The Right to Die April 14, 1991 1 SAMUEL 1:1-7 We need another right added to our constitutional guarantees. Besides the right to "life, liberty, and the pursuit of happiness," we need to add the right to die. If our founding fathers and mothers could have foreseen a time when society would make it extremely difficult to die, I'm sure they would have included the right to die. 1 1/2 years ago, my mother died of bone cancer--multiple myeloma. Aggressive chemotherapy gave her two years following the original diagnosis. In between treatments, she resumed most of her normal living, except for shuffleboard which she loved and was forced to give up. Then came the time when the chemotherapy was no longer effective. She was given radiation treatments with no effect. Dr. Michel is an exceptional doctor. He is clear, succinct, and open. She understood she was terminal. We all understood. She stayed with us her last three months. I can still see her sitting in the bed, in her pink bed jacket, saying, "Call Mary (my sister). Tell her I want it over." She called my brother, called her brothers and sisters, told them she belonged to Jesus and said "goodbye." Then she told the doctor, "Now, I want a shot." We told her the doctor could no longer give a lethal injection of morphine, because society now prevents the compassionate family doctor from ending life mercifully. We didn't know then what she would have to suffer the next four weeks: the terrible pain, incoherence from the increased dosages of morphine, an ugly open sore in her back with a horrible stench even gardenias could not disguise. Why didn't she have the right to die with dignity? Why didn't she have the right to choose how she would die? Why couldn't her family have gathered around her, celebrated her life, said thank you and goodbye, given her a lethal dose or injection, and held her hand while she died? Society says we don't have that right. Why not? We shoot horses. We put dogs to sleep. John R. Brooke, pastor of the Belmont Congregational Church has produced a compelling video of Lillian Stevens telling why she planned to commit suicide. She knew she was at the end of her quality life, and rather than endure the indignity of a death she didn't want; rather than becoming a financial burden, spending funds that might better be used to help the living; she decided to commit suicide. She believed she had the right to die. The title of the video uses her own words, "Pro-choice: From Womb to Tomb." Lillian Stevens eventually took her own life. There was no way for her doctor to help, so she took sleeping pills and vodka all by herself. She died alone because she did not want her doctor, friends, family or pastor to be liable. Why couldn't she be surrounded by those who loved her? Didn't she have the right to die with dignity? It is time to rethink our extreme prejudice against the ending of life. Suicide has been considered a sin in Christianity. Roman Catholics have called suicide an unforgivable sin. The Bible does not deal directly with suicide. The commandment, "You shall not kill," is a commandment against murder, not humane suicide. When King Saul saw his three sons killed by the Philistines, and was himself badly wounded, he asked his armor bearer to draw his sword and thrust it through him. The armor bearer refused, so Saul took his own sword, and fell upon it. Should you not have the right to choose death, when faced with terminal illness, prolonged by futile heroics? But, what about those terminally ill patients who are unable to make the decision to choose death? Laws must be changed so families and medical teams are given the right to let the patient die. Seven month old Sammy was taken to a Chicago emergency room. Something, a balloon or a piece of foil, was caught in his throat. He was blue and unconscious from lack of oxygen. Little Sammy was so far gone there was no movement in the chest muscles. His brain was so severely impaired he could not breathe on his own. Yet, the medical team worked on him for 12 hours to get him stabilized and breathing on the ventilator. Sammy lay for eight months as a "vegetable" with no hope of improvement. His parents begged the doctors to let Sammy die, but they said Illinois law would not allow them to turn off the respirator until the brain was completely gone. Desperate with grief, Sammy's father took a gun, ordered the nurse out of the pediatric intensive care unit where Sammy had lain for eight months, disconnected the ventilator, and sat crying with Sammy in his arms until the boy died. He was arrested and charged with first-degree murder! Didn't his loving family have the right to let Sammy die? Agnes was an 82-year-old woman when she was admitted to Stanford Hospital to have the mitral valve in her heart replaced. The surgery went well but she became feverish after the operation. Over the next six months, she underwent three different six-week treatments of antibiotics. She was completely dependent on the ventilator, her kidneys were damaged by the therapy, and she was too weak to survive another major operation. The Stanford doctors wanted to stop the therapies because they were