by Cindy Hasz
American Reporter Correspondent
San Diego, Calif.
March 24, 2003
THE DELICATE ETIQUETTE OF DEATH
SAN DIEGO -- I am about as pro-life as they come, yet when it comes to control over the time, place and manner of our deaths, I refuse to be so dogmatic. There is a big difference between someone taking a life that is not their own, and wanting to end one's own life when it has become unbearable due to terminal illness.
Euthanasia, like many difficult issues, is easier in the abstract. For it, against it, it's all pretty simple. But real life is rarely so.
Having been at the bedside of many dying people, I can understand how a dying person and their loved ones may want to hasten an excruciating process. It's torture to have to watch someone you love suffer when there is no longer hope for a cure. Pain medication at that point becomes a sacrament of love.
Morphine or other strong opiates in the final stages of a terminal disease can sometimes help distressed breathing as well as reduce pain. I have seen it help patients who are fighting and struggling with death to relax and accept what is inevitable - not unlike pain medication for a birthing woman in transition. And death does indeed have its similarities to labor. Just as it is hard work giving birth, it can be harder work dying. There is even kind of a "dilation" in letting go of life.
I honestly think in those terms. Walking into a room where one of my patients is dying, I can tell when there is a shift or movement towards the final moments. Dilated to three, then six, then crowning. Skin color changes and breathing becomes more rapid and shallow, but you never quite know, of course. Death, like life, is a mysterious business. Each person does it differently, and in their own time.
I know in the days and hours when consciousness is flickering, dappled like sunlight on the face of deep waters, there is soul work going on. You don't want to hinder it by inducing a narcotic stupor that takes days to dig out of, distracting from the more important self-archeology at hand, but then neither do you want to hurry the final exam, the delicate negotiations with the seen and unseen, the sorting of differently-textured luggage of a life lived and leaving.
I have seen morphine likewise have little or no effect in large doses on someone who is obviously not ready to die.
Taking conscious control of your dying has its benefits.
Think of it. If you decide the time and place of your death, you can make sure you say goodbye the way you want to say it. You can let those whom you love most, and want to be with you, make plan to do so they when it is time to go. Again, compare it to a birthing room.
Why not be the director of the final act in your screenplay? Have a comfortable bed, your favorite music, a window looking out over the ocean or the poppy-strewn hills. Why is it seen as somehow more virtuous if control over the circumstances of one's death is abdicated? Can we not at least co-orchestrate? Is it more laudable to be cast off this mortal coil in the back of an ambulance under the harsh glare of streetlights, or under cold neon in a white cubicle on a gurney in some Emergency Room? As your spirit floats along the ceiling and out into the breathless waiting universe, will you look back to see your body being disposed of according to someone else's godforsaken protocol?
Why not make it deliberate and sanctified by consciousness, in your own bed, with the people, person or animal you love besides you? And wouldn't it be lovely if you could choose the lighting? Say dusk, when the crickets start to sing and the world is in the soft, sweet shimmer before night falls, sipping a dying cocktail.
And, of course, free of anxiety, free of pain and free of helplessness. Then make sure they tuck you in just the way you want while you wait for resurrection.
To do it any other way when you can avoid it seems the real immoral approach.