Christenson – Elder Law Attorney
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
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
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
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.