27 Comments

Larry Miller, Right to Die

It’s not often that my 2 loves (religion and sport) combine in a way for me to write about both.  Here in Utah, the death of Larry Miller, owner of the Utah Jazz, is big news.  Outside this area, it’s not a big story.

Larry’s had some health problems, first suffering a heart attack related to diabetes last summer.  He has almost died 5 times since then, but had always recovered, and continued to attend games (in a wheelchair).  He had a setback a few weeks ago, and had his feet amputated below the knee due to diabetic ulcers.  Still, it always seemed like he would pull through.

I was surprised to learn of his death of Friday, and also surprised to learn that Larry knew his condition was terminal on Feb 12.  He had a rare disease called calciphylaxis, which calcifies blood vessels, blocking the flow of oxygen. It was discovered after his amputation wounds did not heal.  There is no cure for calciphylaxis. He could have survived a few more months if he chose to go through dialysis, but he chose not live like that.

Larry is a mormon, and I know that mormons are generally more liberal on right-to-die, and euthanasia than other religions, like Catholocism.  I don’t know if I have any Catholic readers, but I would like someone to comment on euthanasia/right to die if they are aware of the position, or if they think Larry should have kept fighting for life.  I know that there is a big controversy in Italy about a euthanasia right now.

I don’t think that people should be kept alive at any cost.  I applaud Larry for fighting to stay alive as long as he did, but recognizing when his time was up.  Sure he could have eeked out a few more months, but he was at peace with his decision, and I think he made the right choice.  Life is more than avoiding death, and I think some people place too little emphasis on quality of life issues.  I think I would have made a similar decision that Larry made.

This brings me to my next point.  The Deseret News recently ran an article on a new paradigm shift in health care.

The first, HB188, codifies the notion that normally healthy people should normally be healthy, and that overeating, lounging or smoking their way into obesity, diabetes heart ailments and other so-called diseases, which are not diseases but chronic conditions of lifestyle for most, is a key component in the ailing and failing U.S. health-care system.

HB188, which addresses the insurance industry specifically, amounts to a basic paradigm shift in Utah’s health care system for insurers and the insured with a carrot-and-stick approach: Along with offering a basic medical insurance plan for the first time, workers will able to carry coverage from job-to-job instead of drop coverage due to the cost of premiums, and it in effect forces them to stop eating themselves sick and start exercising.

In a different article addressing health care ethics,

Why does 33 cents of every medical care dollar go for end-of-life interventions that usually just prolong imminent death?

Should there be an age limit for open heart surgery candidates?

Should those who cost the system millions by eating themselves sick be singled out for an excise tax like the one proposed this year for people who smoke themselves sick?

Liljenquist is a new member of the Legislature but has experience with a health care decision that is both personally tragic and an appropriate illustration for a courageous public discussion that may help people get educated and “internalize the real costs of their choices.”

His first child died just a few minutes after being born and a few hours after he and his wife and their doctor chose not to fight to keep the infant alive. Doing so would have required costs upwards of $1 million and still probably would not have saved her life.

Care providers have told committee members that doctors are borderline miraculous at extending existence, but that doing so is often tantamount to holding a soap bubble on a grappling hook. “My brother tells of elderly folks during his residency of being kept on life support for months and months because their children felt it was their moral duty to keep them alive,” he said, noting that there is compelling duty as well to at least consider the expense of that kind of care.

Larry Miller understood that his health problems were the result of his own poor habits regarding his diabetes.

The pace he maintained at such times — and throughout much of his career — would have been hard on anyone, but especially a man with type 2 diabetes. There were days when he would rush out the door without eating breakfast, armed with only a candy bar, and by the end of the day the candy bar was uneaten and Miller had gone without a meal, risky behavior for a diabetic.

I really think that we all need to take a greater responsibility for our health.  I do think that people who engage in behavior known to cause health problems such as obesity and smoking, should pay higher premiums.  People who proactively engage in exercise programs should pay less.  I think it would provide an incentive for people to take control of their health, and I think far too much money goes into prolonging life unnecessarily.  Larry fought a good fight, but understood when to quit fighting.

I love this quote from the Deseret News:

Over the past 40 years of remarkable medical technological advances, people have tried to forget that death is part of life, Dr. Chris Cowley said. And in the process they’ve disconnected from the fact that most people, most of the time, have the greatest impact on their own well-being.

Finally, I hope all of us can end our lives feeling just like Larry did.

During one wistful moment while recovering from his heart attack, Miller said, “You know, I don’t want this to sound boastful, but I really have had an extraordinary life.”

