Image by Dimitri Kospakov on Unsplash
Today a couple of things happened. New York took big steps to become the next state to legalize assisted dying, i.e., the right to determine how and when you die, for a narrow group of patients with six months to live.
. And the New York Times published an opinion piece by Ross Douthat warning that it’s a “slippery slope.”
The vast majority of comments criticized Brooks for his attitude, which seems to be religion-based. I did too.
Douthat argues that every day people are told by doctors, “There’s nothing more we can do.” In fact, many people suffer more because they don’t get a quick death–just a condition they have to live with.
I would see this parallel as a reason to expand the scope of assisted dying. Suppose you get a condition which leaves you bedridden and miserable but not in danger of imminent death. Many of us would rather be dead.
But suppose instead of “nothing left to do,” you have the option to accept treatment with “low-probability treatments that take a long time to work, some psychological or spiritual adaptation…” Douthat says that many will choose death because of the certainty factor, With death, it’s “one and done.”
Presumably hat’s the slippery slope. With so many probabilities and uncertainties. allowing a restricted death will risk allowing the restrictions to broaden so much they are meaningless.
But I’d like to see a different interpretation of this. Why is it irrational to avoid high-risk treatments, with uncertain probability of success, which may require a change in values? What’s wrong with a preference for certainty?
In my book on aging, I take a pretty extreme view. I think everyone over a certain age (maybe 75) should be given a cyanide pill, to use when and if desired, with no questions asked. I also half-humorously suggest they get a gift certificate to a Mafia hitman, so the families will be spared any guilt, especially in Philadelphia (“it’s one of those shootings on South Street”)
After all, in World War II spies in many countries were given cyanide pills in case they were tortured, killed, and/or sent to prison camps. Many nursing homes are just like prison camps.
If you’re adept with guns, you have an easier option. If you’re taking lifesaving medication or getting lifesaving treatments, you can stop them. So…why not make these options easier for the rest of us?
In one of her books, Incidental Findings, Danielle Ofri describes an encounter with an elderly patient with unusual frankness. Her 79-year-old patient wants to stop dialysis and die. Danielle is horrified: people can live for years on dialysis, she says
The patient doesn’t seem especially close to her family, She hasn’t been allowed to eat because of an abdominal condition that’s being diagnosed. She has many things wrong. It’s extremely unlikely she can lead a meaningful life.
Danielle talks her out of giving up dialysis, which would be a death sentence. Danielle’s book reports that she is discharged to a nursing home a few weeks later — a fate she had wanted to avoid.
Danielle sees the outcome as a victory over death. I see it as a scam by the medical community. Would the woman have wanted to live if she knew she’d be sent to a nursing home? We don’t have the answer, but I know how I would feel.
Let’s face it: there are no tooth fairies. Not everyone dies a peaceful death in bed. Not every hospice is kind and caring, and not every condition can be ameliorated by hospice. Anyway, hospices are 73% for-profit (up from 30% in 2000). Google it. Often an end to pain means taking drugs with horrific side effects.
Let’s let people make their own choices more easily. We want to be able to live and die with dignity.
