Dr. Donald Low has directly impacted the lives of Canadians, first as a respected microbiologist who eased our concerns during the SARS crisis of 2003. Now, ten years later, he’s still influencing our views on public health, but the focus of this discussion is on what, morally speaking, we owe each other at the end of life.
Through a posthumously-circulated emotional video (above), filmed 8 days prior to his death, Dr. Low candidly shared his personal experience of living with a terminal illness. He spoke at length about his struggles, his anxiety, and his conviction that medically-assisted death should be legal for people who have been diagnosed with a terminal illness, and who have demonstrated competence to decide whether their suffering is worth enduring.
Dr. Low’s video has generated a lot of discussion, but from the content it is clear that much of his message has been lost on a culture that fears death. It is telling that the release of Low’s emotional plea for us to candidly talk about death as a community, to be mindful of human mortality, and to discover what makes each of our lives meaningful came at the same time as the media announcement of Google’s initiative to combat aging, Calico. Though Google reps have been tight-lipped about the specifics of this project, they have scattered just enough teasers to suggest they will be using data-driven methods to slow disease. A worthy goal, no?
Well the reality is that medical, lifestyle, and dietary advances already enable us to live longer. The human lifespan has been extended past the point of what had come to be seen as “natural” as recent as a few decades ago. This prolonged lifespan is often seen as a gift and as a testament to how much human life is valued, proportional to the lengths at which we are willing to go in order to preserve it. But it’s not all to the good. Through our efforts to eradicate disease earlier in life we have created a situation where many people are left connected to machines to do their living for them at the end of life.
If the focus of the medical, political, and moral community remains longevity itself – rather than also factoring in the physical, psychological, and emotional costs of that longevity – then what makes experience meaningful to the individual will continue to be overshadowed, and with tragic repercussions. It is significant that Dr. Low expressed concerns and tremendous anxiety about even the best palliative care. “Palliative care has done a major role and a valuable role, but they can’t take away the symptoms that I’m going to have. They can help make it a little bit better but I’m still going to suffer….”
The solution to human fragility and suffering isn’t longer lives. It is better lives and better deaths. It is embracing mortality and living each day fully aware of the fragility, vulnerability, and beauty life presents us with. Sure longer lives can also be good ones, and extending life can be a worthy goal. But we should also be mindful of the fact that longevity itself presents us with challenges, and that these challenges are not off in the distant future, they are already before us. We are all left shouldering the impact of the simple yet weighty last question raised by Dr. Low: “Why make people suffer for no reason when there is an alternative?”
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It bothers me greatly that an intelligent adult with no mental impairment and a terminal illness cannot chose to end their life with medical and psychological support from our health care system. The argument that it would be a mass cull of the elderly or infirmed is a scare tactic. Criteria could be set-up. We are able to choose to make life, we are able to choose to end that life through abortion so why can we not choose to end our own life when the only outcome is a painful and prolonged illness with loss of dignity and hardship on our loved ones.
I really admire Dr. Low’s video message, Ms. Doyle’s beautifully written opinion and the work of Ms. Graham’s group. I have always firmly believed that we need better choices as we near the end of our lives. My experience over recent years with family and friends strongly re-enforced this view and I believe that making this a reality is one of the most important issues for our society and health systems.
I worked with a group of 4th year nursing students at Trent University this past summer who decided to politicize around this issue, writing letter to MPPs, connecting with the Dying with dignity group in an effort to expand this discussion with many stakeholders; I am so proud of the work they accomplished and that this is a healthy debate!