Saturday, 3 June 2023

Views on death and dying

Death and dying has become such a sensitive and controversial issue. Over the past few months, assisted suicide headlines have appeared quite frequently. Then, just yesterday, there was a BBC article on the “˜pious’ clinging to life. These two diametrically opposed views invite serious contemplations about our own personal stance on living and dying. I speak only for myself when I say that neither of the above options are particularly desirable.

Death and dying has always been closely associated with end of life. However, in cases of sudden death, as occurs with murder, suicide, and accidents, there is no dying process. Is this important? I feel it is. Psychologists have suggested that people undergo several stages in grief and the acceptance of a terminal diagnosis: denial, anger, bargaining, depression, and acceptance. These stages are not necessarily distinct and independent, nor does a person undergo all stages in order. Yet, the stages are there to explain a person’s reactions to grim news. When the dying process is denied, people (that is, the sufferer and loved ones) are not given adequate opportunities to undergo the stages of grief. That is one of the main objectives of Hospice care. They prepare the dying and the loved ones to face death.

Dignitas is an organisation that has been set up to help those wishing for assisted suicide. Proponents will argue that those who enter into this organisation have already contemplated their wish to die and they offer them the chance to do so with dignity. That may be true. But do they really investigate the full details of each case? Or do they offer anyone assisted suicide. Is it done on an honour basis? That is, they rely solely on the individual’s statements and trust that those statements are honest and accurate. They cannot claim that they only serve those with a terminal diagnosis, for they have helped those without one, such as the case of Daniel James.

Why is it that when someone decides to blow their head off we look on it as tragic and inexplicable, yet when someone dies through Dignitas we give it some dignity? If someone is given a terminal diagnosis and has gone through all the stages of grief and acceptance, and they choose not to go through Hospice and they find that the expense of going to Switzerland is too high, will we frown upon their decision to take their own life in a more drastic way? I certainly would have a problem with it, and that’s why I have a problem with Dignitas.

Why must we encourage people to embrace death as an answer to their problems? It is not a fear of death that people have, but a fear of dying, a fear of suffering. That is quite understandable. No one enjoys experiencing pain. But at the same time, many who fear pain and claim nothing helps their pain are also the ones who refuse to be “knocked-out” with pain medications. Unfortunately, that is a side effect of many painkillers. What does Dignitas use to kill people? Potassium, or morphine?

Perhaps it is a control issue. People don’t like the uncertainty of not knowing how or when they will die, so they would rather take the issue into their own hands. I can see that many people who do not believe in the existence of a higher power would want to do this. Taking control of your life is admirable, but taking control of your death sounds cold and calculating.

Then, on the other side, we have people who are extremely afraid to die. It is somewhat unusual for people to expect to live forever. It is perfectly reasonable to expect that children have a difficult time understanding why they are going to die, but adults should have contemplated death at some point in their lives. The BBC article reported that of the people who claimed prayer was the most important thing that keeps them going, most do not have a “do no resuscitate” order. In fact, many wish for extreme measures to be undertaken in order to preserve their lives. Firstly, I cannot understand why, if you believe so much in the power of prayer, that you require all the earthly powers to keep you going. Some have answered me in the past that sometimes prayers need a little help. That’s like saying you put all your trust in God, but sometimes He needs a little help. It would be too rude for me to point out that God doesn’t need your help. If you trust in Him, and He is calling you, why are you refusing to come?

Secondly, all those extreme measures to maintain life at the brink of death are many times useless, not to mention dangerous. Too many gory stories of what happens at a resuscitation event have leaked out and I am surprised that it has not affected many people. Few people survive resuscitation, and of those few, many require life-prolonging measures, such as assisted ventilation and artificial feeding, even if temporarily. Then many of them may undergo another resuscitation. A small percentage have survived to tell us of their experiences and some of them are quite hairy.

Thirdly, I should mention cost to health care, but it sounds almost callous. Yet, intensive care at end of life is always extremely costly and this burden to health care has become unreasonable. I do not wish to tell people they need to die. It is their choice what they wish done. Everyone needs to seriously consider their choices, though. Intensive care is necessary and reasonable in many cases, but not all.

We have two extremes of thinking, and it is fortunate that only a small proportion of people fall into either category. I don’t believe in rushing death, but I also don’t believe in prolonging life unnecessarily.

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