As a blogger, I love to pepper my posts with personal anecdotes, reality being the sharpest rhetorical bolt in any writer’s quiver. But while I usually try to stay as close to the facts as possible, this post’s story has been generously fictionalized, the names and details altered to protect the participants of the real life anecdote I would prefer to tell.
For to do otherwise could get a loved one convicted of murder.
At the center of the story is a family matriarch, let’s just call her Aunt Sarah, a spry old lady, decades a widow, who seemed to cherish her independence almost as much as she did her grand kids, and who one day in her early eighties was suddenly and unexpectedly diagnosed with end-stage cancer. Her doctor thought it started in her lungs, but we’ll never know for sure, for despite the fact that she had shown few symptoms, it had already metastasized throughout her body, the doctors giving her little more than six months to live. She would be dead in three.
The rapid progress of her illness was quite stunning, even to a family that had been ravaged by cancer. My father, his only sibling, three out of four grandparents (the fourth having died young of a bum heart), and a plurality of great aunts and uncles have fought the disease, some successfully, some not. But never have I seen such a precipitous decline, from diagnosis to death, as that of Aunt Sarah.
Only three weeks after stubbornly driving herself to the doctor’s office to receive her own death sentence, Aunt Sarah was mostly bedridden, the pain of the advancing tumors almost unbearable, and by six weeks the cancer had clearly started to eat away at her brain. Aunt Sarah, in her fashion, defiantly insisted that she wanted to die in her own home, and her children dutifully obliged. Home hospice care was arranged, round the clock aides hired, and a rotating vigil of sorts informally organized, family members coming to sit by her side and pay their last respects to the living, while Aunt Sarah’s body and mind withered away before our eyes.
By the third month Aunt Sarah appeared gone, although her body continued to linger on. For days she had lay there, mouth ajar, eyes slightly open but apparently unseeing, her body motionless but for her long, labored breaths and an occasional, wracking shudder that seemed to start at her toes and exit through her mouth in a low, pleading groan.
I was there that afternoon when a doctor (or perhaps a hospice nurse) came by on a routine visit, and pronounced that Aunt Sarah would soon pass on—maybe a few days, or a week at most. Aunt Sarah’s daughter, who by this point was staying with her around the clock, was concerned that she appeared to be in pain, and so the doctor carefully instructed her in the use of a morphine drip, providing ample medication to last the week.
On the recommended dosage he was quite specific. “This much,” he instructed, “should ease any suffering, but if you notice any changes in her breathing, please feel free to give me a call.” Clear enough. “But this much,” he warned, indicating a significantly larger dosage, “Well, you have to be careful not give her too much, or else her breathing will gradually slow and eventually stop, as she peacefully drifts off into a gentle, quiet and painless death.” There was a brief pause, the silence broken only by Aunt Sarah’s gasps for air. Nobody said anything, nor needed to. We thanked the doctor, and gave our goodbyes.
That night, Aunt Sarah died in her sleep.
No, that story did not actually happen, at least not exactly in that way, but something like this did occur in my family, as it does in many other families every day, and throughout the nation. Some doctors choose to provide the information and the medication necessary to humanely terminate the life of a dying patient, and some families choose to act on it. If “Aunt Sarah’s” daughter did indeed up the dosage, easing her mother off into a peaceful death, it was an act of love and compassion. And it was most certainly illegal.
And it would still be illegal under the terms of I-1000, the controversial Death with Dignity initiative on Washington’s ballot this fall, despite the dire exhortations of its opponents.
I-1000 does not authorize euthanasia or physician assisted suicide; it merely allows physicians, under certain narrow circumstances, to prescribe a lethal dose of medication to terminally ill patients for self-administration. And it is not, as Oregon’s decade old measure has proven, a slippery slope toward legalizing the very common practice that shortened “Aunt Sarah’s” suffering, let alone a path toward Soylent Green style suicide centers.
To argue that one inevitably leads to the other ignores two realities, the first, a political reality in which I-1000, as limited as it is, will barely pass if it passes at all, a context within even the thought of a successful euthanasia initiative is a political fantasy. The second reality is that individuals, families and physicians already make these difficult and painful decisions everyday—as was made in the case of “Aunt Sarah”—unregulated, un-talked about, and totally outside the law.
We cannot prevent terminally ill patients from choosing to end their own lives, we can merely make this option more difficult and more painful for them and their families. Likewise, while our current legal prohibition on mercy saves no lives, it does promote suffering, discouraging some doctors from prescribing adequate pain relief out of fear of legal consequences should the patient or family choose to administer a lethal dose. It is a prohibition that simply does not work, and as such, if the goal is to protect the vulnerable, it is a goal that would be better served by pragmatic regulations than by moral platitudes.
Initiative opponents scoff at a “right to die,” but what they’re really telling us is that there is only one right way to die: apparently, of natural causes, no matter how long or how painful the death. Personally, having watched close family members suffer through exactly that, I know what decision I would make in a similar situation, with or without my government’s blessing.
A terminally ill patient, under current law, can legally buy themselves a handgun and ammunition, but not a lethal dose of medication. Go figure. And then go out and vote Yes on I-1000.