I have been surprised that ending my life while still somewhat functional has become one of my main personal and political causes over the past 2.5 years. I have been saying for decades that at some point in the aging process, prior to when my body fully closes down, and while I still have my mental faculties, I will choose not to create another phase of my life.

One reason I am going forward now, is that my physical health keeps slowly spiraling downward with an ever expanding range of problems that began with a serious injury when I was 28 years old. I am tired of the increasing work it takes just to remain barely able to do activities I value. An equally important reason is that my capacity to contribute is vastly diminished now that I have fully retired from being productive professionally, am no longer an active member of a shared household, and in my capacity for political activism.

The cultural presumption is that the best natural death is to die in one’s home, surrounded by loved ones but that’s not the only choice. Nor is it even an option for people like me who are solo agers. Rather than face a long drawn out aging process of unrelenting loss of capability, loss of privacy and dignity, I am actively choosing assisted suicide. Because my German, half Jewish mother, had spent three formative years in Switzerland, she talked to me about suicide as an option for herself. This history with my mother, meant that suicide was not a forbidden topic, but was something that could be discussed.

But then actually doing the deed in a way that avoids legal issues or emotional imposition on others is difficult unless you have a terminal diagnosis (<6 months to live, no hope of recovery).

Proactive dying has become my cause, my project. It is yet another social value that I want to change, by example. This act is deeply appropriate for me as a person, and I believe for many others.

I had two wonderful Celebrations of Life before exiting early by choice by traveling to Switzerland to complete living as a manifested human on this planet, using the services of Dignitas. They allow “weary of life,” as an acceptable reason to choose to die on your own schedule. 21% of the people Dignitas assists have this, not terminal illnesses as their reason for ending their life.

The following is my list of 6 reasons for exiting early by choice:
  5%    1.)  Exchanging meals, food, and socializing with my peers is evaporating.
27%    2.)  To leave $ for people and causes I want to support. 50% people, 50% causes.
21%    3.)  To stop having to limit what I do, due to environmental sensitivities.
27%    4.)   Enough already of dealing with the limitations of a disabled body, exacerbated by the aging process.
15 %   5.) An increasing % of what I want to do electronically and on the web, is a burden or impossible.
 5%    6.)   I might run out of money.
100%

1.)  As a solo ager, with no partner or dependents, my stopping to live will be a loss, but not create a major problem for anyone.
2.)  The main source of my money is having sold the house I lived in. I had saved a little money in an IRA while working as a house remodeler, and I had inherited ½ a million $ from my parents 20 years ago, which we thought would be enough for me to live on for the rest of my life. But before I sold the house I was becoming house rich and cash poor.
3. & 4.)  I know what it takes to live elegantly with a disability, but how I spend my time has tipped downward, in terms of even being able to care for myself, much less contribute to this wonderful world.
5.) The newer methods of communicating are increasingly beyond my capacity.
6.) I feel good when I can contribute money despite having less and less time to support what I believe in. Acting now accomplishes this. Delaying does the opposite.

I dearly hope that you will join Robert, John and others who are planning on offering a workshop at the next Reimagine the end of life in San Francisco Oct. 24-Nov 3, 2019 for a workshop that features a 4 minute video about me titled "The Last Days of Spring".

MY REASONS FOR SCHEDULING ASSISTED SUICIDE WITH DIGNITAS
Index
MY REASONS FOR SCHEDULING WHEN I END MY LIFE, AND MY OPTIONS @ HOW
OUR SHARED HOUSE, MY FAMILY, MY ACCOMPLISHMENTS, WORK
MY CHOICES: HERSTORY, CREATING FAMILY/RELATIONSHIPS
Lifestyle Choices in the 1970's & 80's
Adult life Phase I
Adult life Phase II Construction, Business Owner and Teacher, 1980 – 2014
College and Graduate School: Madison and NYC. My First Jobs
Childhood: My Family Heritage
LOTS MORE DETAILS about my life - 1
LOTS MORE DETAILS about my life - 2
LOTS MORE DETAILS about my life - 3

I have been surprised that ending my life while still somewhat functional has become one of my main political causes. I have been saying for decades that at some point in the aging process I will choose not to create another phase of my life, prior to when my body fully closes down. One reason is that my physical health keeps slowly spiraling downward with an ever expanding range of problems. An equally important reason is that my capacity to contribute is vastly diminished now that I have fully retired from being productive both professionally, in a shared household, and in my political activism, etc.I had two wonderful Celebrations of Life before Exiting Early by Choice by traveling to Switzerland to complete living as a manifested human on this planet.

At some point it becomes time to end it all. But then actually doing the deed is difficult.
Dying has become my cause, my project. It is yet another social value that I want to change, by example. This act is deeply appropriate for me as a person, and I believe for many others.

