Site Map

 

The Leaving Life Questionnaire -- Short Version

 

 
Below are some sample questions from each of the sections of the Full Form. It is not a true short form because many of the areas covered in the Full Form are not sampled.

You might want to check the General Introduction and the LLQ Versions/Section Descriptions before proceeding.

 
 
INTRODUCTION

I.1 Which of the following do you think are good reasons for you to avoid thinking about or planning for D&D:                     

There is a good chance I will die in my sleep.

There are or will be medical or other means to prevent my suffering so there is nothing I need to do except cooperate.

There will be trustworthy professionals or capable relatives to make plans and decisions for me.

I am a person who reacts with strong, long-lasting anxiety or depression, and I would predict I would do so if I continue to explore this subject

I are too afraid, the subject is too distasteful, depressing or morbid.

Other reasons:

 

I.5 If you are going to stop here: Do you think that any of the following could encourage you to continue exploring, now or in the future?

More time to get used to the topic.

Assurance that the physical and emotional suffering of the last stages of life can be reduced to acceptable levels.

Learning a way to reduce the anxiety that make thinking about D&D so difficult.

The availability of emotional support or advice from a professional or a group.

Seeing reports in the media that that our society is allowing people to have more control over their own D&D, if they wish.

More interest in or agreement with the writer's ideas.

A simpler or more inspirational presentation of issues and answers.

Other:

 

1:Your General Ideas about Leaving Life and Where They Came From

The LLQ presents a number of personality characteristics that can affect your response to leaving life. Here is one of them:

1.2 How prone are you to respond to problems or stress with:

        Anxiety

Very ...

Somewhat ...

  Not very ...

Moodiness-Depression

   Very ...

   Somewhat ...

   Not very ...

We know nothing (in the scientific sense of knowing) about what happens after we die. How we deal with this dilemma can affect our approach to D&D:

1.7 What do you do when you must act and you don’t have enough information to make a decision based on evidence:

               I rely on intuition or I listen to my feelings,

     I depend  on God or Fate to show me the way,

  I  rely on an  authority whose advice must be taken on trust,

  I  try to relax and let nature takes its course,

  I  persist in looking for reliable, observable evidence on which to base my decision,

I have these other beliefs that would apply in this situation :

 

1.8 Do you have ideas about D&D that are based on faith in God or in some other authority? For example, what does your faith say about leaving life voluntarily when you are terminally ill and suffering:

 

1.9 Does your faith say that suffering is ennobling or has other positive meaning? Would you be willing to suffer or to encourage others to suffer at the end of life to follow this teaching:

 

1.12 What impressions about D&D did you get when you were growing up from:

 Your family. For example, how did your parents answer your questions about what happens after we die :     

 Your school-,  Sunday-school or college teachers:

 Friends:     

TV, movies, books or other media:

 Funerals or other D&D rituals:

 Personal experience with the D&D of people or animals who were not close to you, such as:  people in the neighborhood, accident scenes, heart attacks or strokes in public, visits to the hospital or doctors’ offices, other situations:

 

1.21 Why do you think that contemplating D&D is so difficult for people-in-general:

     Leaving life is often physically and emotionally painful.

  Leaving life means parting from those we love.

    Most people enjoy living and want it to continue.

     People don’t want to miss anything.

   People are afraid that the afterlife might be a terrible experience that will last forever: God    may not be kind; we may end up in Hell for being bad; we may be able to see what happens on earth after we are gone.

   People don’t talk, think, read or otherwise come in contact with D&D enough to get used to it.

    The fear of death has evolved to become about the strongest instinct there is. This has happened because those with a strong life instinct  tend to survive to reproduce and add more of the genes for this instinct to the gene pool.

 Other reasons:

 

1.22 What do you think keeps people like you from considering D&D as something to plan for:

  The instinctual fear of D&D, plus imagining physical and emotional pain, along with thinking about parting from those I love are too terrible for me think about.

  All kinds of experts – medical, ethical, religious, and scientific – are working on problems related to D&D. If I try to figure things out or plan without their background and training, I’ll just get frustrated and upset.

    Elements crucial to dealing with the problem (for example, what happens after we leave, how to deal with some kinds of physical and emotional pain, including the pain of separation) will always be missing, so what’s the point?

  I am the kind of person who lives in the present.

  I'm too busy with living!

 Other reasons: 

 

2:Your Reactions When Others Leave Life

2.4 What ideas or feelings have you had when someone close to you left life:

       I felt painfully sorry that I would never see the person again. The pain has not gone away.

 

 

       At the time, I felt intensely sorry that I would never see the person again, but the pain has mostly or completely gone away, leaving just the memories.

 

 

       I believed that I would still be able to be in contact with the person, even though he or she was gone.

