On accepting death: scientist David Goodall ends his life at 104 through self-assisted suicide; Barbara Ehrenreich gives up on preventive medical care

May 21, 2018 • 12:30 pm

As we grow older (and by “we,” I mean “I”), one’s thoughts tend naturally to turn to mortality. The comparison of your age to that of those listed in the paper’s obituaries becomes a depressing habit, one gives up beloved foods and behaviors in an effort to stay alive as long as possible, and you realize that the time that has passed since you were 40 is longer than the time you have left.

So it’s somewhat heartening, then—though I can’t get there myself—to hear about older people who are sane but have just decided to either die or not engage in the usual measures to prevent getting ill. And two people have done it in different ways.

As this NYT article notes, Australian ecologist and botanist David Goodall, 104, who was working and active right until recently, grew upset at his worsening health and loss of independence, and just decided that it wasn’t worth it to live any more. Unable to kill himself in Australia (he tried but failed, and there are no laws in Australia allowing assisted suicide), he took off for Switzerland and, with the help of the group Dignitas, turned on a machine that injected barbiturates into his veins. (Another option is to drink a barbiturate containing solution). He died on May 10.

I suppose if I were that debilitated, I might just be weary of life. What keeps me going are things to look forward to, and if those are gone there’s no point in living. (I’m not nearly there yet!) At any rate, I admire Goodall for his tenacity and, especially, his complete lack of a fear of death. One quote from the Times piece:

Asked if there was anything he still wanted to do, he said: “There are many things I would like to do, of course, but it’s too late. I’m content to leave them undone.”

Pressed about what he would miss, he allowed, “I have been missing for a long time my journeys into the Australian countryside, but I haven’t been able to do that for quite a while”

He was asked about his last meal. “I’m rather limited in my culinary enjoyment nowadays,” he responded. “I don’t find that I can enjoy my meals as I used to.”

On Thursday, he received a fatal dose of a barbiturate intravenously. In order to comply with Swiss law that bans the interference of third parties in the process, he opened the valve to release the solution himself and fell asleep, dying soon after. Some of his grandchildren were with him in his final hours, Exit International said.

He wanted no funeral and no remembrance service, and he asked that his body be donated to medicine or his ashes sprinkled locally, according to Exit. Mr. Goodall did not believe in the afterlife, the organization said.

How would he like to be remembered? “As an instrument of freeing the elderly from the need to pursue their life irrespective,” he said at the news conference on Wednesday.

At one point, he was asked what tune he would choose for his last song, and he said the final movement of Beethoven’s Ninth Symphony. Then he began to sing, with verve and vigor.

According to Mr. Nitschke, Mr. Goodall did end up choosing Beethoven, and he died the moment “Ode to Joy” concluded.

My “going out” music would be Richard Strauss’s appropriate song “Beim Schlafengehen” (“At the time of going to sleep”), with Jessye Norman’s incomparable rendition (here). Readers are invited to submit what kind of music they’d like to hear when they were dying.

Second, well known author Barbara Ehrenreich, who is 76, wrote a provocative essay that’s gotten some attention. She’s decided to give up all preventive medical care and not worry about her diet and exercise so much because she’s “old enough to die”, and sees no point in prolonging a long life with expensive medical care, or even preventive tests. It’s an essay worth pondering, and I agree with some of it. Have a read by clicking on the screenshot:

A few quotes:

“In the last few years I have given up on the many medical measures—cancer screenings, annual exams, Pap smears, for example—expected of a responsible person with health insurance. This was not based on any suicidal impulse. It was barely even a decision, more like an accumulation of micro-decisions: to stay at my desk and meet a deadline or show up at the primary care office and submit to the latest test to gauge my biological sustainability; to spend the afternoon in faux-cozy corporate environment of a medical facility or to go for a walk.

. . . I also understood that I was going against the grain for my particular demographic. Most of my educated, middle-class friends had begun to double down on their health-related efforts at the onset of middle age, if not earlier. They undertook exercise or yoga regimens; they filled their calendars with upcoming medical tests and exams; they boasted about their “good” and “bad” cholesterol counts, their heart rates and blood pressure. Mostly they understood the task of aging to be self-denial, especially in the realm of diet, where one medical fad, one study or another, condemned fat and meat, carbs, gluten, dairy, or all animal-derived products. In the health-conscious mind-set that has prevailed among the world’s affluent people for about four decades now, health is indistinguishable from virtue, tasty foods are “sinfully delicious,” while healthful foods may taste good enough to be advertised as “guilt-free.” Those seeking to compensate for a lapse undertake punitive measures like fasts, purges, or diets composed of different juices carefully sequenced throughout the day.

. . . Once I realized I was old enough to die, I decided that I was also old enough not to incur any more suffering, annoyance, or boredom in the pursuit of a longer life. I eat well, meaning I choose foods that taste good and that will stave off hunger for as long as possible, like protein, fiber, and fats. I exercise—not because it will make me live longer but because it feels good when I do. As for medical care: I will seek help for an urgent problem, but I am no longer interested in looking for problems that remain undetectable to me. Ideally, the determination of when one is old enough to die should be a personal decision, based on a judgment of the likely benefits, if any, of medical care and—just as important at a certain age—how we choose to spend the time that remains to us.

. . . In giving up on preventive care, I’m just taking this line of thinking a step further: Not only do I reject the torment of a medicalized death, but I refuse to accept a medicalized life, and my determination only deepens with age. As the time that remains to me shrinks, each month and day becomes too precious to spend in windowless waiting rooms and under the cold scrutiny of machines. Being old enough to die is an achievement, not a defeat, and the freedom it brings is worth celebrating.

Well, I don’t fully agree with her; if you’re in good health, and still look forward to life, why not at least have routine tests for things that are easily treated, like high blood pressure or high cholesterol.

But I can understand the abstemiousness that itself makes life less valuable. I well remember that when I was younger, and could eat anything I wanted, in any amount, without putting on weight, I said, “If I ever had to restrict my diet, I’d kill myself.” Well, here I am fasting twice a week, and with my love of food, it’s no picnic. Yet I’m not contemplating suicide! A “low carb diet”, which I tried, was worse: no bread, pasta, and, especially, no wine or beer.  Is living worth living if that’s what you can’t eat or drink? I gave that up for fasting, but now two days a week I don’t get any food save a latte with Splenda.  And if I really wanted to live a long time, I’d go on one of those diets where you just eat vegetables and fruits, or simply cut down my food intake, like a rat, to near starvation.

But is that a life worth living? Not for me. In my head I sometimes hear the words of U. S. Marine Sergeant Major Daniel Daly (twice a Medal of Honor winner), who was supposed to have spurred on his men at the Battle of Belleau Wood by saying:

“For Christ’s sake men—come on! Do you want to live forever?”


177 thoughts on “On accepting death: scientist David Goodall ends his life at 104 through self-assisted suicide; Barbara Ehrenreich gives up on preventive medical care

  1. I think you misspelled “Schalfengehen”.

    On Mon, May 21, 2018 at 12:31 PM, Why Evolution Is True wrote:

    > whyevolutionistrue posted: “As we grow older (and by “we,” I mean “I”), > one’s thoughts tend naturally to turn to mortality. The comparison of your > age to that of those listed in the paper’s obituaries becomes a depressing > habit, one gives up beloved foods and behaviors in an effort ” >

    1. Thank you. I live in Oregon. I am very interested in how the Right to Die movement is progressing in other states. California
      supposedly has it, but it is being fought right now.

