A Right to Death?

A few days ago, I published my last post entitled "The right to life". Now I would like to examine the opposing side of the coin - death. Or perhaps I should put it in capitals to reinforce its' bogeyman status here in the Western world - DEATH.

One modern way to deal with death is to deal with it through the use of comedy. One of the modern writers who deals with Death to great comic effect is Terry Pratchett - here the portrayal is of a seven foot tall skeleton with the traditional black robe and scythe so beloved of illustrators in the Western hemisphere for many years. As Death himself states "there is no justice, there is just us" - death happens, it is neither fair nor unfair.

This portrayal of Death has been very popular - perhaps because Death scares us, we find we can deal with it when we laugh at it. Other portrayals of Death and difficult circumstances appeared in the long-running TV series "MASH" where doctors and nurses had to make difficult choices in very difficult circumstances and yet the humour was used to make those difficult decisions a little easier on occasions.

The main reason that I wanted to deal with the subject of Death is down to the case of Baby MB over here in the UK. This child has the most severe from of spinal muscular atrophy (if you want a detailed medical description, you can Google it) which affects his ability to move, eat, breathe, swallow, although it does not affect cognitive function. In the most severe form, according to the information I've read, the diagnosed individual rarely lives beyond 18 months of age - the age that baby MB is now. In this case the doctors wanted to withdraw life support which meant he would die immediately as he can't breathe on his own. The judge ruled that life support should not be withdrawn as he had to proceed on the basis that the child 'had the cognition of a normal 18-month-old and that he continued to have a relationship with his family'. However the judge also ruled that the child shouldn't be subjected to procedures 'requiring positive infliction of pain' (e.g. intravenous antibiotics or blood sampling). For Baby MB to require these treatments would mean that his condition was deteriorating and that he was 'moving naturally towards death'. At this point it would be regarded as in his best interests to withhold these procedures even though he'd almost certainly die.

This is a very difficult case - the child himself is in constant discomfort, has some periods of distress and reasonably short periods of pain and the doctors felt that it was unfair to prolong his existence any further. His parents, naturally, feel that he is benefitting from his relationship with them, although they know that his condition is terminal, and believe that he should be able to enjoy that relationship for as long as is possible.

As a parent myself, this is a very difficult case for me, as I am sure it is for many others whether they have children or not. Putting myself in the shoes of these parents, I know that they know their child is terminally ill, he will not live very much longer and they want to have as many precious moments as they can. From the doctors' perspective, I can see that it is distressing to maintain a life that involves constant discomfort, frequent distress and periods of pain, particularly when they are doing so in the full knowledge that they are only delaying the inevitable.

Most of us hope never to be faced with this type of decision, but as we in the Western world face an increasing aging population, more and more of us may have to make similar decisions for our parents; as medical technology advances, more of us may have to face these decisions for our children; or perhaps we will have to face these decisions for ourselves. Just as every person has a right to life, perhaps we also have a right to death - to be able to choose when we can say 'no' to measures that will only put off the inevitable (and let me just be clear that I am not talking about assisted suicide/euthanasia here). We should all be able to say as Chuang Tzu said "When the Master came, it was because he was due to be born. When he died, it was entirely natural."

If it is our 'time' and there is nothing more that can be done other than to put off the inevitable we should be able to accept that it is 'our' time, that we have come to the other end of the natural order, that there is nothing to be afraid of. Unfortunately, here in the West, we have become so distanced from death - more often than not people die in hospital rather than at home, in an antiseptic, clinical environment. As modern society has developed, and healthcare and diet have improved, so we have seen life expectancy rise; people no longer die from easily preventable or even very serious diseases as a matter of course; the death of women during labour is relatively rare. All this means that we encounter death less frequently than those in previous generations, we have become disassociated with the natural order of things.

Perhaps it is fear of what might happen next - Christianity of course talks about Heaven and Hell, rewards and punishments and judgements - that makes us want to hide from Death. As Taoists, we should strive to remember these words from Chuang Tzu:

"We can point to the wood that has been burned, but when the fire has passed on, we cannot know where it has gone."

We don't know what happens next, as Taoists we accept that we return to the whole, to nature, to the divine Universe (depending on how you want to phrase it) - there is nothing to be afraid of here. It is worse for those we leave behind, because they miss us, they grieve. Death is part of the natural order of things, 'our lives cannot be controlled by our own efforts, and coming and going are not our own doing." (Lieh Tzu, Ch.1)

Tag Taoism Death