Euthanasia

Suicide: To Assist or Not? That is the Question, by Stephanie Gray

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     This past week my newsfeed filled with news of the suicides of two famous people, Kate Spade and Anthony Bourdain.  It has struck me that there is consensus among the posts I see that these deaths were tragic, that the loss of their lives is something to be mourned, and that the cause of their death—suicide—is something to be prevented—or is it?

     As best we know, Spade and Bourdain died alone, at their own hands.  But what if they hadn’t been alone?  What if their suicides had been assisted?  What if their actions were aided by a physician?  In our confused culture, a subtle change of facts can make the thing we prevent the thing some assist. 

     Which brings to mind an experience I had on a plane last weekend.  I was flying to Halifax, Nova Scotia, to speak at a conference for physicians on the topic of assisted suicide, newly legal in Canada as well as in places like DC, Hawaii, Washington, Oregon, The Netherlands, and Belgium, to name a few.  During my flight I read a phenomenal book on the subject by my friends Jonathon Van Maren and Blaise Alleyne: “A Guide to Discussing Assisted Suicide.” Shortly before landing, a passenger next to me noticed the cover and commented to me, “That’s certainly not light reading!” he said.  In a brief conversation I learned that he had elderly relatives and his wife worked in healthcare.  “Would you like to have my copy?” I asked.  “It’s a short read—I finished it on this flight.”  He gratefully accepted it and promised to e-mail me his thoughts.

     Van Maren and Alleyne have brilliantly distilled the assisted suicide/euthanasia debate to this central question:

     Who gets suicide assistance and who gets suicide prevention?

     When the debate is framed that way it becomes difficult to give anyone suicide assistance—which is the point.  If we believe in human dignity and equality then everyone inclined to suicide should get suicide prevention, not suicide assistance.  Van Maren and Alleyne help explain it this way: A lot of times in the assisted suicide debate people will say it’s about choice, about the freedom of an individual to choose whether she herself lives or dies.  And yet, if we would try to prevent some people’s suicides (e.g., Spade and Bourdain) then it’s not about choice at all.  By trying to stop their deaths we are overriding their choice.  Which means rather than being about choice, assisting with some suicides is about judgment—about other parties making a judgment about whether someone’s life is worth saving—or not, about whether someone is better off dead—or not.  If person X would prevent Spade’s suicide but assist with grandma’s suicide, then person X is making a judgment about each person’s life and not valuing them equally.  And that’s the problem.

     Van Maren and Alleyne write,

     “Most people who support assisted suicide also support suicide prevention. This is The Split Position… [which] considers suicide and assisted suicide as totally separate topics. People who hold to this position have often never tried to reconcile their conflicting beliefs. Our goal in responding to The Split Position in conversation is to attack this cognitive dissonance – to pit their own beliefs in preventing suicide and assisting suicide against each other, and show that The Split Position is a basic human rights violation because it splits people into protected and unprotected classes. Suicidal despair is always a symptom of some other unmet need. The desire to die is changeable, suicide prevention is a human right, suicide assistance is a human rights violation, and our moral duty to the suicidal is to prevent self-harm, never to facilitate it.”

     In articulating why the “Split Position” should be rejected (as well as the position which favors suicide assistance for anyone), Van Maren and Alleyne explain the pro-life position of total suicide prevention:

     “In a society that truly values each and every human life, we have a responsibility to view the desire for suicide as an opportunity to love that person better, and to love that person more. What someone is saying when they express the desire for suicide is that they are in pain, and that they feel unloved. We have a responsibility to respond. From a personal and social standpoint, we need to ask questions such as: What is our duty to the suicidal? Are we responsible to care for and love those who cannot love us back? How can we love this person better?

     “Opposing assisted suicide does not mean a refusal to recognize how dire situations of extreme suffering or how painful the final days of terminal illness can be. It simply means rejecting assisted suicide as an ethical, humane, or life-affirming response to those circumstances. Instead, we propose that treatment centred around the person (rather than ending that person’s life) be implemented.”

     They further observe,

     “John Paul II wrote that ‘the world of human suffering unceasingly calls for, so to speak, another world: the world of human love.’  Suffering unleashes love, it demands our creative response, and a response to alleviate suffering, but never to eliminate the sufferer. Our duty to the suicidal is suicide prevention, and even in the face of a terminal prognosis or incurable condition, never to ‘quit’ on someone and give into suicidal despair. Rather, we must work to relieve unbearable suffering and apply our creativity and imagination to improve quality of life, even when it is in short supply, even in a person’s darkest moments or final days.”

     And so, in the wake of the tragic deaths of Spade and Bourdain, let us remember that just as they deserved suicide prevention—not assistance, so do the elderly, the disabled, the sick, and the dying.  To further understand why, get a copy of Van Maren and Alleyne’s book today.  It is the best apologetic I’ve read on the subject.  

    

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Assisted Suicide in Select Cases? by Stephanie Gray

 

 

 

 

 

 

If suicide is wrong, why is assisting it right?

 

     Last week I gave a presentation to teenagers on the topic of assisted suicide and euthanasia.  Afterwards, a student had a question for me: She said she was against euthanasia in the vast majority of cases, but said that, for a minority of cases, if someone is at the end of his life and his last dying wish is to have assistance with suicide rather than continue “waiting” for life to naturally end, shouldn’t we give it to him?

     That question can be answered by asking a series of questions:

     *If we refuse to assist with some deaths, but not others, we are making a value judgment about peoples’ lives—whether we realize it or not.  In other words, we are making the call that some lives are worth preserving and some aren’t.  Who are we to decide that?

     *Moreover, who’s to determine which people would be close enough to death to get assistance with suicide?  Would natural death need to be hours, days, weeks, or months away?

     *Even if we could get consensus on how close to death a patient ought to be to qualify, what if the estimated time is wrong?  My friend’s father was told he had days left to live.  Three years later, he is alive and living back at home.

