Zoe Fitzgerald Carter was living in Berkeley with her husband and two daughters when her mother began to call from Washington DC to talk about ending her life.  Carter’s mother, Margaret, a vivacious, intelligent woman, was suffering from Parkinson’s and a host of other ailments and could no longer stand the pain. She wanted to take charge of her life – and her death – by committing suicide.

But Margaret wanted the help of Carter and her two sisters, and that request, and all its ramifications are the subject of Carter’s moving memoir, Imperfect Endings: A Daughter’s Tale of Life and Death. Published just last week by Simon and Schuster, Imperfect Endings is already provoking discussion about filial loyalty, love, and assisted suicide. The book was excerpted in “O” Oprah Winfrey’s magazine, was praised in the New York Times’ Health Blog, and was picked as one of Barnes & Noble’s ‘Discover Great New Writers” books for 2010.

Carter will be appearing at Books, Inc. on Fourth Street in Berkeley at 3 pm on Sunday March 7; at 7 pm March 11 at Book Passage in Corte Madera, and at 7 pm March 18 at Read Books in Danville. In anticipation of her Berkeley appearance, Berkeleyside posed a few questions to Carter.

When your mother first started to raise the question of killing herself, did
you take her seriously? How long was it before you believed she truly wanted
to end her life? How long before you could accept her decision?

My mother started talking about ending her life eighteen months before she did it, and I did not take her seriously at first. I understood that she was worried about where her Parkinson’s disease was taking her, but I did not think she would kill herself.

It wasn’t until she got a prescription for a lethal dose of Seconal, and arranged to meet a member of the Hemlock Society’s “Caring Friends” network, that I began to understand how determined she was. Accepting her decision was a lot harder. I think it happened in increments but it wasn’t until about two weeks before she started her final fast that I gave her my overt support. I realized I had to get my own needs and desires out of the equation.

Do you think your mother knew how difficult her decision would be for you
and your sisters, particularly as helping her could put you at legal risk?

Or were her pain and discomfort so bad she could not think beyond that?

I think my mother was so caught up in the “how and when “of her death that it was difficult for her to focus on how my sisters and I felt about it. She had a tendency to call us up in the middle of the day and casually ask: “How would May first be for me to kill myself?” It drove me a little crazy, frankly.

On the other hand, she chose to end her life by fasting so we could be there with her without legal risk. (It is not illegal to witness a suicide, only to participate in it.) That was a very selfless choice.

But then – just to make things complicated — when the fast wasn’t progressing quickly enough, she took a large amount of morphine. Although she survived it and lived three more days, I found this really upsetting. It raised some very potent issues about the psychic and even moral meaning of participating in someone’s death. I don’t think we can gloss over that part.

Your book raises the question of loyalty. To whom do we owe it? Did you
think part of being a good daughter was helping your mother die?

I think this is one of the key questions in the book. I really struggled with what it meant to be a “good daughter” – help my mother kill herself, or talk her out of it. One of the reasons I wrote the book was to revisit this dilemma and try to understand it better.

After having helped your mother hasten her death, do you think assisted
suicide should be legalized? What problems would it solve? What issues might
it raise?

I do think it should be legal, despite feeling that assisted suicide is tough on families and loved ones. At this point, physician assisted suicide is only legal in Oregon and Washington although Montana just passed a similar law.

One of the advantages of making assisted suicide legal is that these laws lay out very specific guidelines and regulations. I’m not sure about Montana, but in Oregon and Washington, two doctors have to determine that the person has less than six months left to live and there is a two-week waiting period.

There are other stipulations as well: for example, doctors can request that patients get evaluated by a psychiatrist. Obviously, you do not want people getting doctors to help them to die if they are only depressed or in crisis.

Some people worry that certain groups might feel pressure to end their lives if assisted suicide is legal, but if you look at the states where it is legal, not that many people take advantage of it. And the upside is enormous. People like my mother, who are in their right mind and want to die, can get help and support from a medical professional, and their family members are not forced to negotiate what can feel like a Sophie’s Choice between watching their loved ones suffer and entering the murky, guilt-producing world of “hastened death.”

How have you talked to your two daughters about their grandmother’s death? What is their reaction?

I talked to both my girls about it before the book came out. They did not have any idea that my mother hadn’t died naturally so it was a surprise to them. Although they were both in D.C. with my mother during the last two weeks of her life, they were only four and eight at the time and I didn’t think it was right to burden them with that knowledge. It would have been confusing.

They’re 13 and 17 now and have both read the book and liked it.  We’ve talked a lot about the importance of preserving our own memories of my mother and how the book is just a small slice of all that happened and all we felt about her.

Ten years after your mother’s death, do you think she did she do the right thing?

I think she did what she needed to do and I admire her strong-mindedness. She was absolutely fearless and unblinking at the end. But I don’t think there is ever a right or wrong in these situations. Everyone does the best they can under really complicated circumstances.

Frances Dinkelspiel

Frances Dinkelspiel (co-founder) is a journalist and author. Her first book, Towers of Gold: How One Jewish Immigrant Named Isaias Hellman Created California,...

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  1. I am the care partner to my youngest brother who has young onset Parkinson Disease, he is only 44 now. We moved him here to Berkeley four years ago when he had to give up working to support himself.
    Parkinson Disease is poorly understood by most people, even the social security definition for disability purposes is 20 years outdated and does not come close to described how this disease affect ability to work much less daily living.

    Young onset is often more complicated than the decline of elders suffering with the disease, which is hard to fathom considering PD is described as the “suffering” disease. Since folks with PD generally stay as active as possible to remedy the disease, it is easy for the unformed to underestimate how profound the disease is.

    I have had a tough time adjusting to this tragedy, I do not know how I will find the presence of mind and strength to support my brother when/ if this inevitable decision arises. He has already talked about it many times. He is amazingly courageous.

    The majority of people with PD experience psychiatric problems associated with the brain disorder (organic, not situational) so depression and anxiety are common. Dementia, delusions and hallucinations are side effects of the medications required in PD treatment. It is impossible to separate the mental disorders from the motor disorders, which would be difficult to form a legal medical judgment under the Oregon rules as written.

    Lastly I would like to share how angry I am about the lack of regulations of environmental toxins, which are the likely trigger to neuro-degenative disorders. We grew up below one of LA super fund clean-up sites, the BKK dump. It was built on the mesa above the water table. I experience the anger when I have to engage in months long battles to advocate for his benefits, disability, housing, and medical care. He could not do any of this himself, and without my work he would be on the street. The time I have to spend advocating for basic needs is unbelievable. If any of you meet folks in need, the Homeless Action Center does could advocacy support services. I was able to use the internet to inform myself to push ahead and succeed (mostly).