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27 comments on “Larry Miller, Right to Die

  1. I have worked for the last two years in the elderly care industry, and it has been a revelation to me. Palliative care is such a beautiful concept. If you aren’t aware of it, look it up. I absolutely LOVE the philosophy of hospice, summarized by the following quote from Dame Cicely Saunders of St. Christopher’s Hospice in London:

    “You matter because you are you. You matter to the last moment of life, and we will do all we can, not only to help you die peacefully, but also to live until you die.”

    I want to live until I die, and I applaud Larry Miller for his choice to die with dignity on his own terms.

  2. My parents worked with Larry Miller for years. It is sad to see him go so young. He worked very, very hard and it is too bad he didn’t slow down more often to care for himself. He did live a good life and I too applaud his choice to move to the next life with hope and dignity. He will be missed.

  3. Ok, Ray, I had to look it up, and of course the first google link was a wikipedia reference.

    Palliative care is any form of medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than striving to halt, delay or reverse progression of the disease itself or provide a cure. The goal is to prevent and relieve suffering and to improve quality of life for people facing serious, complex illness.

    This is such a wonderful idea. My sister died of a brain tumor about 10 years ago. Towards the end of her life, we knew she would not make it. The radiation therapy, tumor, steroids, and chemo made her unable to care for herself. This was extremely difficult for me to witness.

    She applied for hospice care. The nurse (I’ll call her Mary) who arrived at the door was a wonderful family friend. I remember my sister was grateful that Mary was her helper. Mary took wonderful care of my sister. Since Mary was a personal friend of mine (we had worked together at a hospital about 7 years previous to this), Mary was a great source of strength to me.

    Palliative care was exactly the service that Mary provided. I have always wondered how Mary was able to continue to provide hospice services to the terminally ill. Emotionally, I just couldn’t handle this on a day to day basis as Mary did. I am so grateful for angels among us like Mary.

  4. MH, my wife provides care for the elderly who don’t want to leave their homes. In the past 18 months, among those she has served have been four people who ended up dying in their homes – one 93-year-old woman with a tumor in her stomach whom she had helped for almost a year. I also don’t know how she does it, but I love the fact that she is loved by them and adds joy and dignity to the time they have left.

    Our medical profession is screwed up in this area. For example, if someone wants to live a full and active and dignified 78 years, why do we insist they instead live a miserable and bed-ridden and degrading “x” number of years after that if their health collapses at 78? At the very least, once someone passes the standard longevity age every day after that should be experienced by them as a blessing – not a curse.

    This is a real soapbox for me, if you can’t tell.

  5. MH, I actually thought that Mormons and Catholics are virtually identical when it comes to end-of-life treatments and euthanasia. The Catholic Church is opposed to euthanasia or assisted suicide, as is the LDS Church. Neither are in favour of any action that would bring about death, such as Dr. Kevorkian’s suicide machine, but both are OK with passive action that results in death when death is going to occur eventually anyways (such as witholding food and water from the elderly when they are nearing death, or not prolonging a terminal cancer patient’s life by doing another round of chemo) or if the person is being kept alive artificially, like a brain dead person on a respirator. I don’t think the LDS Church is any more liberal on right to die issues than other churches. In fact, I’m guessing that it’s either pretty much in line with other Christian churches or more on the conservative side, since it’s clearly opposed to euthanasia.

    For me, it’s a lot easier to just say I’m opposed to euthanasia than to actually believe it. I actually have a lot of sympathy for Dr. Kevorkian. I think, honestly, that his heart was in the right place. When you see people desparate in pain, you want to help them. Sometimes the only “help” that will alleviate their pain is death. And sometimes they beg for help. It must be horrible to have to say no. I think the hypocratic oath says something like “do no harm,” but one can wonder sometimes whether making a terminally-ill person suffer through unbearable pain is more harmful than allowing them to go peacefully in their sleep from an O.D. of barbituates.

    The case of Chantal Sebire was one that made me think a lot. Here was a woman who was in excruciating pain with no end in sight. Her cancer was in her sinuses and face (do a google image search of her name to see photos of what the tumour did to her), but as she said, it would probably take years for it to kill her and pain meds didn’t help. Of course, anyone can kill themselves if they really want to, but if you don’t have access to medications that will allow you a peaceful, dignified death on your terms, then it must be a horrible position to be in, both for the patient and the family.

    So I wouldn’t call myself an adamant supporter of euthanasia, but I’m definitely a sympathizer. Maybe because I know it could be me someday.

  6. One thing I have noticed in my handful of experiences with end-of-life issues is that there is not always a clear-cut line between passive decisions that hasten death, palliative care and more active actions that some might call euthanasia. Sometimes it is a matter of timing. At what point do you forego dialysis? Do you use antibiotics to treat an infection in someone weeks from death? Months from death? When do you start the morphine drip? Will that bring about respiratory arrest?

