Choosing a good death

Apr 20, 2018 by

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Both of my parents were able to die the way they wanted to: at home surrounded by family. I hope this is the way I am able to die as well. Unfortunately, medical technology, combined with our own fearful choices, have made “a good death” at home less likely.

Medical technology can often keep our bodies alive even when we have lost all consciousness and control. We can be resuscitated, intubated and ventilated. It used to be that the line between life and death was much sharper: the lungs stopped breathing, the heart stopped, and that was it. But now we can keep these prodded and pumping even if the person is no longer consciously present. Is that how we want to live? Is that how we want to die?

Or how about the often debilitating side effects of caustic drugs and chemotherapy that make life miserable and unfocused? For what? An extra month or year of additional suffering?

Compounding the dilemma is the massive cost of keeping a person alive through expensive technologies and exorbitantly priced drugs. Every dollar spent on squeezing one more miserable month out of our lives is often a dollar less that is available for someone else’s health care.

So why do we insist on prolonging our rapidly deteriorating and often unconscious bodies? I see two factors: misplaced faith, and fear.

By misplaced faith, I mean the belief that it is somehow unfaithful and unethical not to do everything possible to prolong life. Human life is a sacred gift. So according to this line of thinking, we are obligated to do everything possible to prolong it. Not to is tantamount to murder. If we do not prolong life whenever possible, we will be slipping down the slope of euthanasia, making ourselves into God and deciding when life is worthwhile or not.

But isn’t it acting like God to hook up someone to a machine who is comatose and in a vegetative state? Isn’t artificially prolonging life, despite the misery, despite the health care resources being shortchanged for others, also a form of playing God? Human life is sacred, but so is death and dying. It’s all part of the God-created natural process, and it’s all essential in order to make room for a new generation. When the human body has reached its natural limits, and the person is no longer able to live meaningfully, how is it faithful to artificially prolong misery and skyrocketing costs?

Part of misplaced faith includes an insistence on waiting for a miracle, no matter what. I certainly believe in prayer and spiritual resources, and I certainly believe that medical science does not know everything. More is possible than what we know. But prolonging a person’s misery, or a brain-dead body, is not the time to wait for a miracle. This is an inappropriate insistence that God unmake nature.

I believe what really stands behind misplaced faith is fear. We cover our fear with what we think is faith. But faith means trusting in God no matter what the circumstances — including dying and death. Fear is why we pour money into treatments that have virtually no chance of helping, and are more likely to cause more pain. Fear is why we die in hospitals, bristling with tubes and beeping machines, rather than quietly at home.

To die well requires letting go of some of our fear; it requires the wisdom of acceptance. And once we accept that further treatment is not going to improve the quality of our lives, we can then receive hospice care — often at home — which maximizes our comfort and prolongs our ability to do what we want to do. Ironically, many people live longer with hospice care than they would have with all of the excruciating treatments.

When my mother learned she had lung cancer, she chose not to have chemotherapy or treatments. She spent her remaining months visiting all of her children in their homes, and then returned to her own home to die in her own bed. When my father learned that his heart was failing and he was too old for another stent, he decided to go home. He sat in his favorite chair, surrounded by some of his children, and died quietly a few hours later. These good deaths were possible because both of my parents chose not to fear death. They accepted the gift they had been given — along with its natural limitations.

For myself, life is worth prolonging if it means I can continue to engage in meaningful communication with my friends and family — through talking or writing — and with reasonable comfort. But if further treatment is unlikely to accomplish that goal, then let me receive hospice care — and let me die at home. I think that would be a good death.

Ryan Ahlgrim is pastor of First Mennonite Church in Richmond, Va. He previously served for 19 years as pastor of First Mennonite Church in Indianapolis and 11 years at Peoria-North Mennonite Church in Illinois. He blogs at fmcbiblestudy.wordpress.com, where this post first appeared.


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