3 frameworks for the end of life: two I buy and one I don’t

My nearly 90-year-old mother has been faced with some tough situations regarding her 94-year-old sister. These situations have been tough enough that they’ve caused my mother to ask “What’s it all for. What’s the point of carrying on?” I accept these questions. They are reasonable ones to raise when both the need for care and the family tensions of how to move forward rise exponentially.

In several intense conversations, three frameworks for reaching answers have presented themselves. The first is rooted in the logic that drives most of us during our working lives and in my opinion ought to have no bearing during our waning years and is likely flawed all the time. The second and third lead in opposite directions and yet are equally valid.

The first could be paraphrased as “So long as I contribute and produce something of value to the world at large, then I have worth and have a claim to life. But absent that, I have neither.” It would be easy to dismiss this as a bit of Calvinist claptrap except that many of us implicitly live by it when we are well and healthy. Few of us would not want to work in the outside world in some way. That work reassures us of our purpose and meaning on this earth. But I don’t buy it, at least not entirely. As a yardstick of personal value, it is more of a trap for the unwary, than a carrot to inspire us to greater effort.

Courtesy of Jukka Vuokko via Flickr Creative Commons

Courtesy of Jukka Vuokko via Flickr Creative Commons

The second holds that we have the right to die with dignity and that when we decide we’ve lived long enough and have had a good run, it is fine to check out on our own schedule. I can not argue with this. So long as it comes from long reflection and ideally conversations with those closest to us, it seems noble, respectful and rational.

The third framework says that even when we can no longer care for ourselves and might not even recognize those who love us, we still have value because we become the vessel and focal point for that quality that makes us human above all others — our capacity for caring relationships. In a slightly different way, I’ve written on this before. If we weren’t hardwired for complex supporting relationships, we wouldn’t be human. It’s in our DNA. When we allow others to show their compassion for us, we fulfill our role as a species. It’s hard to argue that that isn’t worth a lot.

I leave it to you to suss out your own responses to these frameworks. If you agree with me that numbers 2 and 3 are equally valid, then you might want to consider why they lead to opposite conclusions.  Happy thinking.

~Jon

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One thought on “3 frameworks for the end of life: two I buy and one I don’t

  1. Like your mother I am in this place with my 91 year old mother & sibblings. Though she is of sound mind, my mother made her intentions clear in writing in her living will as to her wishes. The difficulty comes with that it is up to us to carry out the wishes she specified. She has made it clear that if quality of life is not there, and she can not speak or care for herself, that we are not to utilize any life prolonging procedures. She wants to check out. As her durable medical power of attonery even though she first put these wishes into place over 20 years ago and updated them as recently as 3 years ago, when medical issues come up I sit with her an ask what she wants. After all we can change our minds. And she has been consistant throughout the years. One sister however would want to utilize life support to maintain life until everyone can arrive to say goodbye. My sisters and their families live in different parts of the country. This however, could do exactly what my mother has stipulated what she doesn’t want. Though as you point out both senerio’s are valid the test comes when you are faced with asking one’s self what our personal values are and if they differ from the persons wishes. Do we have the strength to see past our own desire to follow through and carry out the wishes of the person who has made their wishes known. I would like to think because of the respect and love I have for my mother that I would follow her living will to the word and not be follow the desires of a sister who might not arrive in time. Knowing situations of friends who have been through the end of life process, that once life support has been started, you may not be able to stop it, thus prolonging what could be a dignified passing for weeks, months or longer. Can we let go and not force someone to live in a condition against their wishes to fill our personal need of not wanting to loose them or to be able to say good bye in person?

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