Chronic disease or illness sometimes leads us to what we term, for lack of a better word, the "choice" to continue life-saving treatment or to cease it, knowing of course the outcome is ultimately death. Control over our own lives and bodies is of normal human grounds, if we look at it through a secular perspective, as control can help mediate harsh environments and buffer shortcomings.
Terminal control, deciding whether or not to continue living, is decidedly a step too far for the U.S. judicial system notwithstanding that if you were dying, offing yourself would be the ultimate in environmental adaptation as resources are scarce no matter what (thanks to our hunter-gatherer beginnings) and end of life care is some of the most expensive care you will ever receive in your life.
Taking this control, however, while under our natural purview, has been cause for debate. Whatever controlling practices we hold over our bodies, body modification, discipline, medicinal and clinical treatments, choosing our own death is downright criminal from a lawful perspective, and pathological medically. Oregon and Washington, being the exceptional cases in U.S., lay their gaze of logic and tolerance upon a relatively few number of cases each year. Interestingly, most were well-educated Caucasians (Oregon's DWDA 2011, Washington DWDA 2011). In 2011, Oregon had 63 deaths and Washington had 70. The number of individual prescriptions written with the Death with Dignity Act far exceeds the number who ingest and die from the medication, a testament to the tenacity of the human spirit.
When I took Anthropology of Death with the brilliant Professor James Green here at the University of Washington, I learned how to articulate and frame the concept of the "good death". While different cultures value different experiences/practices in death, our U.S. culture strives for a peaceful death which can mean dying at home or in hospice care rather than a hospital unit, having all your loved ones near and ideally being pain free. We fear death, naturally so. Good deaths are thought to be peaceful, unhurried and expected. Assisted suicide allows for "good deaths" to be carried out, allowing for preparation and planning, but also can sound unsettling. As primates, our goals are to stay alive and procreate. It is all the particulars of the human experience that produce what Geertz termed "webs of significance". These webs define our "good death" and speak of our understanding of quality of life. From the biomedical perspective, assisted suicide can seem beneficial to the whole group. Spiritually, and here I specify religiosity, it is vehemently denied.
The Roman Catholic Church sees us as stewards of the bodies we live through, not owners with intimate desires. Islam as well fundamentally opposes assisted suicide by having Allah not only control our death, but most everything else as well. Many Christian factions strongly oppose physician assisted suicide in the traditional sense but accept withdrawing life support in certain cases. Religion provides the structural coping to deal with harsh environments, and these are a many varied thing.
While death clearly means different things to different people in differing of significance, to all it means a point of finality and transition, of abeyance and quiesce. The rarity of this opportunity, this "choice" to live or die, is evidence of the well honed biological process called life.
Title: And Death Shall Have No Dominion, By Dylan Thomas
Image: Antony Gormley "Clutch VIII" 2010
