Aging: The Right to Die

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Guest:  Dennis Christenson – Elder Law Attorney

Host:  Sally Smith - Author/Resource literature on age-related disease and healthy aging


Sally Smith:  Welcome to Age to Age.  I’m Sally Smith.  Let’s talk.  Today, we’ve been talking to Dennis Christenson.  He is an elder law attorney.  We talked about the importance of what documents are crucial to have as one approaches end-of-life decisions, for yourself or a loved one; they should be in place from even an early age.  All of this leads us to a really pivotal topic, which is a person’s right to die.  You were saying that if you really want to get a conversation going at a party, just bring up right to die.  Illuminate us on those thoughts.


Dennis Christenson:  As medical science has advanced, extending a person’s life far longer than it used to, it came to the point that not everyone wants to live forever.  There are clients that come into my office who are ready to die.  They’ve had a full life.  There’s nothing, from their standpoint, to live for.  Maybe their spouse is gone, their children are gone, and they’re ready to go. 


Now, our society has pretty universally said that a person doesn’t have the right to end their own life.  Although, the state of Oregon has now allowed it, once it’s been determined that you have a terminal condition.  But more far-reaching is the situation where someone has developed a medical condition, the quality of life that they would have, as most people would measure it, is not one that a person would want to have.  Do they have the right to decide to not live with such a reduced quality of life?


This question went back and forth in legal circles for years.  Finally, our Supreme Court said, yes, a person has the right to die and to make medical decisions that will permit them to die.  From that came our healthcare powers of attorney and living wills that say you have the right, as an individual, under certain circumstances, to die on your terms. 


There’s a tremendous debate in our society about whether you have that right or not.  Many Christian faiths believe that medical science is to do whatever it can to keep someone alive for as long as possible, no matter the consequences.  Sometimes the states get involved, and governors, to try to keep someone from removing life support.  They believe that it’s not their position to make the conscious effort to end someone’s life.  They equate it to killing someone.  Others say that one of the most basic rights as an individual is to make that decision, that of all the decisions you make in your life, probably the most important one is deciding whether or not you have to continue to live, by machines and other methods, when the quality of your life is so poor that, to you, life isn’t worth living.  It’s a very difficult decision.  But, what the courts have done is allow you to have documents appointing people to make those decisions for you.    


Sally Smith:  There have been huge cases in the media where someone didn’t have the documents, and you would have said they were dead already but for the machines that they were on, which could keep them going, almost, in perpetuity, just infinitely staying alive.  What a cost to society! 


Dennis Christenson:  Well, you know, the Terri Schiavo case, down in Florida, is an example.  She was kept alive by tube feeding for, I think, almost 15 years.  And, certainly, there’s a cost that’s associated with that.  Now, she, as I understand it, was in a nursing home, and wasn’t in a hospital, so you wouldn’t have those astronomical medical expenses.  But there is still a cost that’s associated with it, as well as a spiritual cost to the family to decide that quality of life isn’t an issue where someone is supposed to live as long as they can.  It is such a personal thing.  If you raise it, in any context, you can run into problems. 


We’ve had, in fact, people come in to sign a healthcare power of attorney, and I’d ask them who they’d want their agent to be.  And I was thinking they would say their spouse, but they’d say that they didn’t want their spouse.  And you’re kind of surprised, but they had such a different philosophy about what life means that they’d end up naming someone else.


Sally Smith:  Well, you know, it’s interesting because there’s no real answer here.  But you can see the argument, what is life?  If it’s letting someone die, if you had no machines, just letting nature take its course, that’s one kind of life, and death.  But then you put somebody like Terri Schiavo on the machine for 15 years, she can’t speak, she can’t function, she can’t be, in any way, what we would call a living person, and other people are saying that’s life.  And yet, it’s all completely man-imposed.  It’s not God-imposed; it’s man-imposed.  We have learned how to keep people alive for 15 years when they don’t know anything.  It’s, really, a fascinating issue.


Dennis Christenson:  What’s interesting is that all the major religions have their own viewpoint about this.  For example, Catholics recognize that the person has some rights in deciding to be kept alive by machines or not.  The Jewish faith has its own set of rules.  Most of them pay deference to the right of a person to decide, you know, at what point they should be allowed to die.  Now, each religion has its own nuances, but the principle of right to die is something that they all, for the most part, accept.  Some people come to me and say that their religion requires that they be kept alive at all costs, but we can show them that that isn’t necessarily true.  But, the bottom line is what they feel, what they believe.  It’s their decision.  It doesn’t matter what anyone else believes.  It’s their life.  But our courts have recognized that, so we, as a society, have to work within the limits of that recognition. 


Sally Smith:  Well, what I’m hearing you say is that when someone comes in to talk to you about these end-of-life issues and they’re saying how they feel, according to their religious beliefs, they need to be shown that it is okay.  Sometimes they, maybe, need permission.  They need a deeper understanding.  I know people that have been almost dying, and they’ve wanted their children to say that it’s okay to let go, that it’s alright, that they’re okay.  It’s like they were clinging on for reasons that weren’t as real as they thought they were.  And I would think your interpretation of your faith and how you feel might be one thing, but being able to show in the doctrine of a religion how it might be permissible to be unplugged from machines and allowed to die, that’s a very powerful illumination.


Dennis Christenson:  I think the important piece of this is that, oftentimes, the family is involved in the decision.  And it’s so important, for all of us, to be together with our children, to talk about this issue with our spouse.  It’s not an easy issue to discuss, but I think that dialogue is comfort to the person that’s dealing with it.  It’s a comfort to the family.  There isn’t any fighting about what’s supposed to be done, or not supposed to be done.  And, ultimately, if someone knows how you feel, most of the time families will accept that.  They may not totally agree, but they will accept it and try to carry out that person’s wishes.  But if you never discuss it, if you never have that conversation, it leaves everyone at odds.  It may be that the person who is sick wants to die but doesn’t know how to express that.  The kids don’t want to deal with it because it’s unpleasant, so it’s unspoken and unsaid, and now they struggle with it. 


Communication is so important.  And I think those who have any questions about what right-to-die means should talk with their pastor, their priest, or rabbi about this issue so that they have some comfort in what they’re allowed to do, in terms of the control that they have over their life.  Legally, they do have the right.  And the question is, is it going to be put into effect the way that they want, or is someone else going to tell them how that’s going to be interpreted? 


Sally Smith:  What you’re saying, basically, is you can achieve peace this way, your own peace in knowing how you want to die, and being comfortable with it, and the peace that you give to your children and family members that may be torn up by not knowing.  I may think one thing’s right for my father, but may sibling may think something totally different.  It’s a very emotional topic.  But to be given permission and information, one way or the other, is huge.


Thank you so much, Dennis, for talking with us about this.  Thanks to all of our listeners too for joining us.  We welcome your suggestions and comments on our website.  This is Sally Smith, Age to Age, saying good-bye and wishing you courage and joy on your journey.  We are all connected. 


If you enjoy listening to Sally Smith, you can buy her book, The Circle.  It’s the story of how she personally responded to her mother’s journey with Alzheimer’s disease.  It’s a wonderful gift of hope for anyone with a parent with dementia.  Just click on Sally Smith’s name under the Health Professionals tab on the Podcast home page.  All profits support research at the Center on Aging.  Thanks.

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