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Last Updated: Wednesday, 9 November 2005, 11:20 GMT
'I'm scared of how I might die'
By Rachael Buchanan
BBC News medical producer in Oregon

Nora Nicolaidas
Nora Nicolaidas has just months to live
Proposals to allow doctors to help some terminally ill patients to die have been submitted for consideration by the House of Lords.

Lord Joffe's bill is modelled around Oregon's Death with Dignity Act. Since its introduction in 1994 over 200 people have used the law to hasten their death.

Nora Nicolaidas is settling up.

The thought of lying down in a bed helpless, losing my dignity, is my worst fear
Nora Nicolaidas

She has put her house on the market, the childcare she performed for her daughter for the last four years has now passed to a minder, and all her bills are paid.

But it is not her home town of Portland Oregon she is settling accounts with, it's life.

Nora has advanced breast cancer - she was first diagnosed 13 years ago.

She has run through the gamut of treatments but when it spread to her bones and then recently her liver she knew she was in the endgame with the disease.

External symptoms

Nora is 62; a still beautiful Greek woman with a lyrical turn of phrase, she has a delicate bird-like frame but the cancer is forcing itself outwards now.

She is jaundiced from her liver disease which has turned her skin and eyes yellow and her belly is swollen from the tumours.

Nora Nicolaidas and her granddaughter Melina
Nora is enjoying her time with her grandchildren

"I have always been thin," she reflects, "but now I look like I am pregnant, I feel I am pregnant with my death."

In fact, her body is overrun with the disease and she knows that she doesn't have much time left.

The cancer will steadily cause her liver to fail and as it does, she will struggle to eat, the pain she feels daily will increase, more and more of her bodily functions will shut down and in the end even her mind could start to fail.

Nora says that in life she has always been very active, an outdoors person enjoying hiking, camping, skiing.

"The thought of lying down in a bed helpless, losing my dignity, is my worst fear, I didn't know how to handle it."

Alternative option

So, she argues, she is grateful she lives in Oregon and has another option.

This is the option for my family not to see me suffer
Nora Nicolaidas

The state is the only location in the US which permits physician assisted dying.

This is the right for terminally ill patients with just six months to live to be prescribed and to self-administer a fatal dose of barbiturates.

In this way they can choose not to endure the pain, loss of control and loss of dignity that can sometimes accompany the end of life.

"I am not scared of dying," said Nora, "I am scared of how I am going to die."

Sitting in her Portland home with her two grandchildren, 15-month-old Melina and four-year-old Andoni, tearing around the room, Nora exudes an almost joyous serenity and strength that belie the grim inevitability of her situation.

Peace

She ascribes the peace she has achieved with her death to her decision to use Oregon's Death with Dignity Act.

It is not about committing suicide, she argues, but about allowing her to control the manner in which she dies.

"When I realised there was a solution, that I don't have to go through that in the last few weeks and I started the process, a weight was lifted and I felt freer from that day.

"I took extra energy in me and sleep better because the burden of how the last weeks of my life would be, is gone."

She says all her family and friends are supporting her in this choice and it allows her to die peacefully with those she loves around her.

"This is the option for my family not to see me suffer. This is something that is my wish. I want to have a celebration for life and I will do it when I am ready."

Nora's cancer is at such an advanced stage that she probably only has months, maybe just weeks to live.

Drugs ready

Her prescription for 200ml of liquid barbiturate now sits at the pharmacist, waiting for collection.

So how does she square her passion for life with her prescription for death?

"It goes very much together," she argues. "As you go close to death, life gets more precious regardless of how you are.

"The thinner the string of life gets for you the more you hang on to it.

"I choose to go happy and having this option took off the fear and the burden I had of the end coming, because that was pulling me down a lot.

"Now I am free - free to enjoy when my grandchildren come and both run on me, free to hug them.

"To see their smiles is beautiful, it's more beautiful than it was a year ago before I made this decision, its more precious now. I am for life - for good life. And good death."


SEE ALSO
BMA drops euthanasia opposition
30 Jun 05 |  Health

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