Defining Good Death
“Love empowers us to live fully and die well. Death becomes, then, not an end to life but a part of living.” -bell hooks
It’s an unpleasant word and a distressing topic. It’s sidestepped and euphemized with polite platitudes (she passed yesterday; he is no longer with us). We don’t talk about it, yet it happens to millions of us every day.
Euthanasia—Latin for good death—“is the act of killing or permitting the death of hopelessly sick or injured individuals (such as persons or domestic animals) in a relatively painless way for reasons of mercy” (Merriam-Webster).
A culture consumed with pornographic ideals is one avoidant of true intimacy; likewise, a culture that embraces euthanasia is one in which mortality is taboo. We attempt to smother death by sterilizing it, pumping it full of medical jargon, and wrapping it in sentimental gauze—yet the truth is always visible underneath.
Death is a stage of life. Some deaths are quick and uncomplicated, some are drawn-out and arduous, and many are somewhere in between—and to rob someone of their dying rites or to suggest that they forgo them is a tragedy and an injustice.
Death, Dignity, and Interdependence
In conversations regarding end-of-life care, dignity is a word that’s wielded with fervor. Another definition is useful here: dignity is defined as “the state or quality of being worthy of honor or respect”; or, in another phrase, “self-respect.” Death with dignity advocates often paint a pitiful picture: the newly diagnosed person, on a fast track towards certain death, faces an imminent future of restrictions, discomfort, and intense vulnerability. The family of the dying person must witness them suffering relentlessly while dwindling away into an unrecognizable shell. No respectable person should exist in such a state, and no family should watch it happen.
The implication (though it’s been denied by proponents of death with dignity) is that the state of being disabled—whether that means having limited mobility, cognitive challenges or handicaps, or loss of motor control—is synonymous with a lack of respect.
“Dignity” is a classification that has historically been reserved for specialized classes of people; marginalized groups—the poor, the homeless, non-white people, victims of substance abuse—have been bestowed with the constructed burden of being “undignified.”
The reality is that no death is dignified or undignified: it just is. In a hyper-independent environment, in which community care is eschewed for private nuclear units, in which social safety nets are sacrificed to systems of capital gain, many fear being dependent on others for their well-being. When wealth and property are valued over human flourishing and medical care is reduced to checks and balances, sustaining certain human lives is considered a waste of money and resources.
Normalizing concepts like physician-assisted suicide ignores the heart of the matter: a medical system and a culture that does not adequately support disabled bodies, marginalized people, the aging, and the dying. The ones left behind are the first to go.
“Legalized assisted suicide sets up a double standard: some people get suicide prevention while others get suicide assistance, and the difference between the two groups is the health status of the individual, leading to a two-tiered system that results in death to the socially devalued group. This is blatant discrimination.”
-Disability Rights Organization, Not Dead Yet
(Suffering is not Evil)
Avoidance of the dying person is a modern privilege. Quaint are the days of community care for the actively dying and of homespun death rituals like parlor wakes.
An average person no longer regularly interacts with death. The dying are hidden behind hospital walls, enclosed in dying-only spaces so as not to interrupt the rest of us in our life-affirming daily routines and tasks. Families no longer care for the bodies of dead loved ones. Carted off are the carcasses of our deceased to strangers, to be drained of human fluids and made up to look life-like for a few hours display for our comfort.
We need not be reminded about the dying, nor are we encouraged to care about them: their existence, no longer dictated by menial jobs and tasks, by responsibilities, or by ambitions or achievements, are, ostensibly, over. Their pain, whether trivial or significant, is a sign of an overstayed welcome. The best thing for them, it’s believed, is a swift, simple end.
It's unpopular but important to acknowledge that suffering, while unpleasant by its nature, is not evil. A good life does not exclude suffering. Neither does a good death. When we decide that a person’s life no longer has worth or purpose because of suffering (actual or potential), or when we decide that dying is no longer a stage of life and a process but a cue to end everything as quickly as possible, we deny a person’s total humanity. When we ourselves decide that our potential suffering or a terminal diagnosis is futile, we deny the full extent of our own humanity.
