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Helen Beum is the clinical director of Compassion & Choices. When Sandy called, the newly merged group was just getting organized, and even though he was only a few miles from the office, his initial conversations with volunteer counselors were over the phone. At their suggestion, he began looking into hospice care. But once they were convinced he was terminally ill, the nurses also gave him tips about how he could end his own life.
"Hospice doesn't talk about hastening death, and families don't like to," Beum says. "Usually they call us because they want to know about options if the pain gets too bad or the suffering too unbearable. They call us about options to hasten their death. What we do is provide information, and that's not illegal in any state."
They don't provide that information on the Compassion & Choices website, though. Rather, it's given in the context of a volunteer/client relationship. Today, Compassion & Choices has 185 trained volunteers in 38 states.
Although they prefer to visit potential clients face to face, usually at their homes, some consultations are still done over the phone. Of primary importance, Beum says, is ascertaining that people aren't considering hastening death simply because of depression or untreated pain. Volunteers may request mental evaluations, if they deem them necessary. And before they even talk with potential clients, volunteers go through three-day training seminars during which they learn how to look for depression, as well as the various methods for hastening death.
Stopping medical treatment, therapy or medication are all options that clients can consider -- as is deciding to stop eating and drinking. All constitute essentially pulling the plug, a right that every U.S. citizen has.
Obtaining medications that could be used to end life is a final option.
"We don't provide the medications, and we don't administer them," Beum says. "The clients need to be able to obtain the medications and administer them themselves. We've never had an investigation. These are mentally capable, terminally ill people, and we believe what we do is legal. People don't want to die; they just don't want to suffer."
After talking several times with Compassion & Choices volunteer counselors, Sandy had an out-of-state friend with a medical background purchase the recommended pills. He won't say which state and won't say which pills, nor will he discuss where he keeps the pills. He's concerned that opposition to the right-to-die movement is mounting, and that someone might try to take them away.
And should he ever decide to pop those pills, Sandy adds, his wife and sons all have veto power.
Thus far, Sandy hasn't come close to considering it. He has a hard time even defining the line he'd have to cross before deciding to die at his own command. "If I'm bedridden, if I'm in major pain, that would be a primary area," he says. "If I can't do any of the normal things, I can't go to the bathroom, I can't go out to enjoy a show, if I am that way, then that's when I would start considering or thinking where I want to draw the line."
Right now, with whatever time he has left, Sandy wants to be with his family. After he and Joann sold their big RV, they bought a smaller version that will be easier for Joann to handle once Sandy's gone. And in the meantime, he's taking full advantage of it.
Thanks to morphine and that hidden stash of death pills -- which cost less than $50 -- Sandy can think more of living than dying.
"It has cleared me up to a point that I no longer think about death at all," he says. "I'm not afraid about it, I'm not worried about it, because I'm thinking about life. Right now we're talking about taking a cruise. We want to keep doing things that I never would be willing to do before, because I was obsessed with the fear of what would happen to me if I got into intense pain, and then all of the things that happened to people weeks and months before death in the type of disease that I have. I couldn't accept it.
"Now I can accept it, because I know that I will not have to suffer through that if I don't want to," he continues. "I'm convinced that the morphine and the positive attitude that came from this knowledge and this ability of having control at the end have given me an awful lot of life. I don't know how much more, but it's just absolutely relieved me of the fear and concern of 'what about if.'"
Though it's not easy for Joann to think about life without Sandy, she accepts what he is planning. She knows that Sandy always has to be in control, and if he wants to control his life right up to the end, she'll stand by him.
"He'd do the same for me," Joann says. "When he gets to the point that his life is not the life that he and I both know that he likes to live, being in control and not bedridden and not in pain, I think we'll just know when the time is right. I have no problem with it at all. I mean, I'm going to be upset, miserable, unhappy, I know I will be afterward. I'll be alone for the first time. I've spent my whole life with him."