I'm not supposed to know my beloved relative is about to die.
September 23, 2022 10:19 PM   Subscribe

[CW: medical assistance in dying] My beloved aunt, who has been a second mother to me, is planning to end her life under our state's Medical Assistance in Dying Act (MAiD) in the next several days. I am not supposed to know this. I respect and support her decision 100%, including her wish to keep this a secret. But I am struggling with the ethics of knowing the date and time of a loved one's death in advance yet not acknowledging it to them in any way. I am afraid I am making the wrong choice. If anyone has experience with physician-assisted suicide--either as a family member, a professional, a patient, whathaveyou--I'd be profoundly grateful for any thoughts you'd care to share. Thank you so much in advance.

To give some context which might be helpful:
- I re-entered therapy this week. The therapist, while lovely, does not seem to have much experience with this topic. She suggested I ask my mother whether my aunt is aware she told other people, and decide what to do from there, but frankly I don't trust my mother to tell the truth.

- My aunt explicitly asked her sister, my mother, NOT TO TELL ANYONE ELSE about her plans. (My aunt's husband and, I believe, her child are aware.) My mother violated this wish by telling myself, my siblings and possibly other family members. I recognize this for the betrayal that it is, and while I empathize with my mother's profound grief I am furious with her for refusing to respect what is in effect her sister's dying request, not to mention her simple dignity and privacy as a human being.

- Due to the way things work in our family, I am wrestling with the possibility that Aunt may have known my mother would do this and that telling her, even with the request that she not share it, WAS her way of informing us.

- My aunt and I had a close relationship when I was growing up, and I know she still loves me and my siblings very much. Due to the effects of her illness, however, at her request I have not communicated directly with her in years; any information or well-wishes have passed through my mother, who lives near her (I am very far away). To do so now would make it obvious I know what is going on.

- My absolute #1 concern is not causing my aunt any distress. Given the above, this would seem to necessitate not communicating with her in any way that would be out of the ordinary--i.e., not at all.

- I have broached this topic with some people who are close to me, and a few are completely appalled that I would even consider just...not saying anything, not even that I love her, before she leaves. It's starting to make me doubt myself.

I am afraid I'm disguising my own selfishness to myself as "respecting her privacy", and that I'm navigating this wrong, not only committing a terrible act of neglect but also setting myself up for decades of intractable regret.

Am I wrong to believe that the most ethical decision in this situation is to let my aunt leave this life believing (or at least having plausible deniability) that no-one else knows about her decision?
posted by anonymous to Human Relations (26 answers total)
 
She may have wanted you to know but that doesn't mean she wants to or needs to hear from you right now. So brainstorming what you can do, respectful of the boundaries she has set:

* you can continue to send her your love through your mother,

* you can be prepared to send your love and support to her husband and children very soon after her death,

* you can write a letter expressing everything you want to say to her, then decide to keep it or share it with her immediate family or read it at her funeral or burn it.
posted by muddgirl at 10:35 PM on September 23, 2022 [8 favorites]


And of course I don't know the whole story but being respectful of the stated wishes of a dying relative you love is not selfish.
posted by muddgirl at 10:37 PM on September 23, 2022 [44 favorites]


She has requested in the past that you communicate with her through your mother. Continue to respect that. I think reaching out to her now would be a bad decision. You can use this knowledge to help prepare yourself for the day, though. Request time off, get easy nutritious food stocked up, schedule a phone call with your mother and siblings, that kind of thing. You can also write letters to your aunt, light candles, meditate, pray, whatever feels like a good way for you to say farewell to her emotionally.

I think after her funeral it will become clear if your mother told everyone and their second cousin’s hairdresser or if it was just you and your siblings. If it’s just the small group, and your aunt’s immediate family doesn’t know you knew, I think keeping quiet is probably the simplest thing. If your mother was told to intentionally shake up the grapevine and everyone knows, you can talk freely about it.

I am strongly in support of people choosing a good death for themselves but it’s definitely a very unusual thing and we haven’t pinned down etiquette for it. I think your friends who have been taken aback have probably not thought long and hard about what they would want in such a situation themselves. That she is in a place where physician assisted suicide is the right choice for her speaks to a lot of careful thought and a desire for dignity. Clearly part of that for her is keeping things private. By letting her experience this privacy you are respecting her much more than if you rushed to her bedside or if anyone who knows made a big production about it.
posted by Mizu at 11:20 PM on September 23, 2022 [17 favorites]


Am I wrong to believe that the most ethical decision in this situation is to let my aunt leave this life believing (or at least having plausible deniability) that no-one else knows about her decision?

