A 16-minute documentary, made by a grieving daughter, is stirring controversy among American audiences. The short film captures the last 8 days of life of Rosemary Bowen, a 94-year-old woman who chose to end her life by ‘voluntary stop eating and drinking’ (VSED). Rosemary was not terminally ill when she choose to end her life, which is unlike most people who opt to hasten their death. Instead, Rosemary was diagnosed with two acute spinal cord compression fractures, which are often secondary to osteoporosis. She was given a positive prognosis by physicians, expected to heal over three months, but that didn’t seem right for Rosemary. The fiercely independent woman felt she had a full life, and wanted to control her death while she still could. (1, 2)
The Right To Choose Death In America
In America, physician-assisted death (PAD) is legal in nine states and the District of Columbia. Participating states include Hawaii, Maine, New Jersey, Oregon, Vermont, Montana, California, and Washington. Yet, in Montana and California, the final decision rests with the court, and not the individual. Furthermore, in all ten locations, an individual must be able to demonstrate they have a terminal illness and a prognosis of six months or less to live. Each year, several thousand patients across these states are able to partake in PAD. (3)
In Rosemary’s documentary, it is made clear that she would have preferred to end her life with a lethal dose of medication. Yet, living in Maryland and not having a terminal illness would have disqualified her from accessing PAD. In many ways, VSED was the only option for her legally, and practically. Through the documentary, Rosemary’s daughter explains that hospice care was initially withheld from her mother for the same reasoning (she did not have a terminal illness). But once a palliative nurse met with Rosemary and determined she was seriously committed to this path, then an exception could be made for her to access these resources. (1)
Rosemary’s Choice
Patient decision making is a ‘hot topic’ in modern healthcare systems because it is considered very beneficial. In general, allowing a patient to make their own decisions can reduce the overall healthcare costs, diminish healthcare provider workload, and readmission rates. As well, for the patient, having a choice is super empowering, satisfying, and often improves their treatment outcomes. Ideally, every patient should be given a choice of what they want! (4)
In her film, Rosemary shares from her bed in the Jewish Social Service Agency (JSSA) hospice of Montgomery County the many reasons for ending her life. Primarily, Rosemary states her wish to hasten her own death came from her desire to not burden others, and to live an independent life. She had seen a friend die from VSED and felt after that this option was right for her too. Also, during the documentary, her daughter highlights that Rosemary wanted to control her death while her mind was still sharp.
Ultimately, Rosemary sums up her choice to die by saying in the film, “’I am leaving life with great joy,’ and ‘I cannot tell you how content I am and I recommend it highly to do it this way. Be in control. Don’t let people decide anything about you and keep you doing a lot of procedures that are not going to benefit your health at all. Just get on with it and go.'” (1, 5)
Public Concern Or Celebration?
Some media outlets are showing upset over Rosemary’s tale. One article pointed out that Rosemary’s death creates more confusion over the already murky legal, ethical, and moral issues surrounding euthanasia. A few online commentators feel that Rosemary should have lived, as she had a very active social life, and that her story essentially glamorizes suicide. Other families who have lost a loved one to VSED have stepped up, saying that from their experience deaths by starvation are often longer and more painful than the documentary revealed. (2, 5)
Although, watching the documentary myself I see Rosemary as a person and not a universal example for all. She wanted something, and was clearly happy to receive it – can’t we all relate to that? I offer my deepest condolences and respect to her family, who took her passing gracefully and upheld her wishes even when it was hard to do so.
