I’ve got news for you:
You are going to die – and so am I.
Now, I know you know that, but you probably don’t really believe it – not emotionally – unless you are very old or very sick. Personally, I can’t imagine not being alive, even though I know intellectually that I have lived more than half my life.
But when my time does come, I want to die as comfortably as possible. I also want that for those I care about, and so does everyone else who can think rationally about end of life choices.
That’s why I think the hospice movement is so important. Those who run Hospice of Michigan may not admit this, but they have something in common with Jack Kevorkian, the doctor who twenty-five years ago argued in favor of physician-assisted suicide.
Both happened because medical science has found ways to keep many of us physically alive long past the point when we find anything enjoyable or even tolerable in life.
The ethics of medicine have been all about keeping people alive as long as possible, whatever the cost. Too many physicians weren’t even interested in pain management. Kevorkian’s solution was to empower doctors to help you end your life, after which any useful organs you might have could be transplanted to save others.
The hospice solution is different. They realize that at some point, further heroic measures aimed at keeping people alive no longer make sense. As Hospice of Michigan puts it, it is a “philosophy of care that focuses on comfort, rather than cure,” and involves the family, as well.
The goal, their literature says, “is to provide relief from physical and emotional pain so that patients and their loved ones can get the most out of their remaining days.”
That makes a lot of sense. The medical profession has come a long way in recent years. My own parents died, thirteen years apart, in large part from lung disorders. Both were in their mid-80s, and died in the same hospital.
When my father was dying, we had to constantly argue with the doctors to get him enough morphine to make him comfortable. But by the time my mother died, the philosophy had completely changed; they were willing to do whatever was wanted to keep her comfortable.
Frankly, I don’t see any reason we shouldn’t have both hospice programs — and recognize that competent people have the right to decide when to end their own lives with a doctor’s help. Ironically, Dr. Kevorkian originally offered a totally rational proposal for how physician-assisted suicide should work, and published a paper on the topic.
He suggested any patient wanting to die be examined by five doctors, one of whom had to be a psychiatrist, before they were allowed to end their lives. But instead, he set himself up as sole judge, and as time went on, became more reckless till he had damaged his own cause.
But before he went to prison for the last time, Kevorkian told me two things I’ll never forget. First, he argued that the right to choose to die is even more important for those doomed to suffer indefinitely than for the terminally ill.
But he also told me that eventually physician-assisted suicide would not only be tolerated, but encouraged, for this reason; There are so many of us baby boomers that the succeeding generation wouldn’t want to be saddled with the expense of keeping us alive for too long.
In both cases, I am not at all sure he was wrong.
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