In an earlier post, I told about my surprise several years ago to realize that I am not afraid of dying. However, I am not completely without dread about one aspect of the process. That is the loss of cognition. The tumor up to now has been located in the area of the brain that processes vision. My vision has been affected, but really nothing else. The tumor is very aggressive and will not stay confined to the vision area for long. Even now, there are probably some stray cancer cells trying to get established in other parts of the brain.
The doctors have told me that eventually my cognition will be affected. The good news, they said, is that it will be near the end and I won't know it. That it is likely to come near the end is a comfort but that I won't know it when it happens is no comfort to me. I do not want to take up scarce medical resources for no good purpose. Nor do I want my family and friends to suffer by seeing me sitting, tied to a chair, waiting for an underpaid nurse aide to come change my diaper.
In any rational society, I would be able to choose to end my life before things got to that point. The idea that it is against God to take voluntary steps to end life when there is no reasonable hope of getting better, unable to communicate meaningfully with anyone is a cruel idea.
I realize very well the practical difficulties in making voluntary deaths easy. An excellent article in a recent New Yorker, I think it was towards the end of June, reports on the effect of a law in Belgium that makes euthanasia legal upon the certification of three doctors of the necessity for it. Some say the law has made it too easy for persons who are "merely" depressed to decide to die when treatment could make them better.
I don't have any firm opinions on the matter other than to observe that it's very complicated -- much more complicated than the partisans of either side are willing to concede.
In my own case, I want to squeeze as much juice out of life as possible. I want to live as long as reasonably possible, consistent with quality of life. Ideally, I would live right up to the point of losing my mind. I don't know if it is possible to know just when that point has arrived -- I would say it's probably impossible. