Desmond Tutu: a dignified death is our right – I am in favour of assisted dying

[EC]

During all my years of pastoral care, I have never had the privilege of being with someone when they die. I've visited dying colleagues and friends at St Luke's hospice, Cape Town, in the last period of their lives; I've witnessed their being cared for beautifully – but I've never been there at the exact moment of passing. I've been asked why I consider it a privilege to be present when temporal death takes place. It comes from my belief system. It is the wonder of a new life beginning, the wonder of someone going to meet their maker, returning to their source of life. In some ways, death is like a birth; it is the transition to a new life.

I am myself now closer to my end than to my beginning.

Dying is part of life. We have to die. The Earth cannot sustain us and the millions of people that came before us. We have to make way for those who are yet to be born. And since dying is part of life, talking about it shouldn't be taboo. People should die a decent death. For me that means having had the conversations with those I have crossed in life and being at peace. It means being able to say goodbye to loved ones – if possible, at home.

Recently I discussed my wishes with my youngest daughter, Mpho: my choice of the liturgy, the hymns, and who should preach. I'd like to lie overnight in St Mary's Cathedral in Johannesburg. It was such an important place in my life; it's where I became a deacon, where so many important things happened. I would like to be cremated; some people are not comfortable with that idea. I'd like my ashes to be interred at St George's Cathedral, Cape Town.

There are certain African traditions I am not comfortable with: the turning of photos to face the wall, the clearing of furniture from the bedroom and placing of straw mats for the women to sit on for days. I am comfortable that on my passing these traditions should not be followed. It concerns me how people get into debt at funerals, buying expensive caskets, slaughtering animals they can ill afford to pay for. I want to role model modesty. I would like a simple coffin, the one of plain wood, with the rope handles. I would like modest refreshments after my funeral. If people want to slaughter an animal as part of traditional ritual, I'd be happy with a sheep or a goat – it doesn't need to be a big animal. My memorial stone should also be modest. My concern is not just about affordability; it's my strong preference that money should be spent on the living.

This takes me to the question of what does it mean to be alive. What constitutes quality of life and dignity when dying? These are big, important questions. I have come to realise that I do not want my life to be prolonged artificially. I think when you need machines to help you breathe, then you have to ask questions about the quality of life being experienced and about the way money is being spent. This may be hard for some people to consider.

Read more: http://www.theguardian.com/commentisfree/2014/jul/12/desmond-tutu-in-favour-of-assisted-dying

[EC]

Long, but thought provoking. well worth the read. Though I expect this one to be bounced into the Boxing Ring pretty fast, it's one of the more contentious subjects.

My 2 cents - If someone wishes to die, let them do it with grace and dignity. People are tough as hell and die hard indeed. If suffering can be prevented in a terminal case, why not permit it with the patient's full and informed consent? We already have DNR orders, how is this any different?

[MACVSOG68]

I agree with you EC.  Can it be abused?  Yes, just as guns can, but we certainly fight for our right to own and bear arms. 

[PzLdr]

After you, Desmond. I read Lifton's "The Nazi Doctors", and I've read some articles coming out of European countries that have gone with 'assisted dying'. No thanks!

[massadvj]

I fully agree that people do have the right to terminate their own lives.  What worries me is the natural progression from recognizing this "right" to government abuse of it based on economics. It is the unavoidable consequence of government control of health care.

I think this is such a personal decision and so nuanced, it defies development of a firm policy.  And yet, without policy we might end up with de facto serial killers like Kevorkian preying on the weak and infirmed. 

It,s a tough one. 

[Dexter]

I fully agree that people do have the right to terminate their own lives.  What worries me is the natural progression from recognizing this "right" to government abuse of it based on economics. It is the unavoidable consequence of government control of health care.

I think this is such a personal decision and so nuanced, it defies development of a firm policy.  And yet, without policy we might end up with de facto serial killers like Kevorkian preying on the weak and infirmed. 

It,s a tough one.

Just make it so only the person or a personally appointed representative of that person can make the call, no exceptions.

[alicewonders]

Just make it so only the person or a personally appointed representative of that person can make the call, no exceptions.

And even at that, there is potential for abuse - someone making the call against the person's wishes, or for their own personal gain.  But you can not eliminate that possibility entirely, and when something like that happens - it's murder in my book.

This is a subject that is very close and personal to me.  As we speak, my mother languishes in a nursing home having suffered from Alzheimer's for nine years now.  She has been institutionalized for the last four years.  We kept her at home as long as it was possible, but she requires 24 hour care as she can do NOTHING for herself.  She speaks very little now, in very low tones and none of it makes any sense. 