The cultural presumption is that the best natural death is to die in one’s home, surrounded by loved ones.  But at some point a few of us decide that it is time to actually choose death in advance of when physical and perhaps mental infirmities slowly remove my choices.

But then actually doing the deed is difficult.
I am sure that I want to end my life now.  It will not be in my home, partly due to the medical system, and partly out of consideration for others. More resources on this are available through the meetings of the meet-up Options in Dying.

I was surprised that when I retired from my work and household responsibilities, for myself, I choose not to start a new life, but to put effort into communicating to other family members in the younger generations, the few items of family history that I knew uniquely, largely from end of life talks with the generation before me. I also was more comfortable with the topic of suicide than most Americans because my German, half Jewish mother, who had spent three formative years in Switzerland, which contributed to her talking about suicide as an option for herself. This ease of talking about suicide meant that once again as I have entered this last phase of my life, I have drawn a conclusion and a plan of action that I believe is ahead of what many others in our USA culture will come to believe and act on. I am an exception in being on old person who chooses to not reinvent myself in a new and diminished form.

The book “Being Mortal: Medicine and What Matters in the End,” by Atul Gawande, has been providing me with inspiration for my choice.  It discusses end of life choices about assisted living and the effect of medical procedures on terminally ill people and challenges many traditionally held notions about the role of medicine. The graph on page p. 27 was especially informative for me. It shows how modern medicine provides a pattern of one's physical condition between one's birth and death of repeatedly recovering from physical crisis but with less health, and a lower trajectory, instead of what happened until 200 years ago. Before modern medicine, when one experienced a health crisis one would die quickly, and just a few people were able to live till old age. This article, “How to Die Well, According to a Palliative Care Doctor” adds percentages to each path on  graphs similar to those in “Being Mortal”.

On Oct. 16, 2018 I, Spring Friedlander, gave a talk to ‘Death Talks,” on my experience in selecting how to die without a diagnosis of a terminal illness. The California End of Life Option Act (CELOA), physician-assisted dying, only applies in case of a terminal illness. If you are simply ready to die after a life of chronic illness, or in a similar situation, you need an alternative to the Act.

The CELOA went into effect in June 2016 in California,  and about ten other states now have adopted similar acts. Compassion and Choices / Death with Dignity are the organizations that are publicizing / defending this Act and supporting other states to get their version enacted.

At the talk, I discussed two alternatives on how to end one’s life when one does not have a terminal diagnosis:

One alternative is voluntarily refusing food and drink: Voluntarily Stopping Eating and Drinking, (VSED), which is legal in many states. Refusing food and drink at home, VSED, takes time: at least five days for one’s liver and kidneys to fail, which means one is dying; and then another 4 - 5 days to die. Kaiser will provide palliative care at home for the initial period, and then hospice care in the final days. However the transition between palliative and hospice care can be messy. One of the challenges is that Kaiser may send different people at different times, you can't be sure who will show up. Apparently Kaiser has become more supportive of individual people, since I checked with them at the end of December, 2017.

It is good to prepare one's body for VSED by tapering off food and water for 2 - 3 weeks. Then drink only liquid soups (bone broth) and water (down to 8 oz of water / day) for 6-10 days, while taking the amino acid, l-threonine, 200 in the am & pm. In my case I also found two supplements that would keep my sugar levels balanced by taking 6 servings / day of each Collagen Protein- Vite K - 107 with GlycemoVitamin K - 85, both by Apex Energetics. Then one takes the next step, which is to completely stop eating and drinking.

There can be interruptions. People may disagree about your wishes, and you may not have control over your environment because you are dying. So refusing food and drink is simple in concept, but can be complex to execute, especially since you cannot expect to be in control the entire time.  It’s essential to complete Advance Directives before starting this process.

It seems true that the worst outcome to taking your life is failure to complete the process of dying. And without clear responsibility and control, failure is quite possible, even with the best of intentions among everyone present. The chances of success are significantly improved, if there is a team of people who are your advocates, (children, spouse, friends, etc.)

Once I found out about going to Switzerland I choose this path and went through all the steps to apply and be accepted by Dignitas, to end my life. It feels like the right choice for me.   
A second alternative is finding an organization to take responsibility for your death, like Dignitas, in Switzerland. The complexity here is in the initial arrangements and procedures. But once you have completed those, then the actual process is simple: you walk into an apartment in Zurich, Switzerland, you drink a sequence of liquids very similar to what is provided under the CELOA, and within a few minutes you lose consciousness and die. With the help of Dignitas you have complete control over your death, and it is as simple as possible.