actually harming her. They had caused three strokes, but her family refused to allow the physicians to stop. "She's a fighter," they said. Meanwhile, the cost of maintaining Agnes was $1 million. Shouldn't Agnes have had the right to die, rather than endure suffering and strokes, with no hope of improvement? Shouldn't medical teams have the right to let people die, even when the families are not willing or capable of supporting that decision? Arthur Caplan, director of the Center of Biomedical Ethics at the University of Minnesota, wrote in the San Jose Mercury News, January 31, 1991. Listen to a few excerpts. Our moral priorities with respect to health care are... stark, raving nuts. Two cases involving the care of elderly patients nicely illustrate this. Helga is an 87-year-old woman who suffered a stroke and a heart attack that left her comatose...The doctors plan to go to court to get permission to discontinue her life-support... The prospect of stopping Helga's care against her family's wishes has evoked a storm of criticism. Even the outbreak of war has not dimmed the concern many Americans have expressed for her. Right-to-life groups have vowed to do whatever it takes to keep her care going... Now, consider the plight of a 75-year-old former merchant seaman, William. Three years ago, like Helga, he suffered a stroke and a heart attack. Unlike Helga, he was not rendered comatose. He was left partially paralyzed and his speech severely impaired. He is confined not to a bed but to a wheel chair. William needs medicine to keep his heart going. While he is eligible for Medicare, this program does not pay for prescription drugs used outside a hospital. His medicine costs $75 a month, but he cannot afford it... This month William rolled his wheelchair into his bank...He had a savings account there with $4 in it. He withdrew the $4 and demanded $71 from the clerk. He waved around his medicine bottle that he said was filled with explosives... Police arrested him...No one has rallied to William's cause. The nation has taken little interest in his case. Editorial writers are not agonizing about his fate. Right-to-life groups have made no vows to throw their bodies in the path of anyone who would deter William from getting his medicine... The Helgas get our attention because, in our society, it is more acceptable to evince concern about the rights of the comatose than about the rights of the needy... If police had shot William in the head and rendered him comatose, we would spend more time worrying about whether to continue his medical care than we do about why he cannot afford his heart medicine. Kind of wacky, don't you think? Yes, it's wacky. Think of the cost alone in prolonging life unnecessarily, when, for example, funding for our schools is again being cut. According to the April 6 San Jose Mercury News, pro-life groups are now extending their agenda to the born as well as the unborn, and are joining forces with Right to Life groups. In Santa Clara recently, 16 such groups joined forces to battle the growing Right to Die movement. The battle line is being drawn between choice and no-choice, from womb to tomb. Those who advocate no-choice may believe in the sacredness of life, but they have no belief in the sacredness of freedom, and in the responsible use of freedom of choice in the living and ending of one's life. Right to Life groups seem to also share a belief that death is always the worst possible option. Why do they have such a fear of death? There are many alternatives worse than death. Jesus considered his death the lesser of evils. Another alternative worse than death is an agonizing, painful, hopeless, irrational prolongation, when the death might have been an act of mercy, surrounded by loved ones. I believe each individual person has the right to die. When a person is unable to make that choice, I propose an objective panel could decide when it is time to end life responsibly and mercifully. As a minister, I have participated in consultations where the family, physicians, and myself have agreed it is time to unplug the respirator and let the patient die. A panel consisting of family members, physicians, family lawyer, family minister, social worker, objective members of the community, etc., could be given the authority to make the decision to prolong or end life, including the authority to overrule either the family or the medical team. A list of guidelines--moral, ethical, medical, and merciful--might be designed to assist the panel in making its decision. The context within which I place this call for the right to die is our Christian faith. Death is not the end. Through death, God calls us to a new adventure. Jesus has prepared a place for each of us, a place in God's mansion, filled with the glory, wonder, and love of God, where we are reunited with loved ones. Therefore, we can face death courageously and hopefully, not with fear and apprehension, but with confidence, joy and expectation. The right to die a dignified, peaceful, celebrative death is a right each person enduring a terminal illness prolonged by futile heroics, deserves to have. © 1991 Douglas I. Norris