The Ultimate Act of Love

By: Jerold E. Rothkoff

In September, I attended the Life Care Planning Law Firms Association (LCPLEA) annual meeting in Seattle, Washington. One conference presentation was devoted to the Washington State “Death with Dignity Act” which allows adults diagnosed with a terminal disease are deemed to have only six months to live to voluntarily obtain medication “that the patient may administer” to end his or her life. Right-to-die laws are currently in effect in Washington, Oregon, and Montana. Studies have shown that there has not been a surge in deaths connected to the laws in each state.

In February 2013, New Jersey’s Death with Dignity Act modeled after Washington, Oregon, and Montana’s law cleared the New Jersey Assembly Health Committee, over the objection of critics who pleaded with the panel to spend more time to consider the measures moral and legal implications. The bill is still pending in the state legislature.

The “New Jersey Death with Dignity Act” would allow adults diagnosed with a terminal disease and deemed to have only six months to live to voluntarily obtain medication “that the patient may administer” to end his or her life, according to the bill (A3328). The diagnosis must be made by the patient’s treating doctor and affirmed by a consulting physician. Before the prescription is filled, patients must complete a form stating they are making this choice of their own free will. The form must be signed by two witnesses attesting the patient is capable of making the decision.

Approximately eight months ago, our elderly clients for the past five years, a husband and wife, age 85 and 90, committed double suicide in their apartment.

When I first heard the news, besides being devastated, my first thought was that our office had failed them.  We had been working with the husband and wife clients and their children in order to keep them safe in their apartment by bringing in the necessary resources, including home care. However, the clients, being very proud individuals, had been very hesitant to receive assistance in their apartment.

The double suicide was particularly devastating to our Director of Care Coordination, Janie De Leon-Male.  She had been the person from our office who regularly visited with our clients at their apartment.  Our job was to assist in getting our clients the best possible care.  Was there something more she should have done?  Should we have been more forceful in insisting more hours of home care? Should we have seen any red flags that would have indicated what was to come?

Our clients were slowly declining in health, but did not necessarily have a terminal illness, so the Death with Dignity Act, should it have been law in New Jersey, likely would not have applied to them.  Nonetheless, is there something more we could have done?  Maybe.  Did we fail them?  I do not believe so.

Janie remembers fondly the visits to their apartment in which she shared laughs with our clients.  How do we define “helping” our clients?  Janie and our office did help them.  She made their last days brighter.   We are caring people and this is what we choose to do for a living.  We cannot stop caring.  We build relationships with the elderly to assist them in getting the best standard of living they can afford for the remainder of their lives.

What is clear is that our clients, married for over 50 years, wanted to be together forever.  They wanted to pass together, and their love was such that each one did not want to live without the other.  When a bond and a physical yearning to be together is that strong, nothing can break it, and they saw to it that death did not either.  They did not inform us of their intention, because they knew we would be required to attempt to intervene.

They exercised final control over their own death.  It was their choosing.  Our job is to give our clients choices and options.  Sometimes they choose what we recommend, sometimes they do not.  Sometimes I feel as if I could do much more, if only the client would just listen to me.

Our clients’ concept of life did not include receiving care and being less than mobile.  Perhaps they are happier wherever they now are.  Their deaths are not a failure. Perhaps, in their eyes, end of life in total pain, without control, is the failure.

We are in the business of helping our clients make informed decisions.  Once we start taking away their ability to make those decisions we start down a very slippery slope.  We want to thank our clients for allowing us into their world and giving us the opportunity to bear witness to a love that runs very deep.

About Jerry

Jerold E. Rothkoff, a practicing New Jersey and Pennsylvania attorney, is the Principal of the Rothkoff Law Group, an elder care law firm. Jerry dedicates his practice to serving clients in the areas of life care planning, long-term care planning, Medicaid & VA benefits, and advocacy for the elderly and disabled. He is past President of the NJ Chapter of the National Academy of Elder Law Attorneys, former chair of the elder law section of the NJ State Bar Association, and past President of the Life Care Planning Law Firm Association. Jerry continues to be an outspoken advocate for the rights of the elderly and disabled. He writes for and gives presentations regularly to attorneys and other professionals about legal issues related to seniors and those with disabilities. Jerry’s community activities include the Twilight Wish Foundation, the Delaware Valley Stroke Council, the Alzheimer’s Association, as well as numerous other advocacy groups. When not in the office, Jerry spends time with his wife, Erica, and their five children, eighteen-year old identical twin girls, Liza and Julia, fifteen-year old fraternal twin boys, Evan and Gregory, and six-year old Aitan.