Friday, January 22, 2016

On Attending an Intentional Death: Some things to consider before you invite me to join your friends and family for your premature send-off

If all you can see is death,
then I would suggest you look more closely.
I was recently honored to consult on a blog post by my friend, Paul Louis Metzger, entitled “Lights Out: Shining a Light on Caring for the Dying in a Multi-Faith World.” (It can be found here.) He begins by asking, “What would you do if you were a chaplain or pastor or trusted friend given the honor of caring for someone of another faith tradition who is approaching death?” For some, there would be some complications, or obstacles that might prevent them from doing so. For me? Well, I have cared for many outside my faith community, including some whose beliefs differ greatly from my own. But recently, a similar question has been asked, and I now am the one facing the complications and obstacles.

The question is deceptively simple. Would you attend the patient’s death? The answer should not be all that complicated, either.

Can you make death out of life?
Certainly. But why would you?
After all, I have attended myriad deaths, from a variety of causes, in many different venues. As a hospice chaplain, most of the deaths have been serenely accommodated with a gathering of loved-ones clearly aware of the impending last breath. As a police chaplain and as a pastor, however, I have been present when life ended traumatically, amidst the valiant efforts of emergency medical professionals. In a hospital waiting room, I have notified next-of-kin of their loved-one’s death when it was our own law-enforcement officers who fired the fatal shots. I have left the bedside of the woman wounded by her suicidal son, just long enough to confirm that her husband, in the emergency suite next to hers, had not yet succumbed to his wounds. When he died a short time later, I was there to tell her so. I have participated as a first responder and in critical-incident stress debriefings with witnesses to horrific carnage literally on the front porch of police headquarters. There are more and more scenes that come to mind even as I write this, so before I lose track of my point, let me hope that I have clearly illustrated it. There are very few kinds of death that I have not already witnessed.

So, to my ears, the subtext of the deceptively simple question above is this: “Given that I have attended all these deaths under so many and widely-varied circumstances, why would there be any death from which I would choose to be absent? Especially if it is a patient or parishioner with whom I have an ongoing relationship?”

The complications and obstacles I face occur in the specific context of this simple question. My struggle arises primarily from the fact that I have attended some spectacularly overwhelming non-deaths. Those have included SWAT-calls, hostage rescues, and other interventions where the survival of those involved was far less than guaranteed. I have been present when lives were saved by extraordinary medical interventions. And I have been called to the scene when we simply needed someone to argue in favor of life with someone who was intent on ending their own. And that brings me to the reasons you do not want to invite me to your suicide, physician-assisted or otherwise.

I will try to stop you.

Sometimes what we see is not really life.
So, definitely not a time to choose death.
I was one of the founding members of the board of directors and executive committee of The Suicide Task Force of Larimer County. It later became The Suicide Resource Center. Now, since October, 2011 it has a new name. In order to differentiate themselves from other organizations that want to provide you with the resources by which you may commit suicide, the team is called the Alliance for Suicide Prevention. Due to excellent training, and whatever it is about God’s will that passes for “luck,” as both a police chaplain and as a pastor I have yet to lose the argument on behalf of life. Do not mistake me, though. I have friends and colleagues who have lost that argument, though. They were in attendance at a completed suicide and, had I continued in that field, it would only be a matter of time before I was, too. But in each case, we say and do all we know to prevent that suicide from being completed.

That is what I have done in the past; it is what I will continue to do in the future.

So, imagine for a moment that you are not the dear friend invited to attend, but the patient preparing to implement your legally-protected, physician-prescribed, self-administered, and invariably-lethal solution to an unacceptable life. Try to visualize yourself terminally ill, told that your life retains far too much quantity for the declining level of quality—and that the logical decision is to proactively and preemptively end your life? Do you have that picture of a life-not-worth-living firmly in your mind? Good. Now, consider whether you want me to be there.

Please understand, I would be very honored to receive your invitation to be present in that very special moment. But I would also hope to bring your breakfast in the morning, and to be present with you for many more days, weeks, or months.

Don't fear the reaper, but don't rush the hourglass.
What do you need with all that extra sand?
No matter how convincing the arguments in favor of death may be, I will argue in favor of life. No matter how others seek to terrorize you with wild fantasies of unmitigated agony, I can testify to you that it is only the rarest of patients who choose to experience higher levels of pain as a trade-off against greater awareness of the dying process (or simply being as mentally acute as possible for the visit of one more friend or family member). As a hospice chaplain I have seen the life-enhancement that is possible through palliative care (including psycho-socio-spiritual assistance far beyond what most would imagine could ever be made available in our cost-benefit-ration-driven healthcare system) even when the experience surpasses the worst physical deterioration that suicide advocates promise you. You have the option to accept care that neither prolongs your life nor hastens its end, but helps you to live until you die.

So, yes, please, do invite me to attend your going-away party. Just understand that I will still want to win the argument. I will plan to visit with you some more on the morning after. I will never stop encouraging you to give life one more try.


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