Here are some points about Dignitas:

       21% of their clients do not have a terminal illness, but are "weary of life."  Most of their clients are old. The do not service younger people who are suffering from depression. They may service younger people with other types of disabilities.
       Their mailing address is not an actual street address, for privacy
       They require medical opinions from two MDs here in the US, not chiropractors or other health professionals, about your health challenges.
       They did not want me to mention my cancer,  even though I have had melanoma for 15 years, because my cancer was not stage 3 or stage 4 which would indicate one being close to  terminal.
       The web is helpful to learn about Dignitas and their process, but they require original hard-copies of all documents. They will not proceed at any step until they have the originals.
       They are very clear about the information they want submitted. Due to them needing more information on why I am making this choice, it took me submitting and resubmitting three times. Dignitas required signed and certified originals, which I sent by USPS for less the $5 each, and would follow-up by email. I got no evidence that they looked at the electronic version I sent each time.
       They far prefer that when you go to Switzerland you are accompanied by family or friends. (and some airlines offer round trips that are cheaper than one way).
       The complete Dignitas procedure costs money: 300 euros initial fee (about $340), then 3,000 euros ($3,500) for two doctors in Switzerland, and about $11,000 total, not including airfare. They recommended that I pay through TransferWise.  TransferWise requires a physical street address, not a PO Box. Dignitas did provide a street address with about a 10 day delay. If I do not complete the process with them, I get a refund of all but my annual membership in Dignitas, $300, and about $2,000 for their handling the administrative process of accepting my application
       The result is clear control, responsibility and legality of a defined process for your death, which seems only possible if an organization like Dignitas takes responsibility. They assert that Switzerland is the only country where foreigners are allowed to be helped to end their life.

It is unclear to me how long their process takes if everything goes smoothly for completion, but in my case I began in January 2018, and I got my final paperwork accepted in the middle of February 2019. I got delayed because;
they added the requirement that one of my Doctor’s letters needed to be from a psychologist,
and I had to go through extra steps to get my birth certificate to match the name I changed to in the 1970's.

Also after my third round of signed letters from doctors were not accepted, I realized I needed to have them review the letters prior to getting them signed. First they had wanted more details about my medical prognosis and then they wanted briefer letters. They required that I focus on objective physical limitations, not fears of my future deterioration. Then the letters were older then 4 months so I had to get current letters. I recommend that anyone going through their process have them review the letters prior to going to get one's doctor to sign it and put it on his letter head. My last round of 2 MD letters involved me sending them draft letters, getting their feedback on how to change the letters to meet their standard, and then talking with them on the phone to get permission to not include some of the language about assisted suicide they recommended. So on round 4, I was able to get them two current MD letters, one from a psychologist, that met their standards. My other communication with them was by email and USPS air mail.

21% of the people they service have this, not terminal illnesses as their reason for ending their life.
I plan to “exit early by choice,” earlier than when my body wears out more, because of not wanting to live/suffer through much more of being older/old. I choose to be in charge till the end of my life now that “enough is enough.” My feeling is that my life is complete as reflected by my conclusion that “My life has been a good run.” I am unusual because I have chosen to take responsibility for the timing of my death.

The following is my list of 6 reasons for exiting early by choice:
 5%    1.)  Exchanging meals, food, and socializing with my peers is evaporating.
27%    2.)  To leave $ for people and causes I want to support. 50% people, 50% causes.
21%    3.)  To stop having to limit what I do, due to environmental sensitivities.
27%    4.)   Enough already of dealing with the limitations of a disabled body, exacerbated by the aging process.
15 %   5.) An increasing % of what I want to do electronically and on the web, is a burden or impossible.
 5%    6.)   I might run out of money.
100%

1.)  As a solo ager, with no partner or dependents, my stopping to live will be a loss, but not create a major problem for anyone.
2.)  The main source of my money is having sold the house I lived in. I had saved a little money in an IRA while working as a house remodeler, and I had inherited ½ a million $ from my parents 20 years ago, which we thought would be enough for me to live on for the rest of my life. But before I sold the house I was becoming house rich and cash poor.
3. & 4.)  I know what it takes to live elegantly with a disability, but how I spend my time has tipped downward, in terms of even being able to care for myself, much less contribute to this wonderful world.
5.) The newer methods of communicating are increasingly beyond my capacity.
6.) I feel good when I can contribute money despite having less and less time to support what I believe in. Acting now accomplishes this. Delaying does the opposite.

I am putting some time and energy into documenting my end of life, as well as the earlier phases of my life when I was at the cutting edge of a series of cultural and political shifts. I plan to get this up on www.forevermissed.com refer to it on FaceBook and have a video made about it.

Twenty one percent of the people that Dignitas provides end of live services for are categorized as “Weary of life.” This is what I wrote as my own version of being “weary of life”. “My life is not working for me. I have put a lot of effort into making my life work, but the results are no longer enough to persuade me to go on. I just do not have it in me to keep retrying old strategies or trying additional new strategies. I am clear that my choice is to end my life at this time.“
I will check, but I believe that if this is one’s reason for getting their help then they require that one of your MD letters be from a Psychiatrist.