By: Mohini Banerjee
This post is
a small collection of impressions and quotes, hopefully prompting us to
ruminate and reflect on the end-of-life.
“Nothing that you do in science is guaranteed to result in benefits for
mankind. Any discovery, I believe, is morally neutral and it can be turned
wither to constructive ends or destructive ends. That’s not the fault of
science.”—Arthur W. Galston Quoted in an obituary piece for
the New York Times.
Last week I
attended an informal lunch discussion around the circumstances of a “good” death. In full bioethics form, we discussed the
voluntary stopping of eating and drinking and physician assisted suicide.
However, within ten minutes the discussion turned to music—that is, what would
you want to hear when you go? I’ve never considered that
question. It seemed oddly specific, macabre, and perhaps a little too eager.
The scholars I conversed with seemed more comfortable discussing various
likes and dislikes (certainly no Vivaldi), and I suggested my own favorite,
Holst’s “Jupiter”. We talked about music and how Pete Seeger died with his
friends and family singing in his hospital room. Persons and lovely harmonies
seemed to soothe the often painful experience of dying. Some around the table
discussed personal experiences, family or others, and the decisions taken
towards the end-- meant to provide for oneself, while trying hardest to
protect ones left behind. Their understanding of loss was completely enveloped
in an ethical discourse on agency and patients’ needs.
“In
quixotically trying to conquer death doctors all too frequently do no good for
their patients’ “ease” but at the same time they do harm instead by prolonging
and even magnifying patients’ disease.”
― Jack Kevorkian, Prescription:
Medicide: The Goodness of Planned Death
Which words we choose around hastening death are particularly important
since “euthanasia”, “physician assisted suicide”, “death with dignity”, “aid in
dying”, “suicide”, “voluntary stopping”, "palliation", and “no extraordinary measures” are
only some of the terms that contain their own emotional valences and particular
historical backgrounds. Often this language gets conflated, bringing about both
confusion and some misunderstanding. Some, for instance, would object to my
inclusion of a quote by Dr. Kevorkian given the potential harm in including his
ideas into any “reasonable” discussion on aid in dying. I agree that the
mistaken assumption that aid in dying means euthanasia is harmful to a movement towards choices at the end of life. However, if we’re considering values at the
time of death then our discussion should consider the reasoning of those who
advocate for marginal positions.
“With terminal illness, your fate is sealed. Morally, we’re more
comfortable with a situation where you don’t cause death, but you hasten it. We
think that’s a bright line.” –Arthur L. Caplan Quoted in “True Freedom” Time Magazine.
As
a society we may want to be thinking more about the music and people we want in the room than the particular medical intervention that would make us
most comfortable. We may not want to think of this at all. A melody chosen in
the midst of a hypothetical conversation only signals our hope for a certain
mood, however distant and contrived. Death, on the other hand, is uncomfortable
both in actuality and in how we refuse to acknowledge its reality. Discussing
medical decision-making at the end forces a contemplation of physical and
mental anguish, but considering our soundtrack does not. In that potential
future we are free of pain. And, whatever fear of the unknown we began with is
pacified. We simply surrender to the trumpets blaring, drowning out the
likely beeping machines.
Mohini graduated from Smith College in May 2013 and is a research assistant at The Hastings Center, an independent non-profit research institute in bioethics. She founded Bioethx Under 25 in January and acts as Editor in Chief. For interest in the blog please email her at bioethicsunder25@gmail.com.
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