Maybe you are, but if you are, know that I would personally be wrong in exactly the same way.

I would also be making a mental note that if there were ever anything I knew with the kind of emotional heft that your aunt's decision carries, and I didn't want it spread, I wouldn't tell it to your mother.

My mother violated this wish by telling myself, my siblings and possibly other family members. I recognize this for the betrayal that it is, and while I empathize with my mother's profound grief I am furious with her for refusing to respect what is in effect her sister's dying request, not to mention her simple dignity and privacy as a human being.

I think your analysis of this situation is exactly correct, and the only difference in the way I'd react to it is with less fury in your mother's direction. Grief makes people do things we otherwise wouldn't.

I personally rate your decision to avoid compounding the already unfortunate effects of your mother's opsec breach as wholly admirable, and you have all my sympathy for your own nasty dose of those effects.
posted by flabdablet at 11:22 PM on September 23, 2022 [12 favorites]


You are respecting her wishes and her privacy. Dying is a laborious process and people who know they will die should be allowed to control their surroundings and supporters to the greatest extent they are able. If your aunt doesn’t want an audience, and doesn’t want to discuss her decision, that’s okay.

I’ve known someone was dying (not by MAID but someone who was aware they would die within hours to days) and not been invited to bedside. I’ve also been at bedside for a lot of last days, and missed last moments. What gave me peace was knowing they had the passing they would want, and taking time to send my thoughts and wishes for a peaceful transition their way.

A thought: maybe you could talk to your mom the day before or a few days before, if it’s appropriate and usual for you to talk to her, and just share with her some fond memories of your aunt. Maybe that is a way for your to feel connected and present with your aunt as she goes.
posted by assenav at 11:26 PM on September 23, 2022 [7 favorites]


I am wrestling with the possibility that Aunt may have known my mother would do this and that telling her, even with the request that she not share it, WAS her way of informing us.

You can't know what's inside Aunt's head, and trying to second-guess yourself second-guessing her second-guessing your mother will only ever cause you misery. I recommend not doing that.

I've always found that the policy least likely to cause misery is simply to take people exactly at face value unless I have reason to believe they're actively trying to sell me something I don't want, which I can't see your aunt doing under present circumstances.
posted by flabdablet at 11:30 PM on September 23, 2022 [16 favorites]


…after preview but upon revisiting the answers so far, I want to encourage you to listen to muddgirl, who really said everything.
posted by assenav at 11:43 PM on September 23, 2022


- I have broached this topic with some people who are close to me, and a few are completely appalled that I would even consider just...not saying anything, not even that I love her, before she leaves. It's starting to make me doubt myself.

Does this include your siblings? Because I would probably react that way too, but that's because I don't know any of the personalities, mentalities, or dynamics involved.

The thing is, someone who specifically requests that loved ones not communicate with her personally for years is not someone whose mentality is the same as mine; it's a foreign thing to me and I don't truly understand it. So what does it matter how I react to the current dilemma? I clearly don't understand the situation; my view has limited relevance.

I think your siblings are probably the only ones in a position to understand. And even they might read things differently.
posted by trig at 11:59 PM on September 23, 2022


One question you might have to consider (as if there weren't enough) is whether your mother might tell your aunt that she told other people.
posted by trig at 12:02 AM on September 24, 2022


Your aunt has the right to die in privacy and dignity. Please don't bring the drama of your mother over-sharing to her last days.
posted by DarlingBri at 2:11 AM on September 24, 2022 [27 favorites]


You should not make any effort to reach out to your aunt or her immediate family at this time. It would not be a “a terrible act of neglect” ---it is honoring this person’s wishes. They have family and presumably all the support they need.

I wouldn't spend time figuring out who knows what and who told who. Wait til after the death and reach out to the family, share memories, offer condolences, etc..

You are not “setting myself up for decades of intractable regret.” You are honoring your aunt's wishes as you understand them. I am not big on regret in general, but any regrets you may have should be based on the years of your relationship, not the last few days of her life… She could have gotten hit by a bus yesterday; would you have intractable regret in that circumstance?

For your friends who are "appalled", some people have a very Hollywood view of death and dying. It's kind of immature and even disingenuous to think every death bed scene should have reconnections and professions of love. It sounds like you and your aunt had a loving relationship and you've always appreciated her. Don't listen when people tell you how you should feel.

