What we lose by choosing death with dignity

First of November. This is the day a 29-year-old, terminally ill woman named Brittany Maynard has chosen to end her own life under Oregon’s Death with Dignity Act. Diagnosed with an aggressive form of brain cancer and given sixth months to live, Maynard explains that as her disease progresses,

…even with palliative medication, I could develop potentially morphine-resistant pain and suffer personality changes and verbal, cognitive and motor loss of virtually any kind. Because the rest of my body is young and healthy, I am likely to physically hang on for a long time even though cancer is eating my mind. I probably would have suffered in hospice care for weeks or even months. And my family would have had to watch that.

The kind of suffering Maynard’s cancer is expected to bring is incomprehensible to most. Even for Christians who believe in the sanctity of life, this case, in which both death and great suffering appear imminent, challenges deeply held convictions. Law, logic, medicine and even theology seem inadequate to address all the questions. None of us desire to suffer or to watch loved ones suffer. After all, we take aspirin to avoid the annoyance of a headache and undergo invasive procedures to alleviate more serious forms of physical ailments, don’t we? Yet, such actions are intended to extend and enhance life, not end it. Inherent in being embodied spirits is the instinct for life, even though, paradoxically, we are all tumbling toward death from the very beginning of our existence.

Tenth of December. This is the title of a short story (and collection) by George Saunders. It is the date that a character, also terminally ill, has chosen to end his life. Like Brittany Maynard, Don Eber does not want to subject his family to his suffering and imagines his choice to be the heroic one. But his suicide is interrupted by the chance to be truly heroic (spoiler alert) by saving the life of a young boy. After doing so, Eber returns home. He has an epiphany which reveals the meaning in letting himself be cared for in his dying:

Why should those he loved not lift and bend and feed and wipe him, when he would gladly do the same for them? He’d been afraid to be lessened by the lifting and bending and feeding and wiping, and was still afraid of that, and yet, at the same time, now saw that there could still be many - many drops of goodness, is how it came him - many drops of happy - of good fellowship - ahead, and those drops of fellowship were not - had never been - his to [withhold].

Those drops of fellowship: they are not ours to withhold. Our lives are not our own - they are each other’s. I know because my family lost a terminally ill member to suicide. Even more than not seeing a loved one suffering, we need them to live. Or to die trying. This is nowhere better reflected than in Dylan Thomas’ famous poem, in which a son begs his father to cling to life despite the odds:

Do not go gentle into that good night.

Rage, rage against the dying of the light.

There are few, if any, arguments that can answer the questions raised by Brittany Maynard’s decision. But perhaps literature, in embodying the paradoxes of human existence in the same way that human beings embody the paradox of decaying life, can go where law, logic and theology fear to tread. Literature shines light upon the mysteries of our humanity, and in so doing, shows how much more mystery lurks.

One great mystery is that even when death is inevitable (or seems so, for not even the most credentialed physician knows for certain), the desire to live is natural. While this life instinct can be explained by Christian theology - God as the author of life made us in His image, and we therefore reflect Him in our nature - it also transcends creed and culture in being common to all human (and even animal) life. More than being unnatural, the impulse against life and toward suicide - even when undertaken to ease suffering - robs us of the greatest gift we can offer another: ourselves - our always-decaying, ever-dying, suffering-yet-glorious selves.

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This is a great perspective. The idea that we owe it to others to live, or die trying to live, is truly profound. I also really appreciate Karen’s conclusion: as image bearers of God it is natural to cling to life and entirely unnatural to try to end it. At first it might seem like a mercy to let one who suffers end his or her life, but there is more to it: we have to leave room for God, because only He knows what will happen. We only think we know what will happen; and we don’t know what will happen until it has happened…even if we thought it would happen.

I don’t know the answer for those who face the types of decisions faced in this post. But I do know, as KSP says, “Literature shines light upon the mysteries of our humanity, and in so doing, shows how much more mystery lurks.” Literature is one of God’s gifts for us to work through some of life’s most difficult times.

This post so beautifully states many of the things I’ve been thinking about ever since my wife and I watched The Fault in Our Stars this past week. One of the themes that I really felt that work explores is this concept that “we are not our own.” Others depend on us; we’re made to be in relationship, both with God and with one another, which means we don’t have the final say in certain complex choices like this one.

It also makes me think about how Paul said the same thing, in a slightly different context, in 1 Cor 6:19-20. There, we’re reminded that we are “bought with a price,” namely, the price of Jesus’ blood. Which complicates the picture even further: Is it possible that the choice to “die trying” is an act of worship for the One who suffered in our place to deliver us from the same?

I struggle with this.

I have seen my grandmother lie in a hospital bed unable to move and respond in any way.

I saw my aunt decrease to a skeleton with skin cuddled up in bed suffering from Alzheimer’s.

I have seen my mother struggle with Alzheimer’s for over 16 years. The last 15 months of her life she couldn’t speak, eat food or even lift her hand to scratch her nose when it was itchy.

I saw my friend’s mother turn into skeleton’s with skin on asking and pleading to God to take away her pain and let her die.

Being an only child who doesn’t have children or a husband, if anything happened to me I would be without anyone to take care of me.

The health care system does not have the ability to take good care of their dying patients. Instead, they are learned disabled. Taught to use a diaper instead of a toilet. Restrained to a wheel chair instead if being encouraged to keep their strength and mobility. They stick you in your room facing your bed or a corner to live the last of your days.

Not everyone has someone willing to take care of them and not many have the finances to hire in home care.

We put our pets down when they are suffering but we can’t put down our humans.

Thank you, Paul.

Thank you for the affirming words, Chris.

Amen, Tim!

Excellent insights, JKana. Thank you.

Danzur, you offer really important questions to this discussion. Thank you. You point to why community is so very important, both in our living and our dying. I have a spouse but no children, so I confess, I share your fears. I sometimes think about how, in some ways, the way we live today will (in part, not entirely) determine who is taking care of our most intimate needs at the end of life. As a culture, we don’t live as though that question matters. And it does, it really does.

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