Doctor-assisted suicides impact families
End of life talks give the dying a chance to wrap up their lives
LOS ANGELES — Bob Stone sat at his dining room table and twisted open 90 red capsules, one by one. From them he collected a small pile of powder.
In an hour, when the sun finished setting outside his Silver Lake home, he would use the drug to end his life.
Stone mixed applesauce with the powdered secobarbital, a powerful sedative that is fatal in high doses. He ate the bitter blend.
Roberta Stone, his ex-wife, sat next to him, watching. She fixed her dark eyes on a bowl filled with dozens of empty red capsules.
Then they crawled into bed, and embraced. They whispered to each other. Half an hour later, she heard him stop breathing.
Stone, 69, had been diagnosed with bone marrow cancer the year prior, and chemotherapy had failed. He was one of 111 people last year who took advantage of a new law in California allowing people with terminal illnesses to request medicines from their doctors to kill themselves.
Avoiding the ‘hard part’
Roberta Stone said she was grateful Bob avoided what he’d called the “hard part” — not death, but dying. Her brother endured six weeks of agony when dying of Parkinson’s, she said.
“Who would want that for someone they love, or for themselves?” she said.
The debate around physicianassisted suicide laws tends to focus on patients. But California’s early experiences show the practice also has a profound impact on those left behind.
Family members have typically spent months, if not years, accompanying loved ones to doctor’s appointments, sitting by hospital beds, suffering the ups and downs of treatment. They’ve been part of an arduous process that sometimes seemed to strip their relatives of autonomy and dignity.
A request for end-of-life drugs can inspire regret or sorrow among family and friends. But, experts say, it also can be powerful and comforting for grieving family members to know they fulfilled their loved one’s dying wish.
‘This is comforting’
That Saturday morning in September, Roberta, a retired legal secretary with short curly hair and a toothy smile, felt nervous as she prepared to leave her home in Glendale. But she’d promised her ex-husband she’d spend his last day with him.
The couple divorced five years earlier but never cut the ties of their relationship. After meeting in 1991 on a Sierra Club hike in Malibu, they were “together always,” she said.
When they were newly married, talking about growing old, he told her he didn’t want to languish near the end of his life.
In July last year, Bob Stone told the Los Angeles Times in an interview that his mother, father and uncle endured painful medical treatments when they were sick, forced to spend their last few days in hospitals.
Stone said he was grateful to make his own decisions about the end of his life. His doctors had recently told him his cancer treatments had stopped working and he had as little as three months to live.
By July, he’d already received the secobarbital prescription.
“My parents didn’t have that control; my uncle didn’t have that control,” he told The Times. “This is comforting to me.”
Dr. Neil Wenger, director of the UCLA Health Ethics Center, said many people who request lethal prescriptions don’t necessarily intend to use them. Often they’re in clinical trials, fighting to extend their lives.
“These patients do not want to die. These patients just want to control how they die when they absolutely must,” Wenger said.
But the mere conversations that are prompted when patients request the medicines can improve the patient’s care, as well as the family’s experience, Wenger said. Talking openly about endof-life options has spurred patients to write keepsake letters and record video messages for their children and grandchildren. It’s pushed people to say things that may have otherwise been left unsaid.
The process, he said, can force a “coming to grips with the end of life, pulling together one’s affairs, not only financially, but also psychologically, emotionally — bringing families together.”
Between June and December last year, 191 Californians received lethal prescriptions but only 111 took them, state data show. In Oregon, which was the first state to legalize the practice two decades ago, only about twothirds of those who get the prescriptions end up using them.
A Gallup poll last year found that 69 percent of Americans support legalizing doctor-assisted suicide, up from 36 percent in 1950.
Data from both California and Oregon show that the majority of aid-in-dying patients are white, college-educated, older than 60 and, like Stone, suffering from terminal cancer.
Energy level fades
Stone, who had a long career dedicated to helping the homeless, had a handful of things he wanted to do before he died. He traveled to Vietnam, Japan and Thailand. He reached out to old friends. He completed a project to photograph every state Capitol building.
“He actually had on the side of his file cabinet a bucket list,” Roberta Stone said.
But his energy level faded. He had a few good hours each day, at most. He was in hospice.
He decided he would take the secobarbital pills on Sept. 10. He told Roberta that it was on that day more than half a century earlier that he’d moved to Los Angeles as a boy with his mother and siblings.
“Bob had time to come to terms with it,” she said. “And I felt proud of Bob that ... he knew what he wanted to do.”
“My parents didn’t have that control; my uncle didn’t have that control. This is comforting to me.” Bob Stone, terminal cancer patient