Medically Assisted Death and the Family Caregiver

As more states adopt paths for medically assisted death, family caregivers remain virtually omitted from the conversation and care. The lid of this Pandora’s Box is opening wider as Christians flounder in sharing a Biblically founded position. Sadly, the church has all too often let the world hijack social issues, and medically assisted death seems to be another. Valuing life for the chronically and terminally ill—and their caregivers—now stands on the precipice. Paraphrasing Keith Green, the world is dying in the dark “…that the church just can’t fight, ’cause it’s asleep in the light!”

History reveals horrific consequences when governments draw and then move this line about the value of life. The last century provided two graphic examples: genocide (Germany) and infanticide (abortion).  Quality of life and suffering remain subjective.  Death, however, is not.  

Starting January 1, 2019, Our Care, Our Choice Act in Hawaii went into effect for “medically assisted death” (see here or here).

For those wanting to end their lives due to extreme sickness, disability, and/or suffering, the act requires two witnesses attesting to the patient’s desire for medically assisted death and two doctors agreeing the patient has six months or fewer to live. Furthermore, while mental-health evaluations are normally prescribed for those who unsuccessfully attempt to end their life, this legislation also requires such an evaluation to successfully end one’s life—effectively eliminating those suffering from dementia or other mental incapacitation. The “beneficiary” of this act by definition seems to be a cognitive unimpaired individual with a grim diagnosis.

Although some term this act “physician-assisted suicide,” physicians are not necessarily administering the lethal drugs. Others call it “State Sanctioned Suicide” inferring the state is codifying the act.  Legally, however, it is not deemed suicide—if performed according to the act’s procedural outline. Regardless of the name, the outcome remains the same.

While states develop paths to speak death, does the church rush to speak life to that tormented individual?

Shifting boundaries

Bluntly speaking, for those weighing suicide as an option, the sole impediment is an innate moral boundary. Only impairment, disease or societal manipulation can shift that boundary. With an increasing number of similar legislative actions making their way through state assemblies, it appears that more elected officials wish to alter that boundary.

The move to legislate this act raises significant questions and concerns. For instance, the act states the fatal dose of prescriptions is to be self-administered. If physically unable to administer the dosage of drugs for themselves, should a friend or family caregiver help perform the act?  Does performing this act result in legal consequences for the caregiver or the loss of life-insurance benefits?

Additionally, once a “qualified patient” decides to take their own life, they receive counsel from doctors to avoid ending their life alone or in a public place. So, who gets to be present? Again, the attending caregiver, not the attending doctor, seems the most likely choice.

Instructions remain unclear regarding the wellbeing of the caregiver left to deal with the emotional consequences of helping end the life of another human being.  Although the law requires a mental health evaluation for the patient, it omits the same requirement for those caring for the patient.

Should the patient complete this act, a caregiver remains to live with the guilt, sorrow, anger, resentment and other feelings that often come in conflicting waves. While family caregivers may not possess a legal voice on this issue, they certainly can claim a stake in the process—as well as the consequences.

Other questions arise

While discussing medically assisted death is often framed with compassion, is it not also compassionate to encourage suffering loved ones and remind them of their lives’ importance? Is life only valuable if pain-free and if death remains further out than six months? The line of “six months” itself opens the door to more difficult questions.  Why six and not five—or seven, or twelve? One can’t help but think that if government assemblies can draw a line regarding life expectancy and quality of life, then those same governments can also adjust that line.

Again, quality of life and suffering remain subjective.  Death, however, is not. 

Words of encouragement to caregivers

During times of suffering, a caregiver’s is the primary voice heard by someone suffering. A caregiver’s words and attitude can compound feelings of despair or inspire and strengthen. Emotionally unhealthy caregivers struggle to offer strength and encouragement. Yet, healthier caregivers can speak words of life and value to suffering loved ones—even those facing a difficult death looming on the horizon.

As a caregiver for a wife with severe disabilities and in chronic pain for more than thirty years, I understand the heartache in watching someone in agony. Serving as a bystander to relentless suffering can leave one distraught, exhausted and disoriented. It’s difficult to understand the right path in such conditions. Yet those times are not without great meaning and even joy—even in grim circumstances.  We may never feel better about the harsh things we experience or observe. Yet feeling better seems a shallow pursuit. Would not being better serve as a worthier goal?

Granting legal permission for suffering patients to end their lives may offer a path toward what some call “dying with dignity.” In doing so, we possibly deprive those who suffer, as well as those who care for them, the opportunity to embrace such challenges, while still living with dignity.

“Death and life are in the power of the tongue…” Proverbs 18:21

Peter Rosenberger is the president of Standing With Hope, the ministry he and his wife, Gracie, founded following the amputation of her legs. Through a prosthetic limb ministry and a nationally syndicated radio program for caregivers, they seek to reach the wounded, and those caring for them. @hope4caregiver