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December 20, 2014

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Extending our freedoms to the right to die

My newspaperman brother and I have a no-stakes bet on whether Montana and Texas will legalize marijuana before same-sex marriage. And which state will do it first?

He’s betting on pot and Montana, and he’s probably right. But the fact that such a discussion is feasible is an index on the speed and depth of the changes that our culture is undergoing.

Not every American agrees that this is progress, but the ones who do have no trouble imagining an arc that extends toward more equality and personal freedom, from the abolition of slavery, say, through women’s rights, labor reform, civil rights, the rights of the disabled, equality for gays and the right to smoke whatever mind-altering drug you desire, as long as you don’t bother anyone else.

While we’re at it, let’s consider extending the arc just a little further, to the right to die on our own terms.

This comes to mind in light of the death of Sherwin Nuland on March 3 at the age of 83. Nuland was a physician who won the National Book Award in 1994 for “How We Die: Reflections on Life’s Final Chapter.”

It’s a remarkable book that demythologizes death. We like to imagine that death is a gentle passage into the Sweet Bye and Bye, like in the movies, but Nuland reports that of all the many and various ways to die — prostate cancer overtook Nuland — almost none of them is pleasant, peaceful or dignified.

According to Nuland, death is, more often than not, a miserable, prolonged, unseemly event that thoroughly undercuts whatever attempts we’ve made to live disciplined, controlled and dignified lives.

Our efforts to address this important phase of life — that is, death — have been slow and halting, falling far behind more enlightened, or at least more honest, thinking about same-sex marriage and marijuana. Only four states — Oregon, Washington, Vermont and Montana — have taken steps to legalize or decriminalize third-party assistance for patients who wish to avoid some of the prolonged suffering associated with dying.

Any discussion of this issue eventually arrives at this question: Why do we deny for ourselves the gentle, pain-free death that we’re careful to provide for our pets and for the most brutal serial killers?

It’s a good question, one that we’ve never really answered. Of course, we have good reasons not to torture even the most vicious murderers to death, even if they deserve it. We refrain from cruel and unusual punishment in order to honor the Constitution and to preserve our own dignity and humanity, not the killer’s.

And pets? Well, they’re just animals, so we release them from some of the responsibilities that we associate with humanity, the idea, for example, that we’re obliged to endure all the suffering that comes with living our lives out to the very end.

We haven’t been so generous with ourselves. Many Americans still subscribe to the biblical depiction of life as a vale of tears and suffering that’s compensated by a peaceful afterlife.

But in practical terms, even many God-fearing citizens prefer to take a chance on his wrath rather than see loved ones — or themselves — suffer any further after hope of recovery is lost.

Thus, we increasingly hear stories about desperate husbands who slay their moribund wives of many years rather than watch them suffer. And the use of palliative sedation — or, with more candor, terminal sedation — for suffering patients who have no chance of recovery is becoming more common, even if doctors and patients are reluctant to acknowledge it.

Certainly, none of us will ever beat death. But our thinking about individual rights and freedom has generally moved in the direction of enlightenment. The assertion of more control over the circumstances of our dying may alleviate some of the physical suffering and fear. Clearly, it’s time for a candid conversation about the right to die on our own terms.

John Crisp, an op-ed columnist for McClatchy-Tribune, teaches in the English Department at Del Mar College in Corpus Christi, Texas.

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