When Brittany Maynard became youthful face of the right-to-die movement, she brought to the public table several fierce debates.
Does this movement champion suicide?
I don't call Maynard's death "suicide" because, overwhelmingly, the people who commit suicide are those who have a choice to continue to live. People with a terminal diagnosis -- an incurable disease or condition that physicians determine likely will kill them in the next six months -- don't have this choice. Maynard had an aggressive brain tumor robbing her of the life she said she very much wanted to live. Hence, I find the term physician-assisted dying more accurate. Death is not debatable.
What the right-to-die movement led, by advocacy groups such as Compassion & Choices, do signal, however, to the great alarm of many of its opponents, is that suffering is optional and that it might also be spiritually meaningless.
The word "suicide," "suffering" is another word that is used -- and valued -- very differently. Maynard, by dying at age 29, signaled that to carry on while she no longer knew herself was a pointless choice that would only prolong the agony of those who loved her.
That's a very very different perspective than taught by many of the world's religions and philosophies. In 2005, I did a deep study on the vocabulary of death and dying as a project for the Templeton-Cambridge Journalism Fellowship in Science and Religion. I asked about autonomy, suffering and spirituality.
We wince when we hear the word “suffering.”
Former Pope Benedict, in his first address to the world after his election, spoke of heroic suffering, accepted to unite a believer with Jesus suffering for the love and salvation of mankind. And in this, he echoed St. John Paul II's address to the First Annual World Day of the Sick in 1993.
The late pope said: "Your sufferings, accepted and borne with unshakeable faith, when joined to those of Christ take on extraordinary value for the life of the Church and the good of humanity.”
Evangelical author and disabilities activist Joni Eareckson Tada scolded Maynard in a Religion News Commentary, saying her choice defied God and endangered vulnerable people who might emulate her -- or be victimized by others who saw no value in their lives.
In Oregon, Washington, Vermont, Montana and New Mexico, terminally ill patients who fear “intolerable suffering” can ask a doctor for assistance in dying on a day of their own choosing.
“She’s suffered enough” people will say when they grope for a rationale for telling doctors to do no more.
But what’s “enough?” Is there a just right amount?
“Suffering” has no qualitative measure. Unlike physical pain -- expressed with a grimace or a moan or a rational rating of 1 to 10 for the doctor making rounds -- it’s psychological, it’s emotional.
It's fear, despair, anger for the life past or present, the unknown to come.
Suffering may be born of relationships with other people or with God, relationships gone sour, sad or hollow. A San Francisco rabbi and former hospice chaplain Michael Goldberg told me, " A great of the suffering at the end of life is either self-inflicted or inflicted by friends and relatives. It’s not due to disease.”
Often, it’s not the sick person who suffers.
“Psychic suffering requires consciousness. If you are deeply comatose, you don’t feel pain,” said medical anthropologist Sharon Kaufman, who spent years in three hospitals observing death, dying and decision-making for her new book, …And A Time to Die: How American Hospitals Shape the End of Life.
Since suffering, like beauty, is in the mind of the beholder, the choice to bear it, numb it or dumb it down is personal, cultural and spiritual.
Maynard told CNN: "I considered passing away in hospice care at my San Francisco Bay-area home. But even with palliative medication, I could develop potentially morphine-resistant pain and suffer personality changes and verbal, cognitive and motor loss of virtually any kind."
But in Iowa, a high school girl with an aggressive brain tumor has battled back through treatments and surgeries to potentially add years to her life. According to the Des Moines Register's coverage of Bethany Gruich, 17, she whispered to her mother in one of the worst days, that she was not ready to die. Maynard's choice was unacceptable to this Baptist family. Bethany's mother, Lori, said, "My faith goes against that on all levels."
Catholic doctrines exclude physician-assisted dying when suffering appears endless and overwhelming.
“When can we say that the potential to grow or overcome or bear that suffering, that potential which made that suffering meaningful, is gone forever?” asks the Rev. Kevin Fitzgerald, of the Center for Clinical bioethics at Georgetown University. The Jesuit priest’s questions are rhetorical. He asks: “Why do we think someone is enlightened enough to know their suffering is not redemptive?"
Traditional Islam, like Judaism and Christianity, sees life as God’s gift, to give and to take away.
But for the Hindu or Buddhist, suffering may be accepted as inescapable.
“The law of karma says that every embodied soul, every living person, depending on the kind of life one has led, will reap the consequences of our actions, Injustices, and suffering in this world might only be explained by the past,” says Dr. Varadaraja V. Raman, an associate editor of the Encyclopedia of Hinduism.
Best to get it over with now.
Brittany Maynard who was, I repeat, just 29, may represent a disconnection from views rooted in religion or karma. To her, suffering born by her body and her loved ones's emotions was not worthwhile if she were no longer living, thinking, acting as Brittany.
Her choice to die may reinforce to many -- particularly religiously-disengaged millennials -- that spiritual meaning, like suffering, is up to you.
She said, "When my suffering becomes too great, I can say to all those I love, "I love you; come be by my side, and come say goodbye as I pass into whatever's next." I will die upstairs in my bedroom with my husband, mother, stepfather and best friend by my side and pass peacefully. I can't imagine trying to rob anyone else of that choice."