The Myth of ‘Death with Dignity’ – A No on Question 2

As a nurse I’ve cared for hundreds of people who are going into surgery, women who are in labor, people who have cancer, people who are dying. It has been both a privilege and a burden. It brings me face to face with my mortality, my frailty, and my need to figure out what this thing called ‘Life’ is all about.

I have sat with people waiting for their last breath, only to realize there would be none. I have been beside women as they gave birth to still-born babies, weeping with them as tears streamed down their cheeks. Tears that fell on the heads of babies who did not feel them or know the pain of their mamas.

I have cleaned up vomit, suctioned mucus, emptied bedpans,

So there is one thing I can tell you with certainty: There is no dignity in being sick. There is no dignity in bed pans. There is no dignity in throwing up. There is no dignity in fainting or seizures; in high fevers or runny noses, in chemotherapy or intravenous antibiotics. There is no dignity in getting the dreaded diagnosis “You have cancer…”. None. There is absolutely no dignity in labor as you’re hanging out all over the place just waiting for that little muffin’s head to crown.

And Psalm 23 is not kidding about the “Valley of the shadow of death” for there is little dignity in dying.

And yet the Massachusetts ballot is presenting me with a question come November 6 – a question where I have the choice to vote ‘yes’ or ‘no’. It is called the Massachusetts Death With Dignity Act, but it is really a vote up or down for Physician Assisted Suicide.

I get it. We hate pain – for ourselves and for others. “Needless pain!” we cry out! Why should we have to suffer? Why should those we love have to suffer? We’re going to die anyway! Why not be able to control the process?

So why do I, who ooze compassion when I see a hurt bird, let alone human, plan to vote no on this bill that would supposedly “alleviate” suffering?

There are several reasons.

1. While diagnosis is a fact, prognosis is an opinion. Most of us know people who have lived far longer than the prescribed prognosis given for a particular disease state. This is because many things go into living. It’s not about a doctor’s evidence, what has happened before, or what typically happens – it’s about the individual, it’s about will, it’s about faith, it’s about God.

2. Amazing strides have been made in pain relief and end of life care. No longer does end of life care need to be a time of intense suffering. Current research and practice gives great hope to patients and families who are dealing with end of life issues. Palliative care focuses on relief of pain, easing of symptoms, and improving quality of life. This area needs to be strengthened, not weakened by diminishing its importance through allowing patients to request medication that will end their lives.

3. There is no requirement in the language of the law that any family members be notified. This is unconscionable to me! That a patient can take the medication alone, with no one else present, and no record of having taken it is unbelievably bad practice. The potential scenarios this presents have law suits written all over them.

4. Death is not, and never will be, dignified. To paint the issue with language like this is disingenuous at best. Just because you are the one who holds the medicine that can end it all doesn’t mean it will be dignified. The very nature of death is that of losing control, taking a last breath, mouth gaping open, losing control of bodily functions, fighting to live only to die. I am all for easing some of the pain and discomfort of death but let me repeat: It is not, and will never, be dignified. It’s death.

The only dignity given in death is given by others to the one dying, it cannot be given to oneself.

5. Organizations that I respect are against it. The Mass Medical Society, Massachusetts Hospice and Palliative Care Federation, the American Medical Directors Association, and the Massachusetts Academy of Family Physicians are all against it. Why? Because it’s poorly written, because there is already a strong end of life care program in the state that aims to alleviate suffering, because patients are not required to see a psychiatrist or psychologist to check mental health status before being prescribed a lethal dose of medication to end their lives, and because they recognize that physicians should be in the business of providing “compassionate, high-quality care during every stage of life.”

6. I believe the act diminishes and violates the Hippocratic Oath at the deepest level. In the classical version of the oath the statement “I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect.” are words sworn by most physicians on graduating from medical school. The entire oath speaks to the need to practice medicine ethically and compassionately.

Lastly, it is because I operate from a God-centered worldview. I see all of life through this lens. And so I believe that all of Life is sacred – whether it be in the abortion clinic, the battlefield, the workplace, the slum, the homeless shelter, the hospital room, or the hospice. Life, all of it, is sacred. And in believing that Life is sacred, I believe that only One can give or take life. Only One has and knows the big picture.

Only One can offer death with dignity and so, clear-eyed and clear-headed, I’ll vote No. 