     *But, for the sake of argument, if we could get accuracy on proximity to natural death, and if the only assisted suicide cases allowed had to be within weeks of natural death, then what harm, in the grand scheme of things, is a few more weeks on earth—especially when compared to the harms of introducing killing as a solution to problems?

     *If the concern is that the person, in his final weeks, would suffer, then shouldn’t we provide palliative care which alleviates suffering instead of eliminates the sufferer?

     *If we argue that we ought to act on someone’s wishes just because he wishes it, we need to be reminded that we humans can have disordered desires.  A case in point is regarding those struggling with Body Integrity Identity Disorder (BIID).  Consider the story of Jewel Shuping, who had her psychologist put drain cleaner in her eyes because she wanted to be blind.  Intentionally maiming a healthy part of one’s body may be the desire for someone with BIID, but isn’t this proof that not all humans’ desires should be acted upon?

     *If we say it’s okay to assist with some suicides, then what if another person, because of this, asks for assistance with suicide out of guilt, out of thinking he’s a burden and that he should do what others before him have done?  He may even claim to want assisted suicide, but deep down he is asking for it out of duty, thinking he ought to because others have done so already.  Since death is permanent, shouldn’t we err on the side of caution?  In other words, if we had to choose between a society that either a) deprives someone of death when he wants it, or b) gives someone death before he actually wants it, which should we pick?  The person being “deprived” of assisted suicide will still get death—just not at his own, personally-calculated time.  But the person being deprived of life will never get that living time back.

     *If we don’t think health care professionals should be involved in terminating guilty criminals’ lives, why do we think they should be involved in terminating innocent patients’ lives?  In 2016, the New York Times reported that the pharmaceutical company Pfizer “had imposed sweeping controls on the distribution of its products to ensure that none are used in lethal injections.”  More than twenty other drug companies had done the same.  And the American Medical Association has also raised concerns, stating, “The AMA's policy is clear and unambiguous — requiring physicians to participate in executions violates their oath to protect lives and erodes public confidence in the medical profession.”  Couldn’t the same be said about health care workers’ involvement in assisted suicide?

     Finally, it is worth considering this insight from palliative care physician Dr. Margaret Cottle:

     In places where euthanasia and physician-assisted suicide are legal, there has been a rapid expansion and total absence of enforcement of the so-called ‘safeguards.’ Patients with mental illnesses, early stage eye disease and even ringing in the ears have been euthanized. Children and patients with dementia, neither of whom can provide meaningful ‘consent,’ have also been targets. In one study published in the Canadian Medical Association Journal in 2010, the physicians who reported that they caused the death of patients admitted anonymously that one in every three of those patients never gave explicit consent.

      A study published in the New England Journal of Medicine in March 2015 reviewed the most recent data in Belgium around hastened death. It showed that 4.6 percent of all deaths in Belgium were euthanasia deaths, while 1.7 percent of all deaths were euthanasia deaths without the explicit consent of the patient.

     While these percentages seem rather small, serious concerns emerge when compared to the mortality statistics in the U.S. There were 2,596,993 deaths in the U.S. in 2013, and 4.6 percent of that is almost 120,000 deaths. This would qualify physician-assisted suicide and euthanasia as the sixth leading cause of death in the U.S., almost as many as the fifth leading cause of death, strokes, with about 129,000 deaths...

      Patients do not need hastened death; they need excellent care and a deep understanding of their difficult situations. They need all of us to be present with them in profound solidarity. They need the palliative care resources that the majority of patients and families do not have. It is a major human rights violation to be suggesting death as an “answer” to our society’s lack of commitment to care for our vulnerable citizens!

     Every physician knows it is frighteningly easy for patients to die – keeping them alive is the hard work, and caring for them respectfully and compassionately in the process is even tougher. It takes courage and hope to treat patients, especially when the outcome is far from certain.

     Agreeing with patients that their lives are not worth living and helping them die destroys the trust between patients and physicians, while also revealing a distinct lack of ingenuity in our treatments.

     Real compassion is shown by finding ways to be innovative in our approach instead of just following a set of guidelines, thereby reaching people in despair, both at the end of life and in other circumstances, and making it clear they matter to us, their lives are important and we will be with them in their troubles.

 

Image Source: Public Domain 

An Encounter with Grace, by Stephanie Gray

“The greatest disease in the West today is not TB or leprosy; it is being unwanted, unloved, and uncared for. We can cure physical diseases with medicine, but the only cure for loneliness, despair, and hopelessness is love. There are many in the world who are dying for a piece of bread but there are many more dying for a little love.” –Mother Teresa

     It was Lent three years ago when a 19-year-old old Canadian teenager set off on a pilgrimage to the Holy Land—well, that’s how she described her plan to her friends.  But where she was going was not the traditional Holy Land of Israel where Christ once walked; instead, her Holy Land would take her to India where Christ still walked—in the suffering human souls she would serve.  “We all have the desire to help somebody, to do something good,” Grace, one of my recent audience members, said, “but for me it was more that I wanted to meet Christ and have an encounter with him and I knew that’s what Mother Teresa and her sisters found in the poor.”

The Face of Christ

     It was the most solemn day of the Christian calendar—Good Friday, the day where Christ-followers around the world remember the sacrifice of Jesus laying down His life on the cross.  For the volunteers at the Missionaries of Charity’s home for the dying, this is a day off to enter into prayer and reflection.  Grace, however, felt compelled to ask for a special exception: Since the sisters had to serve the sick that day anyway, could she help them as long as she did so slowly and in a spirit of prayer?  They said yes, providing an opportunity for Grace to enter deeply into the “Stations of the Cross” in a way more real than ever before. 