  2. There’s a small typo you may wish to correct – the music by Richard Strauss should be “Beim schlafengehen”.

  3. I want this playing as I shed my mortal coil:

    Pink Floyd, “High Hopes”

    Beyond the horizon of the place we lived when we were young
    In a world of magnets and miracles
    Our thoughts strayed constantly and without boundary
    The ringing of the division bell had begun

    Along the Long Road and on down the Causeway
    Do they still meet there by the Cut

    There was a ragged band that followed in our footsteps
    Running before times took our dreams away
    Leaving the myriad small creatures trying to tie us to the ground
    To a life consumed by slow decay

    The grass was greener
    The light was brighter
    When friends surrounded
    The nights of wonder

    Looking beyond the embers of bridges glowing behind us
    To a glimpse of how green it was on the other side
    Steps taken forwards but sleepwalking back again
    Dragged by the force of some in a tide
    At a higher altitude with flag unfurled
    We reached the dizzy heights of that dreamed of world
    Encumbered forever by desire and ambition

    There’s a hunger still unsatisfied
    Our weary eyes still stray to the horizon
    Though down this road we’ve been so many times

    The grass was greener
    The light was brighter
    The taste was sweeter
    The nights of wonder
    With friends surrounded
    The dawn mist glowing
    The water flowing
    The endless river
    Forever and ever

    The music is so haunting and evocative…

      1. Yes, Comfortably Numb would be my choice, not just for the lead guitar but for the beautiful orchestration of the backing.

        Either that or the hauntingly beautiful version of ‘Going Home’ (aka ‘Wild Theme’) that Dire Straits played in some concert – not the usually played one but the version from ‘On The Night’ CD http://www.youtube.com/watch?v=5UdXXyi5Q-A


    1. I will check this one out and the one Jerry mentioned to include in the list of music I’m imagining for my family to listen to as they sprinkle my ashes in the Yosemite area. “Ode to Joy”: yes. Some Mozart. Some Lloyd Webber (Pie Jesu, even though I’m not religious). There are others. Wish I could find my list.

      If I don’t die of one of the health issues inherited from my family (heart attack or stroke) that strikes quickly, I hope to follow my husband’s Death With Dignity assisted death surrounded by family and friends. His was the most peaceful death I’ve ever seen.

    2. The moment where Gilmour comes in with pedal steel is magic. (I’m referring to the version on the Pulse DVD set now).


    3. Excellent choice! I’d choose possibly the acoustic version by David Gilmour at Meltdown Concert Royal Festival Concert 2002: /watch?v=TDfKRDYE3w0

      Other choice would be The Greatest Show On Earth by Nightwish.

  4. My fear as my parents age is affording for their care as they have no money themselves and only a government pension, which is not enough for care as it isn’t all paid for by the government. I not feel any care will be available for me and really doubt the pension will be there either so I intend to just work until I die, which given how I feel about my present position, is quite dower. I’ve already had to significantly restrict my diet due to IBS, I have issues with my feet which reduce my ability to walk very far at one go and I’ve witnessed what it is like to live when you are far too gone both physically and mentally to have any enjoyment of life. I really get where Ehrenreich is coming from. Our own Diane G recommended Ehrenreich’s book “Brightsided” after my cancer diagnosis and I loved it. The cancer chapter about how we use battle language and ostracize those who don’t, is spot on.

      1. Yes, I got it in 2014 though it was breast cancer so it can always come back and go “Boo! I’m metastatic muahaha”

        1. One of the odd truths you learn to appreciate is that you beat cancer by dying of something else. Since I’m still enjoying my ‘partial remission’ from leukemia I’m doing my bit by ignoring cholesterol guidelines (eggs for breakfast, cream and whole milk used liberally in my cooking) and taking corners a little too fast in my Miata, which turned 27 this week. I think of it in terms of quality of life rather than quantity.

  5. I am reading her book, the one the essay was based upon, and with regard to “Well, I don’t fully agree with her; if you’re in good health, and still look forward to life, why not at least have routine tests for things that are easily treated, like high blood pressure or high cholesterol.” The question then becomes, what is a routine test. For me this now includes ekgs, coloscopies, and varies and sundry other tests. If something is found (there is a new category called “pre-cancerous whatchamacallits”) then there is treatments.

    We have been receiving billions of dollars worth of cholesterol lowering drubs based upon very dubious (and in my opinion biased) research linking cholesterol to heart disease. My parents had “high cholesterol (and lived into their 80’s), both of my sisters have high cholestrol and are taking medication, and I have “high cholesterol” though not as high as my sister’s and I have refused medication. I may end up having a heart attack but I think not. I have quite low blood pressure and it is rare that someone with low BP has a heart attack, even so, I will play the odds.

    As I am reading Ms. Ehrenreich’s book I find myself quite in agreement with the attitude. If I suffer a large health setback, that attitude might change, I guess.

    1. I have read a number of articles about about the efficacy of cholesterol-lowering drugs prescribed for senior people and receive the message that they aren’t beneficial for folks over 50. (We are a good source of revenue, however.) I am told that there are three drugs the feds insist on doctors prescribing for us older folks: cholesterol lowering drugs, blood pressure medication, and one other I can’t think of. When I asked my doctor about getting rid of the cholesterol lowering drug, he offered to lower the dosage, but not stop it.

      Reducing triglycerides is much more important than reducing cholesterol. And, although doctors know a little more about that now than they did 30 – 40 years ago, many of them still don’t know much.

      The women on my mother’s side of the family all ate mid-western or southern high-cholesterol meals all their lives and lived into their 80s or 90s. Mom: 93, Aunts Frances and Thelma: 99. My poor Dad was forced to eat the low cholesterol diet prescribed (no eggs, no bacon, no butter, etc.)for many years and died in his 70s. Maybe, because he couldn’t have what he loved to eat.

      1. My physician has accepted my decision to decline prescription meds for cholesterol and tri-glycerides. Like me, my dad and paternal grandpa both had high numbers in each category and lived healthily to 98 and 91. As they say, choose your parents well.

  6. I think it has a lot to do with what you look forward to. My father 85, has had two knee replacements, two collapsed vertebrae replaced, two titanium rods bolted to his spine and is getting his hip replacement replaced. Along with his meds it’s a lot to keep him going.
    As he’s said repeatedly, once he gets to the point where he can’t travel, golf or work in his wood shop he doesn’t want to live.

  7. Boy does this ring true for me. I’m also at the point where the time since I was 40 is greater than the time I have left. Most of what I’ve “given up” was involuntary…. legs that don’t quite work as well as they used to even with a replacement hip. As for food, I gave meat up decades ago and don’t really miss it. I have given up drinking as much as I used to and find social drinking (defined with the addendum “and your wife doesn’t count”) seems to allow me to enjoy wine/beer/scotch often enough to not feel overly deprived.

    I hope that when my time comes I’ll have an option available like David Godall’s. We need serious political activity on that front, though. Most of us won’t be able to make it to Switzerland.

    1. Very sensible. My “give-ups” kind of match yours; but I still eat meat/fish.

      What I have given up almost entirely is carbs — and I don’t miss them. I still love them (and we do, very occasionally, indulge) but I find them unnecessary.*

      On vacation and such, I eat more or less what I want; but much less than previously.

      I pretty much just eat veggies and fish/meat.

      I do my best to drink less.

      My excess weight was a serious problem and it was impacting important areas of my life. I am now down to where I was 16 years ago and buying “regular” clothes again. It’s wonderful. And very slow: More than a year and still dropping.

      (* I had a brain wave recently: Carbs are just extra calories that don’t really provide any necessary nutrition. We love them but do not require them.)

      1. Heh… for me, “meat” doesn’t include fish… kind of like how “social” doesn’t include my wife. 🙂

  8. I think I would plan to move to Washington, Oregon or one of the other states if something happened and became terminally ill. Here are the first songs I thought of. I don’t usually listen to slower songs but probably would at that time.

