Choice at the End

“How we deal with death as at least as important as how we deal with life, wouldn’t you say?” — Admiral James T. Kirk


There’s an interesting debate going on right now.  Well, “right now” is probably an incorrect phrase.  The debate has been going on for a long time, but it’s recently burst back into the media again with the release in the UK of a documentary called “Terry Pratchett:  Choosing to Die.”

In the documentary (which I have not seen, but would certainly watch if given the opportunity), author Sir Terry Pratchett examines “whether assisted suicide is the right decision for him as he battles Alzheimer’s.” (CNN, “This Just In”)  At the end of the program is footage of an actual assisted suicide.  Peter Smedley (who had motor neuron disease), after consulting with his family, makes the decision to end his life.  With the aid of the Swiss group Dignitas, he says his final goodbyes, drinks two drug concoctions, goes to sleep, and quietly dies.

As you might guess, there has been hue and cry over this, people falling either strongly in favor or strongly against the idea of assisted suicide.

The topic is particularly timely for me because of my elderly parents.  Mom is 87 and has dementia.  It might be Alzheimer’s or it might not (there’s been no “definitive” diagnosis), but the fact remains that, bit by bit, we are losing her.  She is slipping into a twilight world into which we cannot follow and from which she cannot escape.

Dad at 93 has a plethora of medical issues, the top contenders being congestive heart failure and diabetes.  He is failing.  His body has begun to break down and I fear this will be a long drawn-out affair as one medical issue runs into the next.  Despite the use of diuretics, his feet and ankles are swollen with fluid his body cannot expel.  They are so large that I cannot get both hands around them.  The saturated tissue has developed enormous blisters that weep viscous fluid that stains his sheets, his clothing, and seeps through his bandages.  In an ideal world, he would sit with his feet elevated, but he cannot do that because of the pain of the blisters and an open sore on his back that will not heal.  There is little sensation in his feet  The spectre of gangrene looms and the awful, very real possibility of amputation.  If that occurs, there is nowhere he will have to go into a nursing home or hospital,because he is obese and not easily moved.  Once there, he will be subjected to the indignity of having his ass wiped, the loss of private showers, and the humiliation of a lift, of being hauled from place to place like a sack of grain by attendants who are all too often unfeeling.  (Sorry, but I’ve been inside my share of nursing home while treating Hospice clients.  Some of them are lovely places of caring.  In others, I’ve seen the abuse first-hand.)

Did I mention that, unlike Mom, my father is completely lucid?  And he is terrified.  The man who once told me “I’m not afraid to die,” had not considered this outcome and it scares him to the bottom of his soul.  The last time I saw him (at the beginning of June), he said, “Now I understand why some old people commit suicide.”  I replied that if that was what he wanted, I would not stand in his way.  When we spoke on the phone on Father’s Day, he said, “This is hell.”  He means it.  Dying a little every day, going by inches instead of all at once, is exhausting him mentally, spiritually, emotionally.  And all I can do is commiserate.  I don’t know what else to say.

Would my father take his own life if given the means?  I honestly don’t know.  He’s been ready to die for the past 20 years so, yeah, he might.  I wish I could give him that option.  God knows I would help him take it if that was his decision.

Why is there such an issue over letting us control the last days of our own bodies?  If we are capable of making an informed decision, why are we not allowed to do so?

Before someone bites me, understand this:  I’m not advocating making the decision FOR someone.  Yes, we do that for our pets and I think it’s a good thing (I hated having my dog Tucker “put down,” (such a tidy term, don’t you think?), but better that than to leave him laying in his own excrement, unable to get up, unable to keep food down, dying by inches.)  It would be nice to think that there’s a way in which to advocate that for the elderly who cannot speak for themselves, but I don’t think we’re that enlightened a society yet.  But for those who retained cognitive ability, who can make that decision facing into the wind of looming disease they cannot escape, why should they not have that choice?

Some see suicide (assisted or otherwise) as cowardly.  (I happen to disagree.)

Some see it as the ultimate form of selfishness.  (If you’re some guy who blows his brains out in the tub and leaves it for your kid to find and clean up — as happened to someone I once knew — yeah, that’s selfish.)  But for someone dying of disease with no hope of regaining a life of quality, who with full understanding opts for an assisted suicide?  I think it’s the exact opposite.

There are those who even tag assisted suicide as murder, which beggars a question.  I am my father’s health care proxy.  When the time comes, if I say “Pull the plug,” does that make me a murderer?

Some will say yes.  To them I say, Fuck You.  You will not be standing in my shoes when that time comes.  You will not know the interior of my mind and heart.  But know one thing — I made a promise when I took on the role of health care proxy.  My decision that day will be made without the influence of my own emotions, but based upon the wishes and desires of only one individual who trusts me to see him on the path to the next great adventure.  If I can make that passing as painless as possible, I will.  My father’s death (or my mother’s for that matter, I’m her health care proxy too) and the manner in which is occurs will be, if we’re very lucky, his choice.  And I will follow that directive.


About Melissa Crandall

Longer ago than I care to admit--although I will--I cut my writing teeth on fanzines and media tie-in novels. Since then, I've moved on to narrative nonfiction, speculative fiction, and essays. I write to explore and understand the world around me, the things I see and experience nearby or from a distance. If I shake myself up, cool. If I shake you up, even better. Not gratuitously--what's the point in that?--but to set what I know, or think I know, on end and realize, "Well, doesn't it look different from this side!" My work is neither sexually explicit nor graphically violent. Let's face it - your imaginations will come up with things far worse than anything I could write, no matter how descriptive. Besides, it's just not my thing. I live in Connecticut with my supportive husband Ed, a cat named Ruby who might just think she's a dog, and an epileptic Australian shepherd named Holly who isn't quite certain anymore who she is, except she knows she loves her mommy.
This entry was posted in Alzheimer's, Assisted Suicide, death, Dementia, dying, Essays, Fear, Grief, Independent Writers, Loss, love, Melissa Crandall, self-publishing, Terry Pratchett, Uncategorized, Writer, Writing and tagged , , , , , , , , , , , , , . Bookmark the permalink.

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