal time of death many years in advance.
Being prepared for death will empower us
to let go of our lives when the time comes.
Good planning for death will also prepare others
who will be present at the end of our lives.
Let's consider what would be the ideal date of death for ourselves.

1.  AVOIDING IRRATIONAL SUICIDE AND PREMATURE DEATH

    Committing irrational suicide means
harming ourselves by cutting our lives short
—dying before it would be wise to draw our lives to a close.
Perhaps most cases of irrational suicide are obvious to all observers,
even if the chosen date of death did not seem too soon to the victim.

    We can avoid premature death by asking others who are close to us:
"What would be the best time for me to die?"

    Generally, the people who love us will not want to assist us
in any irrational plans to kill ourselves.

    When we include people close to us in our planning for death,
we want their thoughts about the best timing for our deaths.
Besides knowing the health-factors
leading us to set at least an approximate season for death,
they will know the emotional and interpersonal factors
that might be relevant for such a decision.



    A.  CHOOSING APPROPRIATE PROXIES

    Perhaps some of the people who care about us
as we approach the end of our lives
will be dogmatically opposed to any form of choosing death.
Such people are quickly counted and taken into consideration:
They will be recorded as an automatic "NO" to any choosing of death.
Whenever they are asked about medical options,
they will usually choose more medical treatment,
even when the new procedures have almost no hope of benefit.

    Unless we ourselves rule out any end-of-life choosing,
when we select proxies to help us make our end-of-life decisions,
we will certainly not select people who reject all choosing in the last days.
We can still respect their views on how life should end,
even if we ourselves take a different stance.
If we believe we have a right-to-die,
we will select as our proxies only people who share this view.
Sometimes, this might mean not selecting any relatives at all.
This could happen if we ourselves have moved well beyond
what might have been a conservative religious background
we once shared with the relatives who oppose
any exercise of choice at the end of life. 

    If no relatives will support us in choosing a timely death,
then we might have to select specific individuals
from among our friends who agree with our end-of-life philosophy.
Perhaps we have been active in some organizations
that openly support the right-to-die.
And if we are going to choose some such individuals
as our proxies to enforce our end-of-life decisions,
we must make these arrangements well in advance of our deaths,
so that our relatives by blood or marriage
will be able to adjust to the fact that we have chosen someone else
to help us make our end-of-life medical choices.
We ourselves can shape our lives and our deaths.
And we have the right to choose as our helpers for the last days
people who agree with our philosophy of life and death.



    B.  SAFEGUARDS TO AVOID PREMATURE DEATH

    The following 10 safeguards for life-ending decisions
are selected from the complete list of 26 recommended safeguards.
They retain their original letters from that list.
And each safeguard is linked to a complete explanation on the Internet.

A. ADVANCE DIRECTIVE FOR MEDICAL CARE

    The first document we will create in planning for death
is our Advance Directive for Medical Care.
If we write a comprehensive Advance Directive,
we will fully explain our wishes about terminal care.

    And this would be the official place to name the proxies
who will enforce our settled values
if and when we can no longer make our own medical choices
and/or if we can no longer express our wishes
with respect to the specific end-of-life situation.
Even if we can find no proxies who will enforce our wishes,
we can still explain our settled values in our Advance Directives.

    Along with our own written documents,
we will collect the written statements of the people who are closest to us
(our proxies and possibly others who have valid reasons to be heard)
supporting our decision to choose a timely death.
Such statements should refer to the medical facts at the end of our lives.
This might mean revising such statements of support
as the medical facts change.

B. REQUESTS FOR DEATH FROM THE PATIENT

    And when we ourselves are still in charge of our end-of-life decisions,
we should make our requests for death as explicit as possible,
stating our reasons and our preferred approximate date of death.

C. PSYCHOLOGICAL CONSULTANT EVALUATES
            THE PATIENT'S ABILITY TO MAKE MEDICAL DECISIONS

    If anyone doubts our abilities to make end-of-life decisions,
we might seek the professional opinion of a psychologist or psychiatrist.
The fact of such a consultation might satisfy some distant doubters,
even if they have no right to read the psychological evaluation.

D. PHYSICIAN'S STATEMENT OF CONDITION AND PROGNOSIS

    Certainly, the most relevant medical facts can be summarized by
the physician who has primary responsibility for our medical care.

E. INDEPENDENT PHYSICIAN REVIEWS THE CONDITION AND PROGNOSIS

    And especially when considering a life-ending decision,
a second professional opinion will always be meaningful.
 
F. CERTIFICATION OF TERMINAL ILLNESS OR INCURABLE CONDITION

    If we are dying from some incurable illness or condition,
this would have been mentioned in the doctors' summaries.
But there might be useful to create a separate certification
that we have less than 6 months to live no matter what is done.

