Assisted Suicide, Again

Brittany Maynard died this weekend. If you are not familiar with her story, she tells it here, in her own words.

On New Year's Day, after months of suffering from debilitating headaches, I learned that I had brain cancer.

I was 29 years old. I'd been married for just over a year. My husband and I were trying for a family.

Our lives devolved into hospital stays, doctor consultations and medical research. Nine days after my initial diagnoses, I had a partial craniotomy and a partial resection of my temporal lobe. Both surgeries were an effort to stop the growth of my tumor.

In April, I learned that not only had my tumor come back, but it was more aggressive. Doctors gave me a prognosis of six months to live.

Because my tumor is so large, doctors prescribed full brain radiation. I read about the side effects: The hair on my scalp would have been singed off. My scalp would be left covered with first-degree burns. My quality of life, as I knew it, would be gone.

After months of research, my family and I reached a heartbreaking conclusion: There is no treatment that would save my life, and the recommended treatments would have destroyed the time I had left.

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.

I did not want this nightmare scenario for my family, so I started researching death with dignity. It is an end-of-life option for mentally competent, terminally ill patients with a prognosis of six months or less to live. It would enable me to use the medical practice of aid in dying: I could request and receive a prescription from a physician for medication that I could self-ingest to end my dying process if it becomes unbearable.

I quickly decided that death with dignity was the best option for me and my family.

We had to uproot from California to Oregon, because Oregon is one of only five states where death with dignity is authorized.

A heartbreaking story. It is also heartbreaking that in her hour of greatest need, she had to completely uproot her life to move to one of the five states that grants to people what should be a fundamental right for all. No one should be forced to live in a condition where they can do little more than merely exist. It is not a happy thought, but sometimes your life ends before your heart stops beating. It is hard to imagine anything more devaluing of human life than not to recognize that fact. I discussed this in more depth in this post from July.

The folks over at the Discovery Institute demur. Even as they are keen to convince us that life is more than a purely physical phenomenon, they sure do make a fetish of preserving that heartbeat for as long as possible. Here's Michael Egnor:

Ms. Maynard's plight is a terrible one, and we in the medical community should (and do) work very hard to ease her suffering, even if we cannot cure her disease. But physician-assisted suicide is the wrong thing to do, both for Ms. Maynard and for others who are suffering terminal illness.

Killing is not medical care. It is not a “treatment” for suffering, any more than killing is a “treatment” for depression (e.g., Robin Williams), or psoriasis or indebtedness. Killing isn't a treatment for any ailment or circumstance. It is the elimination of the person.

It is morally abhorrent that a state would sanction, and a physician would perform, physician-assisted suicide. It is a violation of the Hippocratic Oath, which explicitly forbids assisted suicide, and it devalues the life of the terminally ill person and implicitly devalues the lives of all terminally ill people.

Charming fellow. He presumes to lecture Maynard, a total stranger, on the choices she ought to make, and then casually likens her condition to psoriasis and indebtedness. Unlike Robin Williams, Brittany Maynard was as clear-headed as could be and made her decision after long deliberation with her family and doctors. In Egnor's strange view, it somehow devalued her life that she was able to decide for herself the manner in which to end it.

But the truly grotesque part of his post is his description of what happened to Maynard as “killing.” There was no killing here. Maynard was given the ability to end her life painlessly when she saw fit to do so. That's it. Had she changed her mind, no one would have stood in her way. Indeed, as she relates in her essay, the sense of relief it gave her to have that option greatly enhanced her remaining time. What kind of monster would want to take that away from her, or from anyone else forced to confront such a situation?

Speaking of monsters, it comes as no surprise that Wesley Smith has also weighed in. To judge from his take on this, it is he and he alone who has any pure motives at all in addressing this issue. Those who have helped Maynard, or those who advocate for her right to make the choices she did, are summarily dismissed as “vultures.”

Here's his list of particulars:

First in line–although Maynard would surely disagree–are assisted suicide advocates:

- Assisted suicide movement leaders are always on the lookout for attractive cases to further their cause, and clearly believe they have one in Maynard because of her youth, beauty, and the tragedy of her condition.

- The movement has obviously orchestrated an expensive and very well planned media campaign to use her planned suicide to force open the door to doctor-prescribed death. I mean the story is all over the place. That doesn’t happen by accident.

- More than that–and most egregiously–by validating and extolling her self-termination, assisted suicide advocates make it harder for her to back off the ledge.

I saw this in the Nancy Crick case in Australia. Assisted suicide advocates and the ghoul Philip Nitschke–were all with her when she planned to kill herself. Then, when Crick had doubts, they backed away from her. The message was clear, kill yourself and we are your friends. Don’t, and we don’t care about you. When she finally did the deed, she had assisted suicide advocates in the room with her. When she took the poison, they applauded.

That Smith feels forced to concede that Maynard would not agree with his characterizations should tell you all you need to know about the merits of his list. It is horrifying that people like Egnor and Smith have made this into a political issue. In a better world it would be recognized that everyone has a fundamental right to make the decisions that Maynard made. But given that it is a political issue, what is wrong with forcing opponents of assisted suicide to face the consequences of their monstrous views?

Smith has no evidence that “the movement” orchestrated anything. But if they did, then so what? This is an important story and the media certainly has nothing to apologize for in covering it.

But it's that third point that really takes the cake. Are we really to believe that Maynard might have felt honor-bound to kill herself so as not to disappoint the people who helped her? Or that those who advocated for her right to make her own choices would have felt cheated, for heaven's sake, had she chosen not to commit suicide? Smith is awfully casual about assigning malign motives to anyone who disagrees with him.

Were this topic not so serious, I might have laughed at Smith's description of the Nancy Crick case. Apparently when Crick started having doubts, advocates for the right to assisted suicide backed off. How does that constitute them behaving badly? If they had publicly condemned her, or lobbied her incessantly to take her own life, then Smith would have a point. But the advocates did no such thing, of course. Moreover, it is positively demented, not to mention incredibly vicious, to imply that the advocates were applauding at the end because they were delighted that Nancy Crick was dead, or that they think suicide is just a marvelous thing. A more reasonable interpretation is that they were applauding her courage in the face of the preachers and moralizers who would tell her how she has to live.

Smith unloads a second list of bullet points against the media. Most of them are just bald, evidence-free assertions about the bad motives of those reporting on the story. The only one worth responding to is this:

By breathlessly pushing the Maynard story, the media are pushing suicide. This totally violates media guidelines for reporting suicide stories issued by the World Health Organization.

This is complete nonsense. No one is pushing suicide, and it is extraordinary callousness to reduce Maynard's plight to a mere “suicide story.” This is a story of a young woman facing an impossible situation with dignity and courage, in a manner that puts a human face on a moral issue that is all too often abstract. Why should the media not cover that?

The bottom line is this: The consequence of what Egnor and Smith argue for would have been the physical and emotional torture of Maynard and her family. All abstract moralizing and pompous self-righteousness fades to irrelevance in the face of this simple fact. These folks have nothing to teach the rest of us about morality.