Tuesday, July 30, 2013

A much-needed topic for discussion

I agree with this author and his well-written, from-the-heart defense of "right to die."

Dying to Die
By Stephen Pizzo

"Better to live or die, once and for all,
than to die by inches."

— Homer, The Iliad

We've all heard - ad nauseam - about the "right to life." Views differ when life begins. So the arguments continue. And that's fine - so long as no one side is able to impose their view of this metaphysical issue on the other.

But there's the flip side of all that, the right to die, where just such imposition persists. So, we need another debate, with the same passion, on a person's the right to die.

I never gave this issue much thought until recently. I mean, hey, who wants to ruin a perfectly good day thinking about our inevitable demise? So I. like everyone else on the planet, just shoved it to the farthest back-burner of my consciousness.

But that strategy fails, and fast, when we are confronted by a family member who has clearly entered their final lap of life. And that's what got me thinking about all this. I'm of an age, 67, where death has become a frequent visitor. Eldercare has become more than just a term around our house over the past ten years. Sue and I have been there for her parents' deaths, then my father's and now my 93-year old mother has begun to decline, physically and mentally.

All four of them lived vibrant, active and successful lives. They raised children, had successful careers and built successful businesses. They lived well and loved life.

It was only the final year or two where things all went to hell, and fast, for each of them.

My Dad, who had built a successful home construction business after returning from the Navy in World War II, was on oxygen the last year, and he hated it. One day I arrived at his house to help him with some repairs and there he was, 91-years old, gasping for breath, his oxygen bottle under one arm, dragging a 60 pound sack of cement with the other. I got out of the truck, angry at him.

"What the hell do you think you're doing?" I asked. "Kill yourself or something?"

He shot me an angry, fatherly, glance.

"Yes," he said. "This sucks. I hate it. Can't we speed this (dying) thing up a bit?"

Fortunately we were able to keep him in his own home to the very end. That was a huge blessing. But during that last week or two he would sleep a lot. One day I woke him up for his medications. It was very hard to rouse him, and I thought maybe this was it. But eventually he opened one eye, then the other, and looked a bit surprised. "Damn." he said. "Am I still alive?"

He was SO ready to go. And go he did, eventually. His final months were unhappy, painful and filled with daily humiliations for a once independent, tough and active man. When the end came I was more relieved for him than sad.

Now I am getting to go through all that one more time, this time with my mother. During her prime she was one amazingly sharp cookie. At a time in history when wives were supposed to be just homemakers, she raised two kids, ran the my father's construction company, and became a successful stock market wizard in her spare time.

Now she can't remember what she did a half hour ago. And she knows it. And she hates it. And she asks the same question, "Is there any way we can speed this up?" She is so ready to go.

But, in our culture, you don't get to go when you decide to go. The right-to-lifers have decided no one gets to make that decision. You own your life, but not your death. Instead your death belongs to some abstract philosophical/metaphysical/spirit-entity. You can't argue with them. You can't reason with them. You will live to the bitter end, no matter how long. how bitter, how humiliating, how painful or how miserable that end might be.

"I'm not afraid of being dead. I'm just afraid of what you might have to go through to get there."
— Author Pamela Bone

This nonsense is not only incredibly cruel, but financially ruinous for families and society as a whole. On one hand, medical advances have given us more years of health. We live better, longer. Terrific. I'm all for that. But when our body's machinery reaches its limit, and we enter what pilots call a "terminal spin." that's when the medical system morphs from friend to foe.

"The (old) idea said David Cutler, the Otto Eckstein Professor of Applied Economics, "life is a series of strokes, and medical care has simply gotten better at saving us. So we can live longer because we've prevented death, but those (final) years are not in very good health, and they are very expensive -- we're going to be in wheelchairs, in and out of hospitals and in nursing homes." (ScienceDaily.com)

Now don't get me wrong. I am not for one moment suggesting that we should expedite the death of any terminally ill person against their will. I know all the examples opponents of physician-assisted suicide; that some patients may not be in any condition to make such a decision, some will make the decision to die based on guilt about the financial pressure their illness is imposing on their family. All those problems are real, they exist.

But they are not the full story. They are individual situations, and should have to be dealt with individually, not collectively. In death, like life, one-size does NOT fit all.

"Death is a punishment to some, to others a gift and to many a favor."
— Seneca

Polls show that over 80% support the right to die and have done so for the last 25 years. Even 80% of practicing Catholics and Protestants support it.

On the positive side I think a lot of folks my age have faced this, are facing it now, or will soon. And I don't think they will emerge from it without thinking seriously about two things:

  1. Shouldn't the medical system switch from it's role as life-preserver and life-saver, to a palliative care system and -- when a patient requests it -- actively help the dying, die. Just as doctors helped them in at birth, help them out at the end of life.
  2. And what about our own, personal end? What are we going to do? What do we want then?

Everyone needs a living will and a motorized medical directive. But those things have limits. They stop at "DNR" - Do Not Resuscitate." Which just mean that if you are lucky enough to start dying naturally at the end, medical personnel will not jump in and try to short circuit the process.

But from what I've seen over the past decade in our own family, DNR is far from a complete solution. "They" will give you pills, blood transfusions, oxygen, whatever it takes to keep the old jalopy coughing along for as long as it can. I am sure this is mostly misguided good intentions. But there are also compelling financial incentives to keep failing persons consuming medical services and products for as long as possible. We spend about a third of our annual $2.6 trillion health care spending in the last year of patient's lives.

Surely not all those dying folks would have chosen an early exit, even if it were offered them. But some - many I would guess - would have made just such that choice, had they been offered a reasonable, legal, painless way to "speed this thing up."

But, if the never-ending abortion debates are any indicator, we will not be settling this matter any time soon. Surely not before I feel the Grim Reaper's cold breath on the back of my neck., given the choice.. .. ah yes, choice.. heard that before.

When fully aware adults in the final stages of life do not have the flip-slide right... the right to leave this world on their own terms and time, then something's terribly wrong with that.

Me? Well, after helping three folks through the last gasps of advanced old age, I see nothing whatsoever inviting there. So I'm with Hunter on this issue, and living accordingly:

"Life should not be a journey to the grave with the intention of arriving safely in a pretty and well preserved body, but rather to skid in broadside in a cloud of smoke, thoroughly used up, totally worn out, and loudly proclaiming 'Wow! What a Ride!'"