My ethic of life: Part 2A

As you’ve surely deduced from my previous Ethic of Life post, I’m for life and I’m not afraid to admit it.

But I also believe that under certain limited circumstances, the ending of a life (animal or human) is sometimes acceptable. Coming from a liberal, non-religious philosophical perspective, my personal ethic is certainly far more consistently pro-life (in all areas) than either side of the political spectrum. But we’ll get there.

This was the statement from a disability-rights advocacy group that stopped me in my tracks. (The group is called Not Dead Yet.) The idea of assisted suicide has long made me uncomfortable. For whatever reason, suicide is a topic that is really difficult for me, perhaps because I’m very empathetic, and the notion of a person being so distressed as to do something so drastic is really really upsetting. At any rate, assisted suicide in the case of terminal illness is a different situation. …Isn’t it?

In recent years, I’ve come to accept that some people would prefer assisted suicide to a protracted illness. But. After witnessing my mother-in-law’s death of cancer; the slow death of my former sister-in-law’s mother of early onset Alzheimer’s; my grandmother’s age-related, dementia-tinged passing; my grandfather’s sudden death from cancer complications; and my disabled uncle succumbing to disability-related septic infection…you’d think I would get on board the assisted-suicide train, but just the opposite. I saw worth, dignity and value in each of their lives, even unto the end. If any of them had chosen an earlier exit, we all would’ve missed out on meaningful time together.

The loss of autonomy due to disabling factors from illness is often what people fear most, that and being in pain. But as Not Dead Yet reasons so eloquently, the first concern is in fact ableist thinking (to use a contemporary term), and the second is largely unfounded. Rather than poorly rehash a better argument, I’ll include this animated conversation that disability activist Norman Krunc created about assisted suicide:

With regard to pain, supportive palliative care is an invaluable service that everyone is entitled to, but I don’t think it’s taken advantage of nearly enough. Palliative care offers levels of pain control that are far beyond what’s available to non-terminal patients, even up to sedation. We need not fear a painful death. Any pain or suffering you may have witnessed in a dying person is likely because you witnessed it in the past, when we didn’t have the tools we do now to ease pain, or—and this is a big one—because the individual didn’t accept palliative care at an appropriate time. So many of us are so afraid of “giving up” or accepting death that palliative and hospice care aren’t employed until the very end, usually within the final days of a person’s life. Accepting this care at an earlier point provides meaningful, pain-free and dignified time to the terminal patient.

And now for the personal anecdotes that inform my opinion.

My mother-in-law, Debbie, was only 60 when she passed away from her second bout with metastatic breast cancer. In the final few weeks of her life, she asked me to help care for her, and because I’m an at-home parent, I was able to do so. I bathed her and washed and blew dry her hair every day (she was always very fastidious about her personal care). I even learned the process of Foley catheterizing her when she lost toileting autonomy. But even had I been unavailable, she received compassionate palliative services by professionals. One of the CNAs who came to bathe her would greet her with a warm “Hi, butterfly,” and treated her with such sure-handed tenderness. If you’re afraid you’d be unable to provide appropriate care for a family member with end-of-life disability, first: you likely can learn, and second: there are supportive structures in place to help you, and to help you learn.

There was no loss of dignity in that. Providing the most intimate personal care—which is often actually easier if it’s a hospice professional, depending on the individual—is not a loss of dignity. It is exactly the opposite. When as a society (but certainly as an individual) we do not shy away from the physical realities of a disabled person’s needs, we affirm their dignity, their worthiness. To fear that for ourselves is a psychological problem, and people with psychological problems are exactly the people who receive suicide prevention. Our fears about loss of autonomy, or dependency on others, or of languishing in a nursing facility are psychosocial problems to be solved; they are not valid reasons for suicide.

I then thought of the final days of my family members’ lives, during which they were sedated and on high doses of pain medication. None of them suffered. But of course, it was painful for those of us who survived them. I can understand an individual not wishing that pain for their families and choosing an assisted suicide within the final days. But I still can’t agree with it. We can, and should, do hard things. Dealing with death, dealing with the sadness and pain of losing a loved one, is an essential life experience. Avoiding emotionally difficult experiences is perhaps our most pressing psychosocial problem: instead, we self-medicate, we fall into unrelenting depressions, we succumb to hopelessness and the sometimes violent or self-harming behaviors that accompany it.

So can I imagine a situation in which an early exit administered by a physician-prescribed overdose would be acceptable? Yes, I can. But I really can’t get behind assisted suicide as a remedy for fear, or rooted in anti-disability bias, or for avoiding uncomfortable emotional experiences.

Up next, the death penalty. I was originally going to include the death penalty along with this topic, but I’m suuuuper busy with school and my brain is absolute shit today (Winnebago Man, anyone? This is the one thing that can within three minutes get me laughing so hard it hurts, because it is so relatable. Will you do me a kindness, and watch it? Warning: foul language used to hilarious effect)

Until next time…