    It has made me a lot more flexible about what I think, and a lot less judgmental about what others decide. The bottom line is that end-of-life can involve some unique and intensely personal decisions.

  7. Ray,

    I think people like your wife are absolute angels for the wonderful services they provide. I get emotional when I think about them.

    FD,

    I wasn’t aware the church was against euthanasia. I checked it out, and the official church response can be found here.

    Euthanasia and Prolonging Life

    The Church of Jesus Christ of Latter-day Saints believes in the sanctity of human life, and is therefore opposed to euthanasia. Euthanasia is defined as deliberately putting to death a person who is suffering from an incurable condition or disease. Such a deliberate act ends life immediately through, for example, so-called assisted suicide. Ending a life in such a manner is a violation of the commandments of God.

    The Church of Jesus Christ of Latter-day Saints does not believe that allowing a person to die from natural causes by removing a patient from artificial means of life support, as in the case of a long-term illness, falls within the definition of euthanasia. When dying from such an illness or an accident becomes inevitable, it should be seen as a blessing and a purposeful part of eternal existence. Members should not feel obligated to extend mortal life by means that are unreasonable. These judgments are best made by family members after receiving wise and competent medical advice and seeking divine guidance through fasting and prayer.

    I have to say I am opposed to the church’s stance on this issue. I read FD’s link about Chantal Sebire, a French woman.

    She also lost her senses of sight, taste, and smell[3] and suffered severe pain that she refused to relieve with morphine due to its side effects, stating, “drugs are chemicals, chemicals are poison, and I won’t make matters worse by poisoning myself.”

    Now, I’ll disagree with Chantal’s stance on drugs–I don’t believe they are poison. Still, I stand by her right to make her own decisions to refuse treatment. The court’s refusal to allow her to end her life is tantamount to torture, in my view. Chantal has no chance of a living, and is going to die. I do not see anything wrong with her hastening her death. I would not choose to live with such a condition either, and would welcome death.

    While Larry’s condition resulted in imminent death (just 8 days after diagnosis), if he had been forced to undergo the pain Chantal went through for an indefinite period of time, knowing that it was terminal as in the case of Chantal, I think he would have been quite tempted to hasten his death.

    When a horse breaks its leg, we kill it as an act of mercy. Why is Chantal treated differently?

    The case I was referring in Italy is found here.

    Eluana Englaro, 38, died on Monday night [Feb 9], only a few days after doctors removed her feeding tubes. She had been in a coma since 1992.

    Her death was announced as the Senate was about to debate an emergency bill designed to keep her alive.

    The emotive case inspired protests from both sides, and much soul-searching.

    Eluana had been in a coma for 42% of her life. That is not living. For the parliament to try to pass a last minute bill to “save her life” is tantamount to torture. Living in a coma is not life.

    I read a book from Larry King called Powerful Prayers. It is an absolutely wonderful book, and I HIGHLY recommend it. King interviews actors, athletes, politicians, theologians, and people from all walks of life. Some of the mormons he interviewed include Orrin Hatch, J Williard Marriott, Pres Hinckley, and Steve Young. He interviews Jimmy Carter, Margaret Thatcher, Robert Shuller, and a wonderful rabbi (his name escapes me.) It is a truly fascinating book.

    He also interviewed Dr Kervorkian, and I learned Kervorkian is an atheist. I must say that Kervorkian’s answers were disturbing to me, so I have real mixed feelings about him.

    Why is it ok for parents, like Rep Liljenquist, to actively decide not to prolong the life of a mortally ill infant, yet we choose to keep people alive for 16 years in a coma like Eluana? This is not at all merciful to Eluana. Her coma like state is no different than the infant. And the cost to keep her alive is borne by all of society–costs that could be better spent elsewhere.

    I really think that society needs to rethink its position on euthanasia. I think it is usually an act of mercy. Anyone who calls it murder should be called a sadistic torturer.

  8. MH, I choose to read the Church’s position a bit differently, since I think it only addresses each extreme. It seems to leave the middle up to us to work out through thought, prayer and consultation.

    I think it’s saying that others shouldn’t end someone’s life prematurely by actively causing a death. Otoh, I see someone with painful, terminal, unassistable cancer choosing to die rather than continue to suffer as fine within the statement – regardless of age. I don’t see “passive suicide” as a problem (for example, refusing to eat and dying as a result). I think we tend to allow this for the extremely old, but we forget to see the connection to the exact same action for someone who is younger but just as sick and in pain and subject to die in the same time frame.

    Bottom line:

    We shouldn’t actively kill others, but we should allow others to die naturally and let themselves die.