I.  PALLIATIVE CARE TRIAL

    If we have already been receiving some forms of medical care
that are intended to reduce all forms of suffering,
this fact will be relevant to mention in the death-planning record.

L. ENROLLMENT IN A HOSPITAL OR HOSPICE

    Likewise, if we are being cared for by some medical organization,
this fact will be strong evidence
that we have pursued meaningful medical care at the end of our lives,
not just 'decided' irrationally that our lives are over.

Q. AN INSTITUTIONAL ETHICS COMMITTEE
            REVIEWS THE PLANS FOR DEATH

    Also, if the medical facility caring for us at the end of our lives
has an ethics committee,
it might be relevant to ask for their considered opinion.

S. REVIEW BY THE PROSECUTOR (OR OTHER LAWYER)
            BEFORE THE DEATH TAKES PLACE

    If there is even a remote possibility of someone claiming
that some harm was visited upon us at the end of our lives,
we might summarize the death-planning record for the public prosecutor,
who will then either investigate more deeply
or issue a statement that no crime will be committed
if the plans for death are carried forward as written.



2.  CHOOSING THE BEST TIME TO DIE—NOT TOO LATE

    Once we have avoided the danger of irrational suicide
and other forms of choosing to die too soon,
we might address ourselves to the opposite danger
—that medical science and technology might keep us 'alive' too long.

    This danger will also be addressed
in some of the documents created to prevent dying too soon.
For example, our Advance Directive for Medical Care
will state what we regard as excessive medical care
—beyond what is reasonable, given our physical condition
and our specific philosophy of life and death.

    When we examine all of the deaths we have known personally,
we can easily name those deaths that were prolonged unreasonably. 
And almost all of these deaths that took place too late
resulted from the application of too much medical care.

    Our determination to die at the best time
should be communicated to all our care-givers.
And if we discover that some of our medical personnel
will not cooperate with our end-of-life plans,
then it is time to change such medical advisors and helpers.
They should not impose their own ethical standards on their patients.
It is their duty to carry forward the thoughtful decisions of the patient.
And if the patient is no longer able to make medical choices,
then the duly-authorized proxies for the patient
will carry forward the plans formulated by the patient in advance.

    Even more explicitly, the patient can project the best date of death.
This choice of date will take into account all of the possible meanings
that might be realized by living a bit longer.
As more time passes, the reasons for wanting to survive will diminish.
And the reasons for choosing death will accumulate.
Eventually there comes a tipping point
at which the reasons for choosing death
are greater than the reasons for continuing to live.
How will we choose the ideal time to die?

AUTHOR:

    James Park is an independent writer
with deep interest in all matters related to the end of life.
He has not yet selected even a projected year of death for himself.
But he now expects to live into his 10th decade.
When the end of his life comes closer,
he will apply the principles of this chapter
to determine what would be the best date of death for himself.
Of course, accidental or other unexpected death
could always cut the planning process short.
In any case, eventually the date of his death
will become a settled fact of history—just like his date of birth.
This essay was drafted on the last day of his 69th year.
And it has been revised several times since then.
Much more will be discovered about him on his website
—the last link below.
Created April 8, 2010; revised 4-23-2010; 5-1-2010; 10-19-2010; 3-11-2011; 12-8-2011;
1-6-2012; 2-24-2012; 3-16-2012; 3-18-2012; 7-28-2012; 8-25-2012; 12-1-2012;
5-30-2013; 6-9-2013; 7-31-2014; 2-4-2015; 4-3-2015; 7-10-2015;
4-5-2016; 11-30-2017; 9-29-2018; 11-14-2019; 5-15-2020;

This discussion of selecting the best day to die has become Chapter 31 of
How to Die: Safeguards for Life-Ending Decisions:
"Choosing Your Date of Death: How to Achieve a Timely Death—Not Too Soon, Not Too Late".

Here are several related essays or chapters:

Choosing Your Own Pathway towards Death

The One-Month-less Club:
Live Well Now, Omit the Last Month

One Million Chosen Deaths per Year?

Taking Death in Stride: Practical Planning

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

The Number of People Reviewing a Life-Ending Decisions
Using the 26 Recommended Safeguards

Pulling the Plug:
A Paradigm for Life-Ending Decisions

Induced Terminal Coma:
Dying in Your Sleep—Guaranteed

VDD:
  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

God Will Decide When Life Will End:
We Should Not 'Play God'

Losing the Marks of Personhood:
Discussing Degrees of Mental Decline



WOULD YOU LIKE TO MEET OTHER SUPPORTERS
OF RIGHT-TO-DIE HOSPICE?

If you agree with the concept of choosing the best day to die,
consider joining a Facebook Group and Seminar called Right-to-Die Hospice.

The essay above has become a chapter of our study-book Right-to-Die Hospice.

Here is a complete description of this on-line gathering of advocates of the right-to-die:
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/

Go to the beginning of this website
James Leonard Park—Free Library