While Anita Ho and I are certainly in agreement that some medical teams can be quick to label family members as “in denial,” the cases she cites in her review of That Good Night: Ethicists, Euthanasia and End-of-Life Care actually illuminate a more troubling issue. Helen’s children, Ho tells us, believed “their decisions would symbolize who they were as a tight-knit family” and Jack’s son worried that “he would have to live with the guilt of having given up on [his father] without trying everything.” But because autonomy is a crucial tenet of our medical system, doctors must follow the wishes of the patient, rather than those of the children. So if Jack’s son knew what his father wanted, and went against it, then he should feel very guilty indeed.
The problem, of course, is that too few of us talk to our loved ones about how we want to die. Not only does this mean we’ll have no say in the way our final days play out if we can’t speak for ourselves, but it also invites disputes between families and medical teams, as well as clashes within families.
Ho believes I oversimplify the meaning of a good death and claims “it is apparent that from [my] point of view a dying process like Helen’s, accompa-nied by physical distress brought about by the family’s desired procedures, constitutes a poor one.” Well, I’m sure she sees a lot more death than I ever will (not that I’m complaining) and she would hardly be the first expert to accuse a journalist of oversimplification, but my book never judges how others decide to die, arguing instead that we all have the right to choose our own “good death.”
If Ho can find dignity and meaning in going out on a flotilla of medical technology, I respect her choice. But she shouldn’t expect everyone else to make the same one. Nowadays, even assisted suicide seems more natural than years spent lingering on life support, so I know how I want to die—as does my wife, just in case.
