Health in Death: Why We Should All Favor the Ultimate Self-Determination

Nov 12, 2014 | Greggory Moore | Moore Lowdown
Health in Death: Why We Should All Favor the Ultimate Self-Determination

image by: Thirdman

Brittany Maynard made national headlines with her choice to spare herself and her loved ones some of the horror that her brain cancer would otherwise inevitably have inflicted upon them. But it wasn't easy. In a country that prides itself on freedom, the U.S.A. has some backwards ideas about life and death.

The very worst laws a society can enact—and the most hypocritical in any land that gives lip service to the sanctity of freedom—are those designed to inhibit the individual's ability to self-determine, at least so far as that self-determination doesn't impinge upon others' abilities to do the same.

A timely and relatively straightforward example is the U.S. body of law prohibiting cannabis consumption. What I choose to put in my body, says the libertarian laying the foundation for a pro-legalization argument, is nobody's business but mine.

But the basis of all self-determination is the ability to choose whether to continue one's own life. This is a timely topic thanks to Brittany Maynard, the 29-year-old who chose to end her life earlier this month, rather than wait a few extra weeks for the brain tumor that was killing her to do its worst, which inevitably would have included tremendous physical pain for Maynard and emotional anguish for loved ones watching her contract into a ball of suffering on her way to being snuffed out entirely.

Maynard chose to use her terrible predicament to campaign in favor of the "death with dignity" movement (DwD), which aims to replace laws meant to prevent terminally-ill persons from obtaining the medical means to end their suffering humanely with legislation like Oregon's Death with Dignity Act.

In January of this year, Maynard learned she had terminal brain cancer. Initially hopeful (relatively speaking, anyway) that she might live as much as ten more years, in April her prognosis became far worse. Told she would be dead within the year, Maynard resolved to live her life as fully as possible in the short time she had left, and then to end it with some measure of peace before the encroaching tumor made such a choice impossible.

Unfortunately, because on the whole Americans are still so selfishly and mindlessly moralistic that they care more about imposing their belief systems on others than enabling complete freedom in what we do with our own bodies, the only way Maynard could exercise true agency in her own death was to move from her home state of California to one of the five states allowing physician-assisted suicide. She chose Oregon, whose Death with Dignity Act "allows terminally-ill Oregonians to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose."

After settling in Portland, Maynard approached Compassion & Choices, a nonprofit advocacy group "committed to helping everyone have the best death possible," to find out how she could best advocate for the cause of providing terminally ill Americans with better end-of-life options.

"I can't even tell you the amount of relief that it provides me to know that I don't have to die the way that it's been described to me that my brain tumor would take me on its own," Maynard said in the first of two videos she recorded for Compassion & Choices in October. "[…] I hope to pass in peace."

Long before I knew the term 'libertarianism,' I understood the principle, if for no other reason than I was effectively romanced by the idea(l) of freedom, which is supposedly more American than apple pie. Why should the state interfere with what I do with my own body, I reasoned. I'm the only one who has to live with it.

Growing up the word I heard most frequently linked with suicide was "cowardly," an association that seemed completely misguided. I had no difficulty imagining countless scenarios in which I would rather die than endure. To this day I believe my life will mostly likely end by my own hand. Maybe it will be next year. Maybe it will be when I'm over 100. What I know for sure is that there are degrees of suffering that I would not wish to endure, especially when suffering is more or less all that's left to me.

That, of course, is a personal choice, and I wouldn't presume to project that choice onto others. While I don't relate to people who wouldn't be caught dead wearing a "DNR" bracelet, their bodies and the choices they make with them are none of my business.

But I feel the amelioration of suffering is my business. It should be everybody's business. And when suffering becomes an abject and hopeless endeavor, those who wish for a merciful way out should not be prevented from finding it. They should not be forced to leave their homes to do so. They should not need to resort to dramatic remedies (leaping off a building, a gunshot to the head), to rely on their own craft (constructing an airtight hood connected to a helium tank), to be one's own apothecary (obtaining the ingredients for and preparing a concoction that will bring about death instead of being vomited up).

