The choice of death is the ultimate dignity

John Bartholow

June 26, 1992|By John Bartholow

MY WIFE Lydia died last June. She had been fighting cancer off and on for 10 years.

During that time, Lydia fought bravely to keep living through various complex treatments and their aftermath. As her condition worsened, her last hope was for a bone marrow transplant. She badgered her doctors to "keep the faith."

Finally the doctors told her that there was nothing more they could do. A transplant was no longer possible, and she should expect death soon.

Since she was quite uncomfortable, she told her doctors that she was ready to die. She had already lived a full year beyond anyone's expectation.

Would they help her? No. Legally, there was nothing they could do. Euthanasia was out of the question. It wasn't that they didn't sympathize; it was that euthanasia is against the law -- and would jeopardize their careers. I respected their decision.

When Lydia came home from her last hospital stay, a hospice tried to help. Although the services of the hospice would not prolong Lydia's life, neither would they hasten death. The hospice's idea of death with dignity often means to ease the pain with drugs.

Lydia hated the discomfort, hated the pain, but she hated being drugged even more. I saw no dignity in this kind of chronic sedation.

It was then that Lydia asked me to find something to allow her to take her life. Though it turned my stomach, I tried. I contacted the Hemlock Society, which recommended a book, "Final Exit," by Derek Humphry. This book graphically described a whole arsenal of techniques, most of which were out of the question as far as I was concerned. Taking hemlock is a painful and uncertain way to die, as are many similar techniques described in the book.

Lydia was now beyond the point where she could actively do much except swallow a lethal dose of some substance. None of her medications was prescribed in a lethal quantity. Doctors and pharmacists apparently are quite careful to prevent this. In addition, if I were to actively assist in taking her life, I would risk going to jail, leaving our children in a most unsettled state.

So Lydia died naturally, but it took seven long days.

Our laws must be changed so that any patient, in consultation with family, close friends and consulting doctors, may voluntarily choose to terminate his or her life humanely when there is no rational expectation for anything but never-ending misery.

I am not trying to put an additional burden on doctors, but this experience has shown me that they can tell when a situation is hopeless. Hope does not spring eternal, as the saying goes; hope can and does evaporate.

Most of us trust that we will die peacefully in our sleep at an old age, but frankly, the odds are against it. I could tell everyone to be prepared, but few will plan ahead. Arranging for a lethal prescription typically involves deceit, which I cannot advocate. The "alternatives," drawing up a "living will" and granting durable power of attorney for health care, are good ideas, but they are fundamentally only requests that people not be treated solely to sustain bodily processes. They are not directives. They protect the health-care professionals without really granting rights to the patient.

So changing the law to support self-determination in dying is the only defensible and humane solution that preserves personal dignity.

It matters not to me whether death is an end or a beginning. We should always come down on the side of personal choice. Exercising choice over the time and place of one's death, once death is a certainty and there is no hope, is the ultimate personal dignity. I was disappointed that a "death with dignity" measure was defeated by the voters of Washington state, but similar initiatives will be on the ballot or have been introduced this year in Oregon, California, New Hampshire, Iowa, Maine and Michigan.

For a decade Lydia fought vigorously to live. Why did she have to fight for a week to die? And why should you?

John Bartholow is an ecologist with the U.S. Fish and Wildlife Service in Fort Collins., Colo.

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