    Did Ye Get Healed – Van Morrison
    And It Stoned Me – Van Morrison
    Queen of the Slipstream – Van Morrison
    The Long Day Is Over – Norah Jones
    New York State of Mind – Billy Joel
    Dweller on the Threshold – Van Morrison
    Flying Horses – Dispatch
    In the House of Stone and Light – Martin Page

    1. Another Van fan. I’d hafta add “Days Like This” to your list. I love how Van turns the “Momma told me” trope on its head, with her saying that there’d be days when everything goes just right.

      1. Definitely. I also didn’t think of Simple Gifts (a string instrumental version) and Copperline by James Taylor.

    2. I quite fancy ‘Always Look on the Bright Side of Life’. But that’s my weird sense of humour and since I won’t be listening I’ll leave it to the survivors to pick their favourite.

      My wife and I have chosen (and pre-paid) for natural funerals though, so that’s something added to the contentment side of the scales.

  9. Pain. Pain is a big one. I understand it well. I am increasingly frustrated with people who think those who suffer pain are irrational for wanting to die. It’s completely rational.

    1. Indeed. I’ve had some very bad pain in the past and low-level orthopedic pain pretty much 100% of the time.*

      Happily, it has always resolved, almost never with help of opioid meds.

      However, if I didn’t think it would get better, I can definitely see ending it. One time, the pain was 100% debilitating while it lasted (sciatic nerve pinch).

      (* My doctor, of many years, recently commented: “You have a really high pain threshold.” I suppose so. Pain has been my constant companion. But it doesn’t (normally) stop me from doing the things I want to do.)

      1. I am a chronic migraine sufferer. I’ve enjoyed the benefits of medication to keep me going but once I had daily, severe, intractable migraines for 2 years. A sociopathic neurologist discharged me in that condition when I didn’t continue buying Botox from her. I have screwed up feet because of plantar fasciitis due to mechanical issues with my feet. I recently messed up the part of the tendon that attaches to the bottom heel. I decided to try cortisone injections. Honestly it was a piece of cake. I had way worse needle pain at the dentist. The rheumatologist looked at me and said “wow, you’re my best patient ever receiving these injections. This really makes things a lot easier for me”. I don’t know if all my other pain had made me raise my expectations that this would be asexual so when it happened it was no big deal but I suspect pain experience helps somewhat. My dad is completely unprepared for pain and he is so surprised when it happens to him. For me, I’m ecstatic if I just manage to almost seem normal.

        1. Asexual. Hilarious auto correct again. It was an asexual experience but I meant painful.

            1. I’m wondering how my phone knows such things. I guess my texting is bizarre enough I have given it a weird vocabulary.

          1. Have mercy! That auto correct overcompensation gave me my best laugh of the day Thank you. And it’s a gift that keeps giving because very time I reread your post, I tear up with laughter. How in the world did “painful” or however you misspelled it auto correct to “asexual”? I kept trying to make sense of it, did cortisone injections make a person asexual; that couldn’t be, but what on earth did she mean? Thanks again, I say as I wipe away my tears of great mirth.

            1. Haha. I know, I keep thinking of plants. I think I mistyped a letter or two and the iPhone just tries to figure it out. Here is something I’m going to warn women about even though it’s probably gauche to mention it, cortisone shots can bring on your period full force. Some menopausal women even got their periods. So, it’s actually a little funny I mistyped and autocorrected to asexual.

        2. I wonder if the brain’s PAIN! Hey you, PAIN! signal gets “turned down” over time for chronic pain sufferers? Kind of like how your nose gets desensitized to constant strong smells?

          I wonder if that was working with your foot injections. Sounds horribly painful!

          I wonder if that’s the case for me. Though my “normal” pain level is pretty mild. At least by my estimation.

          1. It would be interesting to figure out but I’m sure if you punched me in he nose right now I’d piss and moan about it.

        3. CBDs are apparently good for pain according to a friend whose brother passed away from brain cancer a year and a half ago. He liked the CBD part for the pain but didn’t want the high that comes with THC. I believe CBDs are legal and you can find them in teas and things like that.

  10. Mark Twain re: dieting – “It won’t make you live longer; it’ll just feel longer.”

    Last music? Something very up-tempo by maybe Springsteen (Born to Run?) or The Nitty Gritty Dirt Band (Forever Don’t Last the Way It Used To?).


      1. Not Twain. It was Clement Freud; “If you resolve to give up smoking, drinking and loving, you don’t actually live longer; it just seems longer.”

    1. I’ve wondered whether Jessye Norman was the inspiration for the subject of Jules’ fascination in the French super-cool Diva.

  11. One relevant human behavioral quirk that isn’t mentioned here is the gut feeling that if you don’t check to see if you have cancer, heart disease, etc. you will postpone your death. Or, in short, what you don’t know won’t hurt you. This seems to be a thought pattern that men are especially prone to have.

    A related idea is that the mere act of going to the doctor or the hospital will shorten one’s life. This has an increasing basis in fact with all the resistant bugs that live in hospitals and, perhaps, doctors’ offices. There is also the increased chance of catching something from a fellow patient. Finally, medical mistakes are amazingly common.

    Ok, I’ve decided. I am going to spend the rest of my days at home with occasional visits to In-n-Out for a #1 with grilled onions. 😉

          1. Owie! I am laughing, to be sure. It was good but rather weighty for me to come home from getting a CAT scan and find this post, because getting any kind of scan like that makes one contemplate one’s mortality, so being brought to a good, honest laugh at such silliness in a post about the inevitable end of life is a good and healthy thing (not meaning to go Martha Stewart here); and I sure can’t laugh when I’m dead. I want to laugh a lot as long as I have breath to laugh — and the wherewithal to find things amusing.

  12. What I am about to say is speculation since I don’t have any evidence to back it up. I think it is possible that attitudes toward dying may have changed for most people, or at least those not living in poverty, over the last century and half. Even though life expectancy has increased, I would argue that most people now fear death more greatly than in the past. The reason for this is that people today have many more things to look forward to. This would include recreational opportunities as well as curiosity as to what comes next in technology. If a peasant in the year 1000 was asked what the world would be like 100 years hence, he would probably view the question as inane. His answer would be not very different from then, and he would be correct. Today, of course, we know the world will be radically different 100 years hence, although we have no idea what it would like. I wish I could hang around to find out, although I know that will not happen. This is my main disappointment in the specter of death. On the other hand, the world 100 hundred years from now (or maybe in just one year) may be a total hell in which case the saying from the 1950s that arose out of the danger of nuclear war would have come true: the living will envy the dead.

    1. Perhaps, but I think we fear it more today mostly because we are unaccustomed to it. My grandmother, for example, was one of thirteen children. Three made it to adulthood.

        1. Indeed, I think of that often. I think it’s likely because it was simply a commonplace and what one expected from life. And I think most people had family to support them nearby.

        2. She lost three teen aged brothers and sister to the 1918 flu, one brother was killed at age 9 by a milk wagon, one was killed in battle at Belleau Wood (he was 16 and had lied to join up), the rest died in infancy.

          But I think it was precisely because death was so, well, normal, that they didn’t suffer in the way people today would. If I lose either one of my boys, I would be destroyed.

          1. I don’t think parents-of-the-past suffered any less than modern parents when they lose a kid. I offer Abe and Mary Todd Lincoln in evidence.

            1. I didn’t mean to suggest otherwise.

              It’s has been said that one of the reasons Roman children were frequently not even named until they reached two years old is because about half of them never made it.

              That doesn’t mean Roman parents didn’t love their children or weren’t devastated when they died. But if death comes frequently to those around us, I think we can accept our own more easily.

              1. Of course, when you think about it, the frequency of the event hasn’t changed… 100%! But I take your point. We tend to (mostly)experience death as something that happens to old folk and we don’t as often witness deaths of children. But that just means we don’t suffer as frequently as “back in the day”.