Dr. Jack Kevorkian was a hero along these lines. Kevorkian enabled the peaceful death of at least 130 terminally ill persons, risking and eventually losing his freedom for the cause. "[H]is stubborn and often intemperate advocacy of assisted suicide helped spur the growth of hospice care in the United States and made many doctors more sympathetic to those in severe pain and more willing to prescribe medication to relieve it," wrote the New York Times in Kevorkian's 2011 obituary.

In 1999 Kevorkian was convicted of second-degree murder for aiding Thomas Youk in dying. In deciding Kevorkian's fate, the jury was denied hearing details about Youk's illness, as well as hearing from Youk's wife and brother, both of whom supported Kevorkian.

"Terry Youk recalls his brother's description of the agony: a 'body plugged into an electrical socket,'" Time writer Julie Grace reported shortly after the verdict. "It was, says Terry, 'the kind of pain that medicine couldn't help.' 'I don't want to die,' Tom had said, 'but I don't want to live like this.' […] Says Melody: 'He did not want to become a prisoner in his own body.' Of Kevorkian's cause, Terry says, 'You have to put yourself in harm's way when you feel there's an unjust law. There are physicians across the country performing the same medical services. There's only one doctor willing to stand up and put his life on it.'"

“Jack Kevorkian, faults and all, was a major force for good in this society," wrote Jack Lessenberry for the Detroit Metro-Times in 2006. "He forced us to pay attention to one of the biggest elephants in society’s living room: the fact that today vast numbers of people are alive who would rather be dead, who have lives not worth living.”

Unlike Kevorkian, Brittany Maynard did not offer up her life to the DwD cause. But when her young body betrayed her, she made the best of it. So she was stung by those with the gall to call her out for self-determining her dying rather than ceding that power to her cancer.

"When people criticize me for not waiting longer or, you know, whatever they've decided is best for me [Laughs], it hurts, because really I risk [losing my autonomy] every day, every day that I wake up," she said in her second and final video. "And I [choose to live another day] because I still feel good enough, and I still have enough joy, and I still laugh and smile with my family and friends enough that it doesn't seem like the right time right now. But it will come, because I feel myself getting sicker. […] Healthwise, things just keep getting worse. But I guess that's what happens when you're terminally ill. You get sicker and sicker. […] So the worst thing that could happen to me is that I wait too long because I'm trying to seize each day, [and] I somehow have my autonomy taken away from me by my disease because of the nature of my cancer."

Each of us gets to define for himself what it means to have a life worth living. For some this is simply a matter of biology, brain activity or maybe just a heart and lungs that pump by means of machines. But for many of us life must meet a higher standard, a level where the chief components of personal existence are not our own abject suffering and the misery of our loved ones as they sit by helplessly watching agony carry us into oblivion at its own cruel pace.

Let's make a deal. We won't interfere with your ability to hang on until the bitter end, and you don't interfere with our ability to let go in whatever manner we see fit. It's a question of freedom.

"My dream," Brittany Maynard wrote eight days before her passing, "is that every terminally ill American has access to the choice to die on their own terms with dignity. Please take an active role to make this a reality. The person you're helping may be someone you love, or even in the future, yourself."

About the Author:

Except for a four-month sojourn in Comoros (a small island nation near the northwest of Madagascar), Greggory Moore has lived his entire life in Southern California.  Currently he resides in Long Beach, CA, where he engages in a variety of activities, including playing in the band MOVE, performing as a member of RIOTstage, and, of course, writing. 

His work has appeared in the Los Angeles Times, OC Weekly, Daily Kos, the Long Beach Post, Random Lengths News, The District Weekly,, and a variety of academic and literary journals.  HIs first novel, The Use of Regret, was published in 2011, and he is currently at work on his follow-up.  For more information:

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