Tuesday, January 16, 2018

Column: 'Good death' eludes modern medicine

This is a familiar story: In July 2012, 65-year-old Barbara Wise suffered several disabling strokes that confined her to a hospital bed in Akron, Ohio, unable to move or speak.

Perhaps you remember the 15-year vegetative state that Terri Schiavo endured after cardiac arrest in 1990. Perhaps you saw the 1981 movie Whose Life is it Anyway, in which Richard Dreyfuss plays a sculptor who fights for the right to die after a car accident turns him into a quadriplegic.

Perhaps you can imagine the semi-facetious, end-of-life conversations that Barbara Wise and her husband, John, may have had at various times during their 45 years of marriage.

In fact, perhaps you've said, as many of us have, only half-joking, that if you ever get into that helpless vegetative situation, "Please, somebody, just shoot me!"

Which is what John Wise did. On Aug. 4, 2012, he smuggled a handgun into his wife's hospital room, kissed her on the cheek, and discharged a single, poorly aimed shot into her head. She died the next day.

Last week, Wise, 66, was sentenced to six years in prison, three for murder and three for firearms violations.

What do we take away from a sad episode like this? It doesn't provide a sterling argument in favor of mercy killing or assisted suicide. Barbara Wise may have been miserable and helpless but she wasn't immediately terminal, and her doctor says that she was showing signs of responding to treatment. She might have lived a few more years in a nursing home.

Further, John Wise's botched attempt to put Barbara out her misery may have unintentionally caused her another day of suffering.

But at the least this case serves as a graphic reminder of a philosophical and moral shortcoming: As modern medicine has increased our control over our health, comfort and longevity, we haven't paid enough attention to the other blade on medicine's two-edged sword, the misery that comes with a lingering, prolonged death under conditions that would have mercifully killed us much more quickly only a few decades ago.

And we haven't paid enough attention to the potential control that we should have over the manner of our own deaths.

We like to think of death as a peaceful passage into a sweet beyond, like in the movies, but in reality it's often accompanied by miserable indignities that we don't permit our pets or serial killers to endure when we put them to death. In fact, many of us are nagged by a vague obligation to prolong our lives as long as possible and to endure all of the suffering that they have to offer.

But philosophy and religion, rather than medicine, stand in the way of a gentler, more humane death. Some countries, like Switzerland, permit active suicide assistance for terminal patients, but in the United States only four states (Washington, Oregon, Montana, Vermont) have developed laws that allow some version of physician-assisted suicide, under highly controlled conditions.

It's a challenge to defend John Wise's actions, but they clearly demonstrate the desperation felt by sufferers and caregivers as the end approaches. They imply a need for a conversation about ways to re-envision death as a less frightful, more organic part of life. And they suggest that we need to search for ways to make a more humane death more readily available.

John M. Crisp teaches in the English Department at Del Mar College in Corpus Christi, Texas.

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