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Saturday, October 25, 2014

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Death with dignity

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There’s a great deal of discussion in the media and cocktail circuit today about the legalization of assisted suicide. The prevalent terminology is “death with dignity.”

Once again, we’re faced with a moral issue whose parameters are clouded in nomenclature. How one phrases the debate seems especially poignant and persuasive. Is it suicide, or is it a form of murder? Or is it some form of choice that’s bound up with a human right to self-determination. These extremes aren’t invented for the sake of argument, but are indigenous to the realities of our lives and endings. Our beginnings are so joyous. What about the endings? They can be brutal, and many of us face them in a terrifying vacuum.

The first requirement however, is to avoid the superficial elements that seep into the debate. Many of the requirements for a patient’s humane treatment at the end of life are already available. There are all sorts of patient care packages and hospice choices that make those last days or months less intrusive, less full of emergency procedures and hospital healing protocols. Choices are already embedded into our health-care system.

However, to my way of thinking, dying is not laced with dignity. The end of life of someone loved is hostile, painful, dreadful, foul, raw and repulsive. Death violates life, and, therefore, is violent, no matter how much we wish to view it as peaceful. The essence of life is gone and we know not where. We’re left with a loss, an eternal emptiness, as the body dissolves into rotting matter. Where is the dignity?

Our tradition continually shouts: choose life. In all its facets, it reaches out for life-sustaining and supporting rituals, education and healing. When it comes to dying, the goal is to fight death, to try all manner of therapies, even to violate the Sabbath in order to heal. So how will Judaism face this new movement to allow patients and their families death choices at the end of a life?

I understand the problem. We now prolong life with all kinds of cures and lifestyles. Yet there are diseases and disabilities that cripple and crush us – some beyond belief and beyond our ability to suffer. Wouldn’t it be better, and morally preferable, to allow someone to exit this world knowing that life will soon become intolerable?

How can I watch my wonderful, beautiful mother – my mother who took care of everyone – become a vegetable, a prisoner in her own bed. Yes, I know the horrors and indignities. I also know the impossibility of making the right choice, of assuming to know what to do. I know of the real abuses, of human weakness, of children and other heirs’ temptations. The desire may be to inherit or to be free of a burden.

It’s way too easy to clothe the argument in the moral high ground of “death with dignity.” It’s too easy to hide one’s own thinking even from oneself. I wish I could do more for Mom. I wish I knew what to do. Three years ago, the doctors told us she had six months to live. I don’t pretend to understand. I do know there’s no dignity, and I don’t pretend to be able to extract any.

Judaism teaches that we must give the dying the basics of life: water, food, that which is necessary to breathe. We don’t have to perform extraordinary actions, but we may not starve the patient. On the other hand, we shouldn’t prevent death from happening in its natural end of life pattern.

There’s a talmudic story of a great rabbi who was dying. His students gathered round his bed, praying with such fervency that his soul could not depart. He suffered. His maid understood. She made a loud, shocking noise, and the prayers stopped. In that moment, his soul took flight. From that story, our legalists learn that we need to allow death to take place when it is time. We have both positions stated. No assisted suicide, but let death take its place. No extraordinary means necessary, but don’t starve the person.

The Talmud doesn’t pose the question as a moral one with dignity as the goal. Life is the goal. But death is the reality. It has its place. Just don’t dignify it.

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