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10/11/2016

Yes, You Were Misinformed

I love Joyce Wadler’s occasional columns for the New York Times. Under the general heading, “I Was Misinformed,” she comments with great wit on the various aspects of growing old.  But this week, she made a basic error that set me thinking.  Upset after visiting her mother, who has dementia, she calls her friend Harry:

“If I’m ever in this situation just get me the pills and book the trip to Oregon,” I tell him. “Don’t let me exist like this.”

“I know,” says Herb, who goes down this road with me once a week. “Oregon or if the weather is nice, Vermont.”

Grounding the banter comparing the advantages of Ben & Jerry’s to a trip out  West, is the assumption that there is some connection between developing dementia and making use of “Death with Dignity” laws in states such as Vermont, Oregon, and California.  I had a discussion a few days ago that highlighted the same misunderstanding.   I was explaining to a fellow attendee at a conference on aging and society, that my presentation would be on preemptive suicide as a strategy for avoiding Alzheimer’s Disease.  “Oh,” he exclaimed, “my state is voting on that next month!”  Nope. Wrong.  Your state (Colorado) is voting on a law very much like the ones passed in other states.  They all require that the person ending her life be competent, and they all require a physician’s determination that death is likely to occur within six months.  In other words, they are completely irrelevant to someone with dementia.  If you have dementia, you’re not competent, and you are not especially likely to die within the next six months.

This is a very common, and very puzzling, error.  Surely someone as sophisticated as Wadler understands the basics of these laws, and yet I run into this misunderstanding all the time.  Is this a form of denial, a refusal to accept that once one starts down the path of dementia, there is no escape?

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