Death with dignity
PRESIDENT REAGAN'S life was one of power, influence and dignity. But not his death. Ten long years of illness and regression into senility. At the end, a lifetime of independence, accomplishment, and pride slowly eroded into absolute dependence, without memory or hope. And while we celebrate Reagan's life, the painful lesson of his death is that many of us at the end will travel down the same painful and undignified path.
Dr. Jack Kevorkian sits in jail. The cause he championed all but abandoned. The march and miracles of modern medicine continue to lengthen our lives -- 80s and 90s, and soon the century mark will be the norm. But will there be any quality to our lives? Will we end our years mindless or in pain as bedridden, pin-cushioned dependents, burdens on our children? Why?
If Dr. Kevorkian went about this discussion of public policy the wrong way, isn't it still possible to have a reasoned discussion of how we end our lives? Why is it we can make judgments and control every other aspect of our lives, but we cannot control the end? All our life we strive for independence and dignity, but our last years are bereft of all we've worked for.
In truth, enlightened physicians have long agreed that patients should control their lives, including the end of life. Patient or family instructions to withhold heroic or lifesaving measures have been honored and have mercifully ended the pain, and life, for many patients. A more honest review of physician practice would also find that pain medication has been adjusted to bring speedier relief, and death, again in honor of patient wishes.
So if this already happens, why can't we have a more open debate and establish "end of life" standards with which we and our physicians can live. . . and die. We need to consider the hopes and fears of the terminally ill, the severely disabled, and those suffering fierce, chronic, and increasing pain. We need patients to exercise their free will, with counseling and review by multiple doctors. We need serious standards and safeguards. But in the end, why can't a patient, in these extreme circumstances, make a decision not only about how to live their life, but also how to end it?
Like President Reagan, my 89-year-old mother suffers from Alzheimer's. Unlike President Reagan, she still recognizes family and friends and holds onto some old memories. We are still blessed. During the past 10 years she has survived breast cancer, two broken hips, and the indignity of complete dependence on her children. And while I want her to live forever, I look at this once independent and resourceful immigrant woman, and wonder what pain and indignities lie ahead. Indeed, I look at my wife, my siblings -- and in the mirror -- and wonder what pain and indignities lie ahead.
Do any of us want to end our lives in such pain or with the paralyzing fear and anxiety that comes with Alzheimer's and the complete loss of one's mental faculties? Do any of us want our spouse to spend 10 long, lonely years, as has a gallant Nancy Reagan, even after losing all real contact with a lifetime partner? Do we want to spend our last years as dependent on our children as our children were once on us? And finally, while economics is not what drives this discussion, do we want our last years to destroy the nest egg we hope to pass on to our children as they struggle to care for us, even after we have lost all comprehension?
This is a most controversial topic, not unlike abortion and gay marriage, with significant moral and religious implications. But as with these other difficult issues, those with moral or religious objection would be free to exercise their own individual and religious course. They need not make life-ending decisions. But in a democracy that cherishes a Bill of Rights with its separation of church and state, freedom of expression, the right of privacy and individual liberty, each of us in our own way should be free to make this incredibly important and difficult choice.
The final and lasting contribution of President Reagan, and his courageous wife, must come from his death, not his life. As she cuts against party and politics to advocate for stem cell research, she must also restart the debate about how we end our lives. We may be grateful to medicine for extending life, but we must place securely in our own hands how we end it.
George Bachrach is an attorney and teaches journalism at Boston University.