A proposed safe way to bridge the complicated feelings surrounding dying and the longing for an end to suffering is physician-assisted suicide. If death is a dirty word, suicide is a shameful relative. Murder of the Self has been a taboo across cultures, time periods, and religious traditions. Historically, victims of suicide have had their legacies erased by shame, their remains discarded in unmarked graves on unsanctified ground. In many circles, people who commit or attempt to commit suicide are dismissed as selfish or declared damned. On the whole, suicide hasn’t had great publicity.
Anti-suicide campaigns (such as To Write Love on Her Arms) have brought awareness to the topic and have aided in suicide prevention by diminishing misguided assumptions about self-harm; more people are likely to recognize suicidal ideation as a marker of disorder, not immorality. In many respects, it’s a cultural consensus that suicide is an avoidable tragedy.
Physician-assisted suicide, no matter how it’s packaged (Death with Dignity, Medical Assistance in Dying, plain old-fashioned euthanasia), regardless of how it’s carried out (in a hospital setting or self-administered by the patient) is not an act rooted in respect, care, love, or compassion; like any other act of suicide, it’s one rooted in fear, contempt, hopelessness, and desperation. Legalized euthanasia legitimizes self-harm. It’s an egoistic attempt to avoid confronting the despair of the act of suicide and the reality of death by handling it with latex gloves.
“If fear of disability and illness are driving people to make [choices to end their lives], the medical establishment must re-examine how it communicates diagnoses and how it treats those who have terminal illnesses. Palliative care…Does not strive to hasten death, nor does it deny death’s ultimate inevitability. Instead, it strives to improve quality of life as much as possible at each stage of a patient’s illness by keeping the person comfortable, in control, and cared for. Doctors must be trained to make available these options that holistically honor the dignity of the patient.”
(Aimee Murphy, Rehumanize: A Vision to Secure Human Rights For All)
Many medical professionals are caring and compassionate; their role is to alleviate pain and, to the best of their ability, administer treatment. That is why so many of them also feel that when a person can no longer be treated—that is, that their illness is no longer compatible with life—expeditious death seems the obvious and merciful solution.
As well-meaning as this may be, it’s a flawed and single-minded perspective. When an individual no longer benefits from traditional medical treatment, their lives shouldn’t be in the hands of those who administer it. Medical professionals must accept when something is outside of their jurisdiction. Their expertise lies strictly with the living. Being so preoccupied with the functions of the physical body, they cannot always see beyond the immediate and the tangible into transcendental aspects of the human experience.
In the midst of life, we are in death
In a world with values beyond the corporeal, Death would be viewed not as self-annihilation, but as a form of self-actualization: a final refinement before the last transition.
The compartmentalization of modernity erodes meaningful connections and discourages a wholesome life. One component of living an emotionally healthy and varied life is developing a symbiotic relationship with mortality.
Our lives are heavily pathologized. Most people in the Western world are birthed in a hospital room, and many people see their lives end in one. Contrary to the fearmongering and condescension of certain medical professionals, neither birth nor death is a medical emergency. In honoring the full humanity of ourselves and others, we must restrain against efforts that aim to push natural human experiences into a standardized, overly controlled environment.
Complete painlessness is not always an option. Emotional discomfort is often a byproduct of vulnerability. Intimacy doesn’t always feel like bliss and instantaneous fulfillment. Administering care to the dying—whether through physical care or emotional care—requires us to expand our ideas of vulnerability and intimacy beyond our everyday expectations of comfort and order.
In the midst of life, we are in death. In every moment, our bodies break down in minuscule, invisible ways. Every object that we’ve built is in slow decay. Remember that you are dust and to dust you will return: to embrace humanness is to embrace temporality.
If you or a loved one are contemplating suicide or self-harm, some resources may be able to help. The 24/7 National Suicide Prevention hotline is available by calling 988 or by visiting 988lifeling.org. For more information on suicide prevention resources by state, visit http://sprc.org/states/.