Lecretia Seales is a New Zealand woman with terminal brain cancer who is currently arguing for her right to die by choice without her doctor being charged with homicide. The arguments are familiar: she doesn’t want to suffer unduly, cause suffering to her family, become a burden; she wants to die with dignity. I’ve just finished reading Atul Gawande’s book ‘Being Mortal’, a book I hope sparks widespread debate about this issue.
He is a surgeon and recounts his father’s death from a rare spinal tumour. He also takes us through the deaths of patients and friends who all faced either age or terminal illness. What I appreciated about his writing was that it has me confronting my own thoughts about aging, becoming infirm, facing mortality. While you would think it would be depressing it hasn’t been. It has provided clarity about what is important and how to ensure I communicate that with those I love.
At the heart of this debate is control over our lives, and, ultimately, dying is a part of our lives. Lecretia can make choices about that now but the nature of her disease will mean at some point she won’t be able to continue to do so. And that’s scary. If she could crystal ball gaze into the future and see herself peacefully surrounded by those who love her while she quietly stops breathing I don’t think she would be sitting in court.
Much of this debate is about the care and treatment leading up to that moment. Many people have experienced the horror of a loved one enduring countless medical interventions in an effort to delay their death. Accepting that someone we love is going to die is painful and we often want to believe that some miracle might just change that reality. Hospitals are equipped with an array of modern medicines and devices which feed into that belief and the goal of all medical staff is to save lives. It’s a potent combination, fueled by high emotion but often ends in grief.
Dr. Gawande argues that the debate over assisted suicide is really a debate about our health care. Do we have faith that our own wants and needs will be catered for as we die?
Hospice and palliative care specialists have addressed this question head on. They navigate the hard questions to ensure the person dying gives a clear directive about what is important to them, that their loved ones hear it, and that they support them all to the end while meeting those goals.
But death isn’t always peaceful and quick. Even with sedation and pain medicines death can take hours or days. This is stressful for loved ones to experience, even when you know the person dying isn’t in pain. This is at the heart of the debate; preventing the burden of this experience for all involved.
How do we make peace with death? Is it through control over the moment of our death or through acceptance of death happening at its own time? How do we define at what point a person becomes a burden when they’re terminal? Who defines quality of life?
Early and on-going discussion with those we love is crucial to these questions being settled. Having choices and a plan to ensure these are followed are big steps towards making peace with death.
What is certain is that being surrounded by those who love you and not suffering are two points everyone can agree on.