I invite you to think about an issue with me. The issue surfaced for me when my father was ill for several years before dying in 1987. Again, when my mom died in 2000, and when my husband, Rex. died in February 2015. Within the last couple of weeks, renowned columnist George Will, wrote about it in the News Banner.
While it may not be a “pleasant” topic, it is one of necessity. Medical Aid in Dying, MAID, is controversial, to be sure, but it is something that requires of each of us an understanding of just what it is, and more importantly perhaps, what it is not.
Please, know up front that I will not now or ever attempt to tell you what to think. I cannot adequately describe how perturbed, annoyed, disgruntled, and loud I become when someone presumes to think for me, or worse, attempts to tell me what I think, or worse, tells me what to think. Thanks, but definitely, no thanks. I have a brain that functions relatively well on most days. I can read, so I will do the research. I have a mouth so I can ask questions and discuss with others what they know or think. I will make my own decisions.
OK, so let’s get on with it. I have talked with and listened to several people about this topic. I have heard varying ideas and opinions, all adding to my thinking process. So I will tell you some of what I am thinking and invite you to share with me what you are thinking (this is a sincere invitation; not merely word fodder or idle word-speak).
Some say that the Hippocratic Oath requires that doctors “first, do no harm” and that all medical programs have doctors sign the oath. Well, I do not read Greek, so I have to rely on translation. First, the oath does not say “first, do no harm.” Second, it is not a requirement for doctors to sign the oath in several medical programs. One translation reads, in part, “I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients and abstain from whatever is deleterious and mischievous.”
OK, there is the implication to avoid harm, but it is not a priority in the oath. Besides, if “do no harm” was the “bottom line,” then doctors would not do a bunch of things they currently do. Examples might include surgery, chemotherapy, transplants, knee replacements. But the fact is — and I think we can agree here — that some of the procedures which cause harm and pain can bring positive results. But, what if the procedures cannot cure or add quality of life or alleviate pain and suffering? Here’s where the dilemma vexes and troubles me.
I do not use the term “assisted suicide” when considering this issue for a couple of reasons. First, suicide often results from a sense of despair. I think it would be rare for a person to contemplate suicide if he were not in a state of despair. The terms “aid in dying” or “death with dignity” may be different to me … or is that merely a matter of semantics? A person who is terminally ill with a clear diagnosis, is of sound mind, is capable of understanding the weight of his decisions — is that a different enough scenario for that person to consider choosing not to continue life and legally requesting medical assistance to achieve that end? Sometimes I think I know, but then sometimes I just do not know.
Specifically, I know where I stand when it comes to me and my death. But that is completely different than what could or should be the legality of such a decision for an entire population. It is going to be a legislated decision. It already has been in 11 states and eight nations (with some variations in wording). The point is HB 1074 concerning Medical Aid in Dying was introduced in Indiana in 2021. (Note that it has been introduced previously; you can look up the specific bills and their outcomes.) Current Indiana law states that “a person who has knowledge that another person means to commit or attempt suicide and who intentionally … provides the physical means by which the other person attempts or commits suicide or participates in a physical act by which the other person attempts or commits suicide” is committing a Class C felony (Indiana Code 35-42-1-2.5).
What will be the parameters for any changes? Who will make the decisions? What are the difficulties — and there are a multitude — inherent in attempting any legislation concerning another person’s death? Where do you stand on this issue? Who, exactly, do you want making those decisions for you?
While the entire discussion may make us uncomfortable, death is a definite and unavoidable part of life, maybe the only definite part of life. It is not like we can ignore the subject in the hopes it will go away. Rather, it makes sense that we consider this from as many angles as possible. While death is inevitable, how it occurs is not. Some instances require no decision making process; it just happens. But in the cases where there can be, could be, should be choices, who is going to make them?
In this thinking process, we can imagine all variations of “what could happen” or scenarios where decisions are made for nefarious reasons or the question that always appears in any discussion that involves morality or mortality: “Is this just a slippery slope that we will not be able to control once we begin?” There’s no denying it; this is not a black and white, one-size-fits-all kind of equation. There are all forms and sides and perspectives that impact the conclusion. Religion, moral standards, laws, opinions, personal experiences, fears, hopes … they all require and/or deserve attention in the decision.
Here’s the thing: Most areas of life, death included, are not “easy.” Maybe they were never intended to be because they weigh so very much. How we live and how we die are not casual concerns. Decisions regarding end of life practices and procedures demand our utmost thoughtful consideration. The act of dying may well be an individual matter; the legality in some instances most certainly is not. It is not even the question of “if” but the question of “how” that we must deal with individually and collectively. The decisions depend upon our discussions, questions, and research. Avoidance is not an option. Thinking is.
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Editor’s Note: This is one of a series of articles written by a group of retired and current teachers — Ken Ballinger, Jean Harper, Billy Kreigh, Marianne Darr-Norman, and Anna Spalding. Their intent is to spur discussions at the dinner table and elsewhere. You may also voice your thoughts and reactions via The News-Banner’s letters to editor.
