Book Review: On Their Own Terms: how one woman’s choice to die helped me understand my father’s suicide

by Laurie Loisel
Levellers Press, 2019 
ISBN: 978-1945473982

What are our choices if we want to die but don’t live in a state where having a terminal illness will qualify us for medical aid in dying? For many people, there is a great fear of becoming helpless and dependent on others. They decide to die while the decision is still theirs. They commit suicide, often messy and almost always traumatic, or decide to stop eating and drinking and starve themselves. “On Their Own Terms” tells the stories of two very different people who took dying into their own hands and lets us see what it was like.

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Paul Loisel lived in a small town near Augusta, Maine. He was a self-employed independent man. He lived fully, loved fully, drank more than most of his family and friends, and was kind and gentle. Many of his friends said “he was the most full-of-life person they knew.” But Paul knew that there were things he could no longer do, and he didn’t want to lose his independence. In 2012, when he was 82, still in good health, he drove to his local police station and shot himself in the parking lot. The note he left behind said that he was doing it for his children. He chose to kill himself in the parking lot of the police department because “the police would know what to do.” His children found the experience devastating.
         
Lee Hawkins, a friend of Paul Loisel’s daughter, was living independently in Massachusetts, but just. She had no medical condition that suggested death was near. She was, however, 90 years old and dependent on a walker. Her life was increasingly circumscribed. She had little appetite, was in constant pain, and had ceased participating in communal activities. She made her way slowly around her house, pushing the walker with a basket holding what she needed: “house phone and Rolodex, church directory, pens and pencils, combs, magnifying glass, remote control for her TV, a device to pick things up. She kept her cellphone in her pocket and an emergency call button around her neck. She had fallen so many times that she had grown fond of the EMTs who arrived when she pressed the emergency button to summon help. But she always argued the point when they wanted to take her to the emergency room.” In Lee’s words, she was “in a chrysalis stage between a caterpillar and a butterfly” and “balancing between the two worlds felt odd, in some ways uncomfortable.” And so she chose when she would die -- in August of 2014 – and how – by voluntarily stopping eating and drinking, in its medical acronym known as VSED. Laurie Loisel asked if she could be present, and if she could write about it, and this book is the result.
         
I’m posting a review because I can identify with the questions raised in the book. One of the things that haunts me is, who is going to care for me when I can no longer care for myself? Fortunately, I live in Vermont, one of nine jurisdictions that have enacted a law that allows medical aid in dying (MAID). I can live with some degree of discomfort and incapacity if I know that it won’t go on forever. Paul and Lee did not have this option (although Maine, where Paul lived, legalized medical aid in dying last year).
         
“On Their Own Terms” – beautifully written – is an excellent book to share with family and friends to get a conversation started. It’s an even better book to give your state legislator if you live in a state that has not yet legalized medical aid in dying (the jurisdictions that have are California, Colorado, District of Columbia, Hawaii, Montana, Maine, New Jersey, Oregon, Vermont and Washington). It’s time for a national conversation about this topic.
 
Review by Susan Gillotti, PCV Board Member