     When one reads of Christ’s torture, we see how some close to him betrayed and abandoned him.  But then there were the others—those like Simon of Cyrene and Mary His mother—who stood by His side and by their presence were a comfort.  This was the example Grace knew to follow.  At one point she found herself kneeling beside the bed of a dying man, slowly and patiently administrating hydration through a dropper; it was then where the words of Christ played over in her mind: “I thirst.”  As she was reminded of Christ dying on the cross with a crucifix on the wall, she knew she was also encountering Christ in the individual lying in the bed before her.  While incapable of eliminating suffering, she did what she could to alleviate it.

     These moments taught that loving glances, hand-holding, sitting with, and gentle patience can bring much peace to those who are suffering.  As Grace remarked, “Regardless of what life experiences a person has had before death, when they go through such great suffering it has a transformative power—when the person allows himself to be loved and cared for by others there’s such a deep and beautiful reflection of God’s love between the sufferer and the one who is suffering with.”

     Some people who arrived at Mother Teresa’s home were extremely sick and expected to die, but with good care they were restored to health.  Others, however, had their last breath—not on a dirty street ignored by passersby, but in a home surrounded by people caring for them.  Grace told me that the few deaths she saw were incredibly peaceful: “I think it’s because the patients knew they were loved.”

     She shared another story about a man who had a severe facial cancer and most of his face was distorted or missing as a result—his jaw was gone, even some of his neck, so that it was just his eyes, the bridge of his nose, and then the rest was bandaged off.  “I had the honor of being able to be with him the last half an hour before he died,” Grace shared (although she didn’t know at the time he was so close to death).  “I remember making eye contact with him across the room for the first time and then going to see him and greet him and that was the moment that bound my heart to Christ, and the dying, and the home for the dying.  She didn’t see the grotesqueness of what cancer had done to his face; instead, she told me that she peered deep into his eyes and was captivated by the beauty of his soul.

Dignity

     We prove that a sick, fragile human being has dignity by how we treat him.  Grace explained how this was upheld at the home for the dying: she and the others would help patients brush their teeth, assist men with shaving, and brush women’s hair.  The fact that the individuals were dying did not mean such basic grooming should be withheld.  Far from it, to do such simple acts was to stress the dignity of the person—to acknowledge that they were worth caring for regardless of their condition.

     I’ve therefore been mystified by the notion of euthanasia advocates that to be denied assisted suicide is to be denied a death with “dignity.” The not-so-subtle implication is that if one dies naturally, entirely dependent on others to feed him, change him, or wipe his drool, that he has somehow lost his dignity.

     A simple dictionary definition of dignity is this: “the quality or state of being worthy, honored, or esteemed.”  A sick person cannot lose her dignity because she is—in other words, by her existence she ought to be honored, respected, and cared for. 

     Consider that when something is valuable in and of itself we act differently around it—we treat it as its nature demands.  Consider an expensive, one-of-a-kind painting: a museum curator is going to make sure the valuable artwork is “handled with care.”  Or consider a sleeping newborn baby: parents will walk quietly and gently into the bedroom to check on the child, avoiding making startling noises.  When a painting is covered with dust or a baby soils her diaper we do not say these have lost their dignity—rather, we respond in such a way (by dusting the painting and changing the child) as to acknowledge the dignity that lies within.

     So ought our response be to those who are dying—not hastening death, not eliminating the person, but instead being present and caring for the individual with the gentleness and reverence that their dignity inspires.

The Gift of Presence

     When I think of Grace’s experience caring for the dying, I am reminded of a powerful reflection by author and blogger Ann Voskamp, who wrote about her friend Kara Tippetts story of dying from cancer.  Ann wrote,

All the faces of humanity carry the image of God.

What if deciding to end a human life is somehow the desecration of God’s image?

What if a human life is not only a gift of grace right till the end – but is a reflection of God’s face right till the end?

What if we are not at liberty to end or destroy human life, no matter how noble the motive, because all of life is impressed with the noble image of God? 

***

Kara taught us that:

In our efforts to terminate suffering — too often we can be forced to terminate the sufferer — when we were meant to liberate the aloneness of the sufferer, by choosing to participate in the sufferings — choosing to stand with the suffering, stay with the suffering, let the suffering be shaped into meaning that transcends the suffering.

 ***

 The word “suffer,” it comes from the Latin that literally means to ‘bear under’ — suffering is an act of surrender, to bear under that which is not under our control — but beyond our control.

That is why suffering is an affront to an autonomous society:

Suffering asks us to ultimately bear under that which is ultimately not under our control — which proves we are ultimately not the ones in control.

***

She chose to bear under the suffering — because she humbly chose to bear depending on others…. being a community, being a body, being human beings who belong to each other and will carry each other as much as humanly possible.

If suffering is about bearing under — suffering is a call for us all to be a community to stand together and carry the weight of bearing under — only to find that we are all being carried by a Greater Love.

Suffering is a call to come, to show up, to be there. Suffering can be a gift because it’s a call for presence; it’s a call for us to be present. 

      So whether it’s a young mom like Kara dying in Colorado, an old man dying in India, or a suffering soul right in the midst of our own backyard, each of us has the capacity to respond to our neighbor’s suffering as Grace did, with the gift of our presence.

Note: A beautiful book about achieving a good death in the face of suffering is The Measure of My Days.

Comfortable in His Skin, by Stephanie Gray

     It was an encounter science predicted would never happen.   As I sat sipping coffee, my interviewee, a 30-year-old teacher, enjoyed a Root Beer, masking the reality that he normally consumed nutrition by a feeding tube.  But I guess Root Beer isn’t really nutritious.  I suppose if you’re going to ingest it, you may as well let it serve its only purpose—to treat the taste buds.

