Physician Assisted Suicide
Recently the story of Brittany Maynard, a woman with terminal cancer, has been in the news a great deal. She moved to Oregon in order to take advantage of the Death with Dignity law that allows for physician-assisted suicide. On November 1 she chose to use the medication and ended her life. I wanted to discuss the topic of physician-assisted suicide, though not specifically Maynard’s case. Her choices are her own and her death deserves the respect and honor we would accord to any life.
I happen to live in Oregon, and have my entire life. I was young when the Death with Dignity act was passed — it was first passed in 1994 and was reaffirmed in 1997. In order to qualify under the law, terminally ill patients must prove their residence in one of the states that allows it (Washington and Vermont also have similar laws), be over 18, be able to make and communicate their own health care decisions, and be diagnosed with a terminal illness that will lead to death within six months. Two physicians must determine these criteria. The residency requirement does not have a time specification, just proof that you live here so some people, including Maynard, move from their home states in order to gain access to the program. Statistically she was an exception, but it happens. There are a number of safeguards in place to insure that only the patient can procure the drug for self-administration, that it cannot be done rashly or quickly and the family must be notified, among others. When all conditions are met, a patient can receive a dose of fatal medicine that can be taken at the time and place of their choosing.
The church’s position on this is fairly clear. The handbook states that “Euthanasia is defined as deliberately putting to death a person who is suffering from an incurable condition or disease. A person who participates in euthanasia, including assisting someone to commit suicide, violates the commandments of God.” My own feeling with moral issues is that the church handbook is never the final word. I do not reject what it has to say, but I think there is value in wrestling with moral questions without presupposing the answer is obvious and unquestionable. If you only accept one possible answer from the outset, you aren’t really asking the question. In this discussion (which I hope commenters will weigh in on) I want to clearly distinguish this case, doctor-assisted suicide, from other topics such as suicide or involuntary euthanasia programs. I think the moral issues are distinct, and this is worth considering on its own.
I have pondered this question for the last several weeks — as an LDS person, with a testimony of the Gospel and of Christ, do I believe physician-assisted is morally right or wrong? What would I do in that situation? What would I be okay with my husband, mother or other loved one choosing? I don’t have a definitive answer, but I have some thoughts.
Thoughts against physician-assisted suicide:
-The Plan of Salvation necessitates suffering. We came to Earth to gain experience, including very hard, very unpleasant experiences. That is the fulness of humanity.
-Death is one of the great unifying experiences of humanity. As members who understand the Plan of Salvation, we do not have to fear death, we can accept it whenever it may come.
-Even in the extremity of pain, we are not alone in our suffering. Christ has walked every path we will ever walk, individually and personally.
-We have a great deal to learn from death, both from our own and that of others. When my grandmother died, my aunt remarked to my mother about how even to the very last mothers continue to teach their daughters — that dying, and having my mother care for her and witness her in that final process, taught us about death, and about how to die. This is one of the important lessons we learn in life, and God set up our existence to allow for it to happen, almost always with an element of unpredictability that is in itself an opportunity to learn and to teach.
-Taking a human life is wrong. The scriptures are quite clear on this (despite some murkiness involving Laban, and quite a bit of the Old Testament). It is not for us to choose when we leave this life.
-Doctors take an oath to do no harm. Isn’t hastening death the definition of doing harm?
-If we as a society decide that it is okay to end lives that seem too painful, or meaningless, isn’t that perilously close to euthanasia that is not chosen by the patients? This has an appalling history.
Thoughts in favor of physician-assisted suicide:
-Suffering is part of the human experience, but it is not the point of our existence. God allows us to suffer, but does not rejoice in our pain or deliberately cause it. When we are able to prevent or palliate pain, God allows it and rejoices, at least in other situations.
-Often a long process of dying is not edifying to the person who dies or to those around them. Instead it can be traumatic, financially or emotionally draining and horrifically painful. Some illnesses rob the patient slowly of their personality and brain function. How can this be a learning experience for the person, if they are not capable of learning or being themselves? Are months of horrible memories so great a gift to those who are facing bereavement?
-This is distinct from suicide in that it is not a choice based on not wanting to live. Living is not an option in any case. The patient will die soon. It isn’t ending a life that would otherwise be full of opportunities to teach and grow, it is a matter of choosing a moment to say the goodbyes you need and leave in as much peace and dignity as possible. It isn’t choosing death over life, it is choosing a good death, when death is the only choice.
-Not all pain is redemptive. For some it brings them closer to Christ but for others it can be destructive and isolating.
-What constitutes hastening death medically is actually a bit fluid and this is not as cut and dried as it might seem. Often dying patients receive doses of morphine that relieve pain but also hasten death. Similarly the church is okay with not taking extraordinary and heroic measures to prolong life. Is this substantively different?
-Capital punishment is legal, with a strong scriptural precedent. How can we say it is okay to end people’s lives involuntarily, but deny people the right to choose for themselves?
-We came to earth to use our agency. This is an opportunity to have some control over one’s final days in the face of a disease that may rob the patient of all decision making ability.
As I thought about these considerations, my own conclusion is that I would not choose physician assisted suicide for myself, or for my family members. I would gladly have doctors administer large doses of painkillers to provide as much relief as possible, even if it meant hastening the end, but I do not think I would choose the pills available in Oregon. Perhaps those two are not so different, but in my mind they are. When it comes to my loved ones, I guess I selfishly want every scrap I can have. I was glad for my grandmothers when they had release from pain, but I still wanted and treasured every little moment we had, even though their final weeks were hard physically for them and emotionally for everyone. As for myself — I don’t feel I could ask my family to stay for my sake if I wasn’t willing to do the same for them. Even if it meant they mentally went and I only got to hold a warm hand, I think I would want that time.
I know that not everyone feels that way. I am glad that Oregon has the law, not because I personally would choose it, or because I think that God sanctions it regardless of church position. I think, however, that people should be free to choose for themselves and to seek guidance from God and family in making life and death decisions. It may be that in some cases this would not be God’s will, but in others perhaps it would be. I don’t know.
What do you think? What arguments do you see in favor or against physician assisted suicide? How have your experiences informed your feelings on this issue? What do you think you would choose?