              2. I was actually thinking of the Roman example. So many didn’t make it that they sort of tried not to get too attached. Of course, people kicked it early by our standards most of the time as well so children didn’t get to know their parents for long.

              3. The question of Roman parents’ love of their children reminded me that Roman fathers had the right to determine life or death for a newborn (I don’t know until what age: maybe always). Some “unaccepted” children were left on a hill or in the woods to starve or be eaten by wild animals. I think there were other cultures that did this also.

                Not to mention cultures in which children were buried under buildings, burned in fires or killed in some other manner for offerings to the gods.

                As we may remember, not all children now or throughout history were well cared for and loved if they lived.

              4. The Romans did that but also it was known that’s where you went to get a baby. Sort of really shitty child welfare.

            2. Perhaps we should differentiate between suffering and acceptance. I agree that in any era parents suffered greatly when their children died. But, they also accepted it as part of the natural order since the death of children was so common. So, they moved on with their lives. Today, parents don’t accept the death of children from disease as part of the natural order. Anger is a typical reaction. They don’t understand why medical science didn’t save their child. The extreme example of this is the parents who don’t take their brain dead child off life support. They believe irrationally that a medical or supernatural miracle will heal the child.

        3. Agreed. I visited a backwoods cemetery with a friend and saw a tombstone for six children in one family. I have no way of knowing how many others, if any, survived. One set of my great grandparents lost a young daughter to a fire. My mother’s sister died young of measles. My Mom almost died of typhoid. I almost died as a young child of asthma. My grandfather had a list of 24 family members who died during the 1918 flu epidemic.

          That many of us live longer now and have choices about caring for ourselves or how long we want to live, has not been present in our culture for very long.

          1. My (now) wife and I visited many years ago a similar remote village cemetery — now just a clearing in the woods with head stones.

            It was easy to see when the diseases swept the community. In a certain January or December (always in winter) there would be a large number of children’s graves.

            All anti-vaxxers should have to visit places like that.

            Or Venezuela right now, where the anti-vax experiment is in full swing (by accident or mismanagement (more likely)). The #1 cause of death for kids ion Venezuela right now is … measles!

            Jenny McCarthy: Go there now and tell those parents about how dangerous the MMR vaccine is!

    2. I agree that attitudes have changed. It has long been noted that people in rich countries tend to have fewer children. The thought is that this is due to lower infant mortality. An interesting question is whether this is a reaction built into our genes or totally due to parents making a calculation. Of course, the tendency of parents to make such a calculation is likely part of human nature so things are complicated as usual.

  13. “As an instrument of freeing the elderly from the need to pursue their life irrespective”

    Nice. “Life Irrespective” would make a good book title, I think.

  14. My choice for last music is Mozart’s Eine Kleine Nachtmusik.

    I saw my mother give up in the last few days before her death and my father-in-law gave up last summer at 99 1/2 years old. Things have just deteriorated for him too much and if he had wanted to take care of himself he probably could’ve lived a few years longer but I understand his choice.

    I have also left instructions for me of no funeral, no service, cremation and flush remains.

    1. Cremation, have a party (including a pig-roast and consume the remains of the wine cellar — hoping to cheat them of that!), sprinkle remains on Mt. Adams in Washington state.

    2. My husbands cremain’s are stored in a bookcase with some of our many books (he would love that), and are waiting for my cremains to join his for sprinkling somewhere our kids choose near Cherry Lake outside Yosemite in California where our family camped, hiked and fished for years in the woods near a creek. There are many wonderful memories for all of us, and a good place for Larry and I to join with nature.

      1. Sounds like a good plan regarding Yosemite .
        And a bookcase seems like a great place to store his remains in the meantime .

  15. Oddly for a non-believer, I’d want Sam Cooke and the Soul Stirrers’ ‘Near My God, to Thee.’ So powerful and deeply felt. On the other hand, AC/Dc’s ‘It’s a Long Way to the Top’. Also Ray Charles’s ‘You Don’t Know Me,’ The Grateful Dead’s ‘Ripple,’ Rhiannon Giddens’s version of ‘Shake, Sugaree’ (worldly good pawned) and Ella F’s ‘Fly Me to the Moon.’

  16. My old pal Lorenzo suffered a stroke last August, in his retreat south of Tijuana. He lost the power of speech until, at the local hospital, they told him they planned to send him by ambulance to a big hospital in San Diego. “NO!” he replied, and found that the power of speech had at that moment returned completely. As it turned out, he recovered mostly from the stroke, and mostly at home (although with a short stay in hospital).

    As for me, I nominate for passing-away music the slow movement of Beethoven’s quartet #15 Op. 132; or alternatively Sibelius’ Tapiola.

  17. I do not fear dying ,it is just the knowledge that the world will go on without me sticks in my craw.

    I know that sounds selfish ,but that is how i feel.

    And i don’t want a funeral service .

    1. I get this, Mr Coxill, I do.

      Cuz, yeah, the World so will.
      Without me inside it,
      It will do / go on just fine.
      Or, IF not so fine at My Time,
      THEN that, too: It ‘ll go on not so fine.

      A little grandkiddo helped me focus and
      gave her grandmama jarring but t r u e
      perspective some time ago now
      with, “O Gramma Blue, when you die, it
      ‘ll .be. just like it was … …
      before you were ever born, won’t it ?!”

      “ALL o’that, of course, is not only true
      and profound, My Darling Iris Genevieve, except for one wee detail, Dearest,”
      I replied. “That one detail is YOU !”

      ii) And as Ms Erenrich, I, too, have stopped years now
      going for medical checkups and the
      bagazillion so costly “tests” I suddenly
      “should” with my ( quite INadequate but that
      dudn’t matter to ’em all ) insurance … …
      that I “should” have. I eat what I wanna.
      I exercise regularly three times for an hour each per week but only cuz I .like. it ! and

      iii) Music ? as I pull That Lever with
      NO funeral thereafter either ? My executor
      already knows to have readied bedside
      THUS o’My Darling Mr Waylon Jennings:
      for their / the Boys & my grandkiddos’ … …


  18. I understand how people want to end their life. My husband has Parkinson’s and the constant struggle to do simple things that the rest of us don’t even think about is very depressing. When his medication doesn’t kick in for some reason, the struggles are tremendous.
    As for me, I hope to hear St. Paul’s Suite by Gustav Holst if I can orchestrate my death, or Into the Mystic by Van Morrison.
    I can’t believe life happens all so quickly.
    I haven’t given up food (although I don’t eat meat and don’t miss it) or drink yet, but that will be tough when the time comes, whenever that is.

  19. Music I have requested be played at the party they have to consume the remains of my wine cellar:

    1. Joe Brown’s rendition of “I’ll See You in my Dreams” (which you may have heard in “The Concert for George”)

    2. Joe Brown’s rendition of “When I’m Dead and Gone”

    3. Laura Nyro’s rendition of “And When I Die”

    Everyone pick up an instrument and play & sing some happy songs together.

  20. Why not all The Four Last Songs? The cycle of life. I would differ only in choosing Kiri Te Kanawa.

  21. Many people writing here are evidently young or at least in relatively good health. But for the great majority at some point old age brings some combination of constant pain, sickness, decrepitude, a degree of dementia or senility and loss of control over bodily functions. Not prospects to look forward to. My father had a combination of these and shot himself at 82. Why not?
    I can’t see the point of specifying a favorite piece of music. If you’re leaving why have something playing that makes it harder.

  22. I’ve been listening to The Band while working today, and I’ve always had a thing for religious language devoid of religious significance, so I’ma take my exit to “The Weight” — the version the fellas did with the Staples Singers. Hell, I’d as lief listen to Mavis Staple growl through a field phone as to hear anybody else sing at Carnegie Hall.

