The Ethics of Death and Dying

(Sidenote: This is the final essay for the requirements in our Medical Ethics class. I've somehow missed the way Ethics was taught to me during my undergraduate years. Yes, I'd had to read through Kant, Confucius, Foucault and Aristotle. Well, a little of each; I didn't exactly finish all of the required readings for the course but I got the main gist of their ideas. And indirectly, being forced to read so many readings that have no connection whatsoever to my course did benefit me during Medicine. At least now, I can honestly say, although the readings are long at least they're straight to the point. Unlike those philosophers, with Ricoeur as an exception

Anyway, what are your thoughts about Death, Life and Dying? Please leave a comment and again, I apologize if I'm not able to reply instantaneously. Oh, this was written in reaction to the film, "Wit", more specifically the scene where Dr. Vivian Bearing was given the option of being resuscitated or not by the nurse.)

There is always something unknown about death. However, this is in direct contradiction to health professionals who require certainty. A health professional performs a very detailed history and a thorough physical examination. And then orders all sorts of diagnostic imaging to arrive at a certain diagnosis. All of this certainty is built on avoiding the greatest uncertainty of them all: death.

            What happens after we die? Nobody knows and no one can really say for sure. Some say there is an afterlife, some say there isn't  One thing is for sure, a human person ceases to be when he dies and this is what is at the root of death. A human being cease. No one can really say if he went to heaven or became one with the Force or any other primordial energy. What is left is the pain of loss among the dead person’s loved ones and those who knew the person during his life.

            No one can really explain death. Sure, we health professionals can explain the pathophysiology of a patient’s cancer and we can explain how the glutamate cascade is responsible for the death of neurons in a stroke patient but we really can’t say why that particular person. No amount of explanation can wash away a person’s cessation of existence so it is but natural we stave away death. We invent all sorts of contraptions and interventions to avoid death and prolong life just so we can avoid the biggest uncertainty of all.

            Yet there are times when patients opt for a DNR, Do Not Resuscitate. For a physician it may seem like a slap in the cheek. Here you are trying to save this patient’s life yet this patient has given up hope and prepares for the inevitable. Is the DNR patient less than human for giving up? And conversely, is it always the default position to fight for life at all costs? 

            The resounding answer is a big no. A DNR can be seen as an acceptance rather than giving up. Sometimes life at all costs can be too high a price. Can we say that a person is truly alive if he or she is hooked to a machine? Far from being seen as a sign of weakness, a DNR simply means another option. It is but another choice for which nobody can be condemned for. Just as long as the circumstances were made clear to the patient and he’s been given all the time.

            How we treat the dying says about how we think of Death in general. Treating them with scorn and prolonging Life at all costs shows how we secretly fear death. Does a person cease to be a human being if he accepts he’s going to die? Of course not for Death is but a part of being human. There can be no Life if there is no Death.

            Far from thinking Death as a big uncertainty, it can be thought of as another journey that all of us have to take. We can try to delay it as much as possible by living a healthy lifestyle or by heroic measures but inevitably we die. On a personal level, we can never be sure of what is going to happen but for those left behind, we leave a legacy. So really, a DNR is but another option. What is more pathetic are people who can’t come to terms with the inevitable and prolong life at all costs.

            There are a lot more things worse than dying. What we can do is treat Death with humanity instead of fear and scorn.