How To Die

I have stolen the title of this blog from an op-ed piece in the New York Times that deals with the contrast between the attitude toward dying in this country and the attitude in England. The piece focuses on the case of a man in the East of London who had been told he has a number of inoperable tumors and was subsequently taken off life-support at his own request and moved to a quiet room elsewhere in the hospital to spend his last moments with his family.

. . .  the hospital that treated him offers a protocol called the Liverpool Care Pathway for the Dying Patient, which was conceived in the 90s at a Liverpool cancer facility as a more humane alternative to the frantic end-of-life assault of desperate measures. “The Hippocratic oath just drives clinicians toward constantly treating the patient, right until the moment they die,” said Sir Thomas Hughes-Hallett, who was until recently the chief executive of the center where the protocol was designed. English doctors, he said, tell a joke about this imperative: “Why in Ireland do they put screws in coffins? To keep the doctors out.”

The article does give one pause. We don’t like to talk about death and we are committed as a culture to the notion that life in and of itself is of value. We don’t ask whether or not the quality of life may be the central issue, as it assuredly is, we simply insist that no one should have to die.

Further there is a great deal of talk about the “right to life” which tends to focus on an unborn fetus while at the same time tending to ignore the lives of those who have been accused of capital crimes they may not have committed. It also tends to side-step such issues as war and the population explosion which is already overwhelming a planet stressed out from massive and relentless exploitation. But we don’t talk about death or the right to death. We simply assume that prolonging human life is the highest of values. But why do we think this? What about other animal species? And when it comes to humans, why shouldn’t a person be allowed to die if and when he or she has determined that the pain is no longer tolerable, the doctors have done all they can, and the cost to their families will be prohibitive?

The editorial goes on to mention that end-of-life treatment in England was not without its critics but it also addresses the question whether the attitudes about death in this country are likely to change and whether we might take steps toward a more enlightened approach to the subject. The author thinks not and responds as follows:

The obvious reason, of course, is that advocates of such programs have been demonized. They have been criticized by the Catholic Church in the name of “life,” and vilified by Sarah Palin and Michele Bachmann in the pursuit of cheap political gain. “Anything that looks like an official protocol, or guideline — you’re going to get death-paneled,” said Dr. Ezekiel Emanuel, the bioethicist and expert on end-of-life care who has been a target of the rabble-rousers. . . . Humane end-of-life practices have quietly found their way into cancer treatment, but other specialties lag behind.

Though Mary Tyler Moore tried years ago to teach us how to laugh at death (when appropriate) it does seem that certain topics are taboo and that we shy away from asking pertinent questions and opening doors that might have important answers hidden behind them; we have knee-jerk reactions to certain topics and cultural biases that tie our hands and blind our eyes to unpleasantness. We simply don’t like to talk about death and dying even though they are facts of life.

12 thoughts on “How To Die

  1. Another great post, Hugh. We’ve long believed that death is actually part of the living process, and end to our time here, perhaps a doorway into another. Something like 60% of the money spent in medicare is spent in the last year of life, usually in last ditch efforts to keep one alive. Personally, I believe that a great deal of our “Save the life at any cost” reasoning is guilt based. We ignored Grandma for years, now that she is on her deathbed, we need to assage our guilt by demanding extraordinary, and what are usually, demeaning and painful processes to extend a life a few more weeks at best.

    Personally, I’d rather die with dignity, surrounded by loved ones and caring people, at home or in a comfortable hospice.

    And Palin and her “death panels” be damned. Dying is a part of life, and recognizing and accepting that the end is near allows us the final dignity of going out on our own volition.

    Thanks for allowing my personal rant.

    • Barney… If Grandma is an animal and “just meat” then the rest of are too. The primary function of religion is to deny the finality of death. Christianity isn’t working very well in that respect, or, Christians would welcome the prospect instead of fighting tooth and nail to oppose it in any form at all (except to punish). In that respect Europe, largely Post-Christian, and Islamic countries are much better at dealing with death and end of life issues. Face it, you will NEVER see a Christian mother strapping a bomb on her son and sending him off to glory.

      • I personally believe religion has nothing to do with dying with dignity. Going off on a tangent for a moment, isn’t there a wee bit of hypocrisy in believing in the sanctity of life, right up to the moment of birth, then abandoning the baby’s as being the poor mothers problem? Then all of a sudden, when grandma is terminally ill, do everything possible to prolong her miserable life as a vegetable in a wired hospital bed, just so she can breathe on a machine a few extra days? The most disgusting and despicable act in this country’s history was the tragedy of the Terry Schiavo case. Kept on machines for 7 years by a family unwilling to face facts, having GW Bush get politically involved in a deeply personal and private matter, Representative Bill Frist, who hadn’t been a practicing doctor for years, suddenly show up for a speech on the floor of the house, with a stethescope wrapped around his neck. And in the end, after she was disconnected, the autopsy proved she was nothing more than a cadaver kept alive by technology and foolish parents. Is this really what you want in your personal future? I sure as hell don’t.

        And Ms. Neutron, to your last point, christians of all ages have been sending their babies off to war, with the same result, bomb or no bomb strapped to their back.

        I see this as a deeply personal issue, and wish to accept my end when it is time, and not extend it one moment longer.



      • We send KIDS off to war Barney because they don’t think they are EVER going to die. There is a world of difference between strapping a bomb on Junior and sending him proudly off to Allah and listening to the Chaplain tell Mom & Dad that their son is with Jesus now as they cry their eyes out. The first rejoices the second does anything but.

        Of course religion has nothing to do with dying with dignity…. it’s purpose is to deny death.

        You SHOULD be able to accept your end! You won’t find Atheists, Buddhists or Muslims stopping you….. it’s the Fundamentalist Christians who get the court orders to keep the machines running.

        All the best
        Mrs. N.

  2. Great post. You are so right. We should absolutely be able to make these personal choices aand deceisionns for ourselves and our families. Thanks for another great post, Hugh!

  3. You are on the right track with the questions you pose here. I salute you. Death in the United States of America has become a process, not an event.

  4. Great post. This is all more reason to put your words in a legal instrument, so that your children won’t fight over keeping you alive. My mother-in-law before her Alzheimer’s fully kicked in, told us what to do and we had her sign a legal document to ask doctors to not perform life-sustaining treatments if the prognosis was grim. Alzheimer’s is the cruelest of deaths, as it hurts the caregivers probably more than the victim as mom or dad do not know who they are. Thanks, Hugh. BTG

    • Of all the things I worry about, I worry about Alzheimer’s the most. I saw my grandmother succumb to it when I was very young. Thanks for the comment.


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s