  23. Goodall’s Story was quite moving and I have a great deal of respect for his strength and dignity. I had never heard of him or his work on ecology, but it sounds like he has made some important contributions there, as well as his last contribution infighting for the right to have dignity in death.

    As for me, I’d rather not go listening to music. I’d prefer the sounds of the forest, to bird song, insects, or perhaps the trill of a mass of amorous toads and tree frogs.

  24. Four years ago my then 53 year old sister tested positive with a mutation in the CDH1 gene, which brings with it an 85% chance of developing Hereditary Diffused Gastric Cancer. She had an endoscopy and biopsy that revealed the disease in its early manifestation. She had a complete gastrectomy and Roux-en-Y reconstruction and is now cancer free with a very good statistical chance of living out a normal life. I have been advised to be tested for the mutation but at 65 I have decided against it. When I look at the occurrence of the disease related to age I am way out on the right hand tail of the distribution, which of course never touches the abscissa but I’ll take the chance.

    If I’m wrong, then Max Richter’s “On The Nature Of Daylight”, Beethoven’s “Moonlight Sonata” and Bach’s “Unaccompanied Cello Suite in D Minor” with some Leo Kottke thrown in.

    1. Phew! Got that one early. Getting tested for the BRCA deleterious Mutation if you are of ashkenazi Jew descent is a good idea too. Typically, it manifests pretty early and aggressively but sometimes it lays waiting.

  25. Give my parts to people who can use them, cremate the rest and scatter the ashes in the woods.

    C’est La Vie, Emerson, Lake & Palmer.

    1. Oh yes, I am an “any organ” donor, as is my wife.

      I think it’s the only right thing to do.

      And I hope everyone has seen “Jesus of Montreal” (or is it THE Jesus of Montreal?)

      1. I’ve seen it four times. One of the greatest films ever made. But you spoiled the ending! A film with a crucifixion and a resurrection.
        Denys Arcand is no longer making films, sadly. His “Barbarian Invasions” was also about death. My musical choice would be Handel, either the Water Music or something from one of his operas. Giving up carbs is almost impossible because that’s what our body craves and runs on. Hardest thing I ever did was to go on an almost carb-free diet. I could never do it again. But losing my husband last November has kept me from cooking anything and made me lose about 15 pounds. Food does not interest me any more. With luck I wont last too much longer.

        1. Very sorry to hear of your loss. And your continuing trouble.

          My Mom lost my Dad when he was 86 and she was 74. It took her 2+ years to come out her depth of sadness. Don’t give up! It takes time!

          I guess I’m lucky in that I do not crave carbs. (This is no mark of distinction for me — simply luck as far as I can tell.) I am quite satisfied with veg and fish/meat now.

  26. In my head I sometimes hear the words of U. S. Marine Sergeant Major Daniel Daly …

    In mine, I sometimes hear the words of Marine gunnery sergeant Hartman (R. Lee Ermy): “If god wanted you up there, I am sure he would have miracled your ass up there by now, Private Pyle.”

  27. I will only chime in here to add, if you have already experienced the death of your parents up close, you learn far more than you wanted about the process and reality of death and dying. It might help when making plans for oneself but maybe not. Understanding the industry of assisted living and or nursing homes and all the assorted details for your enjoyment there. If you do not have kids then you can do like I or Prof. Coyne and figure this out on your own, but if you do have them, it would be a good idea to get them involved before things are too far along. I only say this from personal experience.

    1. It helped me.

      We have advanced directives, wills, powers of attny. etc. on file.

      We’ve been very open with our sons about our wishes.

      Your comment is very wise.

    2. I recommend the illustrated book, “Can we talk about something more pleasant” or something like that. It’s very relatable.

      1. You must be referring to the New Yorker cartoonist Roz Chast’s, humorous and poignant book chronicling and ruminating on the aging and death of her parents; except it’s Can’t We Talk About Something More Pleasant.” Here’s a very good interview with her conducted by Michael Krasny on KQED radio https://www.kqed.org/forum/201406051000/roz-chast-on-channeling-loss-into-graphic-memoir-2. It’s an hour long. Several videos of her discussing the book can be found on Youtube, but I enjoy this audio. She’s very engaging and the wry wit she brings to her illustrations comes through. But I know that some people despise her.

        I am so tempted to stick the word “asexual” randomly into one of the above sentences, but I am controlling myself, barely — which then brings up the question of free will. Why am I not doing it when I can barely stop my fingers from typing the word?

        1. Haha. I really liked that book. I’ll take a look at some of those asexual interviews.

  28. I get pretty cold-blooded when the “fecal matter is on the air-recirculation device” as I have proved to myself on quite a few occasions.

    So, when the time came for my Dad to go at 86, I felt bad; but I could view fairly coolly that he had had a great, interesting, and long life and the dear love of a family.

    Of course, I could not have spoken in front of the people at the funeral. But that was later, when the whole point was to remember him and grieve.

    Losing my sister when she was 35, on the other hand, was really devastating.

    I recently attended the funeral of a childhood neighbor, almost exactly the same age as me (how did that happen?!). Her son, one of her brothers, and a niece spoke (very, very well) at the funeral, though they got choked up, somehow they did it. (I could not have.)

    It was the most uplifting funeral I’ve ever been to. (People often say: “A celebration of life” — this one really was.) Lots of live music performed by the younger generation (kids, many nieces and nephews), very little religion (and that only as a nod to her parents’ generation I think). Her Mom was there, going strong in her 80s. We had a group sing at the very end (a simple folk song, one of their family traditions). Brilliant.

  29. As an 80-year-old, I thank you for this wonderful post. As I see it, our final responsibility is to leave the world better than it would have been without us.

  30. I’ve never considered ending it, but having that option available is part of what makes life worth living. If I knew that choice was about to be permanently deprived me, I’d snuff it now.

    1. Absolutely!

      It’s all about having the option.

      I suspect, if I had the option to end it any day I chose (but wasn’t in severe pain), I might carry on for quite a long time. Just because I wasn’t being forced to.


  31. Two men at a bar, paunchy and middle aged: one says to the other: The problem with all this healthy living is that the extra years come at the end when you’re old.

    As an atheist and rationalist, I have no fear of dying whatsoever. But for two years I lived with anxiety and depression over my husband of 62 years being on dialysis, which is essentially a death sentence. He died last November and I am still overwhelmed with grief and anxiety, with disbelief and loneliness. Being 83 I have nothing to look forward to at all (we were birders and spent the last thirty years doing bird trips around the world). If I get a disease, I will seek nothing but pain relief. I cannot bear the thought of living without him, on and on into my nineties. With luck I will go soon, without fear. I can’t imagine living till 100 or more. There is no place for the elderly and no cure for grief..except death.

    1. My recently deceased 100 year old mother was an exception – her mind was as sharp as when she was 50, and she made herself “useful” by crocheting day in and day out; baby hats for the hospital and prayer shawls for anyone who wanted one [she would concede that he latter could be a scarf for the non-religiously inclined].

      1. Sounds like my 92 year old aunty who still drives (standard as she is in NZ where automatic is much less common than in NA) and she knits teddies for the hospital. I hope I’m like her when I age. She is fit and sharp.

    2. My great grandmother was grief stuck when her husband died and your words remind me if her’s though I was a young child when I recall my mother reading her letters (we were in Canada and she was in NZ). It seems to me that surviving into old age is devastatingly difficult and if I make it that long I see a lot of sadness and difficulty. But perhaps the cancer will return and kill me off before then, hopefully not before my parents die because it would devastate them to have their only child bite it. I can’t even flippin’ die when I want to.

  32. Here is the information about states with Death with Dignity laws:

    “Death with Dignity laws allow qualified terminally-ill adults to voluntarily request and receive a prescription medication to hasten their death.”

