Along with raising three sons, Ruth Hayden Wanzer held executive positions in the business world and “was steadfast in her opinions,” her son Dr. Sidney H. Wanzer wrote.
Among her strongly held beliefs, he added, was “that she didn’t want her death prolonged if she became physically or mentally disabled and could no longer live a meaningful, satisfying life.”
And so he was furious when his mother’s doctor ignored her living will, didn’t consult with her family, and installed a pacemaker when she was 92 and severely incapacitated with Alzheimer’s disease.
“My mother lived an additional five years in a helpless, debilitated state lacking all dignity, totally contrary to her written request,” he said in his 2007 book “To Die Well,” which recounts his own work advocating for patient choice at the end of life and offers advice on how to ensure that one’s wishes are followed.
Dr. Wanzer, the lead author on two ground-breaking major medical journal articles supporting the ethics of physician-assisted death for “the hopelessly ill,” was 93 when he died March 28 in Portsmouth Regional Hospital in New Hampshire.
At the end, he opted for palliative care when it was clear further medical steps would not significantly address a pancreatitis diagnosis and his failing health.
“He was a hero of mine and I was a great fan of his work,” said Dr. Marcia Angell, former editor-in-chief of the New England Journal of Medicine, in which Dr. Wanzer published two articles, both titled “The Physician’s Responsibility toward Hopelessly Ill Patients,” in 1984 and 1989.
“He was a pioneer,” Angell said. “He came out very early for something that people were hesitant to come out for in those days. I salute him for that.”
For the 1984 article, Dr. Wanzer assembled a group of highly regarded coauthors. They described policies physicians could follow in “withdrawing life-sustaining procedures from hopelessly ill patients.”
“The idea was that if a group of prominent physicians took the lead in suggesting what is possible, that these principles might become accepted among the general physician population,” Dr. Wanzer told the Globe in 1984.
By then he was well-versed in the subject, having worked to help enact in Massachusetts a “living will” statute that allowed patients to put in writing their binding instructions about when doctors should withhold life-sustaining measures.
“In my generation of physicians, few of our teachers ever discussed the rightness of doing nothing,” he told the Globe in 1980, when the state’s Catholic bishops were opposing the legislation. “I’m convinced the average person desires the ability to make statements about life-sustaining treatment in as binding a way as possible.”
Dr. Wanzer knew, however, that many physicians would join some religious denominations and many activists in opposing right-to-die measures.
“One of the most basic precepts of our training is that the physician should attempt to extend life. As long as the possibilities of modern technology were not available, this fundamental guideline worked well almost always, since it was seldom possible for the physician to extend life beyond what the patient would want. Nature would intervene,” he wrote in a 1989 Globe opinion piece, a few months after publishing the second New England Journal of Medicine article — again with a list of distinguished coauthors.
“Now, nature’s intervention can be staved off, and the physician must more consciously address the question of whether any given intervention is truly in the interests of the patient,” he wrote. “When it is not, the physician needs to change the goal of treatment and devote his efforts instead to the creation of a peaceful situation for dying.”
Sidney Hovey Wanzer was born in Charlotte, N.C., on Dec. 27, 1929, and grew up there, the youngest of three siblings.
His father, Charles T. Wanzer, was an engineer and vice president of a utility now known as Duke Energy. His mother, Ruth, was politically progressive and “brooked no nonsense from anyone,” Dr. Wanzer wrote “To Die Well: Your Right to Comfort, Calm, and Choice in the Last Days of Life,” coauthored with Dr. Joseph Glenmullen.
A violinist from age 9, Dr. Wanzer had a union card and played with a dance orchestra at a country club during high school, before he attended Duke University, where he graduated with a bachelor’s degree. He received a medical degree from Duke University School of Medicine.
Dr. Wanzer served in the Army, stationed in Guam as a physician, and did his residency at Peter Bent Brigham Hospital in Boston.
While there he met Anne Backus, who was working at the hospital for the head of public relations.
A violist, she later played with the Concord Orchestra and helped run the used books store Books With a Past in Concord, where she and her husband lived for decades until moving to RiverWoods in Exeter, N.H.
“He did not want to stay in academic medicine,” she said of Dr. Wanzer’s decision to launch a private practice in Concord and become affiliated with Emerson Hospital. “He loved practicing community medicine and treating the whole person.”
Dr. Wanzer “was the kind of doctor who would drop what he was doing and make a house call,” said his son Stephen of Portland, Maine. “He felt there was no greater honor than to have a person invite him into their house when they were sick.”
After nearly 30 years of private practice, Dr. Wanzer worked for Harvard University Health Services, where many of his patients were students and Harvard Law School faculty.
Dr. Wanzer “was a gentle man and he wanted to make the world a better place,” said his son Charles of East Montpelier, Vt. “While doing that, he wanted to understand humans and help them in their lives.”
“He was always trying to improve the situation, whatever it was,” said Mary Adelstein. She and her husband, Dr. Jim Adelstein, the Paul C. Cabot distinguished professor of medical biophysics, emeritus, at Harvard Medical School, were among Dr. Wanzer’s closest friends.
Along with serving on the board of the Society for The Right to Die, Dr. Wanzer formerly worked with the publications committee of the International Physicians for the Prevention of Nuclear War, which was awarded the Nobel Peace Prize in 1985.
Improving the lives of others, especially at the end, informed his ground-breaking work on physician-assisted death, which he believed should always include many conversations among those involved.
“He wanted to talk more about the patient’s responsibility and the family’s responsibility and the physician’s responsibility,” Jim Adelstein said.
The family held a private service for Dr. Wanzer, who in addition to his wife, Anne, and sons Stephen and Charles leaves another son, Timothy of Littleton, and six grandchildren.
A peaceful death, Dr. Wanzer wrote in the 1989 Globe piece, “allows the patient to maintain control and dignity, free from the intrusion of unwanted and inappropriate technology. Only in these circumstances can the patient and family endure a death with peace.”
In his final days, “he had, himself, the death that was his philosophy completely,” his son Stephen said.
A few years ago, Dr. Wanzer gave his violin to his granddaughter Sophie. A college senior, she joined other family members in his final hours as they filled his hospital room, where she played violin.
Bryan Marquard can be reached at bryan.marquard@globe.com.