  9. Ray,

    You make an interesting distinction between passive suicide, and active suicide. I think you and I and the church agree that in the Italian woman’s case, it is ok to withhold food and water, and allow her to die after 16 years in a coma. But, I want to point out that many Catholics in the Italian parliament would probably call this euthanasia, and would liken it to active suicide. I’m pretty sure the Catholic church is against this, which is why I said the LDS church is more liberal in cases like this. (The Terry Shiavo case in Florida is very similar to this case.)

    I would ask you to comment specifically on FD’s example of the woman in France whose face was literally being eaten by cancer. The French courts wouldn’t allow her to take her own life.

    She was later found dead–not from the cancer, but from the drug Pentobarbital, which is primarily used for the purpose of physician assisted suicide. Are you saying that Chantal was wrong to do this? Will she be sent to hell? Do you think the French court was acting in a humane way to deny her active suicide, in light that she was going to die anyway?

    FD mentioned the Hippocratic Oath, which says do no harm. Isn’t it more harmful to force someone to live a life in such horrible circumstances? How would you respond if you were similarly afflicted?

    FD,

    the suffering that we allow humans to endure when they don’t necessarily have to is considered inhumane on animal terms. Why is that?

    I think it is a completely misplaced sense of priorities. I think our ethics are completely wrong. I think forcing someone like Chantal to live through the pain of a cancer is inhumane. We would never allow an animal to suffer like Chantal did. This makes absolutely no sense.

    If Chantal had chosen to take morphine, most doctors would allow her to basically die from a morphine overdose. I know this happens in many cases in the US. We may choose to call this a passive suicide, but to me it is no different than taking Pentobarbital, except for the fact that Pento… is faster than morphine. Whether we look the other way on a morphine overdose, or Pento…, it really is an active suicide. I don’t understand why the Morphine overdose is more acceptable, except that it is slower acting, is also a painkiller, and is easier to hide.

    I think Chantal should have had the same right as Larry Miller. A case could be made that Larry actively hastened his death by refusing dialysis.

  10. I believe in recorded and notarized health care plans, similar in every way to wills – and just as legally binding. One specifies desired treatment and care while living; the other specifies desired treatment and care after death.

    I think everyone should consider the range of possible health issues while they still are lucid and articulate exactly what they want done in general situations. Do they want to stay in their home as long as possible? Do they want to live in a retirement community among other seniors? Do they want to be kept alive if they fall into a coma? Do they want to receive chemo or radiation for cancer? Do they want to take morphine for pain? Do they want to be allowed to starve themselves to death in this or that situation?

    I believe in agency – full and complete agency. I believe nobody has the right to tell me when and how I can live – or when and how I can die. I am entitled to life, liberty and the pursuit of happiness – which, I believe, includes the ability to choose death as one of the manifestations of liberty and the pursuit of happiness.

    Think seriously about that last part. Choosing when and how I die is the final act of the exercise of my agency – and it directly affects both my liberty and my pursuit of happiness.

  11. I work with dementia patients and when they are close to death, I can see the doctor’s dilemma of assisting the suicide of such a patient if there was a law that allowed it, since dementia patients often can’t answer for themselves.

    I can see it being problematic if the doctor or a family member was the one making the decision on whether the person is going to die now or let nature run its course. But the problem is that the person is often too mentally incapacitated to make such a decision. And really, I’ve seen many instances where it’s the family who decides to stop treatment on behalf of the patient who is incapacitated. So it’s not like we aren’t already giving doctors and family members enough power to have some say in when and how we die if we become mentally incapacitated. I remember one dementia patient a couple of years ago who developed pneumonia. The doctor said it was terminal and gave him 3-7 days. The family decided to stop food and water, so all we did was moisten his mouth regularly. I remember it was unusually hot that week and I thought that he would probably go fast, which was good because he looked horrible. He was burning up with fever, literally wasting away and breathing very short, shallow breaths, but still awake and somewhat alert. He had already lost most of his ability to communicate, and I remember thinking that he looked scared. I think he probably understood what was happening. The family was there round the clock, which must have been exhausting. He ended up lasting a full week before he finally passed away, which must have been agonizing for him and the family. I remember thinking how they probably wished that they could have spared him at least those last 5-6 days which were really horrible.

    I’m sure that a lot of doctors would have trouble administering a fatal shot of barbituates to a terminally-ill patient if they were allowed to do so. But on the other hand, they are the ones pulling the plug on brain dead people on ventilators if the family decides to do so. You could almost argue that it’s more ethical to administer a fatal shot to someone with terminal cancer in horrible pain when death is imminent and morphine isn’t dulling the pain anymore, than pull the plug on a brain dead patient who could perhaps be kept alive artificially for years.