     Moe Tapp was “supposed” to be dead 28 years ago.  But sometimes people defy the odds.  I learned about his condition two years before learning about him.  Epidermolysis Bullosa (EB) is something I tell my audiences about when I speak on assisted suicide and suffering.  I tell the story of Jonathan Pitre, a 16-year old who lives with this excruciatingly painful condition, and talk about how killing people ought not be the solution when we need to kill pain.

     And then, one day recently, a person with EB showed up in my audience: Moe was grateful someone was telling others about “the worst disease you’ve never heard of,” as an EB research association describes it.

     When we subsequently met at an A&W in downtown Vancouver for him to tell me his story, I reacted the way most do when they encounter someone whose skin is as fragile as a butterfly’s wings, whose painful blisters cover a majority of his bandaged body: “Is it okay to hug you?” I cautiously asked.

     “Yes,” he said.  “Don’t worry.  If it would hurt me, trust me, I wouldn’t let you.”  He does, though, have a fear of falling and typically needs assistance walking down stairs to ensure he doesn’t fall—because he has, and there aren’t words to describe the searing pain of blistered skin slamming against hard floor.

     It has been said that “Two people can look at the exact same thing and see something totally different,” which demonstrates that “Perspective is everything.” That is certainly true when considering Moe’s story.

     One could focus on Moe’s bedtime routine: How he connects his feeding tube so liquid nutrients can be slowly dripped into him while he sleeps. 

     But better would be to focus on what Moe wakes up for: his employment at a high school where he works with students from grades 8-12 who have learning issues of all kinds, whether ADHD, dyslexia, autism, etc.  His own experience of suffering, and rising above it, gives him profound compassion.  He is fulfilled in being needed by his students, who are fulfilled by him connecting with them, by his belief in them and their ability to achieve.

     Moe could be frustrated by the stares and questions he gets about why he looks different, and whether or not he was burned in a fire or car crash.

     But instead he seizes the inquiries as opportunities to raise awareness about EB.  As Moe said, “We won’t find a cure if people don’t care, and people won’t care if people don’t know.”  Moe confidently initiates discussion of his condition every year with a new crop of students.  He encourages their inquisitiveness.  In doing so, he not only teaches them about his condition, he teaches them how to be accepting of one’s difference.

     One could focus on the brief period of anger Moe went through in his mid-twenties.  Blisters in his throat caused such severe pain he couldn’t eat at all by mouth.  He realized then that he would never be able to be spontaneous and just go travelling without doing weeks of research to make sure all he needed could be addressed in a new environment.

     But better would be to focus on the camp he went to in Minnesota where anyone in the world who has a skin disease gathered.  He first went as an attendee and then returned as a volunteer.  Knowing he was part of a broader community of people whose shared experience enabled them to readily empathize with each other gave him encouragement.  Attendees cheered each other on with this philosophy: “If you can do this, if you can overcome, so can I.” 

     One could spend time dwelling on the burden and pain of baths and dressing changes every 2-3 days that cost $1,000/month—and the infections and exhaustion that come along with living with EB.

     But better would be to reflect on how his Catholic faith has sustained him (and become more personal and real for him in adulthood), and how his family and friends have rallied around him and stood by his side.  Moe is a gamer.  He also loves watching wrestling (and dreams of being a commentator for pro-wrestling).  Old school Rock and Roll is his music genre of choice and reading is also on his list of enjoyable activities.

     Moe has never thought of suicide.  But on that topic, and its close relative euthanasia, he said he does understand why people would consider them due to pain—not that he supports them; in fact, he views both as wrong and would instead focus on pain relief and comfort.  He noted that he got swayed against euthanasia when he heard a compelling pro-life presentation; moreover, he realized that to say someone like him should be allowed assisted suicide, but others should not, is to make the judgment that his life is somehow less valuable than someone who is 100% capable.  He said if someone wanted to end their life he would ask why, then see what their life was like at home, at school, etc., and then work to make that person’s life better. 

     “There’s hope, always hope,” he declared.  “I know it sounds corny, but it’s true.  People will always be around you that care.”

     Of course, if such people are lacking, it would be better to introduce supportive people rather than eliminate a suffering person.  Moe himself has reached out to families whose babies are diagnosed with EB.  They first connect over the condition, but remain friends because of a familial bond that forms.

     At the beginning of the interview I asked Moe how he would describe himself.  “Good natured,” he said.   “[A] good dude, pretty chill.”  That definitely captures my observation of him; and when I think of that, plus the full and satisfying life he leads, even with—and perhaps because of—such a debilitating condition, I think about how, in a paradoxical way, Moe Tapp is comfortable in his skin.

Watch Moe's story here:

Watch a commercial about EB:

The Impact of Choices, by Stephanie Gray

 Photo Credit: Nyx Sanguino, commons.wikimedia.org/wiki/File:Zuly_Sanguino_is_an_environmental_lover.jpg

Photo Credit: Nyx Sanguino, commons.wikimedia.org/wiki/File:Zuly_Sanguino_is_an_environmental_lover.jpg

     At a recent presentation I gave on euthanasia and assisted suicide, an audience member asked about how to respond to people who say that ultimately the debate is about “choice” and if someone wants to choose to end their own life, it’s their body and their choice; it doesn’t affect anyone else so we should allow assisted suicide.

     I’ve already written here about “our” lives and the responsibility we have toward being good stewards of these gifts.  Now I’d like to reflect on the concept of choice and whether any one person’s choice is really independent of, and without effect on, the other.

     In my first year English class at UBC we were assigned to read Dr. Martin Luther King, Jr.’s Letter from Birmingham Jail.  His magnificent writing moved me deeply and so many of his statements became quotable quotes for me; in particular I was struck by these words:

     “We are caught in an inescapable network of mutuality, tied in a single garment of destiny. Whatever affects one directly, affects all indirectly.”

     Choices we make, big or small, positive or negative—these have a permeating influence.  They don’t just affect us.  Like a drop of food coloring in a glass of water, they diffuse into the surrounding area and impact people who, upon being touched, make other choices that in turn affect others.

