We wonder how common it is for would-be parents to ever consider when and how their kids will die. When parents bring children into the world, they can be sure their kids will eventually kick the bucket. Exempting the biblical prophet Elijah, we all do.
Most of us have known folks who have croaked in their sleep, never having suffered. A saying that’s been attributed to several sources goes something like this: “When I’m ninety years old, I want to be shot by a jealous husband” (yeah, it could be “wife”). But you may not have the opportunity to check out without suffering a long, arduous and even painful final chapter. And that final episode could likely include sympathetic others suffering with you.
In an article in the February 3, 2012 New York Times Sunday Review section, professor of medicine Louise Aronson relates the story of the last weeks in the life of her dog, Byron. When he began to lose control of his excretory functions, and whimpered, and needed constant attention, Aronson wondered whether it was time to euthanize Byron. “Our vet said he used the 50 percent rule: were at least half of Byron’s days good days?” she says. “Or was it two bad days for every good?”
The next question is whether half of his days being happy ones is adequate. What about higher or lower percentages? Aronson is a geriatrician, or specialist in medical issues of aging humans. A minority of her patients are ready to say goodbye. They have had enough of suffering with disability or pain or depression. Others are no longer even able to articulate their desires.
“’Why doesn’t God want me?’ asked a 96-year-old felled by multiple strokes and fed through a tube.” With very narrow exceptions, the good ol’ USA frowns upon self-determined euthanasia. So while we can put a dog “to sleep” we demand that humans suffer, unable to control their own bodily functions, until the last drop of suffering is wrung out of them.
Don’t get us wrong. There are folks who want to hang on until their last possible breath is used up. That’s their prerogative (even if society has to pick up the tab). But most parents will never know how their children will bow out. Will they suffer? For days? Months? Years?
Here is the conundrum. People who are animal guardians (we are using the politically correct term here, as advocated by animal protection groups who prefer “guardian” to “owner”) and who truly love their companion animals, have the right to decide when it’s time to pull the plug and end their suffering. People don’t; not for themselves and not for their family members who are no longer mentally of this world. Doctors recently determined that 84-year-old former Israeli Prime Minister Ariel Sharon has some vestiges of brain function remaining, and still persists in a coma after seven years. We wonder whether he or his family members would like to have a say in all of this if they could.
Dr. Aronson still wonders whether she and her family waited too long to say goodbye to Byron. We know what that’s like. In shorter than a two-year period we had to euthanize each of our two dogs. In each case we agonized over “when is the right time?” Were we keeping them alive too long because we couldn’t bear the notion of living life without them or because we truly believed they were still happy? Aronson worries that she may have overcompensated to Byron’s detriment.
She makes the parallel with the last months in human lives. Hospitals often fix acute problems and extend the chronic ones. Emergency room visits sometimes require weeks of recovery from all the testing and waiting. Surgeries sometimes extend life but cause confusion and lead to “hated nursing home stays.” She tells the story of a patient who had 15 major medical issues. He decided that he was done with hospitals, chemo, and any other possible treatments. But then he complained for weeks about palliative (that is, the reducing violence and discomfort of illness) care because he longed to live. “He was sick and tired of being sick and tired. Like so many, his was a reasoned and reasonable stance,” she observes. In other words, he didn’t want to die, but he just couldn’t take the suffering.
We live in an age where, while some diseases are disappearing, others are burgeoning. While we find ways of keeping humans alive longer, we make little effort to figure out how we are going to warehouse the aged ill. Is keeping ourselves alive longer, only to suffer extended diseased demise, a prospect human society aims for?
Getting back to our original question: Before we produce kids with an optimistic, if possibly unrealistic, expectation of how wonderful their lives will be, shouldn’t we consider whether there are Enough of Us on this planet and how the next generation’s lives are going to end?