    If it were all up to me (which obviously it isn’t 🙂 ), then this is what I think would be most reasonable and humane:

    1.) There would be a law allowing only for patients deemed terminally ill by at least two medical professional to have access to the cocktail of meds that would allow the person to end his/her life peacefully and as pain-free as possible on his/her terms. I think it’s important to specify that it shouldn’t just be available to people in horrible pain because some terminal illnesses result in a slow death that may not cause horrible pain per se, but perhaps cause horrible symptoms like suffocation. It would be understandable that some would want to end their lives before they get to the later stage of their illness.

    2.) If possible, the patient should administer the fatal dose his or herself. If the patient is unable to do so and yet able to state clearly his/her wishes, then a willing doctor or family member can administer it in the presence of medical witnesses, “willing” being a key word because some people would have a moral problem with being the one to administer the fatal dose, which should be respected.

    3.) The part I’m not sure about is whether doctors and/or family members should have the authority to decide for a mentally incapacitated person (i.e. Alzheimer’s patient) that a fatal dose should be administered. Perhaps it should only be allowed if the patient had stated on record his/her wishes in such an event while he/she was still mentally sound enough to make that decision. Sort of like what people do now with “Do Not Rescucitate” orders.

    Here’s a thought I just had:

    Many conservative Christians (including Mormons) support the death penalty. In order for the death penalty to be carried out, someone must administer it, either by lethal injection or flipping the switch on the electric chair. Most would probably agree that the executioner is not guilty of any crime, but is simply upholding the law.

    So if a medical professional actively does something to end someone’s life when they are terminally ill (i.e. by a lethal overdose) when the provisions have been made and witnesses are present, then how can we really argue that it’s immoral or that the doctor is guilty of any crime? I know the Catholic Church is adamantly opposed to both the death penalty and euthanasia, but I think that many Mormons — at least in America — support the death penalty. And most of those Mormons would be against euthanasia because the Church is. It seems to be, like MH said, “a completely misplaced sense of priorities.”

  12. Ray,

    It’s nice when people put together a living will, but as you know, the majority of people don’t even put together a regular will. That’s why the courts get involved in these matters–the incapacitated person never made his/her intentions known. While the courts do the best they can, the time frame it takes for them to decide, often results in poor, or at least long overdue, decisions.

    I think society needs to think through these issues better. I think it is unethical to keep someone in a coma for 16 years, and I think it’s unethical to prevent assisted suicide in the case of terminally ill patients. The courts don’t agree with me, but I think the laws need to be changed, and I think society needs to let go of this unhealthy idea that death should be prevented at any cost. There are too many people being kept artificially alive, wasting money on people who are going to die anyway. That money could be better spent on many other needs of society.

    It sounds to me that privately, you support Chantal’s right to end her life, but that you don’t want to go so far as to say you disagree with the church’s official statement on this issue. Would that be an accurate view of your position?

  13. I just thought of an idea. Would you support legislation REQUIRING people to put forth a living will?

    FD,

    The death penalty subject deserves an entirely new post, though I understand your connection. Briefly, let me say that emotionally, I support the death penalty. However, it is applied so disproportionately, that I think it’s use should be much more limited than it is in the US.

    I don’t believe that doctors should just put people to death willy nilly. I know of a case where a NJ nurse decided on his own to end the lives of several patients in a nursing home, by giving them overdoses of various drugs. He did so without detection for quite some time. This is absolutely wrong.

    I like your guidelines #1 and #2, and agree with them. If we legislated that people have living wills, ideally that would help solve the problems of knowing their intentions (#3). My wife and I just put together a living trust, which included a living will. The lawyer who helped us said to consider it well. He reminded us that sometimes people change their minds, in either direction, and to carefully consider what we were writing.

    There’s a movie called “Just Like Heaven” with Reese Witherspoon. It’s a romantic comedy. Reese is a physician, and is in a coma from a car accident. Her sister has the unenviable position of choosing to end her life, because Reese had indicated that she didn’t want to live indefinitely in a coma. Reese is frantically trying to get the sister to change her mind, because the sister doesn’t know that she’s going to pull through.

    These situations are so complex. A living will isn’t ever foolproof, but it is better than nothing. Living wills would also save many relatives from the bitter court battles, which waste time, energy, money, and emotion.

  14. As mentioned earlier, I think there is an almost overwhelming amount of gray area on this subject. But there is one issue that I think has not received much discussion so far, and that issue is probably the basis for the Mormon Church’s (and the Catholic’s too, I suppose) discomfort with euthanasia. The issue is the idea that life is one of the most important gifts God gives us, and we should submit to his will when deciding on how it is ended.