 

 

       I believed that I would see the person again when I left life.

 

 

 Other thoughts or feelings:

 

 

2.7 (If you have ever been with a person who was leaving life), did you notice any of these processes or changes:

        Preoccupation with physical or emotional pain.

 

 

       Strong interest in spiritual matters, such as the meaning of life and what happens after we leave.

 

 

       Detachment from his physical surroundings and from people.

 

 

       Change in values or opinions.

 

 

       Changes in the way the person responded to or talked with the people around them.

 

 

       Change to the extent that  the person no longer seemed like the person you once knew.

 Other processes or changes:

 

2.11 What suggestions do you have for improvements in the treatment of the person leaving or of the person's survivors:

       Better medication for physical or emotional pain.

 

 

       Better nursing or medical care.

 

 

       Better spiritual counseling.

 

 

       Better psychological counseling.

 

 

       More comfortable or pleasant surroundings.

 

 

       More attention to needs for personal dignity.

 

 

       More opportunity to resolve “unfinished business” with survivors, such as unresolved conflicts or the expression of unspoken feelings of love or respect.

 

 

       An opportunity to review one’s life in order to find meaning in it.

 

 

       Better support for the survivors during or after the time when the person was leaving life. (For example, helping people to know how to act with a person who is suffering or about to leave life, and what to expect during and after the person leaves; helping them to grieve by listening to them express their feelings and memories over and over.)

 Other suggestions for improvements in the treatment of persons who are leaving or their survivors:

 

3: How You Have Been Dealing with D&D("Death and Dying")Up Until Now

3.3 Could any of the following help to reduce your anxiety (about leaving life: 

       ...knowing that I have communicated my wishes about how I want to leave life in a living will or in discussions with my doctor and relatives,

 

 

       ...having in place the means for painless voluntary exit that I can use if necessary,

 

 

       ... reading about people I respect who have had positive life-ending experiences,

 

 

       ...approaching the area gradually; thinking or discussing it in the abstract until I become more use to it,

 

 

       ...being able to stop thinking about D&D when I want to,

 

 

       ...using terms like “leaving life” rather than D&D or “suicide”,

 

 

       ...embracing positive thoughts or imagery about what happens after I leave,

 

 

       ...having beliefs that assure me that I will have a good afterlife.

 Other:

 

3.4 Have you been able to take any of the following recommended concrete steps to plan for your exit from life: 

       I have made a will.

 

 

       I have made a living will with durable power of attorney for health care and have sent copies to my doctor, hospital, lawyer, and executor.   

 

 

       I have discussed the wishes expressed in my living will with my doctor and with spouse, partner or close friend.

3.5 If you have not, what has kept you from doing the above things: 

       I do not know how to do any of the above things and don’t know whom to consult to find out.

 

       I don’t have the money to consult an attorney.

 

 

       This kind of planning upsets me because it means facing the fact that someday I will leave.

 

 

       I don’t have the energy.

 

 

       There is no encouragement from others; no one I know has bothered with these things.

 

 

       I am too busy now, but I’ll do it sometime in the future.

 

 

       Discussing these things with my relatives would upset them.

 

 

3.8 Have there been times when you acted as though you wanted to leave life, but really didn’t want to or at least weren’t sure? If so, were any of the following part of the situation:

       I was trying to express my desperation in the strongest possible way.

 

 

       I wanted to punish myself for being a bad or worthless person by imagining or taking steps towards hurting myself.

 

 

       I was angry at certain people or the world and wanted to show them what they had driven me to.

 

 

       I needed help or sympathetic attention from other people.

 

 

       I could no longer be responsible for myself and needed to force others to take charge of me.

 

 

       I believed that God wanted me to end my life.

 

 

       I believed my leaving would benefit those I care about.

 

 

       I believed that my leaving would benefit mankind, perhaps by publicizing a cause or by exerting political power.

  Other reasons:

 

4: Very Old Age

4.2 How you would feel and act if the doctor told you had six months to live? Which of these descriptions would apply to you:

       I would fight on until the last breath.

 

 

       I would want things to be over as quickly as possible.

 

 

       At first I would be shocked and upset, but I would pull myself together and do the best I could for myself and those around me.

 

 

       I would try to remain calm so as not to upset others or drive them away, but I would be terrified inside.

 

 

       I would be overwhelmed with fear and would need a great deal of help from those around me to get through whatever followed.

 

 

       I would be a very bad patient, continually upset or angry, irritable and complaining.

 

 

       I would use the same problem-solving skills that have served me well throughout my life. I would set goals and figure out how best to reach them.

 

 

       It is impossible for me (and probably others) to predict how I would react.

