For many this is a
subject to avoid. Some may also ask why
a blog mostly dedicated to crime fiction and film would interject something
that is political, possibly religious and probably controversial in nature in
this space. I’ve been unwise before in this regard. If I considered the blog
merely a marketing tool for my books, I should remain neutral. But I promised myself and my readers that I
would, from time to time, give voice to what I believe, completely divorced
from savvy marketing. As I write this,
there is legislation in several sates that would allow physician assisted
suicide in cases involving terminal illness and corresponding pain and
suffering. I hope this movement, also called "death with dignity," will gain support and allow each of us to make these critical choices for ourselves when we can, while we can.
Gertrude Stein; What was the question? |
As a mystery writer, death is rarely far from my thoughts.
At my age and with my DNA letting various demons out of the bag, death is a
regular companion. I am paying greater personal attention to the inevitable. Some
of those thoughts are dedicated to practical questions, and the solutions to
those are relatively common sense. (1.) What happens to my belongings when I go?
Some of the concerns are spiritually speculative. (2,) Is there an ego, an
identity that exists afterward and, if so, what might that be? Some are
spiritual and practical at the same time. (3.) If death becomes imminent, what
do I do? How hard do I or others fight against it?
All right. Belongings
are relatively easy. That’s what wills
and trusts are for. Some of the decisions might be difficult. But the chances
are you’ve thought about it long before death became this real. Some things
don’t get resolved. Old photos and letters, for example, and other items of
mostly sentimental value may prove impossible n less a younger family member
has developed an interest in family history. I’ve never thrown away a letter
and it’s equally difficult to part with photographs. I also have all my old
news clippings, those about me as a novelist and those by me during my media
days. Who would want them? Fortunately that wind-up cable car that played a
tinny version of “I left My Heart In San Francisco” got lost during one of my
moves. The truth is I probably will leave my heart here and not much else. I’ve already begun sorting and tossing. It’s not going well.
The ego/identity question is metaphysical and not answerable
in this realm. Those who have chosen a religion may be guided by its tenets and
might get some help from the appropriate spiritual leader. Some religions
believe they have it all figured out. Personally, I doubt that, but I certainly
have thoughts on the subject. It is, at
times, fascinating to consider the endless possibilities of the meaning of life
and what happens, if anything, when it comes to an end. It’s similar to the
solving of a mystery. We have clues,
suspicions, and crackpot theories. The
thing is: When the finally the end
comes, we are rarely any closer to solving the mystery than we were when the
question first presented itself.
There is a story about author Gertrude Stein and her
long-time companion, Alice B. Toklas. It is said they had an agreement that
when the first to die was passing through death’s door, she would reveal the
secret with her last breath. Alice lingered by Gertrude’ bedside when the day
came. And when the legendary Stein
appeared to be shuffling of the mortal coil, Alice pleaded: “What is the answer? What is the answer? Gertrude had just enough
life to respond.
“What was the question?”
The really important question is what do you do about death
when you can still do something about how you die. If we are hit by a truck or
suffer a massive heart attack, no amount of preparation will make a
difference. But given modern medicine
and the nature of some deadly diseases, we may have warning. And we may understand what to expect as we
travel consciously on the path to death.
Also, we may have choices.
In some cases, palliative care specialists may be able to
provide a calm, peaceful and pain free journey to the final moment. Sometimes family and friends are there
providing comfort and company until the person slips away. I think this is
ideal. I’m game to let nature take its course when I have a choice and when the
process is as serene and respectful as this suggests.
Many deaths do not allow for a civilized, dignified
departure. Sometimes we are stuck in between. The treatment for some cancers,
for example, create horrible moral dilemmas as the cancer advances and
conditions worsen.
Chemotherapy may very well be the way to go. In some cases,
after months of discomfort, often severe, the cancer is nonetheless beaten and
the patient has a full recovery and has many more productive and enjoyable
years ahead. There are times, no doubt, when the suffering is worth it.
Sometimes it’s not. There are times when chemo is given simply
because it is the only alternative to imminent death and we’re not allowed to
let people die. But sometimes, such treatment only causes suffering. No
healing. Just suffering. The pain is
prolonged in exchange for a short gain of a few painful, unhappy extra months.
I would question its value. Similarly,
if staying alive is simply staying alive in a state where one can no longer
communicate or enjoy a book, where one is simply trapped in a body, I don’t see
the point. I want out as quickly as possible.
I accept the notion that few get through life without suffering, but it
seems to me most intelligent beings avoid it when they can.
When my father was eventually placed in the Alzheimers unit
in a nursing home, I visited and was able to observe several patients over time. Some sat dazed and confused. Some seemed
withdrawn in fear. Others seemed to be
in constant distress. Still others showed no outward signs of anxiety. It’s quite possible they were in a benign
other world. My father, fortunately,
seemed to keep himself occupied in harmless fascination with his surrounings, examining
them in a way that seemed to provide some meaning or purpose for him. He passed away before we were faced with any
notion that his existence brought him more pain than pleasure. However if I were the woman who appeared to
be in a constant state of terror, I would surely want someone to help me move
on or out, whatever the appropriate word is.
There is an obvious need for more compassion in such cases.
I have, as I’m sure many of you have, a healthcare directive
that indicates my wishes for no extraordinary effort to keep me alive. If I’m
not really going to live a conscious life, pull the plug. But I live in California. As forward as the state is, I am not
permitted to have a physician-assisted suicide even if doctors determine that I
face a long, slow and painful death. To perform the act on my own, without
professional help, could make matters even worse. A botched suicide could lead
to a worse hell.
In the end, shouldn’t we have the right to arrange our own
deaths while we still have the mind and the means to do so and have professional
guidance to do it right? But it is against the law here, as it is in most
states.
Who wouldn’t prefer a quick death or one with pain control
as we depart? But if that’s not going to be possible, then planning our own
deaths is preferable to a season of suffering, mental or physical. Certainly
there are ethical questions. We don’t want someone nudging us to an early end
because health care costs are diminishing the inheritable estate, for example.
Or someone suggesting our condition is worse than it is to get out from under
the burden of providing care. But from
what I’ve seen of Oregon’s law, which has set the bar for new legislation, and
the research from such serious organizations as Compassion and Choices, there
are ways to build safeguards into laws that will protect the ill, the elderly
and the disabled from exploitation while enabling people to make decisions
about their own lives, especially the quality of those lives as they near an
end.
2 comments:
Quite a can of worms you have opened here, although you're not the first or last to let these particular worms into the light. I am reminded, of course, of our mutual friend who left us in July last year, going out more-or-less on her own terms, refusing chemotherapy and surgery, only to meet an ignoble and lonely end at the greedy hands of Christian Science practitioners who were neither very scientific or Christian. That was a horrible way to go and not, I am sure, what she had in mind when she elected to take matters into her own hands. Compassion really ought to start at home. And if ethically aided suicide can do that, perhaps it is not such a bad thing.
I understand and agree. All the more reason to have a civilized law that might provide an alternative to that situation. Having the option might allow for serious evaluation and counseling. Just because it's available doesn't mean it's desirable and certainly not mandatory. Selfishly, I want the choice if going gently is not an option otherwise.
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