Charlotte Allen doesn't want to sign a roadmap that could lead to euthanasia. That's why she refused to sign what is now commonly known as a "living will" when she was diagnosed last year with breast cancer. Writing in Sunday's edition of The Washington Post, Allen recounted her experience overcoming "efforts to persuade me to sign onto the currently fashionable notion of a 'good death.'"
During her hospitalization, Allen was frequently asked to sign a living will. The suggestions came with the implication that such a step was the responsible thing to do -- just accepting one's own responsibility to tidy things up at the end of life. Eventually, she came to feel "ever-so-slightly harassed."
In reality, living wills are a central fact of life and death in medical centers, nursing homes, hospices, and hospitals. Groups such as the American Bar Association and the American Medical Association push living wills and advanced directives as a way of limiting some care at the end of life. In other words, the whole point of a living will is to allow medical personnel not to resuscitate or to deny "artificial" food, water, and breathing assistance.
In the course of her hospitalization and treatment, Charlotte Allen had time to consider what the living will and the concept of a "good death" might really mean. She explains:
In fact, when I contemplate the concept of "dying well," I can't avoid the uneasy feeling that it actually means "dying when we, the intellectual elite, think it is appropriate for you to die." Consider what's happened in recent years: The classic Hippocratic Oath and its prohibition against physicians giving people a "deadly drug" has collapsed with the growing acceptance of such notions as physician-assisted suicide, the "right to die," and even giving some very sick, disabled or demented people a little push over the edge, as seems to be the case in the Netherlands. People facing end-of-life decisions may well feel subtle pressure from the medical and bioethical establishments to make the choice that will save the most money, as well as spare their relatives and society at large the burden of their continued existence. A "good death" -- that's the English translation of the Greek word that begins with an "e." You know, euthanasia.
She also traced how the movement toward a "good death" has spread to places once thought safe from the temptation, such as hospices. As she reports, just a few months ago "the American Academy of Hospice and Palliative Medicine reversed its long-standing opposition to physician-assisted suicide (which is legal in Oregon and said to be quietly practiced by many doctors elsewhere) and adopted a new set of rules that effectively endorsed the practice. The academy even decided on a new euphemism for the procedure: "physician-assisted death." Even where assisted suicide is illegal, many hospices now endorse "terminal sedation," the ethically murky practice of anesthetizing terminal patients, then cutting off their nutrition and liquids."
Changing "physician-assisted suicide" to "physician-assisted death" is a clever manipulation of the language, but it cannot disguise the fact that the key word to the concept is death -- assisted by a physician.
Allen concludes her article in The Washington Post with a flourish:
I wish we lived in a different kind of society, one with agreed ideas about what a "good death" means -- but we don't, at least not now. So I say: Go ahead and sign a living will if you want. Have your doctor pull out your feeding tube or inject you with cyanide or do whatever fulfills your idea of death with dignity. But count me out. I don't want to "die well"; I just want to die in peace.
Christians understand the reality of death, but we must also affirm the gift of life. Furthermore, the Bible makes clear that we are not the masters of our own fates, nor the sovereigns of our own souls. In the end, our lives are in God's hands. This society's transit down a freeway to euthanasia should concern all citizens, but Christians in particular.
The idea of a self-defined "good death" has its place in the pagan cultures of antiquity, but not in the biblical culture of Christianity. Given advances in medical treatments and technologies, end of life issues can be truly vexing and excruciatingly difficult -- even for those who attempt to think ahead. Be sure you know what you are signing when someone presents you with a form for a living will. Are you sure that it is truly consistent with your Christian beliefs? Are you sure that those reading the document will understand -- and follow -- what you sign?