Lastly, I would say don't be too hard on your mother. She might be a hopeless gossip, and it isn't great in term of your aunt's privacy, but your aunt doesn't have to know, and it does give you a chance to support your mom during this time.

My sympathy to you and your family.
posted by rhonzo at 5:51 AM on September 24, 2022 [3 favorites]


Unless you’ve left out some big information, this one seems crystal clear to me - the last loving thing you can do for this person who has been so important to you is to honor her wish that you not communicate with her, and act as if you did not have this information. I believe you are doing exactly the right thing in a difficult situation. I’m so sorry your mother has put you in this position.
posted by Stacey at 5:52 AM on September 24, 2022 [5 favorites]


I mean this with the utmost kindness: you may have difficult feelings in the future as a result of honoring her wishes. It would be perfectly understandable if, after respecting her privacy, while you are grieving her death, you experience thoughts along the lines of, “If I had reached out to her, I wouldn’t be in this much pain. I wish I had.” That doesn’t mean you should contact her, but it’s worth being honest with yourself that honoring her wishes is going to be very hard and painful. Regret isn’t necessarily a barometer of the rightness of your choices. It’s much more complex than that. If/when you feel regret or something like it about how you handled this situation, would you rather it be rooted in the discomfort of having honored or not honored her wishes?

I wish you didn’t have to know her plans. I’m sorry your mom told you.
posted by theotherdurassister at 6:51 AM on September 24, 2022 [17 favorites]


I'm sorry, this situation sucks on multiple vectors. I think the closest I can advise you to accomplish some of what you want while still respecting your aunt's wishes is to ask your mom to do this, if you think she will: "Mom, please tell Aunt that you told me/us that she was (non-specifically) declining and that I asked you to tell her that I love her and I appreciate everything she's done for me." (Or similar message, whatever bulletpoints you want to pass on.)

This way you have respected your aunt's wishes but also at least passed on something vaguely like what you'd really like to say. I'm making the assumption that what your aunt specifically didn't want to deal with was the unsolicited feedback/objections/enhanced grief wave of choosing to end her life, and if this wasn't such a difficult situation probably could have negotiated with your mom to distribute simply the information that aunt is in her final stages of hospice care and it probably won't be long now.

I think that would be a reasonable thing for your mom to have done (rather than what she did), and probably what I would have done in your mom's shoes. It puts her in a terrible position to say nothing at all, and it would be her that has to deal with the repercussions after Aunt dies. I...kinda get it. I would struggle to adhere to the letter of the agreement but if I was the one who had to be alive and deal with the aftermath I might make some discretionary choices too.

None of this is fair, but it sounds like there is a rather large tome of family history here, and that's going to be your context to remember when regrets come. Because they WILL, there's no great fantastic-feeling thing to do here. There's no course of action where you end up delighted and unconflicted about a loss. However you feel in the future, you get to process those feelings and at least come to an agreement with them that your options were limited and your priority was respecting her wishes to the best you could understand them. You can write long long letters that you never send. You can also take what you've learned in this experience and use it to deepen your thinking about end-of-life care, your own and others you will experience in the future.
posted by Lyn Never at 7:28 AM on September 24, 2022 [10 favorites]


I believe you are doing exactly the right thing in a difficult situation. I’m so sorry your mother has put you in this position.

I share this feeling. And I'm sorry because there are a lot of complex parts to this. Your aunt wanting to keep a secret (and limit communication) is very understandable but it can still be hard. Your mom's oversharing is a little less understandable but still hard. You not being sure what to do and also just pre-grieving is also difficult.

Agree with what other people are saying: dying is a job and sometimes it can be hard to hear that people do not want or need your help with this. I was close to a very elderly woman who made the decision to die (not through MAID but by essentially taking to her bed and refusing food/water with the assistance of hospice and family) recently, and I was one of a VERY short list of people she told. And when I asked how I could support her, she said "Keep people away" which I mostly did. And I won't lie, this engendered a LOT of weird/bad feelings from other people who felt weird/bad about not being told and not getting to say goodbye. My interpretation of how to manage these things was that me getting in the way (i.e. by not saying "Go see her, she'll be dead in a few days!") was my gift to her and what she wanted and said she wanted.