    “As of April 5, 2018, California, Colorado, District of Columbia, Oregon, Vermont, and Washington have Death with Dignity statutes; the Hawaii statute, approved in 2018, goes into effect on January 1, 2019. In Montana, physician-assisted dying has been legal by State Supreme Court ruling since 2009.”


  33. Here’s a good song by Pete Seeger about being old but not wanting to die yet. It’s called “Get Up and Go”


    Of course, If I went for assisted suicide, this would not work as a final send-off, so then I might pick the 4th movement of Mahler’s 3rd symphony with lyrics by Friedrich Nietzsche (from “Thus Spake Zarathustra”), which are sort of religious but not in a traditional Christian way.

    O Man! Take heed!
    What does the deep midnight say?
    ‘I was asleep, asleep –,
    I have awoken from deep dreams: –
    The world is deep,
    And deeper than the day imagined.
    Deep is its grief!
    Joy, deeper still than heartache!
    Grief says: Perish!
    But all joy seeks eternity –,
    – seeks deep, deep eternity!’


    I would also want someone to read aloud the opening monologue of “Annie Hall”

    “There’s an old joke. Uh, two elderly women are at a Catskills mountain resort, and one of ’em says: “Boy, the food at this place is really terrible.” The other one says, “Yeah, I know, and such … small portions.” Well, that’s essentially how I feel about life. Full of loneliness and misery and suffering and unhappiness, and it’s all over much too quickly.”

  34. I remember when Goodall did the rounds, because somewhat divergently the local newspapers wrote about a blogger that had become popular at 105 years of age. She started at 100 to compensate for a dwindling supply of nearby friends. They were on video at the same time, and Goodall looked frail in comparison.

    There are individual traits of course, but another 105 year old record breaker show that training gives gains throughout our lifetime. [ http://www.bbc.com/news/world-europe-38510439 ; the article didn’t say, but IIRC in an interview the trainer claimed that her changing his old training regime – adding interval training to earlier pure distance – had made Marchand stronger and faster.]

    I gave that up for fasting, but now two days a week I don’t get any food save a latte with Splenda. And if I really wanted to live a long time, I’d go on one of those diets where you just eat vegetables and fruits, or simply cut down my food intake, like a rat, to near starvation.

    FWIW, it is arguable that calorie restriction does not give primates longer life. They may become leaner with lower intake, which is why I thought people tried fasting instead of simply eating a little less (and/or training a little more). But that is perhaps the only observed effect.

    “To those who enjoy the pleasures of the dining table, the news may come as a relief: drastically cutting back on calories does not seem to lengthen lifespan in primates.”


    “Long-term calorie restriction in humans is not associated with indices of delayed immunologic aging: A descriptive study”


  35. I also think of Strauss, but Tod und Verklarung, though maybe it is too long (perhaps I could just push the button before the final 8 minutes or so?).

    The ending of Mahler’s 9th also comes to mind for such an occasion.

  36. When it’s time to go (barring some catastrophic accident) I suspect it will be with a sense of contentment and relief – similar to the feeling when some long and complicated task has been completed.

    As for music: I spend a lot of time exploring Youtube music videos looking for unfamiliar, maybe overlooked (at least by me) artists. About a year ago I started saving some of them in a playlist with a vague idea that I might create a DVD of it to give people when I die as an expression and memory of who I was. I’d also like to watch/hear it as I go out. The list changes over time as I add and delete things. Here are some things on the list as of now:

    “Wherever I Go”, Mark Knopfler/Ruth Moody
    “Particles”, Olafur Arnalds/Nanna Bryndis Hilmarsdottir
    “Oldurot”, Olafur Arnalds/SinfoniaNord
    “When I Go”, Judy Collins/Willie Nelson version
    “If I Be Wrong”, Wolf Larsen
    “Bamba”, Catrin Finch/Seckou Keita

  37. I’m no princess, but have always liked Pavane pour une infante défunte; Stand by Me, the version done by the Kingdom Choir at the Royal Wedding; Forever Young, Baez version. Three songs should be adequate 🙂

  38. There are a lot of heartfelt comments above. I feel wiser and a bit sadder.

    I am a few weeks younger than PCC(E), and I sympathise with his feelings of mortality. I enjoy the things I do, and the love and company of family and friends; but all good things come to an end. When they do, and if I have the opportunity, my choice would be Gerald Finzi’s setting of “Fear no more the heat o’ the sun” (from Cymbeline) in his “Five Shakespeare Songs”, preferably as sung by John Carol Case on my nearly 40-year-old L.P. The final sestet will see me off just fine:

    No exorciser harm thee!
    Nor no witchcraft charm thee!
    Ghost unlaid forbear thee!
    Nothing ill come near thee!
    Quiet consummation have,
    And renownèd be thy grave.

  39. My ‘going out music’ was decided in my freshman year of college. As a young person, the words made sense. As a person who worked his entire career in the healthcare system, the words made even more sense. As I age out, I have not changed my mind in the least.

  40. I’m fervently in favour of legal voluntary euthanasia (and I might need it myself in a few years).

    New Zealand is on the verge of (we hope) making voluntary euthanasia / assisted suicide legal, though who knows what compromises might be tacked on to pacify the evil ‘right-to-lifers’.

    (I say evil and I mean it. My mother had always believed in voluntary euthanasia on the few occasions when the subject came up. She died in hospital of cancer of the throat which choked her to death, demanding that she be put out of her misery. I’d like to think that some doctor quietly gave her a massive overdose but I rather doubt it and of course I couldn’t ask. What a shitty way to end ones life.

    I could but wish that all anti-euthanasia campaigners (but nobody else) should die slowly in agony begging for relief that is withheld from them. Unfortunately, that’s impractical).


  41. I question whether Ehrenreich is embracing her mortality or going through a sort of denial by avoiding the topic altogether. I think it’s worth noting that the *ways in which people can die are extremely different in terms of pain, duration, and so on. It might be different if ‘right to death’ was available in the US (although perhaps Ehrenreich is planning suicide if any fatal diagnosis is discovered,) but as it’s not, it’s worth watching your health if for no other reason than trying to avoid one of the more excruciating life ending illnesses, if it’s something that can be caught early and avoided. Aside from that, leaving some conditions untreated can make it more likely that a person will suffer from a debilitating stroke.

    That we force people with terminal cancer and degenerative diseases to linger in horrible physical pain – or the psychological pain of knowing that there will be a loss of dignity and great suffering on the part of family members as they slowly forget them and fall even deeper into dementia or a related illness – really doesn’t make sense outside of religious imperatives, to my mind. Perhaps one could argue for a ‘slippery slope’ risk, but if someone has a diagnosis that is most certainly fatal, what is the point in forcing them to live in agony for weeks, months, or years so that we can call the death ‘natural’.

    Outside of terminal illness, the shadow of slippery slopes do worry me more, though, especially when one looks at the increase in mental health diagnoses in the US. If you put some kind of minimum age limit on assisted suicide, it seems as if this would create a kind of societal pressure on those who were past their productive, working years. If there was no limit, then how many 20-year-olds living with depression might really, in all honesty, want to end their lives? And what are the consequences of living in a society that says “Ok, if that’s how you feel, you can make an appointment down the road for that” vs. “We will do whatever we can to intervene to make you view things differently”?

    Ironically, I think it is perhaps the growing modern value system wherein every human life *is* sacrosanct (an ideal I believe in) that might lead to a dynamic that seems – to my mind at least – to devalue those very lives. I wouldn’t want to live in a world where people say “Hey, it’s your life, if you’re not liking this party, the exit’s right over there – just leave, no problem. I’m not going to impose my emotions on you, you’re an individual and do what’s best for you. See ya.” But if you establish death as an individual right that is not subject to communal coercion or concerns (whether you want to frame it negatively or positively,) I don’t know how you can really justify not falling in to some version of that dynamic.

