By Mary Farrow
Denver, Colo., Oct 10, 2014 / 17:00 pm
Brittany Maynard plans on ending her life on November 1.
The 29 year-old has been diagnosed with an advanced brain tumor, and in April was given a prognosis of six months to live. Not long afterwards, after researching her options, Maynard and her family left their California home and moved to Oregon, where Maynard could opt for physician-assisted suicide via the Death with Dignity act.
She carries a prescription in her purse that will kill her if ingested. If she changes her mind, she won't take the pills.
In an op-ed written for CNN, Maynard said: "I've had the medication for weeks. I am not suicidal. If I were, I would have consumed that medication long ago. I do not want to die. But I am dying. And I want to die on my own terms."
A few states to the south and east, Kara Tippetts of Colorado is preparing for the end of her life.
She knows it will come sooner than later. Tippetts, like Maynard, knows great suffering. She has been battling an aggressive form of breast cancer for two years that has metastasized throughout her entire body.
She was diagnosed at the age of 36, and has since been trying to make the most of her time with her four young children, and husband Jason.
After news broke of Maynard's decision, Tippetts wrote Brittany an open letter from her heart, sharing her love and prayers, sympathizing with her extreme suffering and thanking her for sharing her story.
"I think the telling of your story is important," she writes. "It's a discussion that needs to be brought out of the quiet corners and brought brightly into the light. You sharing your story has done that. It matters, and it is unbelievably important. Thank you."
Kara then gently pleads with Brittany to reconsider.
"Dear heart, we simply disagree. Suffering is not the absence of goodness, it is not the absence of beauty, but perhaps it can be the place where true beauty can be known."
Dr. Julie Masters is also glad that Maynard's story is out there. The chairman of the Department of Gerontology at the University of Nebraska, Masters teaches a class called "Death and Dying" for undergraduate students. The class covers everything from funeral planning to grief and loss, religious perspectives and near-death experiences.
It just so happened that the syllabus lined up with the news - her class's discussion on physician assisted suicide and euthanasia was the same day Maynard went public with her decision.
"I really don't believe in coincidences, I think we're given information when we need to hear it," Masters said. Her hope is that Maynard's story will open up the desperately-needed conversations about end-of-life decisions in both families and larger communities.
Her fear is that many will now see Death with Dignity as the only way to go.
"That's where I get concerned about responsible reporting," she said. "That other people will read this and (may) say, 'Well gosh, then I guess that's what I need to do, that's the way to go', but that's not the only option, and I hope folks understand that. That's where the idea of hospice or palliative care comes into play."
"When you see a headline like, 'I have the right to make my decision' … we forget that there's a bigger picture in terms of our understanding of end of life wishes."
Masters made it clear that she could not speak specifically to Maynard's situation.
"We only know a snapshot, we don't know the whole story, and so I'm not sure exactly why … she's chosen that path," she said. Something typically touted as a benefit of physician assisted suicide is that it cuts down the costs of hospice and palliative care, Masters said, though that's rarely the reason people actually opt for it.
In Maynard's op-ed, she mentions wanting to be in control of her own destiny, in having the power to choose when she dies. Masters said this idea of self-autonomy is often the reason people choose this option.
"It's not about financial costs, it's about being in control of my own destiny," Masters said. "But you have to include a different perspective – what does it mean to be in control? Are you really in control? That's something that you have to think about."
Masters also hopes that in the wake of Maynard's decision, end-of-life care can be viewed in a broader perspective that includes longer-term hospice and palliative care.
"If we would think about care in a broader range, meaning not just six months or less, but looking at it from a year, or two years, or three years out, that person's going to have a better sense of care, and a better sense that they will be supported at the end of their life."
Most insurance policies only let people receive hospice care if they are given a prognosis of six months or less to live. Broadening the perspective of what hospice or palliative care could change the conversation about end-of-life issues, Masters said, but even as it stands, statistics show most people don't take full advantage of the care available to them.
"When you look at median length of stay and average length of stay, what we find is that people are not able to take advantage of hospice for as long as it's really out there," she said.
Why aren't they taking advantage?
"I think part of it is we don't want to talk about it, we're afraid of it, we're afraid of death."
Clergy can be key in opening these conversations, Masters continued. A study done by the Nebraska Hospice and Palliative Care Association on the end-of-life planning of Nebraskans found that many people said they wished they had had more conversations with their clergy regarding death and dying.
"(People are) looking to clergy to initiate the conversation. And so is there an opportunity, whether its from my priest or my rabbi or my imam or my minister, you fill in the blank, where they could help me begin that conversation," she said.
Masters recalled how much comfort a priest brought when her own father, a devout Catholic, was dying.
"His faith is what really helped define who he was over the course of his life, and so to have his priest come by and anoint him, to have his priest come pray with him and give him Communion, was very important," she said. "I can't tell you how helpful it was to us, to know that we were doing things in accordance to the faith tradition."
Masters said she often thinks what Mary and Joseph talked about as the foster-father of Christ neared the end of his life.
"Don't you wonder if Mary had a conversation with Joseph about the end of life? We don't hear much about the two of them but they had to have had a conversation, because I don't think he died suddenly," she said.
In the Catholic tradition, St. Joseph is referred to as the patron of a happy death, as it is believed that he died with Jesus and Mary by his side.
"Don't you think at some point Mary said, 'Ok Joseph, what do you want?' I wonder about that and I think about her as a caregiver and where she was, and her intersection with death in so many different ways, with Joseph or with Jesus."
Tippetts, too, said her faith is what gives her peace and comfort in her dying days, and she expresses her hope that Brittany will come to know the same love and the same understanding of beauty in suffering.
"Knowing Jesus, knowing that He understands my hard goodbye, He walks with me in my dying. My heart longs for you to know Him in your dying. Because in His dying, He protected my living. My living beyond this place," Tippetts wrote. " My heart longs for you to know this truth, this love, this forever living."
Tippetts begged that Brittany at least seriously consider the person of Christ before making crucial end-of-life decisions.
"For everyone living knowing death is eminent- that we all will one day face this it – the question that is most important. Who is this Jesus, and what does He have to do with my dying? Please do not take that pill before you ask yourself that question."
"It's a question we all must ask, as we are all dying."
Kara Tippetts recently wrote a book about her journey through life and towards her last breath called The Hardest Peace. She also blogs about her experience at http://mundanefaithfulness.com/.