When she was well, we talked many times about what we would want in case of being diagnosed with a terminal illness.  She made it clear that she didn't want her life prolonged artificially, or if there was no hope of recovery - she didn't want extraordinary means being taken to extend her "suffering".  She was a Christian and told me she wasn't afraid to die. 

The problem is that she was talking about getting cancer or something like that - where she would be clear enough of mind to decide when the time would come for her to choose death.  Never once did we talk about a mental condition like Alzheimer's.  She descended into her hell so slowly that by the time we all realized it, she couldn't communicate to us about it.

Now, my father has the same thing - we're keeping him at home as long as possible - but eventually I won't be able to care for him as he will need. 

My mother is virtually dead - the woman that is that person is gone.  Yet she languishes.....they check her blood sugar all the time, give her insulin when she needs it....give her morphine for her pain....feed her every bite of mashed food that she eats....bathe her and dress her.   Why?  Is this living?  Is this the existence my mother would want to endure?  When she can pass through these mortal bonds and join her heavenly Father in eternity?  I look in her eyes and I see a tormented soul trapped in a useless body that is shutting down bit by bit.  Yet - to great expense - they keep her alive....like some kind of Frankenstein thing. 

Do I want my father to end up in the same situation?  No way.  I hope he dies of natural causes in his home before we are faced with that ordeal again.  My father, on the other hand is of a fighter mentality and would never agree to ending his own life.  He has told me so and if able to decide himself - would want any means feasible to prolong his life. 

Because of my up close and personal experience with this, my feelings about nursing homes and such are that they are in many instances a cruel alternative to death.  If you still have your mind and can enjoy the activities of socializing, bingo, television etc - yes, a nursing home is good for people that cannot stay in their homes.  But if your brain is shrinking, there is no cure, and you face possibly years of losing your cognitive abilities followed by the gradual shutting down of your body - unable to recognize your loved ones, unable to move about - even unable to watch tv - only to start to shrivel and contract as your muscles, and then your organs, start to shut down bit by bit...........................................why in the hell keep someone like this alive with medicines and such?  It is cruel and inhumane in my book..............and I wish I could have helped my mother end her life before they took over her destiny in the nursing home.  I know she would have wanted that.

I was with my mother-in-law in the hospital the night she died from cancer.  She had been in horrific pain and the morphine was making her have horrible hallucinations of monsters and things.  She was so agitated and just writhing that night.  Then she passed and finally there was peace in her face.  It was an experience I will never forget. 

I do not fear death.  I wish there was a way I could help my parents not have to endure this prolonged death that modern medicine has inflicted. 

[massadvj]

That was a very insightful and compelling post, Alice.  My father's brother called 911 then went to his backyard and put a gun to his head when he started losing his memory.  It was very upsetting to some in our family, but I admired him for it.

My wife is currently in chemotherapy with ovarian cancer.  She was very near death a few months ago but has come back somewhat since then.  These issues are always in my mind, though.  There was a point that she told me to let her go, she just could not take any more.  I refused so long as there was a potential path out.  I had to make the choice to send her back to surgery for a fourth time in less than a week.  One of the surgeons I talked to recommended no surgery, go straight to hospice. If the path was not there, I don't know what I would have done.

[alicewonders]

That was a very insightful and compelling post, Alice.  My father's brother called 911 then went to his backyard and put a gun to his head when he started losing his memory.  It was very upsetting to some in our family, but I admired him for it.

My wife is currently in chemotherapy with ovarian cancer.  She was very near death a few months ago but has come back somewhat since then.  These issues are always in my mind, though.  There was a point that she told me to let her go, she just could not take any more.  I refused so long as there was a potential path out.  I had to make the choice to send her back to surgery for a fourth time in less than a week.  One of the surgeons I talked to recommended no surgery, go straight to hospice. If the path was not there, I don't know what I would have done.

My heart goes out for you and your wife massad.  The decisions are gut-wrenching sometimes.  I continue to pray for her healing and for you.  It does make you hyper-aware of the fleetingness and fragility of life...but it makes you face the certainty of death - which we will all face ourselves someday.  Once you face it, once you contemplate it's consequences - it becomes less hard.

In my father's case, I think it was the strain of trying to take care of my mother - but he coped with it by being in denial about the seriousness of her illness.  Now of course, he's faces his own fate with the same sense of denial and that is frustrating to me, because I tend to try to walk myself through the worst that could happen so that I'm prepared in case that happens.  Everyone is different.

Good luck and God bless you. 

[olde north church]

Take away the mumbo-jumbo and the fear somebody might make a penny off a death.  Take away the possiblity of beseeching an ignoring deity.
It's ironic we should use the term "humane" when we end the life of beloved pet, while keeping a beloved family member alive and in pain or unaware of his or her life.  It's nobody's business how you go but your own and those who cared about you and those you cared about.

[DCPatriot]

You first, Desmond.....you first.