Sunday, November 20, 2016

Death's Sting Part II

Editor's Note: This continued reflection is from Christine Alwan. You can follow her on Twitter @ChristineAlwan.



Last time, I talked about how physician-assisted suicide (PAS) and euthanasia received relatively little attention in the 2016 election, despite the fact that it was on the ballot in several states. Furthermore, several states plan to have PAS and euthanasia legislation heard this year. In part II, I want to talk about some potential reasons why few people — including the pro-life movement and many Catholics — are not talking about this issue with more urgency and why we must address this issue with more thought and attention.
The Numbers
According to the U.S. Census, “The nation’s 65-and-older population grew from 44.7 million in 2013 to 46.2 million in 2014.” This age bracket includes the oldest four years of those born in the baby boomer generation (from 1946 to 1964). One of the largest generations in our population is aging significantly, and Americans are living longer than ever before due to medical advances and improved access to healthcare. Although being a member of the AARP may seem like a long way off for my fellow millennials, as of 2015, we now make up over a quarter of the nation’s population, sitting pretty at a generational total of 83.1  million. That’s a lot of people who, God willing, will one day be very old. And, if PAS/euthanasia becomes the law of the land, that is a significant portion of the population that will be fed a lie that, because their lives are inconvenient or painful, they are no longer worth living. They will be fed the lie that says that their dignity is determined by the manner of their death, not the fact that they live and are created by God.
The number of people who utilize PAS based on current data is significantly less than abortion at this point in history for several reasons. First, PAS and euthanasia are only legal in a handful of states. This impacts people who are aware that PAS and euthanasia are options available to them. It also impacts the rate of reporting. For example, before abortion was made legal in the United States, some doctors would perform abortions in secret and without disclosing it to the proper medical authorities because they could go to prison. The doctors never reported that these were abortions because there was no data collection on legal abortions since abortion was not legal at that time. The same may be happening in regards to PAS and euthanasia. However, approval of PAS and euthanasia within the United States is increasing, according to a 2015 Gallop poll.
Second, because PAS/euthanasia are illegal in many states, individuals with terminal illnesses or those who no longer wish to live may kill themselves, but it may be ruled a suicide without further research into the manner of their death.
In the states where PAS and/or euthanasia is legal, we do have some limited data. In the state of Oregon, which legalized PAS in 1997, we see a steady increase in individuals who received the lethal prescription drugs from medical professions for PAS. We also see the number of people dying from PAS increasing. The reason the data distinguishes between the two is because some people may be prescribed the drugs by their doctor, but they may not go through with PAS, their status of taking the drugs is unknown, or they may die of natural causes beforehand. However, we do know that of all the people who ingested the lethal medication in this state, all of them died. According to the state of Oregon and a report by CNN, as of January 27, 2016, 991 people died out of 1,545 people prescribed lethal drugs by their physicians. And according to records by the state of Oregon, the majority of those who opted for PAS had terminal cancer.
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This chart is courtesy of the 2015 Death with Dignity Act (DWDA) Annual Report put forth by the state of Oregon.
This means that PAS is both effective (it works 100% of the time) and increasing (more people are doing it). Despite this trend and the 18 states plus the District of Columbus that either voted on PAS in the 2016 election or whose legislators will be voting on the issue this year, there is very little discussion surrounding PAS both among the secular media and those in the pro-life movement.
Why is no one talking about this?
Suffering Makes Us Uncomfortable
Death — especially a death that involves suffering — makes our culture uncomfortable to say the least. For much of the world, especially the developed, Western world, suffering is quite possibly the worst thing that could happen to anyone. Our culture teaches us that suffering should be avoided at all cost and that, when one must suffer, it is out of punishment or because of some personal wrongdoing. Some even posit suffering as a reason that God either doesn’t love us or that He simply doesn’t exist. But as Catholics, as Christians, we know that suffering and death are two unfortunate effects of sin. Jesus did not choose those for us initially, and He died for us so that we would have the opportunity to be free from death and suffering in eternity. But the world bombards us with messages that suffering is inherently evil and that nothing good can come from it. Suffering makes us uncomfortable. 
States’ Rights vs. Federal Law
Another reason the issue of euthanasia/PAS is largely undiscussed, especially within political life is that, at this point, it is being legalized by states and not the federal government. The federal government is extremely hesitant to intervene in state politics unless a contentious law is is brought to federal courts for a higher-level decision. Amendment X of U.S. Bill of Rights reads, “The powers not delegated to the United States by the Constitution, nor prohibited by it to the states, are reserved to the states respectively, or to the people.” Thus, the federal government legally cannot intervene on these issues because it is not explicitly mentioned in the U.S. Constitution. Remember, it was through one court case that rose through the state courts to the federal level and was heard by the Supreme Court of the United States that Roe v. Wade made abortion legal in the United States. And it is because of those same constitutional limitations that many states are able to impose limitations on abortion largely without the intervention of the United States federal government. The 10th Amendment is one of those tricky policies that has two sides, one that can help us promote a culture of life, and one that can undermine it.