    1. I think most ‘slippery slope’ arguments are bogus. They’re the sort of argument one employs when one doesn’t have a good case on the circumstances as they stand, so one cobbles up an extreme case that is obviously ‘bad’ and argues that. They can also be used in either direction.

      I would suggest that most teens suffering from depression are perfectly physically capable of committing suicide all by themselves if they want to, without requiring assistance or legal approval. And if they’re not physically capable of doing that it suggests that their life may be miserable enough that it genuinely isn’t worth living.

      No law is infallible in all circumstances, but it would be easy enough to build in legal safeguards that anyone wishing to claim ‘assisted suicide’ had to declare this formally in writing on (say) two occasions to an authorised person etc etc.


      1. I don’t think ‘slippery slope’ arguments are necessarily bogus – the problem is knowing which ones are and which aren’t. If someone had made a slippery slope argument about increasing painkiller prescriptions back in the day, it would have been hard for them to overstate just how slippery that slope would get. On the other hand – marijuana as a ‘gateway drug’? There’s no evidence to back that up, that I know of. Sometimes there truly is a slope and sometimes there isn’t.

        Regarding your intuitions surrounding suicide – mine are just very different. I do not think it’s ok to let a teenager end his or her life because maybe it really is too miserable to live, or to not talk someone down off a ledge if they’ve declared their intent to kill themselves in writing twice before. I feel at some point one has to appeal to the concept of interdependence and how the actions of individuals don’t exist in a bubble, they have enormous impacts on the people around them. That said, reading your above post (I think we cross-posted on a similar topic,) I do very much agree that forcing people to live out terminal diagnoses is akin to a form of torture, and I think it borders on depraved that we allow this. If there is a 90%+ chance that a diagnosis is fatal, to insist that someone live through months of excruciating pain or degeneration (including paralysis, loss of motor control, dementia, and so on,) should be considered the far, far extreme end of the spectrum, to my mind – akin to those who won’t even allow for birth control, much less abortion. When you have a moral spectrum, will an extreme end always have to exist *somewhere? Sure. But right now it’s the idea of even allowing someone to forgo that suffering that is extreme, and I think that’s cruel. It would be like saying epidurals should be outlawed because all mothers should experience childbirth in the most natural way possible; or that we should just do away with the idea of anesthesia during surgery because people need to toughen up and not get too soft. Again, the only coherent argument I can see in that case is one of slippery slope – things turning dystopian and fatal diagnoses being overdone when people are elderly or something. But at that particular point on the spectrum, it’s not an argument I agree with (again, however, to my mind that’s limited to clearly fatal conditions.)

        1. I think we’re not far apart.

          I didn’t say *all* slippery slope arguments were bogus, just most. Like ‘some of my best friends are xxx’, it’s not automatically wrong, just suspect.

          Re youth suicide, I think that’s quite unrelated to the question of assisted suicide because the overwhelming majority are quite capable of doing it unassisted. And I would certainly agree with attempting to talk them out of it, we don’t differ at all on that point.

          When I mentioned teens ‘not physically capable’ of committing suicide unaided, I had in mind two cases – first, they might be sick enough from some disease (e.g. cancer) that they were incapacitated. Or, second, that they might be seriously crippled as a result of an accident. Take the situation of someone who is confined to bed or a wheelchair, dependent on full-time caregiving, possibly in constant pain, and with no prospect of ever getting better – then they should have the option of deciding, after due and careful consideration, to end it. Some people in such a condition decide to battle on, and kudos to them, but nobody in that situation should be forced to choose one option or the other.


          1. Thanks for clarifying, I thought you meant teens who were suffering from depression or just adolescent angst.

        2. Just because you can identify a “slope” doesn’t mean it is slippery.

          I don’t think that opioid use and assisted suicide are reasonable analogs. The former involves well documented physiological processes. The latter involves nothing but amorphous feared consequences for which we have no evidence that I’m aware of. As infinite points out, we aren’t talking about young folk whacking themselves because of a lost prom date. That kind of “jump off the bridge” stuff will happen no matter what and doesn’t involve long term suffering. I see little reason to fear a wave of old folk being topped against their will. There’s far more to fear from those who would prevent people from exiting on their own terms.

          1. Maybe reproductive rights and technology would be a closer analogy. Back in the day, women *could get abortions, but they were dangerous and illicit. Today, people can attempt suicide, but it is taboo, dangerous in that there is a good chance one will survive in a maimed state, and something one has to seek out using a generally terrifying method, like jumping off a tall object or point a gun at oneself.

            With reproductive technology – in *parts of the world there have indeed been dystopian-esque scenarios, with things such as forced abortions as part of China’s one child policy, and selective abortions that led to societies that are overwhelmingly male, leading to a variety of problems today.

            In the West, thankfully, things have not been that extreme, but I think there is simply the logical consequence of “You can’t have it both ways.” I remember in my days of dating on eHarmony, one of the most common questions asked was “Do you consider yourself ambitious?” which is code for “Seriously, are you going to make some dough, woman?”. And I believe there are studies showing that males increasingly rate female earning potential as one of the most important things about a prospective partner – unless you are in some specific sub-circles, like Evangelical Christian groups, in my experience (admittedly anecdotal, but I don’t think this is a particularly bold assertion when one simply observes society) you simply don’t find many men these days who are open to their spouse staying home and raising 3 or 4 kids.

            So I feel it’s a bit of a misnomer to say that these technologies give women ‘a choice’. They *sort of give women a choice, but they also change societal dynamics in such a way that one route is easy and the other is a hurdle. Am I saying the alternative – going back to the days where if couples wanted to have sex, they could expect to have babies, so society was based around that idea – is better? Absolutely not. If I had to choose things being skewed one way or the other, I would choose the current dynamic. But it is not without its difficulties, heartaches, and guilt, for sure – I feel like as a woman, when you *finally have your life ordered in such a way that you can afford to take some time off of an established career and pay outrageous daycare expenses in order to have a child, there is often a long and difficult path at a fertility clinic waiting, full of disappointments and unpleasant hormonal and pharmaceutical interventions.

            Similarly, I think it would be surprising if making assisted suicide widely and easily available *didn’t hugely shift societal dynamics around the topic – it’s seems to me that is actually the far more unlikely scenario. And when you shift matters of life and death and move what was once nature’s decision and turn it into a personal decision, yes, I think it’s worth thinking about the overarching consequences of that, and assuming that there will be at least a few.

            1. Honestly, I have a hard time taking most of that as relevant to the subject at hand. How does China’s abortion policy, a state decision to restrict population growth, make assisted suicide’s slope greasy?

              As for “shift societal dynamics around the topic”… well, yes… that’s the point, isn’t it? We’re trying to change the way people view the subject so that there is less suffering imposed on us.

              You still haven’t offered any reason I can detect to fear that people will be “offed” willy-nilly against their will. Where’s the banana peel, exactly?

              1. I’m saying reproductive rights and technology are probably the closest analogy we have to ‘right to death’ and euthanasia related science (in the past, after all, there weren’t necessarily painless, peaceful ways for euthanasia to be conducted, or medical diagnostics that could say pretty definitively if a diagnosis was fatal or not.) On the one hand you have the drawing of lines regarding where human life begins, and on the other, where it ends.