     Consider smoking.  Besides the obvious impact on others being second-hand smoke, if someone only ever smoked in isolation, the effects on his body because of smoking would still impact others: subsequent lung disease would create a use of the medical system, which would impact society.  If he died early as a result and never accomplished things he would have if he had remained healthy—that would impact society too.

     The interconnectedness of our choices to other peoples’ lives can be seen in a delightfully simple illustration: Several years ago in Newington, Connecticut, a customer at a coffee shop decided to pay the order of the patron behind him.  That led to a chain reaction so that the next one thousand customers paid for the order of the person behind them.

     How true it is that we are caught in an inescapable network of mutuality, tied in a single garment of destiny. Whatever affects one directly, affects all indirectly.

     Or consider Zuly Sanguino, a Colombian woman who has overcome profound suffering: She was born without arms and legs.  Her father committed suicide when she was two.  She was raped when she was seven.  She was bullied as a child and almost attempted suicide at 15.  Now, however, she is an artist and motivational speaker who lives an incredibly full and rewarding life. 

     She said, “It gives me so much happiness to know I'm helping people. One boy was about to take his own life with a gun when he saw a TV show I was on. He realized he had to be brave and decided not to take his life. He wrote to me and we're now really good friends. I get letters from lots of people who say I've helped them through difficult situations.”

     How many peoples’ lives are better because of Zuly’s witness?  Correspondingly, had she committed suicide (on her own or with assistance) how many peoples’ lives would be worse (and even over) because of her absence from this world? 

     How true it is: We are caught in an inescapable network of mutuality, tied in a single garment of destiny. Whatever affects one directly, affects all indirectly.

     Our choices impact people for better—or for worse.  Consider the story of Will, a young man who was killed via the death penalty.  His lawyer, David Dow, recounts Will’s story in a TED Talk: Will’s dad left his mom while she was pregnant with Will.  Will’s mom, afflicted with paranoid schizophrenia, tried to kill Will with a butcher knife when he was 5 years old.  Will was taken into the care of his brother until that brother committed suicide.  By age 9, Will was living on his own.  He eventually joined a gang and committed murder.

     The choices of Will’s father, mother, and brother undoubtedly impacted Will.  There is simply no denying that we are caught in an inescapable network of mutuality, tied in a single garment of destiny. Whatever affects one directly, affects all indirectly.

     So the next time someone supports euthanasia or assisted suicide because such a choice “only affects the people who want to die” we can use the above stories as analogies to show that that simply isn’t true.  Involving medical professionals in Person A’s assisted suicide means Person B may no longer trust her health care provider to properly care for her life.  Person A’s assisted suicide will impact the disposition of the individual who supplies the life-ending drugs or injects the deadly poison because you cannot kill another human being without that leaving a mark on your mind, your emotions, and your interactions with others.  Person A’s legally endorsed assisted suicide will create a climate where Person B asks for assisted suicide too—not because she truly wants it, but because she feels guilted into it by a culture that embraces it and makes her feel like a useless burden.  Person A’s assisted suicide will influence others to respond to their own suffering and obstacles by giving up instead of turning them into opportunities (as Zuly did).  How do I know this?  Because as Dr. Martin Luther King, Jr., has said, "We are caught in an inescapable network of mutuality, tied in a single garment of destiny. Whatever affects one directly, affects all indirectly.”

A Resolution for the New Year: In the Face of Suffering, Unleash Love, by Stephanie Gray

     I was speaking with a woman recently who asked me, “Do humans always have value? When do they lose their dignity?”  I told her I believed our human value is inherent to our being, so that our value cannot be lost or lessened“But,” she interjected, “What about the dementia patient who sits by herself all day?”

     I acknowledged that that is a problem; however, I pointed out that the solution is not to say she has lost her value or dignity, but rather for people like you and me to affirm her value and dignity: to slow down our busy lives and, to borrow a phrase from the Canadian Down Syndrome Society, to “Celebrate Being” with such an individual.  We could visit that lonely person, I said.  We could hold her hand.  Humans are made for relationship—for connection.  We could foster that.  We could listen to music with her.  We could sing to, and even with, her.  I talked about the proven effectiveness of music therapy.

     The woman, ever the “Negative Nelly,” asked me to think about all the dementia patients in a hospital ward and how it would be impossible to have individualized music styles for each person.

     I find it fascinating how, when some people see the largeness of a problem they so easily reject any solution.  Maybe we can’t help everyone, but how is that an excuse not to help someone?  We would do well to remember a paraphrase of the words of Edward Everett Hale: “I am only one, but still I am one.  I cannot do everything, but still I can do something.  And because I cannot do everything, I will not refuse to do the something that I can do.

     With that in mind, on the last day of 2016, I spoke about euthanasia to over 100 university students in a workshop at the CCO Rise Up Conference.  After equipping the students about what to say regarding euthanasia and assisted suicide, I ended with what they could do about it.  I told them that if the law is followed then no one should be euthanized who does not ask for it.  So our job is to make sure no one asks for it.  And we do that by intentionally spending time with the sick and lonely.  I left the students with a 2017 New Year’s Resolution that I’d like to challenge all readers to do:

     Make a commitment to visit a sick, disabled, elderly, and/or lonely person one day/week in one of these ways:

      1)      In your own family, or neighborhood, regularly visit a lonely person.

     2)      Contact your church and ask if there is a member of the church who is a shut-in and who would benefit from a visitor.

     3)      Sign up at a local hospital or elderly care home to volunteer by visiting patients.

     Are there more people than you alone can help?  Yes.  Does each individual person ideally need more time than you can give?  Yes.  But remember this: doing something is better than doing nothing.  Starting is better than staying still.  As Anne Frank once said, “How wonderful it is that nobody need wait a single moment before starting to improve the world.”

