Brittany Maynard Highlights Our Health Care System’s Tragic Failures
The story of Brittany Maynard—the 29-year-old newlywed who died Saturday, ten months after her diagnosis of an incurable, rapidly terminal brain tumor shattered her dreams of starting a family—has captivated people worldwide.
While her medical problems were tragic, she responded to them with extraordinary courage, and remarkably-resilient gratitude for the gift of life. In the end, she took a lethal prescription to end her life on her own terms, at home, peacefully, surrounded by her family, making her a special hero to advocates of “Death with Dignity’’.
Brittany is also a hero to me, even though I am a strong opponent of the widespread legalization of physician-assisted suicide. My opposition has little to do with my personal moral qualms about whether doctors should ever participate in efforts to shorten life. I oppose widespread legalization of physician-assisted suicide because even its proponents agree that it should be the “option of last resort,’’ appropriately chosen only when the “gold standard’’ end-of-life options of superb palliative care and hospice prove inadequate. But the reality today is that far too many Americans do not have reliable access to those “gold standard’’ options, or even minimally basic options.
To insist that vulnerable Americans, frightened by the prospect of their approaching mortality, have a “human right’’ to assisted suicide, without first ensuring that they are provided the choice of the “gold standard’’ options, is, I believe, profoundly irresponsible. I consider the near-single-minded efforts of many advocates to promote legalization of so-called “Death with Dignity,’’ independent of guarantees that other options are reliably available, deeply immoral, both as a matter of proposed social policy and as a matter of individual and organizational activism.
In celebrating Brittany Maynard as one of my heroes, I cannot bring myself to describe the way she lived despite her illness as “tragic.’’ As Aristotle explained to us, Greek tragic poets often described the extraordinary capacity of “tragic heroes’’ to achieve “redemption.’’ When they do, the last part of their stories is heroic. Whatever one thinks of Brittany’s final act, the last weeks of her life were much more a story of heroic redemption and triumph than of tragedy.
Unlike Brittany’s last weeks, the end of life for far too many Americans is truly tragic. In confronting their approaching mortality, far too many Americans—and their families—find no redemption or triumph. In striking contrast to the love, grace, and human dignity that Brittany and her family showed us, their final days and weeks are too often dominated by unbearable suffering and the wounds of impending loss. That is not because of their own failings to achieve “tragic heroism’’—it is because we and our health care system are failing them.
We and our health system tolerate enormous physical, emotional, and spiritual suffering of vast numbers of our fellow citizens, even though we know, in every case, how to prevent or at least alleviate it. The ancient Greeks would have understood this as the predictable result of our medical and cultural—perhaps quintessentially American—“hubris’’: Our attempts, always ultimately futile, to deny the fundamental fact of our shared human mortality.
This hubris finds tragic expression in the pride that physicians and hospitals take every day in “saving a life no matter what it costs,’’ willfully blinding ourselves to the suffering we cause in the process.
Our willful blindness extends also to each of us in our own families, when we fail to “have the conversation’’ with a loved one facing a possibly terminal illness. We all know that “it is always too early until it’s too late.’’ We continue to fail our loved ones, even though of the more than 6,000 Americans who will die today (and tomorrow and tomorrow and tomorrow), far too many will leave behind families who are permanently wounded, some deeply scarred, by the memories of suffering in their loved one’s last days. We continue to fail our loved ones, even though we know that other options are available through the rapid advances in pain management, palliative care, and hospice.
We each have our heroes—for some, Ted Kennedy; for others Ronald Reagan, for others Pope John Paul II. We think of them as heroes for the way they lived their lives. Yet we tragically fail to focus on the way they lived their last days—every one of them choosing to die peacefully at home, every one of them declining the alternative choice they had available—the most advanced, potentially life-prolonging hospital care in the world.
We should all be ashamed of how every day we are tragically failing that test for so many at the end of life. We should all be ashamed that our current approach is often far more expensive than even the best possible care at home would have been. But we should harness that shame by working for urgent change.
Honoring Brittany, for some, will mean working toward “Death with Dignity’’ laws like the one she found helpful in Oregon. But honoring Brittany more completely could mean that we all unite, starting now, in private sector and governmental steps that will ensure the basic human right of every American to have access to the other choices for care near the end of life, the other paths of courage, grace, and human dignity, that almost all of us would prefer, and deserve.
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