I live in Oregon so I can legally request the
Death With Dignity option
at the time I deem appropriate if I choose, so I’ve thought about what medical treatments and interventions I would or wouldn’t accept and how I would want to die if this or that happens to my body and/or mind, whenever it happens.
I’ve been involved with this issue long enough (see article)– I was a hospice volunteer off and on for over 20 years, I’ve sat with numerous people and their families as they lay dying, I’ve been a caregiver and a counselor to the dying, I had a near-death experience 40 years ago (see article)– and I understand more about death and dying than most people who try not to think about it at all.
Most folks have opinions related to self-preservation, love of family and their life, or religious dogma, but a narrow perspective of the whole issue. So I’m just going to think out loud here to give others some food for thought… with the caveat that you continue this conversation with someone immediately after reading this and get to work on your own Advanced Healthcare Directive.
I’m 70+ so there’s that. Having seen first hand and studied what happens to the body and the mind of the majority of people as they age, I acknowledge my personal limits. Knowing my body and what I’ve done to it and for it, I’m hoping to live healthy to at least 75 but no longer than 80. Closer to 75, more likely. Beyond 80 things seem to fall apart more rapidly and sitting in front of a TV all day in an assisted living home with a bunch of other half comatose people is not something I could take for more than a minute. Lying in a hospital bed staring at the ceiling with no hope of ever getting up again would be intolerable.
Now I know there are some 90-year olds still driving and playing golf or milking the cows and tilling the fields, but that’s not me. There are also some 60-year old, overweight couch potatoes, who can hardly walk from the couch to the refrigerator any more.They’re on multiple medications with multiple side effects and are mostly miserable most of the time.
One’s past habits and lifestyle have a lot to say about how fit we will be in our old age, and we should be aware of our genes and our base lines so we can keep track of our physical health as we age. If you’re 40 and have diabetes, you’re not likely to make it to experience much of old age. If you haven’t cared about your health during your life, you’re not likely to have a healthy older age.
Of course one can always get hit by a bus or have a heart attack or get shot by a wacko on his own suicide mission. Personally if I’m too far gone and it would take too much or too long to restore me to a reasonable state of health, I would opt not to be resuscitated in the first place.
Certainly cracking open my rib cage, cutting off any limbs or hooking my body up to artificial life support are completely off the table. I want not to live without full use of my limbs or cognitive processes so don’t even think about it. If my heart stops, let me be. If I come back on my own, this time, I’ll talk about it. If my mind starts to disappear, you can bet I’ll be working on my suicide plan, physician-assisted or not, before I forget who my loved ones are.
So you have this pain or these symptoms you’ve been ignoring but it’s suddenly gotten worse and you can’t do things you used to be able to do so you finally go to a doctor and they run a bunch of tests and tell you that you have cancer of the blahblah and they’re going to have to take out your blahblah and then you’ll have to have radiation and chemo and then maybe you’ll have a few good months left but every case is different and they just know you’re going to beat this so here, sign these papers and let’s get started.
And you go… WTF? Because you never thought about it before, never allowed yourself to think it might happen to you or someone you love. You didn’t hear a word the doctor said after “cancer.” Your mind went blank and you felt like the elevator just dropped 20 floors in a second.
You are now spinning out of control but your doctor has moved on to the next patient to give him or her the same devastating news and you’re left to gather your wits and find your way home to tell your loved ones… but the only word that comes out of your mouth is… cancer or brain tumor or kidney failure or multiple sclerosis. Suddenly you’re a dead man walking.
You’ve never thought about it before? Never asked anyone what their thoughts are? Never asked someone who is dying what they think about? Would you want everything done? Do you even know what “everything” means? How much of you abilities are you wiling to do without just to see the next football game on TV?
You suddenly black out and wake up hooked up to machines in an ICU, paralyzed so you don’t try to rip out the tubes and lines, surrounded by strangers with masks on looking down at you and one of them says sprightly, “Welcome back, Mr. Jones. We thought we’d lost you.”
And you’re thinking, “OMG, I was having this wonderful out-of-body experience. I was surrounded by loving beings of light and you brought me back to this? I’ll kill everyone of you!” But you can’t speak, you can’t move. Those people out there think you’re not aware, but you’re aware of everything, you just can’t do anything about it.
You’re wishing you had written that Advanced Healthcare Directive indicating you wanted no extraordinary measures to keep you alive if you were in this unfathomable condition. Unless you have a few lucid moments to state otherwise or can at least blink your eyes if asked, it is now beyond your control. You could end up a living, breathing vegetable for years.
If one is born disabled or becomes disabled through accident or illness, there is a whole added dimension to thoughts about one’s death. Depending on how dependent you are on others for care and whether you are able to communicate or are even aware of what’s happening, decisions are difficult, riddled with guilt and fear, no one ever sure they did the right thing. If you could convey your wishes, what would they be?
Assisted dying is not an option under the current laws unless you can self-administer. It has been tested by brave people with ALS and MS in the U.S. and foreign courts but euthanasia, which allows a physician to administer a life-ending drug to a person who is unable to self-administer because of their disability, is considered murder and many people fear that is opening assisted dying up to a slippery slope that could lead to the wholesale killing of the most vulnerable among us– the elderly, the disabled, the mentally ill, the poor.
Instead of showing compassion for those who are wrestling with these very personal decisions, some groups of religious protestors and bio-ethicists use fear and scare tactics, dredging up images from the Holocaust and other genocides, or hellfire and eternal damnation, to keep everyone from having control of how they end their own lives. These moral absolutists feel they are right and everyone else is wrong, and they have to protect us wayward relativists from ourselves as if we had no values. We do, just not the same as theirs.
I value human life as part of our eternal spiritual journey, I just don’t believe in the sanctity of life as the right to lifers do. Theirs is a religion based on fear and a judgmental god. I believe our Free Will gives us the right to determine when the quality of our life has fallen below our level of tolerance; that we should have the right to decide when it’s our time to die, and be able to ask our doctor to help us by giving us a prescription that will allow us to chose the time and circumstances of our own death.
Physicians, pharmacists and hospitals who provide a public benefit to a diverse society cannot impose their personal religious beliefs or moral values on patients at the end of their lives any more than at any other time in their lives. They work for us, we hire them… they are not the boss of us!
The alternative, if one is able, may be to blow your brains out or jump off a bridge or throw yourself in front of a train. What a mess! How much more peaceful and spiritual to take a pill and just go to sleep. Would you rather your family watch you suffer or allow you to die in peace? How much better for your family to be by your side instead of you having to go off like an animal to die alone.
A good way to count oneself down is to make a list of 100 things you do every day and cross items off as you can’t do them anymore until you’re down to the last 5 or 10 or 20, wherever you draw the line, then call your doctor for your prescription, pick it up when you are ready, gather your family together to say your goodbyes and have a final toast to your good death and peaceful journey home.