California recently became the fourth state — joining Oregon, Washington and Vermont — allowing doctors to prescribe life-ending medication to terminally ill patients under carefully defined circumstances. Perhaps Texas should follow suit.
For many, this medical-aid-in-dying is a very good thing. For others, such laws devalue life, reflecting a journey down a long, slippery slope in an emerging culture of death.
Wise or foolish? Should other states follow? How to decide?
Each school year I teach a university class in which we explore two deeply important moral imperatives that are perhaps universal in all known communities across time, place and life circumstances. The first: “Life is sacred and should be protected.” The second: “Suffering, once detected, should be alleviated.”
The single question that guides our class discussions is “How do we, through our religious beliefs, laws and customs, justify the violation of these imperatives, all the while holding tightly to their importance?”
The answers uncovered tend to be twofold: 1) We resolve moral dilemmas; 2) We draw boundaries of tolerable suffering and social worth. With these answers in hand, we compare aid-in-dying to other life and death decisions linked to the issues of abortion, capital punishment, war and torture.
The embedded moral dilemmas defining the medical-aid-in-dying debate pull us in opposite directions. It is simply not possible to reach a resolution without residual moral tension. Should we alleviate suffering or protect life? The answer sometimes given is to do both. Unfortunately, this is not always possible.
When confronted with this impossibility and a painful, sometimes prolonged terminal illness, do we alleviate suffering and help the patient leave this life, or do we prolong the suffering and protect life, leaving nature to take its course?
Such were the questions confronted in the widely reported case of Brittany Maynard. Suffering from a brain tumor, she decided to leave California prior to the passage and implementation of California’s new law to take advantage of Oregon’s death-with-dignity statute.
When setting moral priorities to resolve such dilemmas, we frequently find ourselves confronted by a second set of questions, this time dealing with the boundaries of tolerable suffering and life worthy of protection.
One thing is certain. Such boundaries are elusive, shifting from one person to another, from one set of life circumstances to another, and even for a given individual passing through various emotions when dealing with loss and grief. How much pain is too much? What about the impact on other lives worthy of consideration such as friends and relatives? When should the line be drawn in progressively debilitating diseases such as ALS?
Many believe that in most life and death circumstances persons most closely connected with the intermeshed decisions are in the best positon to make the final call. It is this belief that is affirmed by the new California law and statutes after which it is patterned.
Dealing with suffering and loss when confronted with life and death decisions frequently takes place on shifting sand. The grief process can lead us through a wide range of emotions and assessments.
It is for these reasons that the laws in Oregon, Washington, Vermont and now California pay close attention to timing and checks and balances. With these guideposts and related requirements in place, providing choices to deal with suffering as we pass from life is a very good thing. Bravo California. May Texas and other states follow this path.
Sheldon Ekland-Olson is the Rapoport Centennial Professor of sociology at The University of Texas at Austin.
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