Monday, October 8, 2012

Death with Dignity

Seneca the Younger committing
suicide with the help of his friends,
A.D. 65 (Luca Giordano, 1684)
Next month Massachusetts voters will decide whether to allow "Death with Dignity," aka physician-assisted suicide. If a majority vote yes, Massachusetts will become the fourth state (after Oregon, Washington, and Montana) to allow a licensed physician "to prescribe medication, at the request of a terminally-ill patient meeting certain conditions, to end that person’s life."

Father Tadeusz Pacholczyk, a Catholic priest and fierce right-to-lifer who weighed in on the issue in yesterday's Wall Street Journal, plans to vote no.

In "Please Step Back from the Assisted Suicide Ledge," Pacholczyk argues that physicians who provided lethal medications would destroy public trust as surely as policemen who provided guns or lifeguards who provided millstones (millstones?) to despondent people. He then offers two anecdotes: one about a woman who felt betrayed by her grandparents' joint suicide (they did not have a terminal illness, and their deaths were not physician assisted, so her story does not apply), and the other about a friend with multiple sclerosis who is glad he's still alive to enjoy his grandchildren (nobody is suggesting that PAS be mandatory, for Pete's sake, so this story doesn't apply either).

Father Pacholczyk makes me embarrassed to admit that I too would vote No.

I'm not going to make an argument here. I'll just point out that, when it comes to dying, there are more than two or three choices. Some people believe dying people should be kept alive for as long as medically possible, no matter how they or their families feel about it, no matter how much suffering is involved. Other people believe that, in extreme cases, doctors should have the right to administer lethal drugs to dying patients (euthanasia). Physician-assisted suicide lies between these two positions. So do hospice care, palliative care, and other dignified alternatives to either prolonging suffering, on the one hand, or causing death, on the other.

I believe that a lot of people support physician-assisted suicide or euthanasia because they fear they have only one alternative--to be kept alive for days, weeks, months, or even years of misery through painful interventions. Extremism breeds extremism. There are other approaches to terminal illness, however, as Bill Keller's excellent article in Sunday's New York Times points out. Last month Keller's father-in-law, Anthony Gilbey, died in a U.K. hospital of inoperable cancer. In "How to Die," Keller describes the older man's six-day dying process and the decisions--personal, medical, and political--that made his death dignified, loving, and peaceful. "We should all die so well," Keller concludes.

The approach used with Mr Gilbey, the Liverpool Care Pathway, doesn't appeal to extremists on either side, says Keller. "'Pro-life' lobbyists ... portray it as a back-door form of euthanasia.... Euthanasia advocates ... say it isn’t euthanasia-like enough." It is, however, realistic, compassionate, family oriented, spiritually sensitive, and sensible. It allowed Mr Gilbey to die at peace with God and his family, knowing he was loved.

The Liverpool Care Pathway is the standard approach "in most British hospitals and in several other countries [where, by the way, assisted suicide is illegal] — but not ours," writes Keller. "When I asked one American end-of-life specialist what chance he saw that something of the kind could be replicated here, the answer was immediate: 'Zero.'"

Learn more about how we Americans could choose to die with dignity, if only we were willing to give up our politically exacerbated extremism. Read Bill Keller's moving (and short) article. Click here.

1 comment: said...

I do not want a good doctor; I would prefer a good vet. I want my treatment discussions to include my quality of life with/without treatment, the cost of treatment, level of discomfort with/without treatment, life expectancy with/without without treatment (plus the quality of the extra time), side effects of treatment, and even euthanasia and it's timing.