Whose decision is it?

Whenever I read the arguments of opponents of Medical Aid In Dying (MAID), one that constantly crops up is a religious appeal to how precious life is. For example, “Every day is a gift from God, and you can’t ever let that go.” That is a faith statement. I may agree with it or I may not. It may rise out of the writer’s religious faith, but that doesn’t mean it applies to mine. And religious faith should never be a basis for making public policy. Otherwise, we will have one person’s religion controlling all others – something our founders absolutely opposed.

In keeping with the diverse religious views that attended the founding of this country, Rabbi Dennis S. Ross wrote in 2012,

The attempts to have religion dictate public policy are particularly troublesome when it comes to religious restrictions about family and intimate life. . . . And when faiths disagree, the state must not umpire the conversation, pick the winning religion or establish one set of doctrines as the rule.

Every voice should be heard, including voices of faith. But we should not make law out of stricture, nor should we establish policy based on religious perspectives alone. Rather, we should promote policies that protect private belief and practice in a way that does not burden, restrict or impose upon the larger spiritually diverse community.

New York State Sen. Diane Savino has sponsored a bill in the New York Legislature to legalize MAID. She explained recently that some people with terminal illnesses choose to fight it out to the very end, but other people don’t want to take that road. For her, the important public policy question to ask is “Do we give people the right to decide which road they choose?”

Throughout my life, I have heard many people explain their choice when faced with a terminal diagnosis. Some might have a wonderful group of people assisting them. They feel blessed to have such support. They may try the best treatments medical science has to offer, but they see themselves as realistic about their diagnosis and prognosis. They may consider participation in clinical studies of promising new treatments. Some are accepted in clinical trials and may improve for a time. This happened to an aunt of mine who had pancreatic cancer. But she knew that the chances of a long-lasting remission was unrealistic. When her cancer came back, she knew that it was time to get her affairs in order and prepare for the end of her life. She talked with her clergy, her brother and sisters, and her friends; and she chose to receive hospice services, with round-the-clock care provided by family.

Unfortunately, not everyone has family members who can take on such a task. In fact, many people do not even know anyone to whom they can entrust the task of being their medical agent, a far less time-consuming matter than providing round-the-clock nursing care. Accepting death when no other alternative is realistic often gives such people peace of mind so that they can make the most of the time they have left before unbearable suffering or semi-consciousness sets in.

Others know that the nature of their illness is such that they will not survive their diagnosis. These people often seek to have quality time, rather than than a bit of extra time filled with the suffering and misery of painful, ultimately futile treatment. If this is a fully-informed decision, who has the right to say that it is wrong?

Often, such people seek out hospice care and then MAID, if that is available. If MAID is not available, FEN may be the chosen resource. Even if they live in a jurisdiction with a DWD law, education and training from FEN may be useful if the patient does not meet all of the legal requirements for MAID. Others choose Voluntarily Stopping Eating and Drinking (VSED – pronounced vee-said)

Many people, faced with what they and their medical professionals, using the best medical science, see as a terminal diagnosis, make plans to have a pain-free, dignified death over which they can exercise control about its timing and circumstances.

For those who want to try to stay alive using every available resource, even when some treatments may make them miserable, that is their choice. I do not begrudge such people their choice. Every person, family, medical professional, and group of friends is unique. All of these people, along with a patient’s personal and religious views can become a part of a patient’s decision. Some view suffering as ennobling. Others want to survive long enough to see a daughter marry, or a grandchild graduate from college (one of my personal goals), or achieve a certain anniversary, or experience one more Christmas, or the see the birth of a grandchild. We cannot know everything that makes up a person’s choice. We can only respect the person’s right to make her or his own choice about when death is preferable to living under undesired circumstances.

As I and others often say (or write), the choice is mine – it is my life and my death. To opponents of MAID, I say your opinion about my life does not trump my opinion. Please go in peace to live your own life and your own death, but don’t try to keep me from having that same right.