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Apr 5, 2023Liked by Leah Libresco Sargeant

I'm late to commenting on this topic. I haven't read Hanania's piece because just the excerpt you quoted was too painful. I've been personally impacted by physician-assisted suicide (PAS). Someone very close to my husband died by PAS in California last spring. My husband called her "Godmother" (she wasn't a godmother in a religious sense; she was not religious and neither is my husband's family). She was like a mother to him because his own mother had died when he was a child. We visited with my husband's godmother after she was diagnosed with colon cancer and had already made the decision to die by PAS. When we were there, I realized that everyone--doctors, her family--was let off the hook by the PAS option. Nobody needed to provide care anymore, and this pernicious idea was made acceptable because a) my husband's godmother chose PAS, and b) it's a legitimate, legal, medical option. Reasonable and caring people don't push back against personal choice AND the legal advice of a doctor (doctors would say they don't advise PAS; maybe they don't explicitly advise it, but its mere presence as an option leads to it being advised implicitly). My husband's godmother hardly knew the doctor who approved the fatal drugs, and appointments were conducted on Zoom and by phone. The doctors did not push for hospice or for other interventions, like in-person counseling. And family members were relieved to not have a drawn-out process of dying (this was because of an overwhelming fear of disease and death; not because they were heartless). The line everyone adopted was, "this is what she wants, therefore it is right." Nobody pushed hard to intervene and say, "you are loved and we want to take care of you." (I tried pushing this message, but I was stymied by the inertia of the system-- the ball towards suicide had begun rolling and it was extremely difficult to push back against the message that "the patient is only taking medical advice! What's wrong with that? This is what she wants!") I will say that everyone involved meant well; they were trying to do what they thought was best. There was no "bad guy," which is what makes the horror of PAS so difficult for many to recognize and fight. Everyone wanted my husband's godmother to have a "good death." Because she chose PAS, they figured that is how she wanted to die and that it would be a good death because she chose it. I'm still struggling over her death because I saw how my husband's godmother didn't have good options and therefore couldn't make a good choice. She didn't have family who were able to step in and care for her. She was exhausted and lonely. She didn't know how long she would suffer, and nobody--particularly people she should have been able to trust, like doctors--would sit with her in person, to try to comfort her and help her navigate the true menu of options before her.

My husband's godmother did not have a good death. I've been thinking ever since about how I'm implicated in her death and the deaths of others like her--people who are lonely, scared, tired, and in pain. In the excerpt from Hanania you quoted, he said "[I] would gladly sacrifice myself when I'm old so that those I care about can live better and more fulfilling lives." I do not live a better life because my husband's godmother committed suicide with the help and approval of doctors, family, and the state of California. If euthanasia is about surviving friends and family members being fulfilled, I would say that my husband's godmother's suicide did not "fulfill" me in any way. I would have been more "fulfilled" (I really must put that word in scare quotes because I do not seek self-fulfillment out of life; it seems there are bigger and better things to aim for) if I had been able to care for her in her last weeks of life. I would have been "fulfilled" if I could have been allowed to show and give care to someone who desperately needed it. I would have loved to give her what she needed. But the legality of euthanasia prevented me from feeling the burden I wanted to feel. It prevented me and others from giving their love and care to a beloved friend and godmother.

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author

I’m very sorry for your loss.

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founding

" I do not live a better life because my husband's godmother committed suicide with the help and approval of doctors, family, and the state of California."

So beautifully put. May she rest in peace, and may you know the peace of Christ that surpasses all understanding.

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Apr 5, 2023Liked by Leah Libresco Sargeant

"There is a reason to stay aware until the end, so that you can know Christ more deeply." I certainly agree with this and remember learning about love and suffering when Kara Tippets was dying of cancer. Years later, I was faced with my own cancer diagnosis and have experienced this love first hand. By choosing to end my life, I would be denying the love of my family and my community. I would miss out on all the beautiful, painful moments where love becomes real. My mom has spent many year with a chronic illness that could kill her anytime. But she holds out for the love of her kids and grandchildren. I have learned so much from her.

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Apr 5, 2023Liked by Leah Libresco Sargeant

If the number one sin of modern culture is suffering, it is followed closely by the sin of losing control or being out of control. The fear at the loss of control of memories, of our bodily functions, of our "right" to die on our terms, of our selves, it overwhelms us. We would rather live in an illusion where we think we have control over the natural world, the natural order of things, than admit that suffering and loss of control is simply a part of our human existence. In a world hell-bent on maintaining the illusion, humility is frightening prospect.

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Oh I meant to comment on this.

