The Right To A Graceful Exit

My great aunt has been wanting to die for the last three years. Society, however, refuses to grant her request. Although her mind is still sharp as ever, the passage of time has taken a brutal toll on her body and even more so on her spirit. Her insistence that she is only taking up space falls on deaf ears in the medical community that has been charged with the responsibility of seeing to her health needs and well being. How can it deny her the right to die with dignity, I argue, when her quality of life has been so severely diminished?

Physician-assisted suicide is a hot-button issue in the U.S.. The religious faction asserts that only God has the power to decide when someone has lived long enough. At the same time, however, it seems to have no problem with human intervention when it comes to extending lives through artificial means. If extreme measures need to be undertaken to halt the spread of a fatal illness or to sustain a comatose accident victim on life support, it seems to me that a purposeful interference with “God’s will” has already transpired.

In the case of my great aunt, she narrowly survived her last surgery for cancer, her third major operation in ten years. Failing eyesight has robbed her of enjoying her lifelong passion of reading novels. Acute arthritis confines her to bed or, on good days, a wheelchair. This is a woman who was always active, always vibrant, always on the go. Even when she gave up her car, it didn’t stop her from taking cabs to her club meetings, organizing parties, gardening, and using the retirement home shuttle to go shopping. She’s the relative we always said would live to be 100. Sadly, I think our prediction will come true. We just can’t call it “living”.

What frustrates and angers her is that she sees history repeating itself. For the last few months of his life, her beloved husband was in a vegetative state as a result of a stroke. She knew he wouldn’t have wanted to exist that way but there was nothing she could do about it. When she tried to talk to members of her church, their response was always the same: God would take him when the time was right. They also reminded her he “wasn’t really suffering”.

Physical pain, though, isn’t the only way we can hurt. While machines could monitor his physiological condition 24/7, they couldn’t get inside his head and tell anyone what he was thinking or feeling about his situation. Never one to squander money, I think he would have been outraged that the high expense of his care wasn’t going instead toward future financial security for his wife. When he finally passed away, she not only had to deal with her grief but with a daunting mountain of bills and insurance issues as well.

The Constitution guarantees all of us life, liberty and the pursuit of happiness. The prohibitions against physician-assisted suicide, however, deny us all three of these. The opponents to physician-assisted suicide legislation argue that it could be used for the wrong reasons. Hastening a death, for instance, could enable heirs to claim an inheritance faster than if they had to wait. What if, however, that was exactly what someone like my great uncle would have wanted? He spent a lifetime working hard so the two of them could enjoy their golden years in comfort. Neither of them ever envisioned that sizable nest egg would go toward keeping either of them on life support. If someone has the freedom to leave their assets to whomever they want, why can’t this extend to the question of when he or she can gracefully exit so as not to relinquish those assets to a lost cause?

If God meant for us to be kind and compassionate toward one another, that definition should apply to how much suffering we can reasonably put patients and their families through in cases where there is no absolutely chance of recovery. Life is a gift from God but it’s also a gift He intended for us to enjoy as fully and actively as possible. There’s no question that science and medicine have enabled people to live longer than their predecessors. Keeping patients alive through artificial means and/or dulling chronic pain through excessive medication, however, is doing them no favors in the end. Not only are their own lives put on permanent hold but their loved ones are indefinitely immobilized, too.

I remember many conversations where my great uncle used to say he wanted her to get married again if anything ever happened to him. Had he not been resuscitated after his first stroke, I think there’s a good possibility she might have found a new companion with whom to enjoy her own remaining years. The combination of fierce loyalty and spousal guilt that she herself was still healthy pushed her into a state of depression. Even though she knew in her heart he would have encouraged her to start dating, the sanctity of her marriage vows included the words “til death do us part”. Neither a merciful deity nor a compassionate physician would have wanted her to endure the misery and stress of a half-life and yet that’s exactly what she was forced to do.

Opponents to physician-assisted suicide argue that pain can be managed through medication and that depression can be managed through professional counseling. The bottom line, however, is that both approaches ignore the patient’s right to exit this world with his or her dignity still intact. Whatever pride the patient may have maintained throughout healthier times in terms of physical appearance, energy and mental alertness are cruelly stripped away when the state steps in and proclaims it a criminal act to facilitate one’s wish to die. The end result we witnessed with my great uncle was a withered shell in a tangle of tubes that bore no resemblance to the robust figure and sharp wit we had always loved.

My great aunt’s anxiety as her own health continues to deteriorate has generated the fervent request we not come and see her if she becomes a vegetable because it’s not the final image she wants any of us to have of her.

Having been blessed with freedom of choice, I see no reason why we can’t be allowed the freedom to write our final chapter when life, as we know it, has ceased to hold promise and permanently halted our ability to passionately contribute.