 “Take away my capacity for pain and you rob me of the possibilty for joy.” Ross W. Marrs

“The role of family physicians is to provide compassionate, high quality health care to all patients, in each stage of life. End-of-life care is no different. Given the tremendous strides made in palliative care delivery services, patients with terminal illnesses often live active and fruitful lives for months, if not years….“Given the seriousness posed by the ballot question, and especially given our daily experience as family physicians caring for patients, we urge Massachusetts residents to vote NO to Question 2 on November 6.” Massachusetts Academy of Family Physicians

“We’ll continue to educate voters that Question 2 is poorly written, confusing, and flawed. This is why concerned doctors, nurses, hospice workers, religious leaders and citizens have banned together to defeat Question 2. Visit our website to see the full list of organizations opposed to physician assisted suicide”. Coalition against Physician Assisted Suicide

16 thoughts on “The Myth of ‘Death with Dignity’ – A No on Question 2

  1. While I do not know anything about Massachusetts Death With Dignity Act, I can readily believe that it might be poorly written or not written well enough. However, as I am sure you know in number of countries around the world law allows physicians to end suffering of those patients whose prolong agonies serve no other purpose but to prolong pain. In other words if not assisted to die, they will not continue to live, they will only continue to suffer. I do believe that life, every life is precious, very precious indeed. But only as long as it is a life … and no, I do not profess to possess a definition of it by any stretch of imagination; I can only offer my views.
    Thank you for such insightful and well written article,
    Daniela

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    1. Daniela – thank you so much for your affirmation in your last sentence. I still struggle with the idea that people get to the point where they are not valuable because they have lost their productivity in the marketplace. And while a number of countries do have these laws in affect, I think (I don’t know this for sure) there are some significant studies that show a rise in other suicide that is possibly correlated to physician assisted suicide. Again – I need to check on those figures. But the idea that we place value on life according to our fallible human whims is tragic to me. Would love to have tea over this one! Thank you once again for engaging in the discussion. I love that!

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      1. Dear Marilyn,
        I would love to have a tea or coffee with you very much too! And I know that I will enjoy our discussion very much because we both love to engage meaningfully. I love your blog and admire what you do. As I think I said at some point; while our views might differ, I will entrust you with what is most precious to me, because I could trust your humanity and integrity.
        Daniela

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      2. I so don’t deserve these words but I am so grateful for them! Here’s to our virtual cup of coffee together :)

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  2. I have sort of another view point on this. While there is no dignity in death. There is often not much more dignity with living in chronic pain. I have a herniated disk in my neck. My biggest fear that I live with constantly is that doctors are becoming afraid of dispensing narcotic pain relieving drugs to people who really need them. I blame this on the futile but costly “war” on drugs. I never know when he will just refuse to refill to my prescriptions. Then I have to go to his office and beg in tears, for him to refill my prescriptions so I can make it through the day.

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    1. Trinity – Thank you for sharing what has got to be a real struggle.While I disagree fundamentally with physician assisted suicide I also fundamentally disagree with poor pain management and physicians worrying needlessly about addiction while their patients suffer with chronic, debilitating pain. And any pain expert will tell you that pain can be appropriately well controlled by using a variety of meds as well as other pain management techniques. So….my heart hurts that you have to beg. It is not right.

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      1. Just got home from another begging session. Got what I needed…this time. I never know though. It is a constant nagging fear in the back of my mind. The pain management is hard road to go down. I don’t want to manage pain.I want it to go away! Sometimes it does and sometimes it’s just there no matter what. I don’t advocate “the death with dignity” thing, but I can understand how someone could get so exhausted by the fight that they contemplate that as an option. That is truly a tragedy.

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  3. I will forward on to others . . . so well articulated! Thanks so much for writing on a topic that many people have difficulty assessing and discussing. I so appreciate the clear view you offer, especially that diagnosis is a fact, but prognosis, an opinion. How truly that resonates!

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  4. It is easy to vote Yes and to convince people about the conservatism of those who vote No. It is however difficult to convince me that I have any Right provided by the Nature or God to end a life only because it is not convenient to see it ending and given that I, as a human being, have absolutely no power in creating this life again.

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    1. I know I am slow in responding but I really appreciate this response. I too struggle with the idea of ending a life because of inconvenience. And it is easy to just cast the argument aside and put it into a conservative camp as you say. Often the easy thing is not the right thing. Thanks so much for reading and responding to what I feel is an important issue.

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