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?
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I was holding my husband’s hand when he finally died of complications of lung cancer. It was a long, drawn out process and he was comatose with his eyes open for the last 20 hours. He possibly could have lived longer had he consented to a jpeg feeding tube: but he declined and I, as his health care agent, abode his wish of NO TUBES. All too few people have actual experience of accompanying someone through the dying process these days. I am relatively healthy and I have had a long life but I do not know what decision I would make were I were in that young woman’s position.
Thanks so much for sharing your experience, Barbara. I’m so glad that you were able to be there for your husband, and that he had the opportunity to make his wishes clear ahead of time.
One thing I’d suggest is missing from the above, Micah, at least from a Christian perspective, is that there is some Christ-like dignity in suffering. That doesn’t necessarily mean that the end of life has to be more painful than necessary, and indeed often our pre-occupation with extending life is really unhealthy. But, the choice to end one’s life on one’s own terms, again speaking as a Christian not as a legislation for others, is slightly shaky theological ground. Hospice provides care and comfort for those in their last days, but to embrace the life of Christ is to be baptized into his life AND death, which includes suffering, and it is Christ who ultimately comes to relieve the suffering that occurs often at the end of life.
This is not to simplify these kind of choices or to say that we should seek out suffering or not alleviate it, but it should be a significant factor for those who follow Jesus.
That’s a great point, Magnum. The way of Jesus goes against the grain of our human assumptions in all sorts of ways!
SOME can achieve “Christ-like dignity in suffering” but, in my experience as a chaplain, they would appear to be a distinct minority.
Pretty sure I’d be with the majority on this one…
I think this is an excellent post. Some thoughts…I wonder how health care providers feel on assisting death? I’ve worked with hospice patients for many years and while I have no problems stopping aggressive futile treatments and even providing pain control that may bring death nearer I’m not sure I could feel comfortable with providing a patient with a lethal dose of medication.
Having just watched my father in law die of his cancer I see how uncomfortable I still am and those around me are with suffering and how few tools we bring to the table except medications. His last few weeks my father in law started having crying episodes and it seemed most unclear where the distress was coming from so we ended up giving him an antianxiety agent to help him calm and be less distressed as he neared death. I tried to spend a good amount of time with him assuring him he was loved and cared about always but….
I worry about a society that is generally not at all comfortable with death and dying and quick fixes. Easy isn’t always best.
Last thought is on whether suffering has any value. And how as Christians we deal with suffering.
Thanks, Robin. So good to hear your experience with hospice, and I appreciate your questions about how we as Christians are called to face suffering. When is suffering redemptive, and when is it just misery?
Suffering can change people. I`ve experienced it, as the sister of my wife got sick of cancer. Before getting sick she was a very difficult person, depressive and angry. But cancer has changed her totally. Even now as I think about her I am always remembering her in the way she was in the last months of her life and never in the way she had been before. Her illness has also changed my faith. It became more mutual and deeper. On the other hand I don`t know, if I were brave enough to face the sufferings she had to experience..
Up until very recently, the “death bed” was considered to be a very special, holy place. People on the edge of death were considered to have special insights, being very close to “the other side.” There was a sense that they could “see beyond” in a special way. For this reason, people’s last words were taken very seriously, often written down for posterity.
Here’s a great example of an amazing final testimony by a dying Quaker minister: http://www.strecorsoc.org/docs/naylor.html
A really great testimony! Thanks for the link.
Gosh, I just don’t think that Christians need to say that nonChristians should have the same idea about their deathbed as a Christian does. And even in what way a Christian sees a deathbed as holy should be informed by actual scriptural teaching, not latent fear about culture wars and what pandora’s box might be opened if people are allowed to die before they’ve drunk every last dreg of whatever ending might come to them.
Hi, Heather. I think you’re reading this post and comments pretty unfairly, and attributing views to me that I haven’t expressed.
I think we probably both agree that it’s important to have open, respectful, compassionate conversations about end-of-life care. It’s precisely because I believe in having those conversations that I’m raising the questions I do.