Often we talk about choice as if it is something that is a right, something we believe in, or something we want to have. It rather implies that we have already decided about what. “It is my choice to die with dignity, at a time of my choosing.”
These things are easy to say, but I wonder, are they sometimes a bit like believing in world peace. You can “choose” to go on a world cruise but, if your ticket is just to cross the river, then your “choice” not only doesn’t mean much, it isn’t a choice at all.
Choosing is about choosing from available options. In most situations, we can increase the range of those options through effort. Our choices, of course, relate to the life in question, our own: not some abstract world where if, like a child, we holler loud enough it will be done.
Many people put off expanding the range of options until it is too late to do very much at all. “I’m going to diet one day soon,” or “I really ought to join the gym and exercise,” or “I believe in death with dignity and one day I am probably going to find out how to do it.” Just like that.
In other words, we put off choosing anything because we think there will always be another day. Somehow our riverboat ticket can be upgraded to a cruise in the Mediterranean. We’ll undo years of strain on our heart by suddenly eating salads and buying a running machine. Or when death comes knocking well, I guess I could buy a book or jump on a flight to Switzerland. Then, when we realise that it doesn’t work like that, we realise that our choices are actually rather limited.
Our goal at Exit is not to get you to vote for a politician that supports our aims. It’s not to ask you for a subscription or to sell thousands of books. Our aim, quite simply, is to take away the fear of death. We want to do that by inspiring you to think about it. Gently, sensibly, but to face life (death included!!) in real terms, not as a “one day I will…” .
It is not the duty of this blog even to tell you whether you should support dignity in dying or whether you are part of a minority with the opposite belief. But you’ve read this far: stop for a minute! Try these questions*:
What is your understanding of your current health or condition?
If your current condition worsens, what are your goals?
What are your fears?
Are there any trade-offs that you are willing to make? Or not?
What would a good day be like?
By thinking deeply about these questions you can begin to approach real choices by addressing your real situation. Whether you are for or against euthanasia, think for a moment if you will about your health, what your death might be like, what you would like it to be like, what you would, or might, need to do in order to have the sort of choices you desire. If you wish, there is a video to help you here.
The original author of those questions, Dr Atul Gawande, rather sits on the fence on the question of euthanasia; but the questions are equally valid whatever your answers might be. You can consider what life might be like in the period before the inevitable. Learn about it if need be (if you need information, there’s an excellent book on the most common ways that death occurs by Dr Sherwin Nuland called How We Die: Reflections of Life’s Final Chapter). If you are opposed to euthanasia, you might wish to investigate the realities of palliative care realistically, to understand best and worst case scenarios. If assisted suicide in Switzerland comes to your mind, it could be worth checking the Dignitas website (or the relevant articles on this Blog) to see what is involved. If self-euthanasia is maybe a back-up plan at the back of your mind, then perhaps check out our publications page or go to Amazon to have a quick look inside some of our books. Or of course there is one other choice: do nothing.
You may or may not have the “right”: but do you choose to have choices?
A notice to our print subscribers (Members of Exit):
You may have wondered why you have not heard from us in the past couple of months. You may recall from the last Newsletter magazine that we were facing a very serious financial crisis. We had to take a hard look at our existence and prepare for some difficult choices. Fortunately we are still running (or ‘unfortunately’ for the abolitionists and those resorting to morally dubious tactics to shut us down). We have reorganised things and the future is looking secure even if (as has been the case for 35 years) we keep going by sheer good luck, grit and determination, and the knowledge that people rely on us worldwide in the work of leading research. Thank you for any help you can give.
*Taken from: Being Mortal: Medicine and What Matters in the End by Atul Gawande.
These types of questions also relate to work Exit did previously in the area of advance medical directives (living wills) by helping to persuade the government to include a section about values in the legislation.