Dying a "Good Death"

Delta Winds cover 2005Delta Winds: A Magazine of Student Essays
A Publication of San Joaquin Delta College


Dying a "Good Death"

Mitzi Genegabuas

My father was an avid smoker ever since he was a teenager. In September of 1993, at the age of 82, he was diagnosed with lung cancer. His doctor said it was inoperable. Eight months later, my father was admitted to St. Joseph's Hospital in March, 1994. During an emotional family meeting, I said I wanted my father released from the life support because I felt that he was suffering from so much pain, not just from the cancer but from all the tubes as well. Sobbing, my aunts did not agree because they thought it was cruel. My uncles understood where I was coming from and respected my decision. My mother, torn in between, finally accepted my will. My father was released from the ICU two months later, in May. Remarkably, my father did better than we expected, so the doctor transferred him to the rehabilitation center located on the fourth floor.

When my father was moved onto the fourth floor, I spent many days after school with him. I would go straight to St. Joseph's and stay there until the evening. It became a daily routine for me. One afternoon in May, I was with my father in his room. I sat at the foot of his hospital bed, doing my homework and watching T.V. My father was lying down. It was very difficult to concentrate. I could hear him moan and groan because the pain was so bad. He and I were on the right side of the room and the T.V was on the left. He had to lie on his right side, facing the wall because his right lung was so badly damaged from the cancer and it was painful for him to lie any other way. He couldn't even watch T.V with me. He couldn't see anything but the white walls of the hospital room. It hurt me to realize that I couldn't share that moment with him. After that point, I knew my father would not make it to his 83rd birthday.

My father was in so much discomfort that some days he wouldn't say but a few words to me. Other days he was knocked out from all the medication taken to alleviate the pain. I absolutely hated the fact that my father had to suffer-day in and day out-waiting for death to come.

In Oregon, Physician Assisted Suicide (PAS) has been legal for seven years. Nora M., from Oregon, whose husband Rick had been diagnosed with "inoperable lung cancer in April 1999," wrote a letter to The Death with Dignity National Center. In the letter, entitled "My Husband Rick," published on their website, Nora writes, "I always believed that my husband was one in a million. But in 1999, he was one in 27. That year 30,000 people died in Oregon. Of those 30,000 people, twenty-seven-less than one-tenth of one percent-chose a quiet death in the company of their families after taking a legal, lethal dose of drugs permitted by Oregon's Death with Dignity Law" (My Husband).

That summer, Rick underwent Chemotherapy. The medical treatments "left him nauseated and listless." Finally, in October, "Rick felt he had had enough. He asked his doctor to write the prescription. The doctor agreed, saying that he considered Rick an appropriate candidate for Death with Dignity-not depressed, well supported by his family, with well-managed pain and solid financial resources. And unequivocally terminal" (My Husband). Rick chose the time of his death himself. One evening in November, he died when he was ready, in the presence of his family. Nora states in the letter, "When I knew he was gone, I felt a wash of emotions-love, loss, relief, emptiness. But I also found comfort and even satisfaction in the knowledge that I had helped my husband when he needed it most. I saw our experience as a difficult but loving last gift to each other" (My Husband). Legalizing Physician Assisted Suicide is respecting autonomy: "Decisions about time and circumstances [pertaining to] death are very personal. Competent persons should have the right to choose death" (Braddock and Tonelli).

Pro-life advocates attempt to convince people not to support the law by scaring them. They say that in legalizing PAS, disabled people, "the poor, undereducated, uninsured, racial minorities and other marginalized people will be encouraged to use the law" (Fact and Fiction, par. 5). In Oregon, where PAS is legal, the Death with Dignity National Center rebut by saying "no one is encouraged to use the law. The law is in place for terminally ill people whose suffering is intolerable and who wish a humane and dignified death. The law is rarely used in Oregon but it does supply real comfort to many people who see it as an option-if they need it." In addition, "Oregon's experience indicates that the people who chose to use the law are well educated, have had excellent health care, good insurance, access to hospice and were well supported financially, emotionally and physically" (Fact and Fiction, par. 5). Nobody wants to die. If a person is diagnosed with a fatal illness, it is frightening and devastating to say the least. Primarily, the patient would want to make the most of the time remaining to him or her. If given extended recovery, patients would take advantage of it. The law would be a last resort to those in extreme situations, in which recovery is no longer possible.

Issues recognized in supporting PAS are the pain and the suffering an ill patient must endure. Those in opposition of PAS say, "proper pain management can alleviate a patient's desire for a hastened death" (Fact and Fiction, par. 3). The Death with Dignity National Center argue that "the truth is even the most ardent opponents of Oregon's law admit that for 5% of terminally ill people the best pain care will not alleviate their suffering" (Fact and Fiction, par. 3). Suffering is not limited to pain. In actuality, pain is only one aspect of this complex problem. There are psychological burdens as well. Suffering yields agony, misery, and hopelessness. "For many terminally ill people, it is the loss of dignity and autonomy-the suffering beyond pain-that becomes intolerable" (Fact and Fiction, par. 3). "It is not always possible to relieve suffering," says Braddock and Tonelli, "Thus PAS may be a compassionate response to unbearable suffering" (par. 7).

I remember that warm, summer afternoon, when my father passed away. It was June 3, 1994. He was surrounded by my mother and me, along with my aunts and uncles. His eyes were still closed and it looked like he hadn't moved an inch in hours. I could never forget the way he was breathing, with his breaths less than a minute apart. We heard him take one quick, audible breath, a quick inhale and exhale. There was no way to ignore it. His inhales broke the silence and the exhales resumed the silence again. The whole experience saddened me because I would await his next breath, and it seemed as though the breaks between each of them were getting longer and longer. I bent over, with my lips almost touching his right ear. I said loudly, "I love you, Daddy!" I started to cry. I backed away a little and watched him. His eyes were still closed and his mouth didn't move, not even a twitch. All of a sudden, I saw one single tear roll out of the corner of his right eye and down towards his ear. I knew he heard me. Minutes later, he stopped breathing and he passed away.

My father, my family, and I were all very fortunate to be there with him in his last moments. Others are not so fortunate. Often, one may pass alone with no loved one nearby. Alzheimer's patients slowly lose recognition of their family and eventually die a death that is emotionally painful to those who survive them-leaving their families feeling empty.

The most important thing is to give the patient the choice. In legalizing Physician Assisted Suicide, patients will not be forced to use the law. However, the option would be open for those who choose to. Nora from Oregon says, "Once you accept the fact of death, you can move on to address the quality of that death. It can be hard or easy, good or bad. For some, it makes all the difference to have the choice" (My Husband). It is important for PAS to be legalized so others may also have that choice.

Works Cited

Braddock, Clarence H., and Mark R. Tonelli, "What are the Arguments in Favor of PAS?" Physician Assisted Suicide. Oct. 2001. Ethics in Medicine. University of Washington School of Medicine. 10 Nov. 2004. < http://eduserv.hscer.washington.edu/bioethics/topics/pas.html#ques3>

"Fact and Fiction." Death with Dignity National Center. 10 Nov. 2004. < http://www.dwd.org/fss/facts.asp>

"My Husband Rick." Personal Stories. 13 Oct. 2004. Death with Dignity National Center. 10 Nov. 2004. < http://www.dwd.org/fss/stories.asp>