The costs of dying can be high. We lose our dignity, and spend all our resources, perhaps even the resources of our children. So, the calculation is so simple. Any bureaucrat or insurance claims examiner can run the numbers, and issue the appropriate form letter notification: “The costs of keeping you alive are not approved for payment. We will however pay the costs of assisting you in taking your own life. Yours truly, the State of Oregon.” [paraphrased, but not much.]
Certainly, a person should be allowed to let nature take its course toward death in his own body without incurring unwanted medical treatment, especially extraordinary treatment with little proven record of success. That truth is not being debated by this essay. The debate has to do with ethics behind the “right to die” laws enacted in Washington and Oregon, and that will inevitably be considered for adoption in other states.
This idea of controlling our “quality of life” and more exactly, controlling the “quality of death” has a flawed assumption: control. We take over the writing of a script that was not ours to write. Our time, our “quality,” our “purpose” are not ours, but God’s. God alone has the full story. Do we have the right to hijack the role of “writer” without knowing the divine plot or likely “surprise ending?” In our passion for “control,” we end the story on our terms. We are quick to abort the lessons, the growth, the transformations, and the inscrutable purposes of God. In that haste, we not only exercise the right to refuse aggressive medical care, but we take prescribed poisons to end our days earlier.
So the question might be: is the avoidance of our suffering our total prerogative? Are the terms of leaving ours to advance as we please? The question goes to a perennial debate: the individual and the community, God and the “self.” Our tendency is to declare the right to terminate our lives independently of concern for others. Others simply need to understand.
It is true that “end of life” issues present very personal and very difficult ethical questions. But we do not come into the world without help, and we generally do not leave this world without help as well. Others are connected to us, and to the issue of how and when we are to die. Others have ethical obligations to us, and we to them. We cannot assist in the killing of another human being, or even ourselves, without regard to God, ethics and law.
We all inevitably die. There is no ethical requirement to prolong life simply because we can, no matter what the cost emotionally, physically, or financially to oneself or ones family, or even the “state.” The quality of life is certainly a critical question to be weighed in deciding treatment options when facing a terminal illness. However, some doctors and families go further than withdrawing extraordinary life sustaining measures. They define “medical care” as food and water. The truth is that patients are allowed to dehydrate and starve when they persist even after medications and assistive devices are withhdraw (sometimes to everyone’s surprise). Even healthy persons do not generally live more than 3 or 4 days without water.
What are the ethics of accelerating a person’s death by active interventions, such as by legally prescribed poisons? The underground of medicine is that doctors are already providing lethal dosages of narcotics to end life based on their own calculations of the patient’s chances of recovery and level of functioning. Old people are routinely killed in this way, by doctors, in all 50 states, with the complicity of family members and medical staff making practical decisions on the cost and trouble of maintaining life by further medical care. Officially, Oregon and Washington now allow persons to accelerate their own deaths. Doctors are permitted to prescribe, but not administer, the drugs that will kill their patients.
Are we right to take these legally prescribed “death drugs” on our schedule, setting our own time, without regard to the significance our final days might otherwise have to either us or others? What might God do with those final days? Is that not for God to decide? Could it be that our final days of pain and “indignity” were meant as an offering to God for his purposes, just as our days of health and energy?
Self-administered death is an individual right, according to the advocates of “right to die” laws. But we are not truly independent. We never have been. We have always been individuals connected by family and community. We can decline treatment in the face of terminal illness, we can reduce the level of pain, we can arrange to die more comfortably, but do we have the right to accelerate death based on ideas that we are in “too much pain” and “we are too much of a burden?” These are simply phrases that express: “I am in control of the meaning, purpose and impact of my life. I will set the day and time of my death.”
In cutting short our suffering, we also cut short the love and care that could be expressed in those final days. We deprive the world, and maybe even ourselves, of living our final days with faith in the goodness of God, even in our suffering. We become as commodities, things to be processed efficiently into and out of life. In this, abortion laws and “end of life” laws serve the same calculation: human life is only worth what we say it is worth.
Those final days are few but important in the measure of eternity. They can be a final and profound statement of faith to those we love. Those days can be our answer to the questions: Who is God? Is He the same God of power, supremacy, and love in our death as we claimed Him to be in our life?
Author’s Note: You can set the level of life support you want after a medical emergency by completing an “Advance Directive.” Check your States particular laws. Most states provide downloadable forms. Links to Advanced Directives for Your State.