 Other reactions:

 

There are several personality traits that could affect your ability to deal with Very Old Age. Here is one:

4.3 Which of these apply to your ability to experience pleasure:

       I think that I am pretty easy to please. I get pleasure from many activities, including those that  do not require mobility, strength, agility or a lot of energy.

 

 

       My capacity for enjoyment seems to be about average. My feelings of well-being do depend somewhat on activities which require some mobility, strength, agility or energy, such as sports, travel, or active expressive activity such as music performance, dance, painting or acting. So, I am not sure whether I would be able to give up or substitute for these activities without significant suffering or frustration

 

 

       My pleasure threshold seems high. I get pleasure only from certain activities which have a high intensity of stimulation and require physical abilities that I probably won’t have when I am Very Old.

4.6 Why do you think that so many Very Old people seem to put up with a quality of life that appears to be so low -- or at least much lower than it used to be:

       They have no choice but to do so because there are too many obstacles to improving their lives or to leaving it.

 

 

       Many are really suffering but don't want to push others away by asking for help, or by complaining or acting depressed.

 

 

       Many are suffering but are too weak to take the steps necessary to leave life or to do anything else about it.

 

 

       The losses of function, pleasure and feelings of accomplishment happen so gradually that they get used to them.

 

 

       They find things to do that seem boring or meaningless to younger people but which give Very Old people pleasure.

 

 

       They adjust their expectations to correspond to what is possible.

 

       They learn to live more in the present without comparing their lives to those of younger people or to their younger selves.

 

  Some Very Old people are simply continuing to show the emotional sturdiness that they have       inherited or developed earlier in their lives.

 Other reasons:

 

4.9 Use this scale to describe your reaction to restrictions in the activities or abilities listed below:

OK=Loss or reduction would pose little or no problem; 

Bad=Loss or reduction would be quite painful.

?=Not sure

 Abilities

Having sex

Having an active intellectual life

 Doing useful work

 Being involved in the arts

 Engaging in sports or exercise

 Being able to move around without help

 Being able to travel

Being in charge or control of:

 My money

 What I do everyday

 My eating

 Bathing and going to the toilet

 What I wear.

 

4.10 If you were to wake up tomorrow and find that you were permanently bedridden, what steps would you take to make life bearable:

 

5: Quality of Life ("QOL") and Suffering

5.4 How much of the time do you feel good about the way things are going, because you are accomplishing things, because you are having a good time, or because you making progress towards improving your QOL: 

       Almost every day

       Most days

       Some days

       Very few days

       Almost never

       I take life a day at a time and don’t look back.

 

5.6 When you look over the list (of your responses to questions about specific aspects of suffering), would you say that your overall level of suffering is: 

       Acceptable, easily tolerated,

       Somewhere between “acceptable” and “tolerable”

       Tolerable; that is,  not ideal, but acceptable,

       Somewhere between “tolerable” and “barely tolerable”,

       Barely tolerable, barely acceptable,

       Not tolerable, but I have no choice but to accept it

 

5.7 What would other people say about your of your QOL or level of suffering? Would they wonder how you can stand it? Would they think you are doing OK or as well as anyone could expect? Would they think you were doing well compared to others like yourself? Would they think you were lucky and envy you? Would these opinions make a difference to you:

 

5.11 Let's say that you were in physical or psychological pain that was not going to get better. There is no hope of a cure. You have concluded that you could not adapt to the pain, and you could find no meaning in your suffering. You were not doing anyone any good by continuing to live. Would you consider leaving:

       ... if you could leave life painlessly and  it was acceptable to your family and to society to do so;

 

 

       ... if the above were true and you were paid to do so;

 

 

       ... if the above were true and your leaving would be contribute to society, say, by  participation in medical research;

 

 

       ... if you received help in dealing with unfinished business such as unresolved conflicts or other negative feelings between you and those you love.

 

 

       ...if the people around you agreed, however reluctantly, that your leaving would be the best thing,

   
  Other:

 

5.14 Have you ever known a person that you believed would be better off permanently asleep? Have you ever wished that the life of a person who appeared to be suffering terribly would end:

 

5.16 Which of these groups do you think should be offered the means to leave life:

       Terminally ill people,

 

 

       Those with intractable physical pain,

 

 

       Those with intractable psychological pain,

 

 

       Prisoners,

 

 

       Prisoners serving life sentences,

 

 

       People who are starving,

 

 

       Nursing home residents,

 

 

       Handicapped or disfigured people,

 

 

       Anyone who asks.

Anyone else?

 

5.17 Especially if you checked “Anyone who asks”: What safeguards do you think should be put in place:

        We should  make sure that the person is rational and not suffering from a mental disturbance.

 

       We should make sure that the person is not being pressured to leave by greedy relatives or an unjust social system that restricts him to a low QOL.