We can't be responsible to people who say things they don't mean beyond a point (if you're agonizing over whether your aunt sent you a coded message). It's a kindness when people tell us what they want. It's an act of love to do what people say they want. I am so sorry you are going through this. I think if it were me, actually this is what I did in the above situation, I'd start writing a bit of a eulogy thinking about your aunt's positive points, stories with her that bring you comfort, and look at supporting your mom (if you want, grief makes people do odd things sometimes, only you know if this tattling situation was just who she is or is more out of character) and your aunt's family when the time comes.
posted by jessamyn at 8:02 AM on September 24, 2022 [6 favorites]


Sorry for your loss. I agree with the consensus here - she has made her wishes very clear, and so you ought to follow them - and stop telling more people about this like your friends!

The fact that you haven't been allowed to contact your Aunt directly since she became ill suggests your Aunt has had a hard time dealing with her illness emotionally. So it makes sense she would feel the same way about her death. While admittedly my experience with this was even more fraught (i.e. not legal), even if we as a society generally recognize that this type of death is different than suicide, "suicide" is still part of how we describe it - and that brings with it all sorts of baggage for most people. Your Aunt may be, rightly, worried that some people in the family will be upset. Or she may feel shame about her choice. Respect her wish to keep this limited to a small circle.
posted by coffeecat at 8:07 AM on September 24, 2022


Managing and responding to other people's sympathy and grief is hard. I imagine your aunt doesn't want to do that work, especially now. That's hard for you, but understandable for her. The fact that she's asked people not to contact her for years makes this extremely clear cut to me. She is shielding herself. The right choice is to respect that.
posted by Mavri at 8:48 AM on September 24, 2022 [5 favorites]


“If I had reached out to her, I wouldn’t be in this much pain. I wish I had.”
You will definitely think "If I had [x], I wouldn't [y]. I wish I had [x]." When you think that, it's helpful to think, "Sure, but if I had [x], I still could have [p] and I didn't [p], nor did I [d] or [q], thus I would still [y] and I would still wish I had [pdqrstu∞]." Even if you did it right, you could always have done it righter. You will always have done something wrong or not done something right. Perfection cannot be achieved. Good cannot even be achieved. Nothing you do at the end can be the right thing, because it is the end, thus there is no right thing: the terrible thing overshadows all. We all did the best we could. That is the thing to think.
posted by Don Pepino at 9:07 AM on September 24, 2022 [3 favorites]


The thing is, someone who specifically requests that loved ones not communicate with her personally for years is not someone whose mentality is the same as mine; it's a foreign thing to me and I don't truly understand it.

I would be in the same perplexity, but this is what tips me over to the Mefi consensus. This is clearly someone who is used to drawing firm boundaries and understands their consequences. Otherwise, I would be wrestling a lot harder with the possibility that this was an indirect way of requesting some token of affection.
posted by praemunire at 9:55 AM on September 24, 2022


I'm so sorry. This is a terrible situation, and you're going to feel lousy about it no matter what you do.

I want to point out that in deciding, years ago, to filter all communications through your mom, your aunt protected herself while putting your mom in a difficult position. Maybe the plan was disclosed to you/your siblings because *your mom* needs your support at this time? Your aunt's husband and child are, you believe, in the know; who does your mom have for emotional support? If we're hypothesizing, consider: did your aunt swear your mom to secrecy, full knowing that you and your siblings would be looped in, so that you and said siblings could play this supportive role for your mom? Can any of you be with your mom in these next few days?

My own family has weird who-knows-what-and-when & strategic-leaking dynamics, too. The cousins and I joke how it's about knowledge as currency. In a similar set-up, I might be compelled to send flowers to my aunt, and my mom, and, like, every woman in their generation, as coverage, all with notes of appreciation. But I'd also struggle: is it selfish on my part, am I giving her husband or child another gatekeeping task (whether or not to allow the delivery), would the note make my aunt uncomfortable, would a bouquet from me in the room where I can't be only make things worse, and so on.

Secondly, was your mom trying to start a conversation about what her own wishes would be, if she developed a terminal illness? (An appropriate topic of discussion with her children, just not how she jump-started it.)

I think in this particular Silk/Goldman "Ring Theory" situation, you try to set aside your frustration and help, and/or grieve with, your mom. If there's a way to reach out to your aunt's husband and child afterward, do that. If you follow any spiritual traditions, you can honor your aunt in your own way, starting right now. Or plant trees, or make charitable donations. Your siblings also have such happy memories of your aunt, maybe plan a get-together with them to celebrate her life and positive impact.
posted by Iris Gambol at 10:36 AM on September 24, 2022 [6 favorites]


I'd ask your mom to tell your aunt that you've been thinking of her, reminiscing on how she was a second mother to you, that you love her and that you are holding her close in your heart. I wouldn't reference the death plan.

