Last Tuesday, I gave a talk on Advanced Directives and Living Wills: the right to a dignified death at a U3A gathering, which saw about 100 attendees. The audience primarily comprised affluent, white, English-speaking individuals, all over 60 and members of this very active organisation. I am always conscious during these talks of the taboo surrounding death and the difficulty many of us face in contemplating our own mortality. In his book, Being Mortal, Athul Gawande tells the story of his father’s last days with cancer, when he was offered a final round of chemotherapy. Being a physician himself, Gawande’s father had three conditions under which he would accept further chemotherapy: he still wanted to be able to play or watch soccer with his grandchildren, enjoy his favourite treat, chocolate ice cream, and maintain control over his bladder and bowels. When these conditions could not be guaranteed, he opted against further chemotherapy.
How do you define your quality of life? What are the things you value above merely being alive? My list is rather extensive…
I noticed during my talk a gentleman in the front row who obviously had suffered a severe stroke. His left side appeared paralysed. I saw that he was visibly moved by the conversation. At question time, he raised his hand to ask a question, looking at his wife, who attempted to persuade him not to stand up. He was resolute, and with some effort, he stood up, turned to the audience, and delivered the most heartfelt plea for the right to end his own life in a dignified manner. A historian and lifelong deep thinker and writer, he had lost most of this ability and felt like a burden to his wife and those around him. He experienced very little quality of life and had attempted to end his life several times. The deadly silence (pun intended) of the audience held his words suspended in the air, the raw emotions palpable. I placed my hand on his shoulder to offer what little comfort I could, as tears streamed down his face. At this point, his wife was sobbing uncontrollably.
I have never experienced anything like this before. I couldn’t have wished for a better testimony to the need for legislation on the right to end one’s own life. So many people are forced to end their lives in the most horrific and inhumane ways. I could see and feel the mixed emotions of the audience – this is not what they expected, nor what they signed up for. Afterwards, many conversations occurred, especially among religious individuals who so strongly oppose the right to end a life. The usual rhetoric of “but you have so much to be grateful for” and the “count your blessings” narrative. This man wanted to die.
When everyone left, I approached him and his wife to thank him for the most incredible gift he had offered everyone. I also assured him that I completely understood his desire to end his life. It was an excruciating conversation. He asked me what he should do, and I realised how complicated this situation is and could be. I explained that I am not in a position to advise him on how to end his life, but that there are methods to consider, and he should weigh his options very carefully, keeping in mind his family and friends. His wife asked me if he should perhaps cease taking all his medication (he was on blood thinners, cholesterol meds, etc.). Could it be that if he did, his next heart attack or stroke would be fatal? I replied that in a way that would be like playing Russian Roulette, not knowing if the next episode might incapacitate him even further. We left the conversation there.
I asked two professionals if they would assist. I realised that perhaps I am the only person thinking that this man has the right to die, if that is what he wishes for himself. He had already discussed it with his wife and family, and, as hard as it is, they have accepted this reality and would not wish to see him suffer the way he did.
The next morning, I received an email from his wife informing me that she had noticed a relief in her husband, that somehow this “coming out” had given him a different perspective, and that he mentioned there might still be a few reasons for him to keep on living. Like her, for instance! Since then, I have received several messages from her and some of the other participants stating that he is in a lighter mood and not as deeply depressed.
The power of being witnessed must not be underestimated. Indeed, this “coming out”, being seen and validated, can change one’s perspective and perception of oneself and one’s lived reality. If we can truly witness someone without judgment, fully present for them and with them, we can offer no greater gift.