On March 27, George and Shirley Brickenden died holding hands in bed after dining on lobster, salmon, and champagne. George, 95, and Shirley, 94, married since the final year of the Second World War, “flew away” (their words) to the strains of Mozart, Bach, and Scottish folk tunes. Surrounding their bed were the Brickenden’s four adult children, the Dean of Toronto’s St. James Anglican Cathedral, and two physicians. George’s last words to his family were, “I love you all.” The Brickendens were very old, very frail, and very happy to end their lives with the help of their doctors, following a lengthy approval process for medical assistance in dying (MAID), under the provision of Canadian law.
Cue the wagging, disapproving tongues. Tom Koch, a gerontology consultant, editorialized in Canada’s leading newspaper, the Globe and Mail, that “This tale of shared termination sets a dangerous precedent, not only for seniors but for all of us.” Predictably, the leadership of Canada’s Roman Catholic churches condemned the Brickendens’ decision, as well as MAID in general, as “grievous sin”. The self-appointed morality police of the Anglican communion, “Virtue Online,” headlined its hysterical coverage with, “Couple Kill Themselves in Joint Assisted Suicide as Anglican Church Official Cheers Them On.” News of the Brickendens’ deaths nearly broke the conservative Christian internet.
You may have seen the Catholic slogan, “Life is sacred, from conception to natural death” on bumper stickers and billboards. On the surface, it seems like a warm, fuzzy sentiment. Dig a little and the slogan morphs into a coercive judgement against abortion and MAID and people like the Brickendens who dare to live and die with intention. But why should life be compulsory?
And what in Hel is a “natural death” anyway? In my opinion, succumbing to appendicitis is a natural death. So is death by measles, or post-partum hemorrhage, or congestive heart failure. The term “natural death” is nonsensical in the twenty-first century. Most of us will die in old age and our deaths won’t be “natural,” they’ll be medically managed.
Let’s place lifespan and mortality in broad historical context. Elders have always lived among us. In the olden days, if children survived to age five, they stood a reasonable chance of living long enough to play with their grandchildren. Typically, the Grim Reaper took the elderly after a brief illness. There’s a tendency to credit medical heroics such as cardiac surgery for increasing longevity. However, most of the gains in human lifespan in the last century were achieved in the youngest demographic cohorts through advances such as immunization, antibiotic therapy, better maternal-child care, and public health measures such as provision of clean water.
In the elderly, modern medical care is a double-edged scalpel. To be sure, an expertly inserted stent in a gunky coronary artery can give a person a new lease on life. On the other hand, modern medicine often keeps people alive into decrepitude, and often against their will. Canadians have one of the longest life expectancies in the world, but they endure, on average, six years of chronic ill health before they finally keel over, a figure that is echoed in other wealthy nations. Nowadays, most of us rust away instead of falling apart quickly and dramatically as in generations past.
Most people tacitly accept that we must pass through a drawn out, gray zone of misery and dependence prior to dying in old age. I say, stuff and nonsense. Imposing medical care on elderly people without offering them a painless means of escape is fundamentally cruel. With our practitioners’ counsel, each of us should have the right to rummage around in the medical tool chest and make plans for a healthy old age and swift demise in the pattern of our forebears. MAID is an optional, new tool with application to this end.
In Canada, the Supreme Court over-turned a long-standing, loosely enforced ban against MAID in February 2015. In their judgement, the court stated that the ban had created a “duty to live” rather than upholding “a right to life” and that “leaving people to…endure intolerable suffering… impinges on their security of the person.” In response to the ruling, the federal government passed Bill C-14 to legalize MAID in June 2016.
To qualify for MAID in Canada, a person must be eighteen or over, cognitively sound enough to make informed decisions, aware of other care options, gravely ill and nearing end of life, and have two physicians and/or nurse practitioners agree to his or her eligibility. After a minimum of ten days of reflection, the MAID procedure may be performed. Medications are administered intravenously, and assisted deaths are peaceful and gentle.
The Brickendens’ deaths were two of over 3,000 assisted deaths in Canada, and MAID is rapidly gaining acceptance as a useful tool in the end-of-life care chest. George and Shirley Brickenden were trailblazers because they died as a couple and they qualified for MAID due to their generalized infirmity rather than an aggressive illness such as cancer or ALS. In time, more trailblazers will push the boundaries of qualification, and perhaps terminally ill, pediatric patients and people with dementia who have specified their end-of-life wishes in advanced care directives will have access to MAID as they do in Switzerland, Belgium and the Netherlands.
Naturalistic Paganism is free of rules imposed by a fossilized, authoritarian orthodoxy. As such, we can decide for ourselves how we want to live and die within the bounds of the law. I believe the Brickendens have offered us a model, or at least a sketch, of a humane approach to dignified death in old age. So, I’m eating vegetables, walking or cycling to get around town, and avoiding crack cocaine and cigarettes. Some day, if I’m crumbly and miserable and sickness casts a terminally gloomy pall over my life, I plan to seek MAID. I agree with the Catholics that life is sacred. Life is so sacred that we mustn’t leave life and death decisions in the hands of religious scolds; we should be the authors of our own stories.
About the Author: Renee Lehnen
Editors note: There is another good article on this over at Atheopaganism.