I grew up living in the same house with my maternal grandparents. My grandmother died of breast cancer when I was 9 and my mom cared for her at home until the last few days of her life even though their relationship was not the greatest. My grandfather died 20 years later and she did the same. By that time I was old enough to help so I spent a chunk of time driving 4+ hours from where I was living at the time back to the family home to do things like help set up a commode at home and meet with the hospice nurse.

I moved back to the area not long ago and the plan for my parents’ own aging is for them to age in place in the same family home. They’re in the midst of a big renovation project so that there’s an accessible one-level apartment they can use if needed (walk-in shower, that kind of thing), the house is in a Medicaid trust, my sister is their executor and I’m their healthcare proxy. We’re both local and have our own kids (I’m single she’s married) and will help for as long as help as needed. If/when they need full time care I’ll either take FMLA leave from my job or leave it altogether to move back into the family home and care for them (I’m a nurse, and since I’m single and rent, I am flexible as to my living arrangement. Kiddo could come with me if he is still underage when this is needed, but probably he will be out of the house by then).

All of this planning has taken a fair amount of open conversation. It helps that my parents are pragmatic. It helps that we all get along, and that we have built a family culture of freely given material support (when my sister had her baby recently, mom and I took turns spending the night at their house so we could get up with the baby overnight and let the exhausted parents sleep). It helps that I’m a nurse. It helps that I watched my mother’s example not once but twice. It helps that my sister and I share priorities. I think the critical thing, though, is mostly the will to do it; a strong will to make sure you can do something ensures that planning occurs. Since my sister and I really want to care for our parents, and my parents are willing to accept help, that’s lit a fire under us.

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What I don't see represented here are the views of the adults who have witnessed parents and grandparents advance through stages of dementia and said to themselves, "That's not going to be me." Not for reasons of being a burden, but for the question of whether, for them, life with advanced brain disease is worth sticking around for. The expense and care requirements are secondary to that personal conviction. For some reason, I know many adults who either intentionally ended their lives or plan to end their lives to avoid a protracted decline, especially a mental one. I agree with you that caring for the elderly and dying is a good and sacred duty, that our society needs to shift its values around caregiving and dependence, that everyone should receive the care they need at the end of their lives. And I share your horror at the thought that elderly adults would feel pressure to euthanize for reasons of being "burdensome." But for adults who independently conclude that they would rather choose their death than surrender to the organic processes of brain disease or terminal illness, I tend to honor their decision and wish there was a way for them to exit the world with peace and dignity in the manner of their choosing.

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Exactly echoes my thoughts. I actually welcome taking care of my parents. When my father-in-law was dying I saw the last 2 months of care that we spent with him and gave him every single day helped us all. I welcomed the opportunity to take care of my father and ease him into assisted living. I have seen great sickness in my family and this discussion is something we've all had a number of times. I believe there is a point when a person should be able to choose their course of action with the full support of their family and with full knowledge of all their options. Having witnessed what happened to my dad with dementia and now is happening to my mother I have thought very seriously about what I would like to do if and when I am diagnosed with dementia. I also face the fact that I'm a single mother and the oldest in my family. My son who is not necessarily going to be available to me or able to help me in the way that I would wish. There is lots of love there but I also recognize each of our limitations. I guess what I'm trying to say as long as this is discussed and everybody understands and all the feelings and options are out in the open, I think a person should always be able to choose to end their lives in the way that makes sense for them. Personally I don't want my fate to be left in the hands of strangers and my care to be subject to the weaknesses of our healthcare system

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founding

Spot on. I also think it’s worth looking at who is supporting policies to expand the accessibility of healthcare and hospice vs who is supporting euthanasia bans. From what I’ve seen those opposed to bans (politician and pundit wise) favor universal healthcare including adequate funding for home care and hospice. And most of those who favor bans seem to believe that family members (women) take on that burden rather than the state. This fits with the general approach of respect for the individual on the left vs the belief in enforcing ‘traditional’ norms on the right.

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I think two big sources of opposition are Catholics and people with disabilities, who both often support expanding healthcare support. (And, of course, the two groups overlap—I meet way more disabled people at church than anywhere else, especially for disabilities like Down Syndrome for the obvious reason).

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founding

The Canadian MP records are clear. And many activists don’t favor a full ban, particularly when there’s a terminal diagnosis.

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I agree 100% with Jenni’s comment. That’s exactly how I felt caring for my mom, except I wasn’t adopted.

Her comment, edited to reflect my situation:

Caring for my mother was an honour even if heartbreaking and hard in a number of ways, emotional and practical. But it was a privilege and a gift to have had the chance to love her and to have been loved by her. Even though it was the steepest learning curve. It was a profound experience.

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