Dying Man Saved from Suicide

by Miles Gloetzner

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Note: Identifying details have been changed to protect the privacy of those involved and maintain confidentiality.

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The family members stepped out of the room and paused by the door. Before they left, they told me they had spoken with Arthur about an "end-of-life option," and that he wanted to talk with me privately about his decision.

I knew exactly what that meant, and a wave of mixed emotions hit me. My first thought was a pang of self-doubt: Had our care facility failed to make him feel supported?

I paused outside the door of the room, said a short prayer, and went in. During the conversation that followed, it became clear that Arthur had decided to utilize medical aid in dying (MAID). On one hand, I felt partially relieved since his decision wasn’t about a lack of care and it wasn’t about me. It was about his history. He had watched multiple family members endure horrific, unmanaged pain at the ends of their lives, and he was terrified that the same fate awaited him.

Arthur told me with a resolve that he planned to end his life, even using the word “suicide” to describe his choice. He claimed it was his right to choose how to die and went so far as to say that he didn’t care how it impacted his loved ones: “They’ll just have to deal with it.”

The only crack in his armor–so to speak–was the mention of his cousin, Claire. She was the light of his life, and the only one who was reserved in supporting his plan. But in that moment, even she didn't seem like enough to change his mind.

I didn't argue. I asked open-ended questions and let him vent his fears. Internally I felt a heavy pressure to change his mind, but I focused rather on holding space with him and asking questions. After twenty minutes of conversation, he was still set on his path.

When I returned for the night shift a few hours later, Arthur rang for assistance to be repositioned. As I settled him into his pillows, he looked at me and said, “Thank you for having that hard conversation with me.”

I waited in silence.

“After you left, I realized how selfish I was being,” he whispered. “Even if I have to suffer a bit longer, I’m not going to end my life.”

He spoke then of Claire. We learned that Claire had lost her own mother to suicide; Arthur had been the one to pick up the pieces and raise her. He realized that by choosing MAID, he would be reopening a wound in his cousin that might never heal. He couldn't do that to her. It also gave us the chance to talk about improved management and discuss options to support him living his dying life as comfortably as possible.

Arthur eventually passed away naturally at our care center, surrounded by the very people he thought he needed to leave behind. His final weeks weren't defined by the "miserable death" he feared, but by a deepening of his relationships and courage to face it with a caring community.

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I wonder with sorrow about how many patients like Arthur have missed out on precious moments of life because their fears were met unquestioningly by a doctor, nurse, or friend who are (often unknowingly) holding their fate in their hands. And I wonder how many people, when asked about their desire for MAID, simply gave the “right answers” to get what they wanted in that desperate moment but whose heart was never discovered because no one held space for them.

To family, friends, and community members: A knee jerk reaction to support someone’s stated intent to end their lives by MAID can have the opposite effect you’re hoping for—it can imply to that person that they would be better off dead, that their life doesn’t matter, or that it doesn’t make a difference to you if they live or not. A stated request for MAID may be a request to know how important they are to you.

To healthcare professionals: We have the obligation to do proper assessment and to have hard conversations. It has never been our practice to simply do what someone tells us—especially if it means supporting something that will end their life. Our practice demands that a MAID request not be accepted at face value—it’s our duty to go deeper and to listen to their heart, which may in fact be crying out for better pain treatment, to know that they won’t be alone, and to know that those who change their diaper are going to do it with dignity.