The Mercy of Choice
A reflection on autonomy, mercy, and the quiet right to decide when enough is enough.
When the Body Speaks in Uncertainty
Lately, I have been thinking more about my body and its quiet language. The flutters that come and go. The lab numbers that live outside the range of normal. The fatigue that sometimes feels older than I am. It isn’t terminal, at least not that I know of, but it has invited me into a new kind of awareness. The kind that lives somewhere between vigilance and surrender. Surrender, historically, has not been a comfortable space for me; yet, I am noticing in this moment that it is where my spirit wants to live. Yet, residing in this space makes me really think about how much control any of us ever really have over our endings.
Over the last few months, I have often imagined being told that my time here was coming to an end sooner rather than later. I pictured the stillness that might follow those words, the way sound falls away after a bell rings. I wonder what peace could feel like if I were allowed to decide when the pain had gone on long enough. I imagine the room where I would want to take my last breath. The incense I would light. The hands I would want nearby. The sky outside the window shifting through its colors. I imagine an ending shaped by intention rather than circumstance, a closing that feels like a true act of love.
Working in death and grief means living in constant conversation with what people hope for at the end. So many of them do not want to die. They simply want to stop suffering. They want to rest inside their own dignity. They want to know that when the time comes, their body will be allowed to stop fighting.
The Sacredness of Choice
Medical Aid in Dying is one of the few legal ways to offer that mercy. It is available only in a few states in the US, but wherever it exists, it opens a door that has been locked for too long. It allows a terminally ill, mentally capable adult to request and receive medication they can take on their own terms, in their own space, when they decide their body is ready to rest. The process is careful, guided by physicians, and filled with safeguards. Yet beneath the legal language is something far more human: the acknowledgment that a person’s final act can still belong to them.
I have sat beside people who wished for this option but did not have it. They asked for release, but the law kept them waiting. I have watched the way pain reshapes time. Hours turn into lifetimes. A day can feel like a mountain that cannot be climbed. In those moments, choice itself feels like a kind of grace. The ability to say, “I am ready,” and to have that readiness honored, is not an attempt to escape life. It is a way of honoring it all the way to the end.
When people speak about death with dignity, they often imagine control, but what I have seen is tenderness. The tenderness of a family gathered close. The tenderness of someone choosing the clothes they will wear or the music that will fill the room. The tenderness of planning a goodbye that feels personal, sacred, and kind. Choice brings intimacy back to a process that has been stripped of it. It gives space for conversation and preparation. It reminds everyone involved that death is not some failure or a crime to be hidden. It is a continuation of the story of living.
A silent trust forms when we accept this truth. Trust in the person dying, trust in their loved ones, trust that compassion is wiser than fear. I have learned that this trust is not easily given in a culture that sees death as something to resist at all costs. Yet resistance has its own violence. It pulls the dying away from their own agency and from the peace that could have been possible. To me, mercy feels like a return. A remembering that the body belongs to the one who has lived inside it.
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Mercy and the Law
There is something profoundly spiritual about the idea that we might get to choose our final moment. A final offering to ourselves and those we leave behind. It asks nothing of belief, only of compassion. When someone chooses to die through medical aid, they are completing their story with intention. They are giving their loved ones a memory that is rooted in peace rather than panic. They are teaching us how to listen when a soul says it is ready to go home.
Dying well is part of living well. It is an art of presence, of awareness, of surrender that is not passive. It is an opening. When I imagine the way I would like to die, I see light through a window and the sound of wind through trees. I see my animals sleeping nearby. I see the faces of those I love unafraid. I want them to know that it is all right. I want them to feel that my leaving is not an absence, but a soft return to something greater.
A World That Leaves Some Behind
There is a part of this conversation that I cannot let rest. Medical Aid in Dying, as it exists now, excludes many of the people who might need it most.
For those living with dementia or Alzheimer’s, the option is unavailable. The law requires a person to have a terminal diagnosis and to be mentally capable of making the decision. By the time dementia or Alzheimer’s reach their later stages, that capacity is gone, and the law will not honor a choice made in advance.
It breaks something inside me each time I witness this reality. I have sat with families who watch a loved one fade by degrees. Their person is still breathing, but the self they knew has already slipped away. The law does not consider that as dying, even when the spirit already has one foot beyond this world. It asks people to hold on through years of confusion, fear, and loss of self, without the mercy of choice.
There is a cruelty in pretending this is compassion. We preserve bodies long after the person inside has disappeared, as if memory alone could hold their humanity together. The current laws were written to protect, but in doing so, they overlook those who can no longer advocate for themselves. It is a disservice to call that protection when it denies the very autonomy that defines our humanity.
I do not have the answer for how to fix this. I only know that a society that values both life and dignity must find a way to honor choice even when the mind begins to unravel. I dream of a time when living wills can truly speak for the self that once was clear, when compassion stretches wide enough to include those who can no longer name their own pain.
Returning to Peace
Each time I write about this work, I return to the same question: what does mercy look like in action? It looks like listening to a person’s truth, even when it makes us uncomfortable. It looks like trusting them to know when they are ready. It looks like acknowledging that choice is a sacred part of being human.
When I sit with that truth, I feel calm. I do not know how my own story will end. None of us does. But I hope when the time comes, the people I love will know that I have lived my way toward peace.
Love today,
Heather 🌸
Where Medical Aid in Dying is Legal
As of 2025, Medical Aid in Dying is legal in:
California
Colorado
Hawaii
Maine
Montana
New Jersey
New Mexico
Oregon
Vermont
Washington
Washington, D.C.
Delaware (the most recent state to pass its law in 2025)
To learn more about the process and current legislation in your state, visit: