At this point, you’ve almost certainly heard about Brittany Maynard, the 29-year-old woman with brain cancer who moved to Oregon to avail herself of that state’s Death with Dignity law, which allows physician-assisted suicide. Facing the terrifying prospect of degenerative brain cancer, Maynard recently ended her life with the help of her doctor. Maynard’s choice has resonated deeply with millions, causing many of us to ask the question:
If I was facing terminal illness, what kind of care would I want? Is there a point at which I would say, ‘Enough is enough’?
These are conversations that we all need to have. Personal questions about how we want to live our last days and what kind of treatment we do (and don’t) want to receive. For decades, the hospice movement has been working to increase awareness of end-of-life issues, to empower each of us to make the choices that are right for us. Hospice creates space for each of us, when it is our time, to experience a death that is compassionate, personal, and dignified in every possible sense.
The Death with Dignity movement takes things a step further. In addition to hospice’s focus on comfort and quality-of-care at the end of life, Death with Dignity proponents also see the choice of when to die as a matter of personal autonomy. They push back against the word suicide, with all its negative connotations and religious overtones. Instead, Death with Dignity advocates seek to normalize the choice of terminally-ill people to end their own lives with physician-prescribed medication.
Before the story of Brittany Maynard became national news, I was on the fence about physician-assisted suicide (PAS). Despite some serious reservations, I leaned towards the idea that PAS should be legal. Although I personally find PAS morally ambiguous at best, I tend to think that health decisions should be made by patients and their doctors rather than politicians and bureaucrats. When Maynard’s story became national news, I felt the same way: I don’t know that I agree with her choice, but, together with her family and doctors, she is in a better position to make it than I am.
Is it Suicide if You’re Going to Die Anyway?
Then I read a post by Benjamin Corey, a Christian blogger from Maine. Corey says that Brittany Maynard didn’t commit suicide, that she didn’t really have a choice in whether she was going to die – just about how it would happen. He criticizes the judgment and condemnation he has observed on the part of many Christians who decry Maynard’s choice.
Corey is right in calling out the self-righteous judgment of those who have never faced death yet feel free to disparage a young woman who faced a terrible decision. Condemning individuals for their end-of-life choices is unhelpful at best – hateful at worst.
I was bewildered, though, by Corey’s comparison of Brittany Maynard’s terminal illness to the September 11th terrorist attacks. He says that Maynard faced a situation just like the people who jumped out of the flaming Twin Towers. They didn’t have a choice in how they were going to die, just when.
And it’s true: Those who jumped from the Twin Towers didn’t choose to die. At a certain point, reflex just takes over. If you’re being burned alive, your body is going to seek to remove itself from the flames. Like pulling your hand away from a hot stove, this is reflex, not a decision.
But that’s got nothing to do with physician-assisted suicide. For Death with Dignity advocates, the whole point of physician aid in dying is precisely to restore autonomous choice to the dying process. The whole reason that Maynard went public and engaged the national news media with her story is that she believed that everyone should be free to choose the way they want to die. For those who support the right to physician aid in dying, assisted suicide is a proactive choice taken by an autonomous individual, not a reflex action taken in hopeless extremity.
No One Gets Out Alive
Corey says that Maynard’s decision is not a choice to die (suicide). It’s just a choice to pick the most painless way to die. But the reality is, none of us have a choice about whether we’re going to die. Death is not an optional feature of human existence. We all have choices to make about how we want to spend the limited time we have on earth. And these choices reflect our most fundamental values.
Corey’s suggestion that Brittany Maynard was helpless to make a choice is not merely inaccurate, it distorts the decision that she did make when she decided to go public with her story. For Maynard, PAS represented an important choice that was hers to make under Oregon state law. Her witness was for freedom to choose, not to elicit compassion for herself as a helpless victim. While I question the moral logic of physician-assisted suicide, I respect Maynard’s courage and conviction. She definitely exercised agency in her last months of life.
Is Suicide Normal?
Yet, the growing call to normalize physician-assisted suicide gives me cause for concern. It’s one thing to believe that PAS should be permitted, on the premise that individuals and their doctors often know better than abstract laws dictated by politicians. It’s another thing altogether to promote Death with Dignity as normative in end-of-life care. After all, hospice has been showing for decades that it’s possible to have a dignified death without taking measures to end our lives prematurely.
For me, the question goes far deeper than public policy. It’s a question of story. What story do we want to be part of? As Christians – as compassionate people of any faith – do we really want to join in a cultural tide that sees human life and death as a decision to be made? Do we desire to live in a nation that prioritizes the avoidance of suffering above all other considerations? Is it really a step forward to begin referring to physician-assisted suicide as death with dignity, perhaps implying that those who make different end-of-life choices are somehow less dignified?
We’ve Got Options
While none of us can opt out of dying someday, millions will soon have choices to make about how we want to live our last days and months. Physician-assisted suicide is now one option, but there are alternatives. The hospice movement is growing by leaps and bounds, offering another kind dignity – one that is found when we neither hasten death, nor prolong the inevitable with futile and painful treatment. Hospice and palliative care offer other choices at the end-of-life, choices that provide dignity and reduced suffering instead of the frantic rush to cure death.
Brittany Maynard made a different choice for herself and her family. I don’t agree with her, but I respect her. Let’s not dishonor her memory by assigning her the role of victim, incapable of making the decision to end her own life. Many of us will find ourselves facing similar choices soon enough.
What Do You Think?
- Have you accompanied a loved one in the last stages of life? What was that like?
- In your experience, is there a difference between pain and suffering? How would you describe it?
- If you were to face a terminal illness, is physician-assisted suicide an option that you would consider?