Thoughts on Brittany’s Choice

Chances are, you’ve heard the name “Brittany Maynard” uttered frequently over the past several weeks. Chances are, your social media feeds have been full of videos, articles and opinions posted about the decision the 29-year old made to publicly share her decisions related to her terminal glioblastoma diagnosis.

Chances are, you have strong feelings about the choice she made to end her life over the weekend, utilizing Oregon’s “Death with Dignity” act.

As much as I’m sure Brittany valued her privacy, I appreciate her giving a voice to this debate, for coming out and sharing her story, in the face of strong criticism. In many instances, her experiences have sparked a healthy and important debate, from the philosophy and ethics behind the death with dignity concept, to whether there should be a distinction between how Brittany died and other forms of suicide, to whether we have over-idealized death. It has certainly led to conversation about whether death with dignity legislation will reach beyond Oregon, Washington, and Vermont. It has also raised awareness about the important and thought-provoking work of Compassion & Choices, the organization that advocates on behalf of and directly supports terminally ill patients throughout the country.

I’ve also been disappointed (but not necessarily surprised) about the vitriol and judgment that has come across my computer screen..I won’t dignify this hatefulness by linking to it, but you wouldn’t have to look hard. I was shocked to hear a hospice physician declare that she didn’t understand why Brittany wanted to “off herself just because she had a terminal diagnosis”. I feel compassion for the patients with their own terminal illnesses who came forward and begged Brittany not to end her life. I was amused by the comments on Facebook and Twitter that we live in a death-obsessed society, when in my experience, it’s been exactly the opposite.

The reason we struggled with Brittany’s public (and in my opinion, courageous) choice was exactly because we don’t know how to talk about death.

In an era of medical technology that far surpasses the imagination, accompanied by a religious movement that believes that cures for cancer come from prayer, we don’t like to acknowledge that we will all be there someday. We use terminology like “battles” and “courage” to describe those who pursue aggressive treatment, sometimes at all costs. Then we turn around and call people like Brittany Maynard a coward for acknowledging the inevitable and going out on her own terms, after she crossed off the last item on her bucket list (a trip to the Grand Canyon) and after she celebrated her husband’s October birthday.

Working in palliative care and hospice (and with a background as an oncology nurse), I’ve seen “good deaths” and “bad deaths”. But the important lesson I have come to understand is that I don’t get to decide what makes them “good” or “bad”. I may have emotions or opinions, but it isn’t my death to face. And when the time comes for it to be mine, I can only hope that I live in a state that gives me the freedom to face death on my own terms, in my own home, surrounded by my own family.

Death comes to us all, whether we like it or not. I’ve often heard fellow hospice nurses refer themselves as “end of life midwives”. I think this is quite poignant. Just as coming into this beautiful world need not be medicalized to the hilt, neither does leaving. We can love our lives, we can cherish our loved ones, we can grieve for ourselves and for what we might miss when we finally say goodbye. But the truth is, we will all be saying goodbye at some point. How (and with whom) we choose to say it is our last chance to make a choice.

And what a profound choice that can be.

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