Inconvenient Lives, Inconvenient Truth
The third — and probably the most significant — reason why we hear so very little about PAS in American culture is because we don’t like talking about lives that inconvenience us or remind of us who we could become. The pro-choice movement cloaks its arguments for increased access to abortion in discussions of women’s control over their bodies; the social, economic, and political injustices that might lead to an unwanted or unplanned pregnancy; and the audacity of lawmakers (many of them male) to legislate over such a private, personal issue. Like some pro-choice advocates who rarely mention the outcome of an unplanned pregnancy — a baby — our society doesn’t want to discuss the potential outcome of a large aging population: health problems, the need for loving caregivers, demands on our time and our resources, and the pain of death. The elderly who advocate for PAS want to “die with dignity.” Perhaps they acknowledge what our society says with our silence: that, when they are old or terminally ill, we no longer value them. We believe — and, because of society’s inaction and lack of care for the elderly, they do too — that they have lost their dignity and worth as a member of society.  Our society doesn’t want to talk about unpleasant realities because we’ve internalized the idea that suffering somehow robs us of our dignity. If we pretend suffering doesn’t exist, if we live it up, and if we shut down any potential source of pain or devaluation by society, we don’t have to face the truth.
How many of us want to discourage PAS as an idea, yet we can’t bear to visit our elderly relatives in the nursing home once a week because we see them deteriorating so slowly and painfully?  How many of us want to spend time with our loved ones or with those who have no one to love them who are suffering from terminal illnesses? How many of us would rather hire someone to take care of our sick loved ones instead giving of ourselves if we are able — changing adult diapers, making sure they take their medicine, serving them with all we have, letting them know each day that they are valued and loved?
That, in my opinion, is largely why people — even the most pro-life among us — would much rather focus on abortion than PAS. We may not think it’s a social problem yet. I’m telling you, it’s a problem. It’s here. We may think the cases are much fewer than abortion, so we have to focus on that issue first. Just because the data is limited and says it isn’t a problem, it may already be one. Many women were having illegal abortions before our country decided to legalize it. It wouldn’t have been an issue up for policy decisions, even at the state level, if it wasn’t already a reality. If you think that PAS will go away or that is simply isn’t happening because it isn’t being recorded, think back to that one Supreme Court case that changed the course of our nation’s culture back in 1973. Think of how many times we have heard pro-choice advocates say we can’t overturn Roe v. Wade because we will go back to the days of women dying from back-alley abortions, when abortions still occurred, regardless of their legal status. Abortion happened before Roe v. Wade made abortion legal in every state. The same may be said of PAS.
Death is scary and uncomfortable. Suffering is scary and uncomfortable. Sure, people may want to adopt a baby from an unplanned pregnancy, but how many want to adopt an elderly person in a nursing home who never gets any visitors, who may not remember your name, who is a shadow of the person they once were? How many of us want to be reminded that, we too, could be like them someday?
Why We Must Act Now
As a legal precedent, it’s incredibly difficult to overturn a Supreme Court decision. We need to ensure that these measures don’t rise to higher levels of government so that they become the law of the land with one Supreme Court decision.
But, most importantly, we are at a crossroads. I hear the people saying they want to die with dignity. I see that as both a failure and an opportunity of the pro-life movement. We have failed to show them that their dignity comes from their life, not from the manner in which they die. We have failed to assure them that we will be with them in their suffering and on the day that God wants to welcome them home. And, yes, we have failed to develop a more holistic understanding of what it means to be pro-life beyond trying to end abortion.
This is an opportunity to show the elderly and the terminally ill how much we love them, how much they mean to us, how much our society needs their wisdom, their experience, and, yes, their suffering. A society is judged by how it treats its most vulnerable. This includes the unborn, but it also includes the elderly and the terminally ill who have come to believe there is nothing of value left for them, that they themselves no longer have value.
Our society can learn a great deal from them. We can see that suffering exists and cannot be avoided. We can see that those who suffer still have dignity and do not become their suffering. And we can see that God can turn even the bitterest suffering into something beautiful. In Colossians 1: 24, St. Paul tells us that our sufferings unite us to the the suffering of Christ and to the graces that God bestowed on us from His suffering:
Now I rejoice in my sufferings for your sake, and in my flesh I am filling up what is lacking in the afflictions of Christ on behalf of his body, which is the church. – Colossians 1: 24
My friends, these are trying times for our faith and our country, especially when we, as Catholics, seek to develop a holistic understanding of what it means to promote a culture of life. But we have a precious opportunity before us, a chance to show the suffering, aging, and terminally ill members of the Body of Christ that they have inherent value. Let’s get to work.

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