Brittany Maynard is going to die on Nov. 1. That's her plan, her choice.
And with that decision, the 29-year-old West Coast woman has ignited a national discussion about the end of life.
Her story is wrenchingly sad. Maynard is terminally ill, diagnosed on New Year's Day with brain cancer. After a pair of unsuccessful surgeries to stop the tumor's growth, she learned in April it had become even more aggressive and was told she had six months left. She and her husband, Dan Diaz, had been trying to start a family.
With no effective treatments, worsening symptoms and the likelihood that her final weeks would bring intolerable pain and devastating mental changes, Maynard and Diaz moved from California to Oregon, one of three states that have death-with-dignity laws.
Now she has the pills to end her life and intends to take them, on a day of her choosing, in her own bedroom, family at her side.
"I do not want to die. But I am dying," Maynard wrote in an essay on CNN.com. "And I want to die on my own terms."
That's what many of us want -- a say in how we die, just as we chose how to live. Sometimes, that's hard to achieve. Many elderly patients yearn to spend their final days at home, only to be chained to nursing homes by an inscrutable health care system.
Many times, we want our loved ones to keep living more than they want to. When the time is right to let go -- and how -- will become more of an issue as America ages.
How do we really know when it's the end? What about the patient who was given four months and lived three years? Or the person who didn't make it to the projected date?
I'd want to live up to the last shred of quality of life -- pain and debilitation be damned, as long as I can be with my family. Not believing in an afterlife makes that easy to say, though the thought itself is terrifying. But I also acknowledge that's what I think now, as a relatively healthy middle-aged person.
That's not what Maynard is. Her age and her poise are poignant. A video featuring her and her family posted on YouTube is profoundly moving.
She talks about living her life as fully as she can. She's traveled to Yellowstone National Park and Alaska, and hopes to make it to the Grand Canyon. "Seize the day," she says. "What's important to you? . . . Pursue that, forget the rest."
She also talks about moving to Oregon and receiving the life-ending drugs after meeting conditions laid out in legislation passed in 1997. The state's Death with Dignity Act says you must be 18 or older, certified as terminally ill by two doctors, orally request the drugs on two occasions, and not suffer from depression. And you must take the drugs yourself. No help allowed. Washington and Vermont have similar policies.
Oregon records show 1,173 people have received prescriptions for lethal drugs under the program and 752 patients ingested them. The median age of those who died: 71. Only six were younger than 34.
Maynard is now an advocate for death-with-dignity laws. Several states are considering such legislation. Oregon is an experiment to study closely.
This much seems clear: There must be defined procedures, the patient must have a terminal illness, his or her mental competence cannot be an issue and there can be no external pressure on the patient choosing to die.
Ironically, Maynard in a way has done that to herself by setting a date. Now people are anticipating Nov. 1.
But no one should say a word if she wakes up, decides it's a wonderful morning, and keeps the pills in her pocket one more day.
Michael Dobie is a member of the Newsday editorial board.