Three states in the United States have Death with Dignity statutes that allow physicians to prescribe lethal doses of medications to mentally competent adults suffering from terminal diseases. Oregon is one of those states, and Brittany Maynard was one of those adults. Earlier this spring, Brittany was diagnosed with Stage 4 glioblastoma, a fatal form of brain cancer, and given six months to live.
According to The American Brain Tumor Association, glioblastomas represent a very aggressive form of brain cancer. The cells reproduce very quickly, have a large vascular network to support the tumors, and are notoriously difficult to resect and treat. Most forms of cancer do not form simply shaped tumors. They often have an elongated and pebbled appearance throughout the tissue they are in, which is what makes them so difficult to remove surgically. Glioblastomas are found in the brain or spinal cord and develop finger like tentacles that spread throughout the tissue of the brain. This makes them nearly impossible to completely remove, especially when located near parts of the brain that control functions essential to life such as the brain stem, or parts that control speech, coordination, or cognition.
The brain is a very delicate organ, encased in an inflexible bony skull. The rapid growth of the tumors can quickly lead to pressure inside the skull. That pressure can further damage brain tissue leading to severe headaches, nausea, speech and vision problems, paralysis or difficulty with movements in body hemispheres, memory loss and other complications. Extensive surgeries can also cause inflammation that leads to these same symptoms. The varied composition of these tumors make them difficult to treat with chemotherapy and radiation as well. The different cells that these tumors are composed of are not uniform in their responses to the anti-cancer drugs, some being almost completely impervious. Even with aggressive treatment, fewer than 10 percent of people diagnosed with glioblastoma are alive five years after receiving that diagnosis. Seventy percent don’t live to see the two year mark. Most live about 14 months.
As horrific as these statistics are, the actual death from this form of cancer can be worse. Inter-cranial swelling can cause pain that cannot be controlled. Suffers often lose control of bodily functions, lose their ability to communicate, suffer seizures. Some slip into comas towards the end. Death with dignity is rare when dying from the natural progression of the disease. With currently available treatments, death is almost inevitable. Treatments may prolong life, but for the most part, they contribute to a significant decline in quality. More and more people are finding these options unacceptable. With the breathtaking prevalence of cancer, there are few people who have not been touched by it in some form. Far too many people have sat at bedsides of loved ones, holding hands and feeling helpless as the cancer slowly stole the life, but quickly escalated the pain. Many people report being torn apart by their emotions, not wanting to let go of their loved one but at the same time absolutely desperate for the pain and suffering to end.
Brittany Maynard became the face of the controversial Death With Dignity movement. After coming to terms with her diagnosis, she found her options to be unacceptable. She discussed her diagnosis and feelings with People Magazine last month.
“My glioblastoma is going to kill me and that’s out of my control. I’ve discussed with many experts how I would die from it and it’s a terrible, terrible way to die. So being able to choose to go with dignity is less terrifying.”
Brittany moved to Oregon in June to be able to take control of her final moments with the legal protection of the state’s laws pertaining to Death with Dignity. She had long planned to take her life on November 1. In recent weeks she had capitulated on the date as she was feeling well, but in the end, her tumor worsened. She was declining rapidly and chose to stick with her original plan.
“For people to argue against this choice for sick people really seems evil to me. They try to mix it up with suicide and that’s really unfair, because there’s not a single part of me that wants to die. But I am dying.”
Brittany Maynard died with the dignity she had hoped for on Saturday November first at the age of 29. Her fight is over, but she put a beautiful face on this terrifying fight. She boldly started discussions on this dilemma of death with dignity. She had hoped to leave a legacy of contributing to expanded access to death with dignity laws for others who would rather avoid some of the more painful and demeaning aspects of dying from natural progression. Her family and friends have been leaving beautiful tributes to this bold woman, and supporting her fight, using the hashtag #DeathWithDignity.