There is a man I know — a very good faith-filled man — who is choosing to die. He has been a dialysis patient for over 10 years and is not a transplant candidate. He has slowly watched the quality of his life ebb over those ten years and has finally decided to stop dialysis.
This is a man who some would say is not intelligent, having tested with an IQ score of 82. However, this is also the man who one day asked me “How is the mind like a parachute?” I shrugged my shoulders and he smiled and said “When it’s open!” Pretty wise. I have told him over time that he has a very high level of emotional intelligence, a fact he reflected when noting that those he needed to talk to about his decision might need to express some grief of their own (as did I).
My friend approached his decision in a very thorough manner, talking to people at the dialysis center, people at the nursing home where he lives, his brother, and his pastor. When he first discussed this decision with me, he indicated his church planned to have a healing ceremony with him. When he returned after that time of prayer over him, he was more settled and at peace with his decision. I told him the healing had worked. He said that, of all the people he’d talked to, the only one who was angry about his decision was his medical doctor. My friend displayed full awareness that the process of dying would be painful and could take a few weeks. Nonetheless, he was ready
As I gave him a hug, I told him that I fully supported his decision and that Jesus was waiting for him with open arms. I assured him that he was completely rational and that this was not an extension of the suicidal thoughts he’d had in years past.
When my father was into his third year of dementia, my cousin mentioned “Some of us live too long.” This was true of my dad. It’s also true of my friend. Modern medicine is indeed a miracle but at what price?
The beauty of this man is that he is not just suddenly paying attention to the quality of his life at the end. I have known him for 20 years and have watched him overcome mental illness and a history of childhood trauma while trying to embrace life as he joyfully rode his bicycle about town.
I am not a believer in suicide as a solution to life’s problems. But my friend has challenged me to consider to what degree I am obliged to prolong life, my own in particular, if quality is absent. I can only hope that, if I am ever faced with such a decision, I will face it with the same degree of courage as my friend.
Reflection: Have you had any experiences with people choosing death?
I have a couple of thoughts on this, none very conclusive. I buried my husband a couple of months ago. He was sick for a number of years, and talked about suicide during that time. He complained that no one would help him. (And he was right. At least, I would not.) But it was also clear to me that this was a way he had of expressing misery and psychic distress, rather than a real desire to die. He didn’t need any help– there was a bottle of tincture of opium in his medicine cabinet that would have killed him several times. As a physician, he was well aware of that. When euthanasia became legal in CA, he never mentioned assisted dying again.
When he finally accepted hospice care, a couple weeks before he died, I found myself tasked with giving him morphine. It was provided to me in very generous amounts, and I’m sure I could have fatally overdosed him and no one would have noticed or commented. He was comotose, his body was emaciated and wrecked. He was enormously difficult to keep care for. Partly through my own mistakes, partly through agency mess ups, I often didn’t have enough help. It was the hardest thing I’ve ever attempted.
I always gave him enough morphine that he was comfortable, but I couldn’t give him an overdose. Even though I questioned my own reasoning–what sense did it make to keep alive a comatose man who would never regain consciousness?–he was my husband, I loved him. We had been togther for 28 yrs. I couldn’t do this.
Was letting him linger for days, when I could have shortened his suffering, the right thing go do? Would he have wanted me to do that, given the ambiguity of everything I knew of his desires? I’ll never know the answer to these questions. I am at peace with that never knowing. But also aware of how fraught these questions are.
In 2013 a good friend chose to do nothing about her second occurrence of cancer. She put her affairs in order and arranged to move into hospice for the last month of her life. During that month I spoke with her on the phone several times because we did not live in the same town or state. Although I would have preferred to visit her every day in person, even that long distance contact was profoundly healing and awakening for me and a great blessing to her. I wholeheartedly support the Compassionate Choices movement. Dying, whether we are aware of it or not, is a spiritual journey, and if we know that consciously, then in the midst of untenable suffering, we have every right, and perhaps and obligation, to get on with it.
I did have an experience with a patient who chose death after years of chronic pain. Unlike the doctor of the man you mentioned, this man’s medical doctors emotionally (but not physically) supported his decision. They were sanctioned for doing so. Viktor Frankl supported choosing death in one instance. I wish more of us could look at death as a spiritual journey as was mentioned in one of the comments.