Wednesday, October 28, 2015

A Cure Worse Than Death: The Failures Leading to Physician-Assisted Suicide

Do you want to die? Most reading this will, on most days, say no. But why? The reasons vary for each of us, but the strongest tendency is to imagine waking again tomorrow morning. How do I know? I’ve done it over twenty thousand times now. Maybe you’re only halfway or less to that number, but you have to admit, it’s habit-forming. So it is almost impossible for most of us to imagine, on most days, how someone might choose to break with such a long-standing pattern and to proactively end their lives.

But there are enough who do that our culture now embraces what was, until very recently, pushed to the margins, into the dark corners, out of polite conversation, and certainly against public policy. What had become an illegal cottage-industry leading up to the publication of Final Exit by The Hemlock Society and the media-celebrity of Dr. Jack Kevorkian, has now gained not only broader acceptance, but legal sanction in several states. The number of states establishing a “right-to-die” through Physician-Assisted Suicide (PAS) seems destined to grow until, eventually, some case or other prompts the U.S. Supreme Court to decree it as a constitutionally-protected right (as in 1954 – Brown v. Board of Educaction “legalizing” public school integration; 1973 – Roe v. Wade “legalizing” abortion; or 2015 – Obergefell v. Hodges “legalizing” same-sex marriage).

Understandably, some physicians see a patient’s decision to proactively hasten their end-of-life as representing a failure. So do I. But there are two different failures in view here. One of them is unavoidable. At some point, the tools, techniques, and therapies of modern medical practice fall short of restoring a patient’s health, or even of preventing that patient’s death. But while, in my life, there is still hope of the process accomplishing its stated goals, I am thrilled to have a primary-care physician who clearly states what steps are required to prolong and improve my life. I have known physicians, though, whose patients have died, despite efforts that should have prolonged or enhanced their lives. Sometimes, the medical system fails to keep a human’s physiological system functioning.

But there is a second failure in view when a patient chooses to proactively hasten the end of their life. Not that I am unsympathetic to the decision. In more than three decades of pastoral ministry, I have sat with enough patients and families to know how dreadfully difficult life can become, even with vitally-supportive faith communities being as attentive to their needs as possible. Still, even when the medical system announces “there’s nothing more we can do” (by which we mean “there’s nothing more we can do to cure you”), I do not support suicide, even if legally sanctioned and popularly recommended.

My belief in the sanctity of life extends from conception (and even prior to physical conception—given Jeremiah 1:4-5) to natural death. So, is the legislation sanctioning Physician-Assisted Suicide a failure of the Church’s emphasis on the sanctity of life. Perhaps to some extent. But only because we have failed to offer a viable alternative to torturous procedures. For some patients, we propose what they interpret as senseless dissection (surgery), systemic poisoning (many pharmaceuticals, including chemotherapy), and selective incineration (usually through radiation). We accept the cost-benefit ratio when there is an expectation of recovery, restoration, or at least slowing the dying process. But what about those patients for whom there is no longer any hope of cure, who see our role as merely prolonging a life of intensifying misery? The dichotomy routinely being presented to such patients is a false one, but it proves a compelling argument for many: “When the cures we offer are no longer effective, you deserve the right to have us kill you.”

The dichotomy (a choice between only two options) is a false one. But it is a pervasive one, nonetheless. Modern medicine routinely lives up to our expectation: “Cure me.” When we are beyond its best efforts, what do we then ask our doctor to do for us? If we imagine that we have no other options than to die painfully and protractedly, in a downward spiral of ever-decreasing self-determination and dignity, it may make sense to many to choose the only other option being so popularly promoted: Physician-Assisted Suicide.

So, the patient asks the medical community: “When you can no longer prolong mu life, are you willing to hasten its end?” The legal answer in a number of states is now, “Yes, we are. And yes, we will.” But before you or a loved one finds yourself facing that binary decision, the false dichotomy of choosing either “painful life or peaceful death,” consider that there may be other answers.

A small, and apparently invisible part of the medical community exists to serve a third purpose. Our goal is neither to prolong your life nor hasten its end. Providing pain-relief, symptom-control, and as much improvement in your quality of life as possible, the goal of hospice care is nothing more or less than to help you live until you die. Amidst a culture that will continue to gravitate toward offering just two options to dying patients, my hope is that you will at least discuss with us what we might be able to do for you, when you’ve been told “there’s nothing more we can do.”
"You matter because you are you, and you matter to the end of your life. 
We will do all we can not only to help you die peacefully, but also to live until you die."
— Dame Cicely Saunders, nurse, physician and writer, and founder of hospice movement (1918 - 2005)

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