Thursday, August 20, 2009

 

Political Mayhem Thursday with Special Guest TallTenor

Razorites, this week's mayhem is brought to you by Talltenor. We had been writing back and forth on this issue, and I thought he had a fascinating take on the issue:

Something happened within my extended family that I thought might be a good topic for the Razor. It's not pleasant or pretty, but it's something that I think we will begin to see more often in the future, as time goes on.

In July, an elderly cousin of mine (my dad's first cousin) ended his wife's life and then his own, using a firearm to do so. E. (my elderly cousin) and A. had been married just shy of 60 years. They lived alone in their suburban home, where E. served as A.'s caretaker - she had Alzheimer's and was pretty much gone, in every meaningful sense. E. was not in the best of health himself, being both worn out from caring for A. but also apparently fearing that Alzheimer's was beginning to overcome him, too.

I believe I can understand the "why" of E.'s decision. They were, by all accounts I've read and family e-mails I've received, exceptionally devoted to each other. I suppose that he could not bear to see A. suffer any more, and that the the thought of living without her - whether because she died or because his own dementia became too overpowering - was too much. To me, the saddest thing about this is that E. did not seem to feel he could reach out to anyone for help... none of his four children had any idea, nor did his priest, his friends, or his doctors. E. took this very rash decision all by himself, and everyone else is still trying to pick up the pieces.

The reason I wanted to bring this to the attention of the Razor is that I feel we are going to see more and more of these types of decisions, as time goes on. When Dr. Kevorkian frist started doing his thing, 20 or so years ago, I thought it was horrible and awful. That was before I had had any personal experience with losing someone I loved to an illness that killed slowly, surely, and painfully. Again, I believe I can understand why E. felt he needed to do what he did. The "how" still gets me.

We put our pets to sleep so as to end their suffering. Could it ever be "right" to decide to do the same for ourselves? Razor readers, please do not turn this topic into a discussion of health care reform. I am more interested in the idea of how we (should) feel about taking the step to end one's own life.

Comments:
First of all, please know that I am sorry it ended the way it did. However, I have literally seen someone die (I held my grandmother's hand and sang to her for the last four hours of her life), but what was more painful was watching her die for years. I am conflicted on how we die in America in this era. For me, it is not so much the idea that we would take our own lives or the ones of those we love in a deliberate manner but more that we hang on to the endless life-saving efforts. This is much more clear when there is a clear-cut diagnosis such as acute, terminal cancer. With a diagnosis such as Alzheimer's, it gets very difficult and very complicated. In a perfect world, people would reach out to their family, their clergy, their medical professionals. Reaching out and getting help and support really does work. It can lessen the burden of the caregiver and can provide respite where it is so needed. The problem is that most people don't know how or where to do that.
So - I have no answers. My hope, though, is that families talk about these issues before they become a reality and keep talking about them because there is a way to get help, although it is complicated.
I don’t believe in assisted suicide or putting people “to sleep” the way we do with our pets. But, I don’t fault those that do. Their burden is more than I know.
 
My reason for opposing assisted suicide, at least given our current health care scheme, is because I think that many elderly or terminal patients will choose the "easy way" of assisted suicide rather than face the potentially difficult road of seeking expensive treatments that might save their lives.

I suppose it is the same thing as "refusing care" right now, but I wouldn't want someone to have to choose between the Scylla and Charybdis of treatment and saving the family money.

On the other hand, it does seem cruel and selfish of us to force others to go through painful and expensive treatments, prolong suffering and so on, just so that we can have more time with them here.

I don't know if there's any way to resolve this on practical matters, so I'll stick to categorical imperatives: we ought not assist with suicide.
 
Yes, this is a really tough one, and I agree with all the comments made.

I don't think we should condemn or judge people who end their lives or the lives of others for reasons such as your cousins', Talltenor. It's going to happen anyway, and making it legal and easier to do is probably going down too slippery a slope given the current health-care situation, as you say, Lane.

One irony that strikes me about your cousins' particular story is that guns were used. I suspect many people who oppose assisted suicide are in favor of the right to own a gun--an instrument whose only purpose is to kill.
 
Not long ago, a close friend of mine, J., decided to kill himself using a firearm. He did it while he was intoxicated and apparently because he and his wife were going through a difficult time in their relationship. He also had a number of chronic health problems, although he was only in his 30s.

In another situation, a close friend watched as an elderely friend slowly and painfully died over a course of weeks. She instructed the doctors to leave her on life support at one point and they kept her on it, despite having to revive her repeatedly, in part because they didn't have a DNR and in part, it seems because they made some errors. In any event, the bills are horrendous.

In both cases, family and friends suffered greatly because of the decisions made by a loved one. In the first case, two families were hurt very badly. All of us who knew J. were shocked. I had made plans to see him only a week after he killed himself and the decision seemed to be made on the spur of the moment. That is a major fear for me. When people suffer they often make bad decisions out of fear or pain. And their decisions have consequences for those who care about them.

I still think the suicide was worse. People were left feeling guilty and confused. Arrangements were left unmade. Others bore the burden of J.'s essentially selfish act. With the woman who was kept of life support and revived beyond her ability to communicate or recover, at least everyone felt like they had done what they could, though there was still a lot of suffering over her pain.

I think suicide is terrible, but I think refusing treatment is very different. For me, the guiding principle is that we should not force others to suffer because of our actions if we can avoid it. Whenever someone kills themselves or is killed, others feel some responsibility and that isn't right. When a dr is prevented from continuing treatment, that is hard, but we have no right to compel a person to accept treatment and expense they don't want. It's out of our hands. With suicide, assisted or otherwise, people are always left wondering if there is anything else they could've done and that is worse.

The best solution, however, is to think these things through before we lose our ability to be rational about it and to discuss it meaningfully with those who love us. But I'm glad suicide isn't legal. Death is too final a decision to be undone if someone realizes they've made a mistake.
 
Isn't there a religious aspect to this for anyone? Suicide is contrary to most faiths' teachings.
 
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