 

 

       We should make sure that the person goes through a process of decision-making with a professional who checks and challenges every step.

 

 

       There should be a short waiting period (less than two weeks) to allow the person to change his mind.

 

 

       There should be a longer waiting period to see whether the person could adapt to his situation.

 

 

       Anyone who asks should be helped to leave. Everyone has the right to choose.

 

 

       Anyone who asks should be helped to leave because it will save resources and help deal with the problems of overpopulation.

   
  Other conditions:

 

5.18 Which of the following do you think are good reasons for not offering people the opportunity to leave life voluntarily, because making this opportunity available would: 

       ... lead to an increase in the number of people leaving that would continually remind us of our own mortality,

 

 

       ... force us to make uncomfortable and complicated decisions about when we or other people who are suffering should consider leaving life,

 

 

       ... deprive  people of the opportunity to grow spiritually or to find meaning in their suffering,

 

 

       ... create the need for people who would help others to leave life,  a class of professional murderers

 

 

       ... lead to abuses, such as trying to convince people whose care is inconvenient or expensive that their lives are no longer worth living.

   
 

 Other:

 

6:The Effects of Your Leaving on Others

6.1 Perhaps you don’t believe that a person’s worth to society should ever have any bearing on whether or not he leaves life. If this is so, you can indicate the reasons that you think this way, and then you can skip to the next section:

       People are created equal under God.

 

 

       The Constitution of the United States defines people as equal.

 

 

       Except for extreme cases (saints and serial killers), there will always be strong disagreement on how much a given person is worth, so there is no point in anyone trying to make this the basis of an important decision until we all agree on how to make this assessment.

 

 

       Differentiating people on the basis of overall worth will create a unique source of unhappiness for those lowest on the scale, such as welfare cases, removing the possibility of their saying, “Well, at least I am worth something just because I am trying.” 

 

 

       Differentiating people on the basis of overall worth will increase social division and tension by creating another group of “have’s” and “have not’s”.

 

 

 

6.2 Think back over your life. What things have you done that have had an especially positive or negative impact on others:

 

6.5 If the earth were going to be destroyed, and there were a spaceship that could allow only a small number of the most useful people to escape, where on the list do you think you would be and why:

 

6.6 What do you conclude from your responses to the preceding questions: 

       I think the question is meaningless because everyone has enough intrinsic worth to give them a right to life that is equal to everyone else’s.

 

 

       There are other things that are much more important to consider when deciding whether to leave or not than personal worth... unless your worth is extremely high or very negative.

 

 

       I am not sure about how much I am worth to the people around me or to society. I am not sure to whom to compare myself or what standard to use.

 

 

       I am not sure about how my worth to the people around me or to society should affect what I think about leaving.

 

 

       I think that I am important enough to the people around me or to society that I should stay, if at all possible.

 

 

       I do not think that my worth to those around me or to society should prevent my leaving, if my level of suffering is unacceptable to me.

 

 

  Other conclusions:

 

6.10  How would those you care about respond to your leaving voluntarily:

       They would believe I had committed a religious sin and condemn me.

 

 

       They would believe I had sinned but would try to forgive me

 

 

       They would believe I had done the wrong thing because of the pain it caused them, and they would be hurt or angry at me.

 

 

       They would stop caring about me; my memory would be tarnished.

 

 

       Although there would be strong negative reactions at first, these would die down, to be replaced by some sympathy and understanding.

 

 

       The main feeling they would have is sorrow when they realized how bad my life must have been to drive me to leave them voluntarily.

 

 

       The people I care about would understand and agree with my decision “with a heavy heart”, perhaps because we have discussed leaving as a hypothetical or real possibility.

   
 

 Other:

   

 

6.14 Which of these additional factors could influence your ideas and feelings about leaving: 

       Being convinced that my value to family, friends and society is higher than my current estimate.

 

 

       Being convinced that my assessment of my current QOL or level of suffering is too negative or pessimistic.

 

 

       Having some hope that my physical or emotional problems are not hopeless, or that the  conditions outside myself causing my suffering can be changed or avoided.

 

 

       Having permission from others that it would be OK for me to leave when I want to or under certain circumstances,

 

 

       Having permission from society that it is OK to leave when I want or under certain circumstances,

 

 

       The availability of a pain- and anxiety-free means to leave,

 

 

       The availability of a way to make my leaving useful or financially rewarding,

 

 

       The availability of a way that I can live on through some kind of tangible memorial,

 

 

       The availability of more knowledge about what it is like to be dead.

 Other:

 

7:Other Factors Affecting the Decision to Leave Life

After leaving life, what?

7.1 What belief or image do you have of leaving life and of what might happen afterwards: