Death with Dignity

There are currently ten jurisdictions (nine States, and the District of Columbia) that have “death with dignity laws” (a.k.a. physician-assisted suicide). According to the Death with Dignity National Center, these laws “stem from the basic idea that it is the terminally ill people, not government and its interference, politicians and their ideology, or religious leaders and their dogma, who should make their end-of-life decisions and determine how much pain and suffering they should endure.” At first blush, there is something appealing about these laws. If I am the one suffering, the one dying, why shouldn’t I be the one to decide when I go? It is my life, after all. Shouldn’t we Americans, increasingly reared on the triple isms of individualism, consumerism, and materialism, support these benign laws which merely seek to increase consumer choice, and decrease suffering?

But of course, all that glistens is not gold. If every life were its own cosmos—or, as David Foster Wallace quipped, if I were truly the king of my own tiny skull-sized universe—then the choice to die might be simple: I am, on the whole, better off dead, so my choosing to die is good. But we are not isolated individuals. As the philosopher Alasdair MacIntyre writes, “I can be said truly to know who and what I am only because there are others who can be said truly to know who and what I am.” In other words, we are social creatures dependent on one another. If our life has an enormous social element, might not our death likewise?

This social element of death and dying is complexly drawn in Christopher Beha’s novel What Happened to Sophie Wilder (2012). Recent Catholic convert Sophie Wilder has taken it upon herself to nurse her dying father-in-law, Bill Crane, despite the fact that her husband is having an affair and hates his father. For his part, Crane wants nothing to do with Sophie; instead, he wants to die alone and to “no longer exist.” Against her husband and patient’s will, Sophie does her best impression of Dorothy Day and goes to Crane’s apartment to provide him end-of-life care. Why? Through agapic love, does Sophie hope to convert this miserable, broken man, haunted by his own past? She wonders, “was it for his sake or her own that she wanted to save his soul?” Is her act one of humility, or pride?

The Death of St Joseph [Patron saint of a good death] Giuseppe Maria Crespi (Lo Spagnuolo) 1665-1747. The Hermitage Museum

One might hope that Sophie’s good intentions would be rewarded; that, even though Crane renounces her charity and promises there would be no death-bed conversions, she would nonetheless experience God’s presence and bounty. But life is more complicated than that. When Sophie begins reading Crane the story of Jesus’s raising of Lazarus in John’s Gospel, Crane claims that he knows “that book a lot better than you do.” Rather than vindicating Sophie’s newfound faith, Crane mocks it. He renounces Sophie’s goodness, and the supposed goodness of God, attacking God for being a “fascist” and the “first totalitarian,” who “has to control everything. Reads your mail. Bugs your phone.” This might be OK if God hadn’t also given humans supposed “free will,” where “you’re free to do what you choose, and if you don’t choose to worship me, I’ll send you to the flames.”

These antagonistic, rational arguments do not pose a real threat to Sophie’s faith, but Crane’s visceral suffering does. He is in tremendous pain, and his debilitating suffering is humiliating. At one point, Sophie finds him on the ground, and he dejectedly declaims, “I shit myself.” Sophie soon finds it “impossible to watch Crane struggle without praying for it to stop,” but then is forced to watch “the unmistakable proof that her prayers had not been answered.” She wonders, “what did it mean to say that God answered prayers if He chose which ones were worth answering?” And then Crane asks the unthinkable: “kill me.”

Sophie is horrified, yet tempted. On the one hand, does not all life—no matter how broken, how pitiful, how full of suffering—have inherent dignity? Redemptive capacity? Yet, what redemption could there be in Crane’s raving pain? He who had not wandered blindly from God, but who renounces and hates God. Isn’t the merciful thing to end his suffering?

Sophie wonders, “what did his suffering win him? Where was the nobility in prizing her own soul at the cost of his suffering?” Thus, after many days witnessing Crane’s agonizing suffering—including three days where “he spent every waking moment calling out for his own death”—Sophie obliges Crane’s death wish and feeds him an overdose of sleeping pills. Though she claims to have “set him free,” she also immediately “knew that she’d made a terrible mistake—had known it even as she’d done the thing—but there was no way now of undoing it.”

Unable to be forgiven, she believes, because she had committed the act with full knowledge and intent, she experiences her own deep suffering. Not the physical suffering that Crane endured, but the spiritual suffering of feeling “herself outside of God’s attention.” Unable to bear the guilt of her actions, she soon commits suicide with some of Crane’s pills. She had hoped to be a vessel for Crane’s salvation; instead, Crane became a vessel for (potentially) Sophie’s damnation.

Sophie Wilder portrays the visceral qualities of suffering and death, and examines unflinchingly the agonizing eternal consequences involved in dying well. In particular, Sophie agonizes over the question of whether Crane’s soul—like his body—suffered, or “had it escaped.” But she realizes “where could his soul be found, if not in his body, while his body still lived?” There’s something about the body, and the inescapable fact that each and every one of our bodies shall die and decay, that rightly causes a degree of horror and outrage in us. We sense that it shouldn’t be this way; we weren’t meant to die. This deep and abiding mystery of death persists in the year 2021, just as in the year 1500, or the year 5000 B.C.

Perhaps death is the one thing that makes us most like our ancestors. We in the Modern Age (or is it the Information Age now?) have witnessed great revolutions and upheavals and “progress” in technology, science, politics, religion, and pretty much every other sphere of human activity. Yet, we have not learned how to escape death. Perhaps death with dignity laws, where the exalted individual is finally given control over death itself, are the inevitable culmination of Modernity. Yet, the individual has always had the capacity to end his or her own life, no prescription medicine needed. Nothing new there. What we haven’t figured out is how to destroy death itself. This, I suspect, is at the heart of death with dignity laws: a misguided attempt to destroy death by destroying life. But mere humans can’t destroy death, nor can we destroy suffering. In a desperate moment, Sophie Wilder tried, and it ended up destroying her. But we can’t escape it. Instead, in some way or another, we all must face death head on, its horror, its pain, and its uncertainty.

If COVID-19 has taught us anything, perhaps it is that death is as much a part of our reality as it was every other generation’s. Further, suffering and death are never simply an individual affair. It has often been noted that one of the most terrible aspects of the pandemic is how often people have had to die alone, away from their loved ones. It is terrible because there is a deep social element to death, and one person’s suffering and death has the capacity to move another either towards or away from God. In Sophie Wilder, Crane’s death closes her off from receiving God’s love.          

What are we to make of the notion of dying with dignity in light of Beha’s tale? Is dying with dignity even possible considering the tremendous suffering endured by these characters? If Crane had allowed Sophie to continue reading from John’s Gospel, he would have heard how Lazarus was dead four days when Jesus rolled the stone away from the entrance to the tomb. At Jesus’s command, Lazarus stands up and walks out wrapped in bandages. Imagine the shock. The utter amazement of all who stood by. Imagine what Lazarus and Jesus then conversed about. Those of us raised on the Christian belief in the Resurrection perhaps glance over this story too quickly. Put yourselves in the shoes of those present; put yourself in the shoes (or bandages) of Lazarus. What strangeness. What awe. What mystery.

As with life, death remains a mystery—for Christians and non-Christians alike. Perhaps especially for Christians, who believe in Christ’s Resurrection and the promise he has made of Eternal Life. Yet death remains (even Lazarus must have died again). Why? If Christ is victorious, if by His march towards Calvary he was also marching Satan to his demise, why does death remain?

St. Dismas (with the halo) is a patron saint of a good death. The Icon of the Crucifixion: Between the Two Thieves, written in 1711 by Ioannis Moskos.

There are no easy answers for Sophie or for us. But I am convinced that in some way our movement towards God is not a movement away from suffering and death, but through it, to the very heart of God. The paradox remains; the fear remains; the uncertainty remains. But we can’t escape death. We can, however, hope that Christ’s Kingdom is slowly (as we perceive it with our eyes) being delivered to the Father, and when it is finally fully handed over, then “the last enemy to be destroyed [will be] death.” We can then triumphantly sing with Saint Paul, “Death is swallowed up in victory. O death, where is thy victory? O death, where is thy sting?” And that’s a reality worth hoping for.

Jeffrey Wald writes from the Twin Cities.