    The discussion here has presented some heart-wrenching examples of human suffering. I certainly pass no judgment on anyone who is forced to make decisions in light of these kinds of situations. At the same time, and speaking only for myself, I am not sure that ending suffering is always the highest priority. To be honest, I just don’t know why God allows that kind of suffering, and I certainly don’t know how long He thinks is necessary or acceptable for a particular individual, or under what circumstances it should end. If I were personally faced with such a situation, I honestly cannot say what I would think or how I would face it. I would hope, however, that a large part of my decision-making process would be, “What does God want me to do with this problem?” As I write it, I realize what an interesting and complicated question that is, including elements of agency and submission. It is such a personal question; the answers are bound to be unique to each person. That is why I pass no judgment on anyone’s decision in this regard, especially if they have really sought to do what God wants them to do.

  15. Ray mentioned refusing food and water was a passive way to induce death. I just want to point out that I have heard this is a very painful way to die. (I don’t think there is any way to verify this.) We’ve all been hungry–can you imagine not eating or drinking for a day or two or three or a week? That does not sound humane to me, whether one is in a coma or not, nor is it palliative care.

    We all would like to have a quick and painless death, or to be changed in the twinkling of an eye. Yes, suffering can be a teaching tool for God, but I’m not so sure he wants us to have our face eaten by cancer. What is the lesson in that? If God is merciful, I can’t imagine he would condemn Chantal’s actions, or anyone who assisted her.

  16. MH, from what I understand, withholding food and water from a dying patient is not just to hasten the death process, but to alleviate suffering. As horrible as it is to starve or be dehydrated to death, forcing nourishment and fluids into the body once it has started shutting down, even by IV, can cause more pain and discomfort to the dying patient. I do wonder, however, whether it was much worse for someone like Terri Shiavo, who wasn’t really “dying” when her feeding tube was disconnected.

    The Teacher brings up a good point, which is the only reason why I think the Church opposes euthanasia. “The Lord giveth, the Lord taketh away.” He gave us life and He decides when it ends. But the older I get and the more complex I discover life to be, the more “disconnected” I think God is from us. I’m not saying He doesn’t care or is oblivious to our suffering. But I think perhaps He intervenes or changes the course of nature a lot less than we think. First of all, God seems to let the laws of nature unfold, which have allowed for terrible diseases to form and affect us. For some reason He lets nature take its course for the most part, giving “free agency” to gene mutations and superbugs. Maybe we underestimate just how much agency He gives us as well. In fact, He gives human beings enough agency to kill each other, rape children, commit genocide, and plenty of other attrocities without intervening in most cases. For some reason, He allows us to cause horrible suffering to our fellow man (which we will no doubt pay for later). Is it impossible to think that He also gives us agency to end a life when it’s on purely compassionate grounds? As MH said, I’m not so sure that God really directly wants or intends for someone’s face to be eaten by cancer and left in excruciating pain to die a slow death any more than I think that He wants children in Ethiopia to starve to death. But for some reason He appears to allow both things to happen as long as we don’t intervene. Could it be that He wants us to alleviate the suffering of dying people like Chantal just as much as He wants us to alleviate the suffering of starving children?

  17. Teacher,

    I’ve been trying to leave a comment on your blog for 2 days, but it won’t let me. That character generator is not working, so it won’t let me leave my comment. (I tried Explorer and Firefox and it does the same thing.)

    I’ve been thinking about what you said, and I agree that there is much discomfort in the church regarding euthanasia. Death is such an uncomfortable topic for everyone. Even for me, I expect to outlive my parents. It is unthinkable for me to imagine how I will react when either one of them dies. I think this is the reason most people don’t do a living will–it’s just too uncomfortable of a topic.

    When I met with the lawyer, he had a form for me to consider who I would like to speak at my funeral. I chose a sister as the person in charge of my estate should my wife and I die together, and I just told her that I didn’t want to think about my funeral–I’m sure whatever decisions she made would be fine with me.

    Anyway, back to the church’s discomfort. I think all of society has discomfort regarding euthanasia. “The issue is the idea that life is one of the most important gifts God gives us, and we should submit to his will when deciding on how it is ended.”

    Let’s look at polio, or bubonic plague, or breast cancer, or whatever. At one time, it was considered God’s will that people be afflicted with these diseases. Now all 3 of these diseases are highly curable. Where once it seems that God wanted these people to die, now it seems that it is God’s will that we use our science to prevent death.

    I don’t believe that God’s will has changed. I don’t believe that God afflicted people in the middle ages with the plague, wanting them to die, and now he changed his mind and wants us to live. I think God would have been happy if society had progressed to a point where the plague had been curable in the middle ages.

    I agree with FD–“I think perhaps He intervenes or changes the course of nature a lot less than we think.”

    I’m certain we as society misunderstand God all the time. Who is to say that God didn’t allow the discovery of Pento… to alleviate suffering, and allow people to die in dignity?

