Lots of talking about this lately.
Lots of talking about this lately. A 29 year old is dying of a horrible disease, and she is choosing to take control of that moment. Thank whatever power you choose that she has such an option.
#tinysoapbox warning - - -
It is important to have the conversations that this sparks, and this article is not too bad in discussing the need for a culture that embraces and provides palliative care. However, it also fails in its arguments in ways that are common in such discussions.
My most disagreed with quote is this: "We can more effectively promise that someone will die with dignity without the need to take precipitous measures while they still believe they can."
My considered opinion, personally and professionally is that we can't promise squat. Ever. We do not have that kind of control, nor will we. This does not mean we should not do a vastly better job of caring for people for whom we cannot guarantee a greater quantity of life. But we need to start looking ourselves squarely in the eye and admit we simply cannot control some things. No promises. Improvements in our attitude, treatment of, and respect for people suffering such a terrible experience we can and should act on, but we will never be able to promise the time and manner of someone's death.
Nor is it up to us, in our deeply subconsciously ingrained Judeo-Christian cultural ethos to EVER judge another person's "need" in this regard. If you personally happen to believe that if you commit suicide, you will go to hell, that is your personal belief for yourself and should be respected only in that context. It is not a perspective from which we should be judging everyone regardless of their personal beliefs.
What people are struggling with is the need for control. Sure, it's always an illusion, but most of us need it to survive. When a ravaging disease takes everything else away, the only thing left you may have to try to totally control is your death. Is that a Pyrrhic victory? Maybe, but since you are dead either way, I don't think so. In fact, I think while it may be desperate, it is desperate courage. I can control nothing else, but I can control this. And I will.
And it has been observed that many people, given the means to control their death, often ultimately do not use it. Knowing they have it, and that choice is there, is enough. Sometimes it is used. They can arrange for their loved ones to have the closure they need, in a way they may also have some control over, and it may make it possible to ensure that people for whom it is important can be there for whatever services or rituals are comforting, ensuring necessary support is in place at that moment.
Ultimately, I believe that making available the option to choose to control your own death is palliative care. It isn't the option of first choice, it isn't the option that trumps all other options. However, we need to respect that it is normal and important for people to have some control over this terrible chaos in their bodies and their lives. And we can give them that.
http://www.newrepublic.com/article/119744/brittany-maynard-and-assisted-suicide-lessons-dying-oregon-woman
http://www.newrepublic.com/article/119744/brittany-maynard-and-assisted-suicide-lessons-dying-oregon-woman
#tinysoapbox warning - - -
It is important to have the conversations that this sparks, and this article is not too bad in discussing the need for a culture that embraces and provides palliative care. However, it also fails in its arguments in ways that are common in such discussions.
My most disagreed with quote is this: "We can more effectively promise that someone will die with dignity without the need to take precipitous measures while they still believe they can."
My considered opinion, personally and professionally is that we can't promise squat. Ever. We do not have that kind of control, nor will we. This does not mean we should not do a vastly better job of caring for people for whom we cannot guarantee a greater quantity of life. But we need to start looking ourselves squarely in the eye and admit we simply cannot control some things. No promises. Improvements in our attitude, treatment of, and respect for people suffering such a terrible experience we can and should act on, but we will never be able to promise the time and manner of someone's death.
Nor is it up to us, in our deeply subconsciously ingrained Judeo-Christian cultural ethos to EVER judge another person's "need" in this regard. If you personally happen to believe that if you commit suicide, you will go to hell, that is your personal belief for yourself and should be respected only in that context. It is not a perspective from which we should be judging everyone regardless of their personal beliefs.
What people are struggling with is the need for control. Sure, it's always an illusion, but most of us need it to survive. When a ravaging disease takes everything else away, the only thing left you may have to try to totally control is your death. Is that a Pyrrhic victory? Maybe, but since you are dead either way, I don't think so. In fact, I think while it may be desperate, it is desperate courage. I can control nothing else, but I can control this. And I will.
And it has been observed that many people, given the means to control their death, often ultimately do not use it. Knowing they have it, and that choice is there, is enough. Sometimes it is used. They can arrange for their loved ones to have the closure they need, in a way they may also have some control over, and it may make it possible to ensure that people for whom it is important can be there for whatever services or rituals are comforting, ensuring necessary support is in place at that moment.
Ultimately, I believe that making available the option to choose to control your own death is palliative care. It isn't the option of first choice, it isn't the option that trumps all other options. However, we need to respect that it is normal and important for people to have some control over this terrible chaos in their bodies and their lives. And we can give them that.
http://www.newrepublic.com/article/119744/brittany-maynard-and-assisted-suicide-lessons-dying-oregon-woman
http://www.newrepublic.com/article/119744/brittany-maynard-and-assisted-suicide-lessons-dying-oregon-woman
Yes
ReplyDeleteI have always thought it horrible that this choice is denied people. If we don't own our own LIVES, what on earth do we own?
ReplyDeleteA partially non-flippant answer is that is part of the subconsciously religious aspect of this. Our lives belong to god, doncha know; his to propose, his to dispose. And it is all over our laws and the arguments about this, even when people claim they are being objectively ethical.
ReplyDeleteI know.
ReplyDelete(Also, while I am aware that religion CAN have some positive effects on those who prefer to outsource their ethical thinking, I mostly see it as a hideously toxic influence EVERYWHERE, and wish more people would grow beyond it.
...and that has been my unashamedly offensive comment of the month.)
That's not offensive. As I said, I totally respect people's beliefs with regards to themselves. And there absolutely are other types of situations where religion has had a positive effect. We keep acting as if it isn't at play here, though, and I think that keeps up from being able to really address that death is part of life, and laws need to consider the broader, not the narrower view.
ReplyDeleteThe fact that she has to make this choice makes me sad.
ReplyDeleteHowever, the fact that she lives somewhere where she can make this choice is very comforting to me. It's not a happy thing, though that's what I almost wrote, but it is a good thing.
" We can more effectively promise that someone will die with dignity without the need to take precipitous measures while they still believe they can."
ReplyDeleteI don't think that's even remotely what palliative care means. I'd go so far as saying that these are two orthogonal things.
I don't think it's really part of palliative care — but it's close enough to be in the same department at the care store as it were, in the sense that it should pretty much come up in the same conversations.
I can go with that. To me palliative care is not just about physical, but about mental, emotional, and spiritual care, as well. In that sense, to me, this falls within the range of the latter three.
ReplyDeleteThe reason I have this expansive view of palliative care is because of the care provided by hospice to my father. They didn't just hand out pain meds and anti-nausea meds. They came to the house and sent counselors, supportive care teams, and even clergy, if you wanted them. Not just for the patient, either, for the family caregivers, as well. The medical care itself was excellent, but it would not have made the difference that it did without the other things.
Yeah, fair enough. That actually makes more sense than my thing.
ReplyDelete