     Will this work?  Consider these stories:

     My friend Kathleen LeBlanc shared this experience she had a few months ago: “Every Friday morning, I've been spending an hour playing Scrabble with a lovely 93 year old lady at a local care home. It's my simple way of helping the elderly find joy in their daily life. I'm always praying for opportunities to talk to her about God, or to simply show her that she is loved. Today, that opportunity came in full force.

     “After our game, she outright asked me, ‘What do you think of doctor-assisted suicide?’ and pointed to an article from the paper on the topic. I told her that I felt it was very sad that anyone should feel the need to take their life, and it's our failure as a society when anyone is left feeling this way. After some time discussing this, she expressed to me that she can sympathize with people who don't feel they have a reason to live in their suffering, as she too, often wonders why God still has her ‘stuck in this wheelchair.’

     “With tears in my eyes, I was able to tell her what a joy she is to me, and that I look forward to visiting her every week. She teared up as well, shock in her eyes, and said, ‘Really? Is that true?’ I nodded, unable to get more words out. ‘Well then, perhaps there is reason enough for me to be here.’

     Or take another friend of mine, a nursing student.  She saw on a patient’s chart that the patient had made an inquiry about euthanasia.  My friend intentionally visited that patient more than others.  She never discussed euthanasia, but she did spend time getting to know the woman.  She became interested in her life; she connected over common interests and common backgrounds; she smiled and was joyful; she engaged the patient in conversation.  In short, she poured love out on her.  A few weeks later when my friend checked the patient’s record, there was a note indicating the patient was no longer interested in euthanasia.

     So please, make 2017 different.  Make it better.  To borrow a concept from St. John Paul II, resolve to respond to someone’s suffering by unleashing your love.

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Finding Meaning in Suffering, by Stephanie Gray

 Image Source: Prof. Dr. Franz Vesely, Viktor-Frankl-Archiv, Wikimedia Commons

Image Source: Prof. Dr. Franz Vesely, Viktor-Frankl-Archiv, Wikimedia Commons

     When acceptance of assisted suicide was written into Canadian law earlier this year, one of the criteria for it became this: that the person “have a grievous and irremediable medical condition” which is defined, in part, as an “illness, disease or disability or …state of decline [that] causes them enduring physical or psychological suffering that is intolerable to them and that cannot be relieved under conditions that they consider acceptable.

     Everyone suffers at some point or another, but most do not select suicide.   So to suffer so much that one chooses death over life is to suffer to the point of despair.  Rather than assisting with a despairing person’s suicide, we ought to instead consider the insight of psychiatrist and Holocaust-survivor Dr. Viktor Frankl.  In this interview he talks about the following mathematical equation his observations and lived experiences caused him to create:

     D = S – M  

     He explains it as follows: Despair equals Suffering without Meaning.  Some people get cancer.  Others get hurt in car accidents.  These are very real cases of suffering—not to be minimized.  But whether someone despairs in light of these experiences is in direct proportion to whether they find meaning in the situation or not.

     Dr. Frankl cites a teenager in Texas who became a quadriplegic—undoubtedly, an experience of suffering.  And yet she did not despair as others in her situation have.  What set this young woman apart was not her experience of suffering but her response to it: She spent her days reading newspapers and watching the news for an important purpose—whenever there was a story about someone experiencing difficult and challenging times, she would ask that a stick be placed in her mouth so she could use it to press keys to type out letters of encouragement, consolation, and hope to the people she read about.  Dr. Frankl said, “She’s full of confidence.  She has a strong sense of abundant meaning in her life.”  She turned her experience of suffering into a springboard to reach out to others; it enabled her to have empathy and share hope.  In short, she found meaning.

     Or take another person with quadriplegia, a young man who became paralyzed at 17 years old.  Dr. Frankl received a letter from him: “I broke my neck but it did not break me.  I am at present helpless and this handicap will remain with myself apparently forever.”  Why, like the aforementioned young woman, did this man not despair?  Because he found meaning in his situation: “I want to become a psychologist to help others,” he said in explaining his decision to pursue post-secondary education. “And I’m sure that my suffering will add an essential contribution to my ability to understand others and to help other people.” 

     When speaking of individuals like the two mentioned, Dr. Frankl noted, “They can mold their predicament into an accomplishment on the human level; they can turn their tragedies into a personal triumph.  But they must know for what—what should I do with it?”

     The brilliance of this philosophy is that it empowers everyone.  While we cannot necessarily escape suffering, we can escape despair, and we can escape it in direct proportion to the meaning we allow ourselves to find in a situation.  In other words, when circumstances prevent us from eliminating suffering, perspective allows us to add meaning, and that, in turn, helps alleviate the suffering itself.

     This can happen in profound ways.  Dr. Frankl told a story about a man who was electrocuted and all four of his limbs had to be amputated.  That patient wrote, “Before this terrible accident I was bored, always bored, and always drunk.  And since my accident I know what it means to be happy.”

     This is proof that happiness is not determined by physical wellbeing but by an attitude of the mind.  So if someone is struggling in this area and requests assisted suicide, it’s our job—not to facilitate their despair—but to facilitate their search for meaning.

     If a Holocaust survivor, amputee, and quadriplegics can do this, why can’t we all?

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Live Every Stage Fully, by Dr. Julia Bright

As I wrote about here, in the Spring I had the great joy of giving a talk alongside my best friend from childhood, Dr. Julia Bright. We re-joined forces to share a stage again this Fall, this time speaking on euthanasia to an assembly of hundreds of high school students.  Once again, I was impressed with Julia's message and decided to share it here in its entirety, below.  As for what I shared, it was a shortened version of the presentation in the Youtube video above.  May these help you help others.

