Friday, August 14, 2015

The Sanctity of Death

I have never cried at a funeral. I used to think this was because I had never experienced the death of someone close enough to feel the loss that deeply. Last summer my dear friend and adopted grandmother passed away. None of my biological grandmothers are involved in my life so I thought the pain would be acute. But three times she had battled breast cancer and three times she had survived and thrived. Her body was weak. Her mind was failing. She had lived a full and influential life. I miss having her in my life. But her death -the end of suffering- was a relief.

Now another friend is facing terminal cancer. He has had many wonderful months since his diagnosis but in the past few weeks his body is giving up more and more. We have said goodbye and are waiting for the news of his death. When the news arrives, once again, it will be a relief. He will again be lucid and pain free.

My adopted grandmother died surrounded by her family. Her children had respected her throughout her life and as she aged and they took charge of her care they always honored her wished above all. Even when they disagreed on what was best for her they recognized it was her decision to make.

On his deathbed this friend of my family is being cared for by the children who for many years were estranged. From the beginning of his treatment he has been very adamant about wanting to be medicated as little as possible. He does not like the way the drugs make him feel and wants to be fully present for his final days. He is dying. The drugs are not healing him, they simply mask his pain. He would rather feel the pain than feel the emptiness. But he values peace with his children above his preference and has deferred to them. His children no doubt love him and want the best for him but they have not respected his decision.

Do we take away the sanctity of death -of life itself- when without cause for hope of improvement we interfere with the course of nature? The family has an opinion. The health care providers have opinions. We as a society have an opinion about the right and wrong way to die. But do we have the right to have an opinion? In India the greatest blessing a person can receive is the blessing of an elder. Does our disrespect for the decisions of our passing elders take from us that blessing?

Is it right to, against their will, rob the lucidity of a person's final moments in the name of comfort? To what point should we help the inevitable come quickly and comfortably? Is dignity in death even possible?

As a daughter who one day will make decisions for my parents...as an individual aspiring to a profession that gives care in the final moments...I ponder these questions. I suspect I will never know the answers. Perhaps it isn't for me to know but just trust that what will be will be and when the time come God will give the wisdom and grace to do what is right.

I don't know. I wish death was black and white. I wish there was a clear right and wrong. But there isn't. So we ponder. We accept. We give dignity. We comfort. We respect.

2 comments:

  1. So many good points! You would do so well in a bioethics class in med school!

    When I experienced my first working code, I found myself shocked that I actually didn't feel anything about the fact that there was a dead body (my first experience with one) in front of me. Over the next 5 years, the only time I was phased by one was because I saw the family members' anguish and sorrow. When I experienced the death of my grandfather, one of the first people in my life who I knew well that was no longer with me, it tore me apart. It took months for me to feel like myself, and I still get waves of sorrow every once in a while. Now, when I see death, it hits me so hard, and I have to mentally and emotional force myself not get attached. I never thought I would change like that but it does happen.

    Your point about the sanctity of death is such a fascinating topic! I have never thought about it in the way that you put it. When did we have a cultural shift? Part of it comes from the fact that medicine has helped human society age further in life. About 100 years ago, or even 50 years, we didn't have people live in their late 70s and 80s. It's impressive when we see 100 year old folks now, so imagine what it was like back then! Since medicine has helped individuals live longer, it makes sense that laypeople believe that medicine should be used right until the end to prolong life as much as possible.

    Unfortunately, we've now come to a point where prolonging life means that we are also creating more pain. To the younger generation, many people do not understand what that pain is and since this is so new, we haven't been taught what the proper way to deal with death is, we just do what we know.

    Death is so difficult, I used to have anxiety attacks about it when I was only 6 years ago because in my mind (I was so scientific... even when I was little...) I thought that since my brain is what makes me me and allows me to think, that once I'm dead it will stop working and I will no longer exist. I will no longer think. I still have these attacks every once in a while, but I've learned to cope with it. I've also learned to cope with death of others, whether it be strangers or family. But as a society, there hasn't been anyone out there that has taught us how to deal with it, and because we're all afraid of it, it's taboo to discuss it. But if we did have a conversation, we could get closer to the "black and white" ideal of yours. Alas, nothing is that black and white, except maybe for a checkers board...

    My condolences to you and your family. I hope that your loved ones get the peace they deserve and that you cherish their lives in your memory. Thank you for sharing with us.

    Roxi

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    1. Exactly. I feel we have developed the tools to prolong life but have not yet acquired the wisdom for making difficult end of life decisions. And they are difficult decisions because every person and case are so different it's impossible to have a right and wrong answer. You are absolutely correct...openly discussing these issues is the only way we will ever improve our societal understanding.

      In many ways, I think the reason I have coped with death in the past is because I believe it is possible to know what happens after death. But I also strongly believe in the sanctity of all life and I feel that when we mismanage end of life care we disrespect life itself. Does that make sense?

      If you are interested in medical ethics I cannot recommend enough Better by Atul Gawande. He poses some very thought provoking questions but leaves you to consider the answer.

      I am very sorry for the loss of your grandfather. It sounds like you were very close and hold his memory dear. Our friend passed away yesterday, ironically, on my birthday. It is bittersweet. I will miss him and the role of grandfather he played for my brothers but I am happy that he is pain free and once again in possession of himself.

      Thank you for taking the time to share your thought, Roxi. Friendship and discussions are the very best part of blogging.

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