In fact, I'd write a short letter with your memories and love, text it to your mom, and have your mom ask your aunt whether she'd like to have your mom read it to her, so she can hear it in your words if she wants.
posted by fingersandtoes at 10:46 AM on September 24, 2022 [5 favorites]


One thing to consider is that if you haven’t spoken to her in years then the mutual attachment between you is not as strong as you’re feeling right now. Either of you could have broken the prohibition at any time — and your aunt could still choose to do so. If she is not choosing to do so then she may feel that she is satisfied with where your relationship is now. Any late burst of regrets, affection, or anything else will solely benefit you.

If that is the case then ethically speaking honoring her wishes definitely overrides your need to say a few last words.
posted by Tell Me No Lies at 11:28 AM on September 24, 2022 [3 favorites]


The circles of support model might be of use to you here: Only comfort goes inward; seeking of support goes outward.

Aunt, being the one who is dying, is at the centre of this particular circle. She gets to seek support from anybody else she feels able to, and it's not on her to comfort any of them.

Your mother is in the circle that directly touches the centre. Her role, therefore, involves directing only comfort inward toward Aunt, but she's now in a horribly difficult emotional position as a result of that, so she gets to seek support from anybody outside her circle, which apparently includes you. It would have been better if she'd been able to find a way to do that while still honouring Aunt's request for nondisclosure, but to be fair that's actually quite a tricky thing to achieve.

So now you're in your own horribly difficult position, and you're mad at your mother for putting you in it, but there's a really good chance that your mother is every bit as torn up by what Aunt has asked of her as you are, and just really needs your support right now. Neither of you needs to be directing anything back inward within each of your circles but comfort.

The best outcome for Aunt would be to go to her grave believing that her request for privacy via nondisclosure has been honoured. Your mother couldn't bring herself to carry the whole burden of nondisclosure on her own shoulders, so she's pressed you and some siblings and other family members into service as well to support her in at least maintaining Aunt's privacy. Hopefully the resulting two-layered circle can at least preserve Aunt's belief that her privacy is being respected, by behaving as if the only people who know are those whom Aunt told directly.

So the most gracious way that you could possibly behave is to direct only comfort inward to your mother, and seek the support you need - and there will be a lot of that, because this shit is really hard - mostly from outside the second-layer sibling and family-member circle. This will be tricky to do without risking an inward privacy breach, but hopefully your wise choice of an anonymous AskMe that's garnered so many supportive replies will help at least a little bit.

(((you))) <-- internet hugs
posted by flabdablet at 10:09 AM on September 25, 2022 [1 favorite]


OP, I was in your mom's position last week. My own mother had a MAID death and she demanded absolute secrecy, not even her banker or attorney were allowed to know. Only me and her doctor were fully clued in.

In my family, it's just my mom and me, so I had to wear a number of hats; I had to counsel her, reassure her that her decision was an okay one, help her plan things, be the good son / good company as we visited with her and her friends in her final days, and now that she is gone, I have to execute her estate.

I live far away from my mom. I shared her story with my own local circle of trust. Practically, this was not a big deal; none of them are in contact with my mom or my family in any way. Morally, it violated what Mom had wished for, but in order to be there for her I needed to be well supported, so I forgive myself for it.

I saw her say final goodbyes to friends who had no clue about what was going on, and in amongst the other feelings I was very angry at her for this. But I had to trust that she knew best. I felt that if you trust someone to consent to their own death you also have to trust them that they know the specifics of how they want to go about it.

Yesterday her friends confronted me about certain things they'd noticed in her final days, and I confessed to them that she'd had a MAID death. It was not a big deal that I saw. They still attended her memorial and burial.

I don't have anything concrete to offer except to empathize with your mom, and with you. I hope you find peace with this.
posted by Sauce Trough at 12:42 PM on September 25, 2022 [8 favorites]


Sauce Trough, I am sorry you had to go through that in such isolation. I firmly believe that whatever privacy agreements you had in life are nullable upon death, so you are free of any guilt from telling people now. And you are allowed your own support system; telling people who don't know her and have no way of making her departure any different from what she requested is not a privacy foul, especially as this is something also happening TO YOU, not just to her.
posted by Lyn Never at 5:18 PM on September 25, 2022 [4 favorites]


Thanks Lyn Never.

OP, if you would like to talk about this more, or just vent, my memail is open.
posted by Sauce Trough at 6:07 AM on September 26, 2022


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