How We Die Is No One’s Business But Our Own

When my father was hospitalized on what would eventually be his deathbed, my brother walked him through the DNR form ― “Do Not Resuscitate.” Pop had never heard of it.

My brother explained it and asked, “Whaddya wanna do, Pop?”

Dad didn’t even blink. He took one look at the form and said, “Pull the plug, everybody take a drink.”

He wasn’t suffering. He wasn’t in pain. He was quite lucid. But he was deteriorating, and after having lived such a rich life, he was simply too practical to spend the money on expensive medical procedures ― even though he was a veteran and on Medicare ― just so he could live what he figured would be another few months. He was 90.

The moment revisited me after news broke earlier this month about Lynda Bluestein, who had terminal cancer and ended her life by taking prescribed medication. Except that wasn’t the whole story.

Ten states allow medically assisted suicide. Connecticut, where Bluestein lived, isn’t one of them. Vermont is, but Vermont had a residency requirement in its so-called Patient Choice and Control at End of Life law. If you didn’t live in Vermont, you couldn’t travel there from out of state to obtain the medical cocktail to end your life.

Bluestein sued, arguing that Vermont’s residency requirement was unconstitutional. The state settled, and Bluestein was able to use the law to end her life in Vermont. Shortly thereafter, Vermont revised its law, becoming the first state in the country to remove the residency requirement for terminally ill people who want to end their lives.

I was surprised to learn that only 10 states allow medically assisted suicide. I was further surprised that until Bluestein’s lawsuit, states barred out-of-state residents from availing themselves of the option. Before Vermont’s decision, only Oregon allowed non-residents such access.

I’m also surprised that we’re even debating what is nothing more than a private decision about a personal matter that is absolutely nobody else’s business. Perhaps that’s because it’s just too much for the sanctimonious to resist.

Advocates have learned to shun the term “assisted suicide,” preferring to call it “aid in dying,” “compassionate care” or “death with dignity.” I have a better term: “freedom.”

Or, if you want to be snarky, you might go with “mind your own business.”

Opponents of assisted suicide argue that actively ending a life, however frail, is a moral violation. Whose morals? Yours? What makes yours so special, and who are you to impose them on someone who feels they are doing what’s in their own best interests, especially since that choice will affect you in no way whatsoever?

In other words: Who died and left you in charge? Pun intended.

Annoyingly, these interlopers tend to identify as small-government conservatives and people of religious conviction.

What is it about such conservatives wanting to control every aspect of our personal lives while simultaneously trumpeting their love of small government? How often have religionists (and conservatives) complained loudly in the same-sex marriage debate that they’re sick and tired of having the “gay agenda” shoved down their throats? How is it any different when moralists are doing the same thing on the matter of assisted suicide? Or — say it with me now — abortion?

Moralists insist we should endure our remaining months, even if it means excruciating pain, because every life is precious. Yet we treat our terminally ill pets more humanely. Opponents of the assisted suicide fret about those who might be harmed, but fail to consider those who might be helped.

Some opponents have long claimed that entire categories of people — the elderly, the poor, racial minorities, and the physically or mentally disabled — might choose assisted suicide unnecessarily, due to coercive family members or negligent physicians ignoring the laws and safeguards put in place to prevent abuse of the practice.

It’s all theory, conjecture and fearmongering. Empirical data collected from jurisdictions where the practice is legal — the 10 states in the U.S., as well as Canada, Australia and European nations — found that claims of abuse are utterly baseless, and uncovered no evidence of heightened risk to the people thought to be vulnerable. Data presented by opponents “is generally incomplete, frequently filled with factual inaccuracies and distortions, and often meant to construct a false empirical foundation for what is essentially a moral opposition to the practice of physician-assisted death,” one bioethicist and professor of philosophy at the University of Utah concluded.

In other words, they’ll tell you whatever they have to, and they’ll do it simply because they don’t like the practice, not because they can prove any flaw in it. These are scare tactics whose rhetorical force exceeds their logical strength.

More to the point, the argument looks through the wrong end of the telescope. If there’s abuse, it’s not the fault of legalized assisted suicide. It’s the fault of the system that regulates it. Fix that, rather than throwing out the law entirely. We don’t ban cars, firearms or elections because of poor drivers, irresponsible gun owners or people who don’t vote (or who lie about election results).

We agonize over health care costs, yet most spending occurs in the final months of life when death is inevitable. We celebrate medical advances such as organ transplants that extend life beyond what is “natural.” Why prohibit a choice to use advances to end a life that has become medically unsustainable?

How many people have faced a more desperate moment than Robert Marquis? He was caring for his dying brother, Roger, in 2015, a year before California lawmakers would legalize physician-assisted suicide.

“I had gotten to the point where Roger was unconscious and I actually put the pillow over his head,” Robert told me. “But then I thought, ‘No, I can’t.’”

For years, Roger had been suffering from postherpetic neuralgia, a chronic and incurable disease that affects the nerve fibers and the skin, transforming the simple act of touch into an excruciating ordeal, like a bad burn. Sleeping, even while wearing clothes, induces waves of relentless, agonizing pain. The condition is not fatal, but the ceaseless pain can be torturous enough to make you wish you were dead.

When Roger’s wife died of cancer, it came as a final blow, leading to what’s called “failure to thrive” ― a gradual decline in health typically caused by medical problems like a chronic disease. With the help of a chaplain, Robert eventually managed to get his brother into hospice care, where he simply faded away.

“Roger was in constant, constant pain, crying, bleeding, unable to sleep,” Robert recalled. “He finally asked me at one point, ‘If I get to where I’m not able to communicate to anyone, just put a pillow over my head. Make sure it’s done. I don’t want to be a vegetable.’”

“The most humane thing in the world would’ve been to do that,” Robert said. “I wanted to, in the worst kind of way.”

What stopped him was the possibility of being found out and tried for murder. Perhaps a jury would have exonerated him, out of empathy, “but even going through the process of a court trial would have been a nightmare,” he said.

The matter appears settled in the minds of the public. A 2018 Gallup poll found that 72% of participants favored and supported laws allowing physician-assisted suicide. Why it remains illegal in 40 of the country’s 50 states is a mystery.

We talk a great deal in this country about personal freedom. We prize it highly. And yet we deny it to people who want the freedom to make a personal choice because it offends some nanny-staters claiming their version of the high moral ground.

“Death with dignity” isn’t about being allowed to die. It’s about having the freedom to choose how and when. Until you have the freedom to choose the time of your death, it cannot be said that you are entirely free.

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