October 28, 2014; Boulder Daily Camera

While some may squirm in their seats at the uncomfortable thought of discussing their mortality with a stranger, one nonprofit broaches the subject head-on. Conversations on Death, according to Kitty Edwards, one of the founders, was formed in 2012 in an attempt to change the attitude and culture surrounding the discussion of death. The Colorado-based nonprofit has found a burgeoning, curious audience wishing to delve into what many would think was a morose subject.

“We didn’t know if there would be an audience,” said Edwards. “We wanted it to be a collaborative effort, so the conversation would be diverse.”

Since being founded by Kitty Edwards and Kim Mooney, coworkers for 22 years at a hospice in Boulder, Colorado, the organization now organizes monthly “Death Cafes” as well as “Death at the Movies” nights, providing individuals a safe forum and space to participate in discussions of death. Most recently, the group has sold out a symposium that is to take place this coming Saturday that focuses on the end of life.

Through encouraging easier dialogue on death and dying through these kinds of events and other workshops, the nonprofit seems to provide valuable resources that individuals may not be able find otherwise, given the country’s general defiance to related topics like dying-with-dignity laws.

NPQ readers saw this defiance firsthand in AARP’s decision to deny a right-to-die group, Final Exit Network, permission from participating in the healthcare organization’s annual exposition this past September in San Diego. Most recently, Brittany Maynard, a terminally ill 29-year-old woman, captured national attention when she moved from her home in California to Oregon, one of only five states with a death-with-dignity law, in order to end her life this Saturday. Diagnosed in January with Stage 4 malignant brain cancer, by April, she had been given six months to live. After realizing there was no treatment that would save her life, she considered her options.

Instead of succumbing to her illness in what she described in a YouTube video from October 6th as “a terrible, terrible way to die,” Maynard has chosen her path and, in doing so, has put a face to a silent minority in the country who are also choosing to end their lives before a natural, painful death. She has taken the past several months to travel with her family, including a trip to the Grand Canyon, which was on her “bucket list.”

In an ironic sort of way, having the opportunity to choose the circumstances of death has taken away the fear, anxiety, and dread and, instead, replaced those emotions with relief. “I will die upstairs in my bedroom with my husband, mother, stepfather, and best friend by my side and pass peacefully. I can’t imagine trying to rob anyone else of that choice,” said Maynard in an opinion piece for CNN. In sharing her journey, Maynard has become the public figure for the nonprofit Compassion & Choices, which is the leading organization “committed to helping everyone have the best death possible.”

Through Maynard’s story, uncomfortable conversations about death turn toward a choice few of us could imagine making. Ever since Oregon became the first state to instate a “death with dignity” law 17 years ago, there has been significant pushback and controversy. Much of that is over ethical questions regarding whether doctors’ participation in deliberate attempts to end their patients’ lives violate their code to “do no harm.” A 2013 poll of 2000 doctors by the New England Journal of Medicine found that 67 percent oppose physician-assisted suicide.

However, the president of Compassion & Choices, Barbara Coombs Lee, said assisted suicide is much more common and may be taking place informally beyond the five states in which dying with dignity is legal. “In an unauthorized state, when the patient is vocalizing their intention (to die), the conversation has to be in code,” Coombs Lee said. “The physician or nurse might say: ‘Now, this is the amount of sedatives and morphine you should give your loved one—be careful not to give more because that could cause their death.’ Or they might say: ‘Don’t worry about how much morphine to give. Do you understand me? Give as much as he needs.’”

For Maynard and others in her situation, there is significant relief in being able to plan their deaths and prepare their families. Similarly, Conversations on Death approaches the topic of death through workshops, gearing individuals with methods of preparing themselves and their families for the aftermath of a death. Mooney, who has been running grief groups for nearly 17 years, has seen firsthand the impact of a “bad death,” which would presumably be characterized by a sudden or violent death after which family members have difficulties coping.

To Geo Case, a board member of Conversations on Death, and, perhaps, also Maynard and other participants of assisted suicide, “The more we look at death, (the more) it’s teaching us how to live.”—Shafaq Hasan