                Seeing as how reproductive technology did end in some dystopian scenarios (again, as in China,) once widely available, I think it’s reasonable to say this analogy may well apply to euthanasia as well. In places that are still developing towards increased human rights, it could indeed be downright dystopian. In places where human rights are more established, there could well be a cultural shift that puts pressure on the elderly to end their lives after a point, just as there is often, to my mind, pressure on women not to have children too early and not to have many at any age. Not because anyone chose that, but because societal dynamics simply push people in that direction (two income households are the norm, women who put off careers until their 40s while raising kids will be ill equipped to jump into a working world that favors those who start early, and so on.) For example, fewer elderly people in nursing homes may well mean that the homes that are available go up substantially in price, placing a financial burden (or I should say, even bigger financial burden,) on anyone who lives to an age where they need round the clock assistance or care – leading more people not to go that route, leading to even higher prices, and so on.

                I’m not saying I’m staring into a crystal ball and feel certain than any one particular scenario will play out. But I think it is quite likely that handing control of one’s death over to individuals will have *some very significant impact on societal dynamics. Whether one sees that as slippery slope or simply the times a changin’ is a matter of semantics, but I think it’s very probable that some sort of shift is quite likely if euthanasia becomes commonplace.

              2. What evidence we have does not suggest a horror show. It has been legal in Switzerland for some eighty years now. The consequences seem entirely to be of the beneficial kind.

                When put to a vote in the Canton of Zurich in 2011, 85% voted against adding restrictions.

                I wish all slopes could be this slippery.

              3. It doesn’t seem to be without issues, however, and remember this is *in some of the most liberal countries in the world. Consider these same issues exported to different cultures:


                I’m probably taking up too many of the comments at this point so I’ll leave it at that – again, I am ‘for’ assisted suicide for fatal illness but not without a lot of consideration and caveats. I think there is good reason for a lot of societal pushback on this issue.

              4. I’ll let it go, too. But first this:

                The problem with “slippery slope” arguments in situations like this is that they assume that shifts in public attitudes toward various applications of (in this case) assisted suicide are inherently superior to those of the (feared) community of the future. I don’t think there is a rational justification for that. We should not get a veto over decisions our descendants might make. We should decide our own situations as best we can using information and desires we have now. If there is a slope out there, so be it.

  42. Back on the subject of preventative medicine – I go once a year to see a neurologist for a muscle problem I have. Every year the medical assistant asks me when I’ve had my last colonoscopy. Why do they need to know??? I’m not there for a gastrointestinal problem, and I have an internist to handle such issues. It’s maddening.

    As for my last song, I’d like Marin Marais’ La Sonnerie de St. Genevieve, and Ravel’s Bolero. And Led Zeppelin’s Kashmir.

    1. You should ask some equally unrelated question right after, “when did you last clean your bath tub?” It’s funny but sometimes they take it as a sign of dementia so the joke comes with some risks.

    2. If you’re going to play Zeppelin, why not make it their arrangement of In My Time of Dying, from the album Physical Graffiti? A bit goddy but still a damn fine song.

  43. I only opened the comment box to say this one thing: Jerry, few 60+ guys are as vital as you, traveling and hiking around and writing these blog posts (not to mention the duck monitoring obsession). I sometimes find myself envying the amount of energy and vigor you seem to possess. I think you may have another good 30 years left, my friend.

    John Black

  44. Something by Bill Evans, though it’s tempting to pick John Cage’s 4 33 (maybe just the second and third movements).

  45. I’ve rather fancied “when I’m gone” by Phil Ochs as an exit song and rallying cry to those left behind….

    There’s no place in this world where I’ll belong when I’m gone
    And I won’t know the right from the wrong when I’m gone
    And you won’t find me singin’ on this song when I’m gone
    So I guess I’ll have to do it while I’m here

    And I won’t feel the flowing of the time when I’m gone
    All the pleasures of love will not be mine when I’m gone
    My pen won’t pour a lyric line when I’m gone
    So I guess I’ll have to do it while I’m here

    And I won’t breathe the bracing air when I’m gone
    And I can’t even worry ’bout my cares when I’m gone
    Won’t be asked to do my share when I’m gone
    So I guess I’ll have to do it while I’m here

    And I won’t be running from the rain when I’m gone
    And I can’t even suffer from the pain when I’m gone
    Can’t say who’s to praise and who’s to blame when I’m gone
    So I guess I’ll have to do it while I’m here

    Won’t see the golden of the sun when I’m gone
    And the evenings and the mornings will be one when I’m gone
    Can’t be singing louder than the guns while I’m gone
    So I guess I’ll have to do it while I’m here

    All my days won’t be dances of delight when I’m gone
    And the sands will be shifting from my sight when I’m gone
    Can’t add my name into the fight while I’m gone
    So I guess I’ll have to do it while I’m here

    And I won’t be laughing at the lies when I’m gone
    And I can’t question how or when or why when I’m gone
    Can’t live proud enough to die when I’m gone
    So I guess I’ll have to do it while I’m here

    There’s no place in this world where I’ll belong when I’m gone
    And I won’t know the right from the wrong when I’m gone
    And you won’t find me singin’ on this song when I’m gone
    So I guess I’ll have to do it, I guess I’ll have to do it, guess I’ll have to do it while I’m here

  46. or simply cut down my food intake, like a rat, to near starvation.

    Some of my colleagues are gerontology researchers who used to work on calorie restriction models (rapamycin and various rapalogs are more popular approaches now) for lifespan extension. Two observations: none of the researchers I know apparently followed the calorie restriction regimes themselves, and the terminology has changed from “lifespan extension” to “healthspan extension.” Hmmmmm. Because who the hell wants to live to be 120, if you’re subsisting on a diet of undercooked soybeans and seaweed? (And yes, I tried the Roy Walford longevity diet for a few months and was vaguely miserable much of the time, including during food prep time, which I usually enjoy).

    I have to go with prog rock for my exit music. Maybe Yes Heart of the Sunrise or Long Distance Runaround, and King Crimson The Sheltering Sky. Definitely Peter Gabriel Solsbury Hill.

      1. I eat heaps of: Brussels sprouts, sour kraut, kimchi, coleslaw (sense a theme here?), and fresh asparagus, along with salads. Artichokes. Pickles.

        Basically: Eat a lot of veg.

        1. Agreed. I typically eat a lot of veggies, some of which I grow in my backyard, and some of which I ferment. Regular aerobic exercise is important too. Like PCC(E), I fast two days a week. Unlike him, though, my fasting diet allows 500 calories per day (2 meals separated by 12 hours) – I don’t have the discipline to go without eating entirely. The diet works best on days that I’m distracted by teaching gross anatomy, and stuck in lab with demanding students for four hours at a stretch. I think I’d feel woozy on those days if I hadn’t had a small meal (e.g. a hard-boiled egg and a piece of fruit) at breakfast though.

    1. I think there’s some new research out that concludes that caloric intake restriction doesn’t work on primates. Sorry, don’t have a reference so could be “fake news”.

  47. Apologies if this has already been covered, but Ehrenreich revealed in Nickel and Dimed that she’s a smoker (or at lease was) and not just a smoker, but one of those smokers who considers the “incorrectness” of smoking as some kind of rebellious act. It’s been my experience that people of that persuasion are usually addled in their thinking on health and priority of life choices. They’ve made up their minds that they’re going to do the hell they want, health and life expectancy be damned.

    It’s her choice to make, but her choice is not terribly surprising, given her disposition. Nor should it be taken as a strong conviction of a thoughtful person, or a model to be emulated.

  48. I think that “control of the end of life” is as important as control of the beginning. (Personal, etc.)

    But 76 … that’s a year older than my parents or there abouts.

    And yet I see the end in both of them very clearly now, so …

  49. Last song for me:
    Jimmy Buffett
    “Drink it up, this one’s for you.
    It’s been a lovely cruise.”

  50. I was diagnosed with end-stage lung cancer 2 years ago.
    Prognosis for survival was 3 months. Modern science sustains me and my quality of life is excellent. I have no regrets and will elect assisted suicide at the opportune moment.

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