From “House MD,” pilot episode.
“(…) steadily there came down from the hills the ceaseless strong murmur of the pines but no other sound yet although he strained his ears listening in both directions along the road, not for the dignity of death because death has no dignity but at least for the decorum of it: some little at least of that decorum which should be every man’s helpless right until the carrion he leaves can be hidden from the ridicule and the shame,” – Faulkner, Intruder in the Dust
Is there dignity in dying – any at all? The organs malfunction, cease to function, begin the process of cellular corruption – rot – becoming meat. The sensorum shuts down – slowly or quickly, we lose touch with the world. Everything goes dark – then: “the rest is silence.” Often there is pain, sometimes terrible pain; other times there is some sudden snap – then – nothing. Consciousness dissipates, and then – gone.
My gut feeling is that the hope for some ‘dignified death’ or some ‘good’ death is simply an illusion bolstered by various strands of ideology and generated by the normal, perhaps unavoidable fear of death naturally found with an animal consciously aware of its own inevitable demise.
The illusion has its detrimental aspects – it contributes to the hope that life can be directed toward a ‘good’ end – which totally ignores the vagaries of chance that plague life – unexpected accidents and diseases, being in the wrong place in the wrong time when a war breaks out, or an earthquake strikes. And it psychologically links with (frankly futile, I think) expectations for an after-life – it forms a continuity bridge to ‘the great beyond’ – if we can die well, perhaps this will establish claim to a superior ‘post-life’ existence. A ‘good’ death completes a ‘good’ life, that leads to greater happiness for the soul on the astral plane. Except there is probably no soul, and the astral plane has yet to be discovered through scientific research.
However, the illusion has its humane uses. Most notably of these are its contribution to the movement to allow assisted suicide for the terminally ill in pain, and providing ideological ground for efforts to provide hospice care for terminally ill patients. Both movements are worthy causes. A rational person should be granted the right to decide when pain becomes too great and death becomes certain. And even a non-rational person deserves care that reduces pain in the last weeks of a painful life.
These movements and the responses countering them somewhat complicate the issue. For instance, one would expect conservative Christians to be supportive of movements easing the suffering of the passage from this life to what they believe lies beyond. But in fact they oppose these movements, on the principle that modern technology merely allows (thanks be to god!) to prolong life until god calls us at his choosing. Thus conservative christians argue that there is no such thing as “death with dignity,” since dignity (as they understand it) is a function of grace relating to human acceptance of god’s will. And of course there are family members who really object to a parent, sibling, etc., who decides to remove themselves from pain a moment earlier than is absolutely necessary. There are also those committed to a technologically determined world, who believe that the dying should allow technology to prolong life as long as possible – as some sort of experiment perhaps? – as well as religious ethicists convinced that suffering, being ‘good for the soul,’ should be drawn out to its absolute limit.
So puncturing the balloon of the ‘good’ death illusion is not so simple as it seems. One has not only to deny the ‘dignity of death,’ but all the ideological opposition to it. One has to be able to make the claim that not only is there no dignity in death, but also no good in suffering. No meaning to life, and no after-life awaiting us. And one has to be able to make the claim that people should have some right to end unbearable suffering and cut short the process of dying.
A combination of such denials and such claims form what I tend to believe in the matter. But articulating this belief, in a manner that would not only convince but persuade others in the current social context, presents considerably difficulties. Is it preferable to support movements I agree with, even if their arguments are unfounded? or to draw a line and make a counter-case that might be misused by those with whom I clearly disagree?
I don’t know right now; I am still considering it.
The supplementary media is a brief scene from a pop-culture cult TV show; remarks by the insightful American writer, William Faulkner; and perhaps most importantly (and most informatively), a panel discussion concerning hospice care, by professionals in the field. I have no further comment on these materials without further consideration on the matter as a whole.
Panel on “Dying with dignity,” The Aspen Institute.