    In my post on MM on Joshua, one of the commenters said “If God says “kill” you kill. If God says “don’t kill” you don’t kill. What’s so hard to understand about that?”

    It makes me laugh because on the one hand, we call Joshua’s genocide righteous, and the Crusades unrighteous. Could it be that we (as society) just have really thick heads? Is God inconsistent here, or are we inconsistent in understanding God’s will?

    We certainly don’t seem to interpret God’s will consistently, yet claim God is the same, yesterday, and forever. Perhaps all of God’s seemingly inconsistent behavior is the result of our own misunderstandings of God. Perhaps God doesn’t deal so arbitrarily as it seems at times. Perhaps he does want euthanasia, and we are trying to apply “thou shalt not kill” in a situation that is not applicable.

    D&C 138:50 says, “For the dead had looked upon the long absence of their spirits from their bodies as a bondage.”

    Isn’t a person in a coma for 16 years also in a form of bondage, being neither fully dead or alive?

    Could it be that He wants us to alleviate the suffering of dying people like Chantal just as much as He wants us to alleviate the suffering of starving children?

    I think the answer to this question is obvious–Yes! We need to eliminate the suffering of Chantal, and the starving children of Ethiopia, but the ways we do that are different because the situations are different.

  18. Let me be very clear.

    There two basic ways for someone to die:

    1) Through the proactive ending of their life;
    2) By reactive “neglect” of some sort (this includes palliative care).

    There are two basic “persons” who can cause someone to die:

    A) That person;
    B) Someone else.

    This means that there are four different, fundamental manners of death for each individual:

    1A) Active suicide through “unnatural” means;
    2A) Passive suicide through “natural” means;
    1B) Generally considered murder, manslaughter, assisted suicide, etc;
    2B) Refusal to administer life-prolonging care.

    My main distinction is that I am wholly opposed only to 1B – someone else actively taking someone else’s life without commonly accepted justification and against the person’s will. I don’t think anyone should end another’s life against that other’s will – ever. Therefore, I am against euthanasia in every instance where it is known that the person does not want his or her life to end.

    Every other instance is open to allowance for me. Obviously, mental capacity should play a part in each determination, but I simply don’t believe suicide and palliative care options qualify as “euthanasia”.

  19. “I don’t think anyone should end another’s life against that other’s will – ever.”

    Sorry, that is a misstatement. Obviously, there are exceptions for war, self-defense, protection, etc. My brain was having a seizure when I typed that sentence.

  20. Heretic: Thanks for the heads up on my blog. I ran a test and had the same problem. I have taken the word verification off for the time being, until I can figure out what is going on.

    On the right to die stuff, I think I generally agree with Ray’s analysis, with the caveat that I think whether making decisions about one’s own end of life, or that of a loved one, seeking God’s will would be very important. In addition, making decisions about someone else would be significantly more complex, since their agency would have to be honored (if possible) and one’ own motivations would have to be carefully evaluated. That said, I could certainly see withholding medical care, nutrition and hydration from a loved one in a persitent vegatative state, rather than allowing them to remain in a medically supported coma for years.

    I guess I believe that there may be purposes to suffering that we do not understand. Some suffering is a natural part of the human condition, and there is no need to go looking for it, or to prolong it when we encounter it. I agree with FD that God may intervene in our life less than we think. On the other hand, it is not beyond the realm of possibility that God wants us to experience certain things, maybe even painful things. We should be senitive to the fact that our will should align with His, especially on something so important as ending a life.

  21. Ray,

    Thanks for the clarifications. I think everyone is against 1b. In this medical context, putting someone to death who doesn’t want to die is murder, not assisted suicide. (No need to talk about war, self-defense, or execution, as these are obviously different subjects.)

    I decided to check the definition of Euthanasia, to make sure we’re all operating on the same definition, because I think were talking apples and oranges in some cases. Here’s the LDS church’s definitions.

    Euthanasia is defined as deliberately putting to death a person who is suffering from an incurable condition or disease. Such a deliberate act ends life immediately through, for example, so-called assisted suicide. Ending a life in such a manner is a violation of the commandments of God.

    The Church of Jesus Christ of Latter-day Saints does not believe that allowing a person to die from natural causes by removing a patient from artificial means of life support, as in the case of a long-term illness, falls within the definition of euthanasia.

    This would seem to imply that the church endorses the way Eluana (the Italian woman in a coma) died, but rejects Chantal’s suicide by Pento.

    Stanford University defines voluntary euthanasia and involuntary euthanasia.

