Monday, March 28, 2016

Wondering Aloud Toward a "Death with Dignity"

During this legislative season, Iowa lawmakers considered and then abandoned a proposed "Death with Dignity" bill.  It received some attention along the way, punctuated by a lead editorial in the Des Moines Register last week supporting passage.  I was hopeful that an extended conversation would ensue, and toward that end contributed a guest essay for possible publication.  Alas, as I indicated, the bill died in the funneled legislative session -- with or without dignity -- and the news, along with the Register's attentions, have moved onto other subjects. 

Still wishing for a serious and extended conversation, and since the Register passed on my essay, I opt to post it here and invite responsive participation.  You will search in vain for solutions in what follows.  The reason is that I don't know what they are.  What you will find instead (vetted and approved by the subject's family) is my passionate sense that among the unacceptable solutions is the status quo. And so read, reflect, consider and, if you wish, contribute your own wise thoughts.

On a bright but sobered October Friday morning 5 years ago my wife and I drove our beloved Welsh Corgi of twelve years for a final time to the vet.  Several months earlier he had been diagnosed with lymphatic cancer, and through the ensuing weeks had submitted to chemotherapy and acupuncture, along with the discomforting miscellany of deep sickness and constant handling.  Eventually, however, it became obvious even to us who were blinded by our affection for him that continuing on might be in the best interest of our sentimentality, but not to his well-being, comfort and quality of life. He was, to sharpen the point on it, dying whether or not we chose to admit it.

After conferring with the doctors, we scheduled that next day’s heart-heavy final drive to the clinic.  The staff had prepared the room – softened its otherwise clinical appearance and feel with blankets and quietness.  We cried, the doctors cried, the front desk staff cried; we held him, spoke to him, caressed him, until with the medicines’ help he relaxed in that final way and breathed his last.  As miserable and grief-filled as it was, it was beautiful. It was tender, loving, and gently peaceful.

Meanwhile, within days of these precious moments, a dear friend and parishioner mere blocks from that animal clinic was struggling with her own diagnosis.  A physician in her earlier years and later a medical librarian, Barb was coolly and methodically rational.  She had cared attentively for her husband who had gradually declined first through Parkinson’s Disease and then deeper and deeper into dementia before dying a few years earlier.  Now given a similar diagnosis herself, beginning to experience its symptoms and clear that she didn't want her children and grandchildren to go through her own agonizing decline, she put her medical and analytical researcher’s skills to work exploring alternatives.  She studied the laws in those few states that permitted physician assisted suicide and concluded that she could not reasonably qualify.  She broached the subject with physicians nearer at hand, knowing deep down that they could not help her.  Throughout, Barb kept her thinking and her inquiries secret from her kids – contrary to her nature and their usual family patterns -- since both were involved in medical careers that would have obligated them to intervene in ways contrary to her wishes.  She began to advocate for a change in the law.  In the end, however, she calmly and rationally reached an unenviable conclusion:  time was not her friend.  She would not live long enough, with faculties enough, to effect a change in the law.  The laws that did sympathize with her were inaccessible to her.  So, out of options, after writing an extensive letter of explanation  to her children whom she charged with continuing her advocacy , she stepped off the 9th floor balcony of the retirement community apartment where she lived; taking matters into her own hands.

I know, this is a complicated subject.  As a minister I am fully mindful of the moral and spiritual issues that routinely and necessarily trouble such discussions, and I am sympathetic to those tormented by the medical ethics brought into question by considerations of physicians assisting with the death of a patient.  These, and I am not oblivious to the thorny and complicated public policy issues at stake.

But what haunts me is the juxtaposition, by a matter of days, of the tender and lovingly beautiful death of my dog in the hands of those who loved him, and the jarring plunge to her death of a dear and beloved mother and grandmother, carried out in secret isolation, whose options she deemed to be too few and untenable.  I don't know how to resolve the complications; I don't know how to rewrite the laws.  I only know that together we have to figure it out.

Because it's unconscionable that our pets have a better death than our parents, our spouses, our grandparents and our children.