Saturday, November 29, 2014

Phrase of the Day: DEATH WITH DIGNITY

Brittany Maytnard . . . a name that has garnered a lot of attention lately . . .

. . . not because she was financially well-off, not because she was famous for being famous (aka a reality TV star), and not because she was on trial for a salacious crime . . .

Brittany Maynard ended her life.

On the 1st of this year, Maynard was diagnosed with grade II astrocytoma, which is a form of brain cancer that develops in the astrocytes, which act like glue holding the brain together.
Credit: American Brain Tumor Association

She was initially told she had three to ten years to live.  In the Spring of this year, however, the astrocytoma had advanced to grade IV, the worst case, and was then told she probably only had six months left.  In addition, those six months would be very painful, feel dragged out, and would affect cognitive function.

In Oregon, where Maynard lived, there is a law on the books called the Death with Dignity Act, enacted in 1997, which allows for terminally ill individuals to end their lives with prescribed lethal medications.  Maynard had acquired those medications and used them on November 1.

In an October 7th piece for CNN, Brittany wrote:
                 "I would not tell anyone else that he or she should choose death with dignity.
                 My question is: Who has the right to tell me that I don't deserve this choice?"

Who indeed?

I believe there are multiple reasons why Brittany Maynard's decision is an uncomfortable one for others to hear and accept, even though the decision was, of course, hers alone to make.  I'll start with religious reasons.

Religion teaches the value of life.  I know about how many are killed in the name of religion (i.e. most wars have been started for religious reasons), but the teachings of religion without twisting meanings -- that's key -- is that life is special, is sacred, is to be valued.  To end one's own life goes, at simply a basic level, against that teaching and belief.  There are probably many religious persons who strongly disagree with her decision.

To that extent, three days after Maynard ended her life, a Vatican official, Monsignor Ignacio Carrasco de Paula, head of the Vatican's Pontifical Academy for Life, called her decision to end her life both undignified and reprehensible ... a condemnable death without dignity [my wording].  His argument was with her stance that a terminally ill person should have the freedom to end their life.  It may seem like a harsh stance to some, but religiously, it makes sense.  It's a bit of a quagmire if you say that all life is precious one one hand and then also say that taking one's own life is just fine on the other hand.  It would require breaking down the value of life to the quality of life.

That leads me into a second reason why Maynard's decision is hard to accept -- the stigma of suicide. Mention suicide to most persons and an uneasy feeling arises, maybe faint, but an uneasiness, nonetheless, is present.  How bad was it really? and Why didn't he/she ask for help? are common questions.  Survivors are left to feel angry, hurt, confused, and even guilty (i.e. "If only I knew").  While some have argued that such an act requires a level of bravery, considering the person is ending his/her life, the stigma is that it's an act of cowardice.

Another reason, I believe, is simply death itself.  Most individuals don't want to talk about death, let alone give it serious thought.  For most, death is scary, an uncomfortable subject, an unsettling prospect.  The irony is that cognitive acknowledgement is not a problem for those persons: you're born ... you live ... you die.  Pretty linear, pretty simple.  That's life.  We even plan for it in a linear, cognitive manner: life insurance, for example, which, let's face it, is really death insurance.

Life -- more specifically, the cycle of life -- includes death, not excludes it.  You came into existence one day and, one day, you will go out of existence.  Sure, look at the leaves on trees: how they die in the Fall and come back again in the Spring.  Eventually, however, those trees will die, no longer able to give birth to leaves.  That, too, is a part of life.

Now, let me address the issue of dignity.  A couple of definitions of the word "dignity" are "the state or quality of being worthy of honor or respect" and "self-respect".  One of things that strikes me about that word is the many ways it is applied.  When there is a dead person, on the street or in a morgue, the body is covered out of respect.  When there is a funeral, a viewing, or a memorial service, we pay our respects.  We even have those rituals to honor the dignity of the deceased.  When someone has a condition that is not considered socially okay -- allow me to use incontinence as an example -- there are undergarments designed for that person to maintain his/her dignity.  If someone ends up undressed, or at least stripped down to their underwear, someone offering something to cover up is for maintaining that individual's dignity.

We sure do have a lot of ways in which we honor dignity.  How one dies, in the face of a terminal illness, is not one of them.

I do think the stigma of Jack Kevorkian's right-to-die movement in the 1990's is a residual part of this.  Even though he had stated his goal was "helping the patient", "not to cause death", and "to end suffering", he was unable to avoid the courtroom and criticism.  He was convicted in 1999 of second-degree murder.  Some of his methodology had been questioned (i.e. not all patients were terminally ill, abbreviated length of consulting time, absence of psychiatric evaluation), which made equal levels of "right-to-die advocate" support and "murderer" opposition inevitable.

Before I get further into my point, let me address that there are plenty of people who would want to misconstrue things and use assisted suicide as an easy way out.  I am speaking solely of terminally ill individuals here. 

In reading Maynard's story, I am sure that there were many who viewed her decision as an easy way out, nothing more than giving up.  To those individuals, I would pose the following questions: Is it, then, more dignified for her to suffer?  In the face of death, is the only dignity to be found in suffering?  Why is someone choosing to end their suffering in the face of certain and painful death an undignified choice?  Does facing certain death nullify any final choices of the individual? 

Brittany Maynard did not want her life to be painful and miserable ... did not want her loved ones to see her that way ... did not want to simply be alive, or some semblance of alive, instead of living life to its fullest.  In short, Brittany Maynard did not take the easy way out and she did not give up.

She made a couple of videos regarding her decision.  The last one, released just days before her death, is below.  This is in her own words...

Personally, if faced with a terminal illness or condition, I would want to be able to end my life on my terms without any negative stigma or legal ramifications.  I applaud her decision.

Everyone should be able to make that decision in the face of terminal illness.  Currently, five states in the Unites States allow for assisted suicide -- Oregon, Washington, Montana, New Mexico, and Vermont.  Recently, there was a rally held in Maryland's state capital, Annapolis, urging lawmakers to put a death with dignity law on the books, and some states are considering it.  Here in New Jersey, the State Assembly passed a death with dignity bill, which goes on to the State Senate.  However, Governor Chris Christie has already said he will veto the bill.

When faced with a terminal illness, the only thing undignified is denying an individual the right to die on their terms and not the illness' terms.

For more information, check out Compassion & Choices' website.