I have reached the age where I have seen a few deaths. And I have had time to think about it a bit. I feel the most important thing is to die with dignity. The advances in modern medicine, though effective in keeping us alive longer, may rob us of the dignity with which we would like to go. The focus is on keeping the patient alive. But the fact of the matter is that everybody will die. So medicine will lose the battle, and it is a sore loser. That’s why the statements like “Cancer is the biggest killer” etc. are, to some extent, meaningless. When we figure out how to prevent deaths from common colds and other infections, heart disease begins to claim a relatively larger share of deaths. When we beat the heart disease, cancer becomes the biggest killer, not so much because it is now more prevalent or virulent, but in the zero-sum game of life and death, it had to.
The focus on the quantity of life diminishes its quality near its tail end due to a host of social and ethical considerations. Doctors are bound by their professional covenants to offer us the best care we ask for (provided, of course, that we can afford it). The “best care” usually means the one that will keep us alive the longest. The tricky part is that it has become an entrenched part of the system, and the default choice that will be made for us — at times even despite our express wishes to the contrary.
Consider the situation when an aged and fond relative of ours falls terminally sick. The relative is no longer in control of the medical choices; we make the choices for them. Our well-meaning intentions make us choose exactly the “best care” regardless of whether the patient has made different end-of-life choices.
The situation is further complicated by other factors. The terminal nature of the sickness may not be apparent at the outset. How are we supposed to decide whether the end-of-life choices apply when even the doctors may not know? Besides, in those dark hours, we are understandably upset and stressed, and our decisions are not always rational and well-considered. Lastly, the validity of the end-of-life choices may be called into question. How sure are we that our dying relative hasn’t changed their mind? It is impossible for any of us to put ourselves in their shoes. Consider my case. I may have made it abundantly clear now that I do not want any aggressive prolongation of my life, but when I make that decision, I am healthy. Toward the end, lying comatose in a hospital bed, I may be screaming in my mind, “Please, please, don’t pull the plug!” How do we really know that we should be bound by the decisions we took under drastically different circumstances?
I have no easy answers here. However, we do have some answers from the experts — the doctors. How do they choose to die? May be we can learn something from them. I for one would like to go the way the doctors choose to go.