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Julia's Speech:

     Thank you for the opportunity to speak today about physician assisted suicide, or “medical aid in dying”. Since this is now legal in Canada, it is a reality that we need to know about.  As was mentioned in the introduction, I am a family doctor.  I’ve been working for 9 years in my office, the hospital, the hospice, and nursing homes.  So I’m speaking to you today from the perspective of someone who works everyday with the sick and dying.  But I also speak from the perspective of a person who faces her own mortality when thinking about these issues.  And as a person of faith, who believes that our ultimate home is in heaven.

     I find I am drawn to sick people.  I feel comfortable in hospitals.  That may seem strange, but it is because I see opportunities there to show my concern in practical ways.  I spend much of my time trying to prevent disease and cure disease, but I recognize that eventually, our health always fails.

     When I hear people speaking in support of physician assisted suicide, I sense an underlying lie being spread-that the time just before we die when we are suffering physically and emotionally is not important.  That we’d be better off avoiding it.  Or that we should be able to control how much of that time we have.  But I have seen that this is untrue.  Sick people can be happy.  Dying people can acknowledge their death and still feel peaceful.  My job is to try and help people with medicine and support so they are free to find that place of peace.  As a Catholic, I know that the times when we suffer are sacred-because Jesus suffered.  He brings meaning to our suffering.  And He teaches us how to lessen it for others.

     Why is this lie being spread, that says we should avoid suffering and ask our doctor to end our lives?  I think it is because people have suffered without relief and their families have watched and felt helpless. But I don’t believe the solution is to kill those who suffer.  The solution is to provide palliative care.  This is a particular approach to medical care that involves focusing on comfort and relieving symptoms like pain or nausea, as well as providing emotional and spiritual support. 

     I think it is possible for people to have a “good” death.  I think of my patients who come to the hospice when it is clear that their cancer is not going to be cured.  They may choose not to have further treatment, based on the side effects.  [This is an important point.  Patients can still refuse interventions that seem too burdensome, even if they don’t believe in physician assisted suicide.]  Once at the hospice, they have their own room.  They are surrounded by their families until the end.  They can accept what is happening and face it with peace, even though it is always sad to say goodbye.  Nurses are present to try to ease their pain and take care of their needs.  I think of the time they have talking to their loved ones.  When you know that your time is limited, each conversation is more meaningful.  Each moment together matters.  Families will not forget those moments.

     Palliative care is not easy-it requires people to be creative.  Like helping people redefine their goals.  Sometimes if a parent has a terminal illness, this means helping them write letters to their children to be opened at specific times-like high school graduation.  Even though the parent longs to be there in person, they can still be present through a meaningful letter.  Palliative care takes flexibility-like nurses coming into a patient’s home to give medication.  Or setting up a mini hospital room on the main floor of a patient’s house if the bedroom is too hard to get to.  Mostly, it takes compassion-a willingness for everyone involved to “suffer with” the patient.  It isn’t easy to visit patients in the hospice-there’s a lot of emotion in the room.  But taking that on for a few minutes with them is such an important part of palliative care-at least as important as giving medication.

     I have several fears about physician assisted suicide becoming accepted into our society.  Firstly, I worry about vulnerable patients feeling pressured to hasten their death. What if your family lives far away or there is not enough money and the option of physician assisted suicide is seen as the responsible thing to do? Their request for death wouldn’t be based on a true desire for it, but rather on the guilt they feel because of their circumstances.  Or what if a patient finds out they have early dementia and makes a decision to choose death instead of finding out how they feel as time progresses?  They may assume they'll want something in the future that they can't really know until they are facing it in the present moment.

     I fear how families will cope when they find out their loved one is choosing suicide.  The choices we make when we’re dying have a significant impact on our families.

     I fear what it will do to palliative care.  What is the incentive to develop advances in care for the dying if we don’t cherish that time of people’s lives? 

     I am concerned about what it will mean for the culture of health care.  I’ll give you a common scenario in my work right now to explain this.  Let’s say I get called to a nursing home to see a patient who is 95.  She has multiple health problems and is starting to lose her memory because of dementia.  She needs a wheelchair to get around.  It’s getting harder to look after her-she gets confused, tries to get out of her chair, and then falls.  The nurses spend much of their time trying to redirect her to keep her safe.  I get called to see her because she has a bad cough.  I drive to the care home and ask the nurses what’s been happening.   We’re all thinking about how we can best care for her and what treatment for her cough will get her through it and keep her comfortable.  I sit with my patient for a few minutes and see if anything has changed from when I last saw her.  I don’t think she really remembers who I am.  I listen to her breathing.  I think she needs antibiotics again.  She keeps getting pneumonia.  Maybe because she can’t swallow very well anymore and is choking a lot.  I order the medication and call her daughter to let her know.  I ask the nurses to call me if she isn’t getting better.  Her cough improves for the time being and she wanders less now that she is feeling better.

     Compare that to what my mindset could be in 20 years if I get used to physician assisted suicide.  I’ve dulled my conscience and given in to patients who request to hasten their death.  I’ve become indifferent-what the patient wants, the patient should have access to-I merely deliver that service.  I get the same call to the nursing home.  My patient made it clear before she got dementia that she did not want physician assisted suicide.  It’s getting harder to look after her.  I’m having a busy day when they call me about her cough.  There’s lots of younger people to see at the office first.  As I drive to the nursing home, I can’t help thinking-why is she still here?  What is the point of all this?  I have to suppress the thought—wouldn’t it be easier if she were like my other patients who chose death earlier on?  How might that attitude affect the care I give her?  What if she sensed what I was thinking?  Is this why I became a doctor?

     It seems scary.  But I really believe there is hope.  Creative and dedicated people are working on improving palliative care.  And most doctors are listening to their consciences and upholding their commitment to help people live.  God is still present to the suffering who call on Him. 

