You may or may not have heard the story. Brittany Maynard, 29, has been struggling with a terminal illness, and has chosen assisted suicide. After extended suffering, she has chosen to end her life on November first in a legal and humane way. As a result of this, she has become the face of assisted suicide and the controversy surrounding it. I have seen every viewpoint possible on my Facebook the past day or so, but in weighing in, I just had too much to say to simply comment. So here I am.
What do I think of assisted suicide? That’s a complicated answer. My blog is about exploring the enchantment of life, something I strongly advocate. Having myself struggled with depression, I am an avid advocate for appreciating life and finding reasons to live. I am proud to say that, despite having been through some very dark times, I have chosen- and will always choose-life. I believe that life is a precious gift, and that we owe it to ourselves- and to others- to keep fighting, no matter what.
I have also worked in suicide prevention for the past six years. That means I have spent six years of my life talking people out of killing themselves and urging them to choose life. Many of those persons had chronic illnesses; some of those persons had terminal illnesses. It was the stance of the American Association of Suicidology- at least at the time that I was certified- not to support assisted suicide. Their reasoning at that time was that it is a gray area in a life-and-death situation. According to the CDC , suicide is still the tenth leading cause of death in the United States. This is not the time to give more people reason or support to end their lives.
I have also, however, survived the loss of my mother, aunt, and grandmother when I was in high school. It is a hard lesson to learn, at fifteen, that life can be so short. Even harder was watching my loved ones fade away. Some images are stuck in my mind forever, and here I will be blunt, because I don’t think that many people, even people who know me well, understand what it is really like to support a dying person. So here is what I experienced. I watched my aunt struggling to get through her son’s wedding despite failing health. I watched my grandmother urinating on the floor right in front of me. I watched her slowly forget who I was. I listened as my mom, whose mind was going, was telling me excitedly (and repeatedly) that she could walk again when her emaciated legs were clearly not moving. I gave my mom sponge baths and changed out her IVs. I spoon-fed her and stood there waiting for her to inevitably throw it all up again. I watched her hands turn blue and stiff has death began to set in. She was losing her mind and body until the person in front of me was completely unrecognizable. Death takes over all the senses. The person in front of me looked, sounded, felt, and smelled entirely different from the mother I knew and loved.
When my mom was ill, I prayed for a miracle, but what I didn’t realize at the time was that she had only been given a one percent chance of living in the first place. Even knowing that information, she valiantly fought the disease for months. One percent, after all, is better than zero. That is the person my mother was- eternally an optimist. Eventually though, when it became clear that she had no other options, my mom entered hospice care. At that point, it was clear to her doctors, who have the training to differentiate these things, that it was time. It had been clear to our family for some time, although it was a difficult thing to say out loud. Hospice care is available to provide support and comfort to those who are clearly dying. It involves discontinuing treatments meant to fight off the illness in favor of those that provide comfort. This is not a far leap from assisted suicide; it’s a small step. In fact, AAS identifies these two treatments as “passive euthanasia” versus “active euthanasia”.
My mom is my hero. There are many things that she had done throughout her life that were very brave and inspiring. However, I don’t consider her last month of suffering to be bravery. Why? She had no choice. You might say that her bravery came with her outlook, bravely facing death. I might agree, except that her mind was already pretty much gone. She was a shell of the person she once was, suffering in a body that was rejecting her. I sometimes wish that my mom could have had a different method of dying, not only because she was clearly in a lot of pain, but also because she deserved to have more dignity than that. And I don’t want to appear selfish, but it was difficult on my family as well, not only because we had to watch her in pain, her last breath a painful, fearful gasp, but also because by the time she entered hospice care, she was too ill to settle many of her affairs. I’ve heard of moms leaving notes to their children. That’s something that we were never able to have.
My mom, aunt, and grandmother were clearly all terminally ill, and in a lot of pain and discomfort, and the only humane solution would have been assisted suicide, or perhaps a very heavy dose of pain medications that would have had the same result. (Trust me, especially in my mom’s case, small doses of morphine were not cutting it.) There are a lot of differences between traditional suicide and assisted suicide. One is done in solitude; the other with the support of friends and family. One is done illegally, often with violent means, while the other is done with end-of-life counseling and approval under strict parameters, family support and (to my understanding) supervision of medical staff. One is usually the result of mental illness, while the other is a choice that needs to be made with sound mind. And most importantly, one is choosing death over life, while the other is choosing the manner of death when death is already imminent.
And that’s the key difference to me. It’s not about choosing to live or die. I know many, myself included, feel that particular choice should be out of our hands. It’s about choosing to die with dignity. So, do I support assisted suicide on the whole? Not at this time; while the parameters have become more well-defined, I’m not sure that the public fully understands the difference. And when it comes to life-and-death decisions, understanding is key. I wouldn’t want anyone facing a difficult -but not terminal- illness or a difficult life situation thinking that suicide is a solution. But- I do support further education about the difference between assisted and traditional suicide, as well as a change in the use of the term “assisted suicide,” perhaps to “euthanasia” or some other term to further differentiate the two. I hope that this further education and change in name will make the two distinguishable enough that euthanasia can eventually become a common hospice treatment. And I support Brittany’s choosing the manner in which she dies. I see there a person of sound mind, facing definite and imminent death with courage. I applaud her for speaking out so bravely on what she must have known was such a controversial issue, especially in knowing that she will not live long enough to see this issue resolved.
J.K. Rowling once said, “To the well-organized mind, death is but the next great adventure.” Death is a part of living, and it’s an important part. It is what drives us to succeed, what compels us to seek some sort of legacy, and what allows us to see the beauty in life. I have no doubt that this young woman is terrified of dying, and I don’t believe that it’s fair that she should have to die so young. Still, she has faced her death in a way that my mother was never able to. In doing so, she has been able to truly live the last few months of her life, wrap up those loose ends that so often get left to other family members, say her goodbyes, and face that next great adventure with as much courage and dignity as possible.
Yes, “to be or not to be, that is the question.” But what if your only option is not to be? The decision of assisted suicide is tied up and knotted in with traditional suicide at this time. But folks, this is like comparing oranges and grapefruits. They may look similar, but they taste entirely different. To lump them in together causes more pain to both groups of sufferers. We don’t need to condemn assisted suicide; those who are already dying deserve the right to die with dignity. What we need is a stronger differentiation between the two, and more education on the difference. I think what we are all fighting for, each and every day, is to love and respect the lives we have been given, however short or long they may be. Brittany, thank you for reminding us how precious life truly is.