Category Archives: doctor assisted dying

More thoughts on dying a good death

Everyone keeps telling me, “You don’t look ill! You look great!” I know they mean it as a compliment, but I DO have a belly full of cancer, and I definitely look better than I feel. In truth, I’ll probably be the best-looking corpse at the funeral home later this year.

I’m definitely on a long slow slide downward, with small upticks along the way during which I look and feel better. I spend long productive hours at home weaving, spinning, and writing, when not sidelined by drug-induced fogginess.

The palliative painkillers have certainly saved me a good deal of physical distress, but they create additional problems (some of them detailed already). As I observed in my earlier blog, dying people are offered handfuls of drugs to ease pain, to reactivate sluggish bowels, to quell anxiety, to fall asleep at night, but we generally are not offered non-drug alternatives that might help us maintain a clearer, cleaner and swifter end-of-life. Conscious death is a movement that has not yet taken hold here, so we have only the drug model to turn to.

Because Indiana is so backward, and because it has permitted medieval religious ethics to taint our laws on assisted dying, there is no death-with-dignity option for me. Because I do not want my death to be prolonged, I instead have drawn up a Do Not Resuscitate order that has been suitably witnessed and registered.  But here’s the question: in effect, don’t my painkillers constitute an artificial prolonging of life, since they keep me alive without allowing me to recognize how gravely ill I am? In ancient millennia, without pain relief, people at my point in the disease would simply curl up in a corner and refuse to eat until they shriveled up and died, but modern pain relief is now keeping me alive, and enabling me to eat small meals, since I can’t feel the majority of the pain in my belly.

Many people would at once say “That’s the benefit of modern medicine! It allows you to maintain your quality of life for weeks, even months, much longer than you would have had in a pre-industrial society.” Well, that quality-of-life issue is the sticking point. I’m still on a very low dose of prescription painkillers, and once my cancer has grown sufficiently to require higher dosages, my current quality of life will vanish as I become too groggy to write, weave, spin, or even take a stroll outside without a buddy to watch over my staggering feet. What then? And with my mind increasingly stupefied by narcotics, how can I expect to practice mindfulness meditation, self-hypnosis, or the daily attempts at maintaining a good attitude that have served me well until now?

Are these drugs really the best we can do for our dying ones? I don’t have a lot of answers, or a lot of wisdom; I’m just stumbling down a darkening passageway, commenting out loud as things slowly occur to me. But it seems to me that piles of drugs are not the best option for someone who wants to die peacefully, with dignity and intention, and without any nonsense.

Image by Chessley Sexton.
Image by Chessley Sexton.

The most difficult question

20141027_101624Doctor-assisted dying is not a choice for ill people in my state. Nor is it an option nationally, as it is in Switzerland, Belgium, the Netherlands and several other more enlightened countries.

Many people will immediately protest: “But obviously, suicide should never be legalized or encouraged.” To which I reply, as a person with terminal cancer, “My desire to take an early exit is a completely different thing than a healthy person who commits suicide.” I want only to hasten the inevitable and painful death that already looms on my horizon; I do not seek to end a healthy life filled with possibilities.

Speaking rationally and without depression, and after a lifetime of considering the ethics of the question, I would choose physician-assisted dying in a heartbeat, knowing what I am soon to endure. But it’s not legal here.

(Warning: skip the following single paragraph if you are easily horrified.)

I have carcinosarcoma, also called Malignant Mixed Mullerian Tumor, which is so rare that there is little research being done on it, and no cure. After living with it for a year and a half and enduring major surgery and various chemotherapies, I’m now in the terminal stage of the disease. The cancer has spread throughout my abdomen and into my liver and lymph glands, but this won’t be what kills me. A large inoperable tumor is embedded low down between my intestines and is impinging painfully upon my bladder and rectum. The rapid growth of this tumor will soon pinch off these vital systems and leave me completely blocked, unable to urinate or defecate. The tumor is growing so fast that my belly already resembles that of a woman five or six months pregnant; this distension will increase swiftly in the weeks to come. Any surgical attempt to correct the blockage would only temporarily extend my life while exposing me to even more continued suffering.

Quite calmly and rationally I ask you: why is it against the law for a physician to help me make a dignified early exit with my head held high? Why should control over the end of my own life be dictated by other people’s emotional and religious scruples? An assisted death with dignity would spare me horrible suffering and would prevent my family and friends from seeing me waste away to a skeletal form with a hugely distended belly. Why do lawmakers feel so certain that dying people should have to endure their full quota of pain?

In this country it’s legal to put down a dying pet. In fact, it’s considered to be the most humane solution to ongoing pain. So why does our government compel human beings to go through the kind of suffering that we would never allow in our own cats and dogs?

Perhaps you happen to believe that human life has a sanctity that must not be tampered with. That’s fine, and I respect your religious values (although I must point out that the Bible nowhere contains the phrase “sanctity of life”). But an enlightened society should not allow followers of a single religion to enforce their religious beliefs upon others, nor should those religious tenets be encoded into the default government over all Americans. I believe that subjecting me and my family to extended suffering serves no useful governmental purpose and displays a profound lack of compassion.

I seek only peace, and a quick end to my suffering. And this is exactly what’s being denied me. I believe that the Swiss, the Belgians and the Dutch have it exactly right when it comes to compassion for the suffering: after a waiting period of several months, and a close vetting of the medical records, patients are allowed to gently and painlessly pass away in the presence of their family and friends. We need this option in the United States.

Please share this text with your legislators and your governor.