When I started working in hospice care, the phrase ‘death with dignity’ meant maintaining respect for the individual who was dying as that person became more and more vulnerable. For example, dignity meant
- maintaining a person’s privacy by keeping body parts covered;
- keeping by a person clean and groomed;
- talking to instead of around him or her; or
- repositioning an individual gently despite time constraints or limits of patience.
Death with Dignity Becomes Law
In 1994 this phrase took on a new meaning. Death With Dignity became a law in Oregon. Under this law, an individual with a terminal illness could voluntarily end his or her life by self-administering a medication which was prescribed by a physician for the purpose of ending life. Attempts to repeal this law were made, and on October 27, 1997, Oregonians reaffirmed passage of this law. Oregon was the first state in the U.S. to pass a Death With Dignity statute. Four additional states have enacted it since then: California, Montana, Vermont and Washington.
There is also a non-profit organization named Death With Dignity. This group defines death with dignity as follows:
- an end-of-life option that allows certain eligible individuals to legally request and obtain medications from their physician to end their life in a peaceful, humane, and dignified manner;
- state legislation codifying such an end-of-life option; or
- a family of organizations promoting the end-of-life option around the United States.
Brittany Maynard Chose Death with Dignity
In Oregon in November of 2014, Brittany Maynard’s goal was death with dignity. She ended her life so that she would not die from the untreatable brain tumor with which she had been diagnosed. This is her rationale for making this choice:
I considered passing away in hospice care at my San Francisco Bay-area home. But even with palliative medication, I could develop potentially morphine-resistant pain and suffer personality changes and verbal, cognitive and motor loss of virtually any kind.
Because the rest of my body is young and healthy, I am likely to physically hang on for a long time even though cancer is eating my mind. I probably would have suffered in hospice care for weeks or even months. And my family would have had to watch that.
Does this mean that Allowing Natural Death (AND) is undignified? The body changes as it declines, and different functions and abilities are lost. But has the human being lost his or her dignity? One’s perspective makes all the difference.
“Independence is Overrated”
Thomas Petri wrote an article entitled ‘Independence is overrated. There’s courage in depending on others in life and in death.” He said,
What marks our great nation is not absolute freedom, but a freedom to care for others and to be cared for ourselves. Those who suffer and those who are dependent challenge us out of our selfishness. They remind us that the preciousness of life is not determined by ability but by an inherent dignity that cannot be taken away. There is no doubt that death and dying interrupt life, but we can be glad that they do because we need to be reminded that success is not all there is. Those whose lives are ending offer a testimony that life is more than independence and that the human spirit is greater than disease and disability. (emphasis added)
Is suffering inevitable when watching and caring for a loved one who is dying? I had a friend whose wife died of cancer when they were both in their early 40s. He told me that was one of the most difficult things he’d ever experienced but he wouldn’t trade those last few months with his wife for anything. “We learned so much,” he told me. “So much about what is important and what isn’t. It was incredible.”
Do we deny others who may be our caregivers a priceless experience if we choose Death with Dignity by medication?
Dignity or Fear?
What role does fear play in the human heart? How much of the desire for dignity is related to the fear of the unknown?
There are more things in heaven and earth, Horatio,
Than are dreamt of in your philosophy.
I don’t condemn nor do I condone the Death with Dignity movement. I do wonder if it’s correctly named.
Death with Dignity (non-profit). (n.d.) Retrieved from https://www.deathwithdignity.org
Death with Dignity Act. (n.d.) Retrieved from http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/index.aspx
Hamlet Act 1, scene 5, 159–167. Retrieved from http://www.enotes.com/shakespeare-quotes/there-more-things-heaven-earth-horatio
Maynard, B. (2014). My right to die at 29. CNN. Retrieved from http://www.cnn.com/2014/10/07/opinion/maynard-assisted-suicide-cancer-dignity/index.html
Petri, T. (November 26, 2015). Independence is overrated. There’s courage in depending on others in life and in death. The Washington Post.
Photo credit: Craig Gardiner Photography