Any nuanced effort to analyze why Bowers died immediately
after a spinal cord injury is perceived to be in bad taste if not cruel. Any
criticism of Maynard’s highly public end of life replete with two tear jerking
videos is also thought to be cruel. How can one criticize Maynard and others
who are terminally ill? Criticism is needed.
Without criticism and serious discussion end of life issues will remain
obscured. This criticism is not about Maynard or Bowers directly. I do not in
any way criticize the Maynard or Bowers families. Maynard can legally die in Oregon via the
Death with Dignity Act: that is her legal right. Bowers family had the legal
right to ask Tim Bowers if he wanted to die. Both the Maynard and Bowers families did
what they thought was right. Again, I do not question this. Maynard and
Bowers were loved by their families. I accept this as a given and they have my
deepest sympathies.
Like a few others, I take exception to the slick Compassion
and Choices PR campaign. I decry the
romantic vision of death and extreme emotional hype the media has used to
generate news ratings. I despise the lack
of reason involved. I am deeply disturbed that
neither Bowers nor Maynard has generated the sort of serious discussion that
desperately needs to take place. I
question why did Bowers die? Why was autonomy so narrowly perceived? Why was life post spinal cord injury believed to be a fate worse than death? These are questions, social problems, that need to be addressed. It is not an exaggeration to note lives are at stake. Bowers did not want to live in a nursing home. What young married man would want that? None.
This is the leap of logic no one took—why do people with an injury as severe as
what Bowers experienced live in a nursing home? Why do the vast majority of people
with a disability remain unemployed? Why is poverty and disability commonplace?
I can only conclude the ADA, and the last 40 years of progressive legislation
designed to empower people with a
disability, has been a legislative success and social failure. Simply put, laws that were supposed to make
people with a disability equal have not resonated culturally.
Maynard’s end of life options, like the choices Bowers
encountered, are not good. End of life,
especially assisted suicide, is perpetually in the news. What makes Maynard different is the extreme
emotional manipulation. Rather than asking how can we empower people with a
terminal illness to get the most out of life via outstanding palliative and
hospice care we frame the discussion around the right to die. Dying is not a
right. Dying is a biological inevitability. No one dies in a social
vacuum. The extreme emotional framing
effectively negates any real discussion of the social implications of assisted
suicide as practiced in Washington and Oregon. Even the slightest dissent is met with a
backlash. For example, Ira Byock suggested Maynard could have the peaceful
death she desires via palliative and hospice care. He suggested she need
not take a lethal medication. I thought Byock was deferential but Maynard
lashed out and stated she was concerned
“that Dr. Ira Byock will speak on
my behalf and that as a terminally ill patient I find it disrespectful and
disturbing when people discuss my personal health with details that are not
accurate to push an agenda”. Byock did not speak on Maynard’s behalf but
rather suggested other viable options existed. The person with an agenda is not
Byock but rather Maynard. This is not a critique but a matter of fact
observation. In this regard I am no
different from Maynard—we share oppositional agendas. We are both acting as advocates. We both have the right to state our opinions.
Lost in emotional rhetoric are the social, political, and
health care ramifications of assisted suicide legislation. Kevin Yuill, in Assisted
Suicide, wrote:
“The right to die
sought by proponents of legalization of assisted suicide is not a right or
freedom at all. It is a heavily regulated process that will undoubtedly become more and
more regulated with so many safeguards that those who suffer at the end of life
will be worse off… The death bed scene will have to be regulated if it is to be
transparent. The actions of relatives and doctors alike may have to be
monitored. The time-honoured tradition whereby doctors occasionally bring
relief to suffering patients in their last few hours or days will be brought under official control… Once
bureaucratized, there will be no space for compassionate deeds… Thus,
ironically legalizing assisted suicide may well be worse for the dying. Whereas we might impute the noblest reasons
to those campaigning for a change in the law, the devil is in the details.
Byock is correct in stating “physician assisted suicide is
not a personal act. It is a social act”. If this social act becomes as
bureaucratized as Yuill suggests no person near death will benefit from
assisted suicide legislation. This is exactly the sort of discussion we have
failed to engage in. Reason is replaced by emotion—Maynard is an extreme
example of this. No one is questioning
her personal health care choices. To do
so would be wrong. As Yuill noted the
devil is in the details. I want to those details to be subject to intense
discussion.