    Euthanasia may be conducted with consent (voluntary euthanasia) or without consent (involuntary euthanasia). Involuntary euthanasia is conducted where an individual makes a decision for another person incapable of doing so. The decision can be made based on what the incapacitated individual would have wanted, or it could be made on substituted judgment of what the decision maker would want were he or she in the incapacitated person’s place, or finally, the decision could be made by assessing objectively whether euthanasia is the most beneficial course of treatment. In any case, euthanasia by proxy consent is highly controversial, especially because multiple proxies may claim the authority to decide for the patient and may or may not have explicit consent from the patient to make that decision.

    I won’t push the issue further, as I’m pretty sure I understand your position, and I don’t view it as materially different from mine.

    Finally, wikipedia makes some further distinctions:

    Euthanasia may be conducted passively, non-actively, and actively. Passive euthanasia entails the withholding of common treatments (such as antibiotics, pain medications, or surgery) or the distribution of a medication (such as morphine) to relieve pain, knowing that it may also result in death (principle of double effect). Passive euthanasia is the most accepted form, and it is a common practice in most hospitals. Non-active euthanasia entails the withdrawing of life support and is more controversial. Active euthanasia entails the use of lethal substances or forces to kill and is the most controversial means. An individual may use a euthanasia machine to perform euthanasia on himself / herself.

    If we use these definitions, then it seems the church supports passive euthanasia (refusing medical treatment, or allowing morphine overdose), and non-active euthanasia (removing life support). The church is against active euthanasia (assisted suicide). I think active euthanasia is morally acceptable, but agree with FD that some proper guidelines (like #1 and #2) should be put in place to ensure that we’re not putting someone to death who doesn’t want to die. Chantal should have been given that right.

    Now, I’m not sure of my position on how to deal with people who want to die because they are in excruciating pain, but are not terminally ill. I believe Dr Kervorkian assisted some people who were in constant pain that could not be relieved by drugs or other methods. When the pain is so bad, you can’t sleep, and it consumes every waking thought, I can’t imagine living like that. I wouldn’t want to live that way, and would probably welcome death if there was no way to cure the pain. If the church is saying the only way out of this is to refuse food and water, that seems like a cruel way to die. I think active euthanasia is a better option than passive euthanasia in this situation. (Non-active euthanasia would not apply in this situation, since life support is not being used.) Even in this hypothetical situation, I can see a well-meaning, but misguided, relative asking for a court ordered feeding tube to prevent my death. They would probably claim that the pain was making me mentally incompetent to make such a decision.

  22. That Stanford University link has another interesting piece of information.

    Debate about the morality and legality of voluntary euthanasia has been, for the most part, a phenomenon of the second half of the twentieth century and the beginning of the twenty first century. Certainly, the ancient Greeks and Romans did not believe that life needed to be preserved at any cost and were, in consequence, tolerant of suicide in cases where no relief could be offered to the dying or, in the case of the Stoics and Epicureans, where a person no longer cared for his life. In the sixteenth century, Thomas More, in describing a utopian community, envisaged such a community as one that would facilitate the death of those whose lives had become burdensome as a result of ‘torturing and lingering pain’

    That is where society needs to be on this topic, IMO.

    Yes, Teacher, I agree with your sentiments. Of course we should always try to ascertain God’s will. I believe God has purposes in suffering, even long-term suffering. But I don’t believe that endless suffering serves any of God’s purposes–that just seems pointless to me. All tests should end at some point, and I don’t think that God would choose unending, excruciating pain as a way to teach us. That sounds too much like the catholic/protestant understanding of hell to me.

  23. I had never heard of Larry Miller until I moved to Utah a few months ago, but from the people I’ve spoken to who knew him personally, he sounds like an extraordinary individual. I’m sorry I never had the privilege.

  24. Larry was amazing. Due to my freelance work, I saw him often at the Delta Center, though I never spoke to him, other than “hi.” I am one of his 7000 employees, though I am a very very part-timer. It was tough to see him in a wheelchair. He looked very sick over the last few months.

  25. Here’s an interesting article relating to what we are talking about here. Washington has an assisted suicide law, and it sounds legal in Montana as well.

    http://www.msnbc.msn.com/id/29454171/

    Under the Washington law, any patient requesting fatal medication must be at least 18 years old, declared competent and a state resident. The patient would have to make two oral requests, 15 days apart, and submit a written request witnessed by two people, one of which must not be a relative, heir, attending doctor, or connected with a health facility where the requester lives.

    Two doctors must certify that the patient has a terminal condition and six months or less to live.

    That decision was made easier by the law’s clear option that physicians could opt out if they wanted to, said Dr. Larry Robinson, vice dean for clinical affairs at the UW School of Medicine.

    “We’re not forcing anyone to do anything,” he said.

  26. […] If you were diagnosed with a brain disorder, do you think that assisted suicide is acceptable? […]

  27. […] If you were diagnosed with a brain disorder, do you think that assisted suicide is acceptable? […]

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