     I would like to challenge each of you today to think about how you can be defenders of life.  One of the most important things that sick people need is companionship.  People fear abandonment even more than pain.  So if you know someone who is unwell or in a hospital or nursing home-visit them.  Get to know them.  If you feel awkward or don’t know what to say, just be present.  Think about when you were a kid and your mom or dad sat by when you were sick-something about them being there was comforting.  Pray for the people you visit.  Read to them or listen to music with them.  I think of the character in the book Still Alice who loves ice cream.  Even as her memory fails because of dementia, she continues to enjoy the experience of eating an ice cream cone.  Find out what people enjoy and make it possible. 

     When you’re thinking about your future career, consider how you can help improve the lives of sick, disabled, or vulnerable people.  This could mean working directly in health care, but the possibilities are broader than that-think of interior designers who make nursing homes more beautiful, or chefs who prepare meals for patients in a hospice, or engineers who design new equipment to keep people mobile, or administrators who organize volunteers to visit the elderly.

      Finally, don’t give in to the notion that our time is only worthwhile when we are young, healthy, productive, and independent.  Look for meaning in the things that last-family, faith, goodness, and the simple pleasures in life.  Don’t be afraid to discover how to live every stage of your life fully.  We are each precious to God and He will give us the inner peace that we seek along the journey.

You Before Me is Better than Me Before You, by Stephanie Gray

“Wait for it…It’s going to make you raaaaaaaage.”

     That’s what my friend texted me who had told me about the book, and soon-to-be-released movie, “Me Before You.”  She suggested I read it, not because under normal circumstances it would be worth my time (or hers), but rather because she had just attended a pro-life apologetics presentation I gave on assisted suicide and euthanasia and she thought I should be aware of the story as my future audiences might bring it up.

     So on the weekend, as it poured rain, I curled up and got caught up in the world of the main characters Louisa Clark and Will Traynor.  So would I recommend it?  Absolutely not.  It’s dangerous—very dangerous.  Setting aside the obvious problems of blasphemous language and sexual references, the storyline supports assisted suicide—but it does so in a sneaky way, making it all the more dangerous.

     Initially Louisa, hired to be a companion and helper to wheelchair-bound Will, was my hero.  She was from a family that, while it had its own dysfunctions, overall lived a self-less philosophy:

·         Louisa worked so as to help provide for her poverty-stricken family.  You before me.

·         Her parents welcomed her sister home when faced with an unplanned pregnancy, and helped care for their grandson.   You before me.

·         Her mom quit work to care for the family’s ailing grandfather.  You before me.

     But the world of you before me was about to collide with another world—the ugly world of me before you.  The Traynor family had it all—by the world’s standards: unlimited wealth and the ability to go wherever and do whatever.  But they were all miserable because they lacked love:

·         Mr. Traynor was having an affair (not his first).  Me before you.

·         When Will’s sister Georgina visits and learns of his plan to have assisted suicide in 6 months she gets angry that he would do it, but instead of using the 6 months to give him the gift of time, attention, and love, to try to convince him he’s valuable and should stay alive, she returns to Australia saying, “…this was just a visit…It’s a really good job…the one I’ve been working toward for the past two years…I can’t put my whole life on hold just because of Will’s mental state.” Me before you.

·         Will himself, pre-accident, lead a life of self-indulgence.  Me before you. 

     So why was Louisa my hero initially? When she learns that the parents have agreed to assist Will in his suicide in 6 months’ time, she quits because she doesn’t want to be part of killing.  Louisa, you’re my hero.  Then she decides to return to work, realizing she can spend the next few months trying to make Will’s life as incredible as possible so he doesn’t choose suicide.  Louisa, you’re my hero.  Then she takes Will on a life-creating and spirit-building vacation and tells him she wants to devote her life to loving and serving him, but he refuses saying he still plans to commit suicide, so she cuts him off in a decision to remove herself from the killing.  Louisa, you’re my hero.

     But then it all goes downhill.  And I understood why my friend said “It’s going to make you raaaaaaaage.”  Almost every single character caves.  Mr. and Mrs. Traynor, Georgina, Mr. Clark, Louisa’s sister. And Louisa herself.  They all cave.  They all encourage, facilitate or are actually present at Will’s suicide the way he wants it. 

     And a morally un-formed reader will think, “Maybe it’s not so bad after all. Maybe, by being present, that was the loving thing to do.”  No, no it’s not.  Would they have been present if Will was killing a child?  Then why would they be present when Will killed himself?  His life is just as unrepeatable, and just as irreplaceable, as a child’s.  Life, whether our own or someone else’s, is not ours to take.  Moreover, Will couldn’t have gotten to the suicide clinic without their help.  So his act of suicide actually turned into their act of homicide.  Had they refused to “help” him, especially when, as a result of Louisa’s involvement in his life, he admitted those were the best 6 months of his entire life, Will may have gone on to thrive in a world of human connection and a world of you before me.  But we will never know.  Because he’s dead.  And they helped kill him.

     Will was obsessed with control, and argued he needed to end his life because it was the one thing he could control.  But he could control more than death—he could control his perspective.  Holocaust survivor Dr. Viktor Frankl wrote in his book, “Man’s Search for Meaning,” that “everything can be taken from a man but one thing: the last of the human freedoms—to choose one’s attitude in any given set of circumstances…”

     When someone is despairing so much that they can’t see they can choose their attitude, it’s the job of people who care to help them see this, not to feed into despair.  As one palliative care website says for why they don’t allow or encourage assisted suicide, “In our experience, the issue of physician-assisted suicide often arises as a response to a complex set of problems which we help people sort through and address.”  If only Louisa et al had helped Will sort through and address his problems.

     So when the movie is released this Friday, and unsuspecting movie-goers who’ve seen the trailer may have no clue it’s actually about assisted suicide, please boycott the film and encourage others to do the same.  And when someone asks why, you could begin by explaining, “You before me is better than me before you…”