Posted on: Sunday, January 16, 2005
ISLAND VOICES
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By Robert M. Rees
A metastasized and malignant melanoma was removed from the lymph nodes of my left groin on Dec. 6. When the offending lump was excised, even I, under local anethesia, could offer an accurate diagnosis based on its discoloration from the pigment-producing skin cells — melanocytes — that caused it. The background noise switched abruptly from operating room banter to silence. Poet Emily Dickinson, as she so often has, offered up insight:
I heard a fly buzz when I died;
A subsequent CAT scan revealed yet another lump in my right lung. And a biopsy traced it to the same virulent melanoma. All of this, of course, is about as close as you can come to a death sentence without appearing before a Texas judge. I may have anywhere from just a short time to a handful of years.
One of my first ruminations, as odd as it now seems, was on Ernest Becker's classic Pulitzer Prize-winning book of 1973, "Denial of Death," a study of the human inclination to spend a lifetime in denial of mortality by obsessing on self-importance. I imagined I was no longer in denial and had beaten Becker at his own game.
Becker turned out to be right. In short order, I developed an interest in the minutia of college football, in reruns of "Cheers" and in plowing through the New York Times "Guide to Essential Knowledge." I became living proof of what my zoologist friend at Harvard, professor Edward Wilson, wrote in his book "Sociobiology: The New Synthesis": "The human mind is a device for survival and reproduction, and reason is just one of its various techniques."
But sooner or later, reality triumphs. The unique ability of humans to visualize the future is a two-edged sword. It was Ernest Hemingway's protagonist in "A Farewell to Arms," Catherine Barkley, who presciently said to her lover, "Sometimes I see myself dead in the rain." When she dies, Lt. Henry leaves the hospital and walks back to the hotel in the rain.
One prepares for the storm. And among other things, depending on the ailment, one might want to have at hand the option of being able to terminate one's own existence when the only alternative is a semi-comatose fight against intractable pain. The easiest and best way to secure this option would be to ask the physicians who have looked after me for a simple prescription to have on hand for when the alternatives narrow. But in Hawai'i, there is an obstacle to physician-assisted suicide. Thanks to our legislators, it is against state law for a doctor to write such a prescription.
America's conservatives tend to accept as an article of faith economist Milton Friedman's treatise called "Free to Choose." These conservatives are happy to fight for the freedom to make mundane economic choices and yet want to deny anybody with a terminal illness the right to have at hand a medical prescription with which to end one's own life at the time and place of one's choosing.
They have forgotten U.S. Supreme Court Justice Robert Jackson's remarkable words in the midst of World War II when he determined that government may not compel the Pledge of Allegiance. "Freedom to differ," wrote Jackson, "is not limited to things that do not matter much."
The U.S. Supreme Court ruled on "Death with Dignity" in 1997 and concluded that due process of the U.S. Constitution does not include a generalized right to commit suicide. However, the court urged the states to reach their own conclusions on the narrower question of whether the terminally ill with intractable pain have a constitutionally based interest in controlling the circumstances of imminent death.
So far, Oregon is the only state to pass a Death with Dignity law. In spite of ongoing but failed attempts by the Bush administration to pre-empt Oregon's law, it has been in effect for five years and apparently has been well received. In the August 2004 Journal of Clinical Ethics, Oregon's Health Sciences University reported, "Death with Dignity is a safe, well-regulated option of last resort that improves end-of-life care for everyone." The report noted that only 25 people per year exercise the option and concluded, "For many patients, simply knowing the option exists creates a climate of comfort."
Legislation proposed for Hawai'i would do exactly what the court prescribed and what Oregon already does. In 2002, at the urging of Gov. Ben Cayetano and state Sen. Colleen Hanabusa, such a bill nearly passed. After approval on second reading in the state Senate, three senators changed their minds and succumbed to pressure from the Catholic Church, Hawai'i's Family Forum and others. One of the senators who voted no defended his vote by proffering that the state shouldn't be involved in a life-and-death issue. This, of course, is a red herring, because by denying the option, the state of Hawai'i already is involved.
The Death with Dignity bill was introduced again last year but was withdrawn by the Democratic House leadership because they thought it lacked the necessary 26 votes. After all, the cynical thinking went, why take a close and controversial vote when a general election is imminent? This year, however, with commanding control of the state House and Senate, there is no excuse for the Democrats not to pass a Death with Dignity bill.
As for me, supported and loved by a marvelous wife, daughter and son — how truly lucky my life has been — I am planning on waging what I hope is a long, existential struggle of epic proportions. I hope to roll back the rock of Sisyphus hurled down by what, after all, is a tiny and random occurrence in the scheme of things.
Robert M. Rees is moderator of 'Olelo Community Television's "Counterpoint" and Hawai'i Public Radio's "Talk of the Islands." He wrote this article for The Advertiser.
The stillness round my form
Was like the stillness in the air
Between the heaves of storm.
