Monday, October 17, 2011

The Right to Die

by Alex Lickerman, M.D., Psychology Today

The notion that dying is a right seems nonsensical to argue: death is given to all of us equally without the need of anyone's sanction. The right to die well, on the other hand—well, that's another matter entirely. A good death is, in many cases, something our fellow human beings have great power to grant or deny, and is therefore, sadly, a right for which we must indeed fight.

The notion that we'd even need to fight for the right to die well has only come to make sense relatively recently, within the last forty years or so. Prior to that, our ability to prolong dying—meaning, keep extremely ill people going in hopes that they might overcome whatever health problem threatens even when the likelihood is vanishingly small—was actually fairly limited. But with the advent of modern intensive care units and all the amazing technology that's emerged in the last four decades, we can now stretch the quantity of out our last days often to weeks or even months. Unfortunately, a similar stretching of quality hasn't yet occurred; if anything, we see the opposite (to be fair, the same technology also stretches some lives to years and even decades, meaning it's enabled some people to recover from insults that in the past would have undoubtedly killed them).

Health providers don't wield this technology to prolong suffering intentionally. As I argued in a previous post, Knowing When To Stop, it's quite difficult to predict the timing of death, even in the terminally ill. In one sense, then, the horrific deaths many patients experience at the hands of modern medicine reflects our species' profound optimism bias. Even when in our hearts we know it's time to stop, we often don't.

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