Choosing physician-assisted suicide

Ben Underhill has given his death a lot of thought. It’s not that he’s morose or macabre, or even that he’s given up on living. Underhill remains passionate about the Boston Red Sox, Bruce Springsteen and the beauty of his adopted hometown, Brattleboro, Vt.

The 54-year-old insurance salesman’s focus on his own mortality stems from his medical condition. Underhill has a rare and deadly form of blood cancer called multiple myeloma. A decade ago, he was given three to five years to live.

“I’ve had 10 years to think about this. I’ve written my own obituary,” Underhill said. “I was in bed for a long time, between hospitals and being bed-ridden, probably a year or two, so you have a lot of time to think about what you want and what you don’t want.“

What Underhill wants is the option to end his life – with his doctor’s help, on his own terms – when his condition becomes unbearable, preferably surrounded by family.

Thanks to a new state law, Underhill has that choice.

Passed this year, Vermont’s Patient Choice and Control at End of Life Act allows state residents with a terminal disease to hasten their deaths with a physician-prescribed drug. The law makes Vermont the third state with a so-called death-with-dignity law, joining Oregon and Washington.

“There comes a point you know it’s going to get so bad,” Underhill said. “Someone else is keeping you alive, and for what? Three extra weeks? To me, I’ve had seven extra years, so three weeks is nothing.”

Underhill has undergone chemotherapy, radiation, a stem-cell transplant and surgeries, suffering nerve and bone damage in the process. He now gets around on crutches, with difficulty, or in a wheelchair.  

“I don’t fear death at all,” Underhill said. “Dying is easy. Life is hard.”

After he was diagnosed with an aggressive prostate cancer in 2004, former Vermont Speaker of the House and U.S. Rep. Dick Mallary, and his wife, Jean, made a televised appeal in favor of a physician-assisted suicide law.

“We just hope it’s in time for us,” Jean Mallary said in the ad. Dick Mallary added: “We hope it’s early enough for other people, too.”

The bill failed. Dick Mallary took his own life in 2011. He made sure to commit suicide when his wife was out, so she wouldn’t be accused of playing a role in his death and charged criminally.

“It was a beautiful fall day, and I came home and found a note on the door,” says Jean Mallary, fighting back tears. “He certainly didn’t want to put us through watching him become helpless, and he didn’t want to be nursed. He was a very proud, proud man. My hugest regret is that I couldn’t be with him, and that’s because it was not legal.”

In April, Underhill lobbied Vermont lawmakers for a physician-assisted suicide law, which had been debated – and defeated – in the State House for the better part of a decade. The legislation passed, and Gov. Peter Shumlin signed the bill into law in May.

Carrie Handy, who lives in Burlington, opposed the law and has joined a group called True Dignity Vermont to repeal it. Handy says she fears the elderly, especially those with limited means, will feel pressure to end their lives rather than putting a strain on the family’s resources.

“I don’t want an environment in the future where people are pressured to ending their lives prematurely,” said Handy, who watched her 90-year-old mother die this year.

She added: “I think it’s the exception not the rule that death is ugly and scary. They want you to think the only way to make it pretty is to plan it and take a pill for it, and I don’t think nature is that cruel.”

Underhill said he’s been through plenty of ugly and scary days and nights living with his cancer. There were times when he’s been helpless. He’s had to be bathed or picked up by caregivers. He’s lived through a lot. Now, he simply wants to die on his own terms.

Underhill’s cancer is now in remission, but he says it will come back. When it does, when the end is near and he can’t enjoy living anymore, Underhill plans to have a pill at his bedside.

He has envisioned how his life would end.

“Initially, I thought I’d have a nice meal, put on some Springsteen and watch a Red Sox game,” Underhill said. “Now I found out you need five hours between the meal and taking the medicine. So now, I guess I’d eat, wait five hours, listen to some music and watch the game. Have my family with me if they want to be there, be surrounded by them and fall asleep.”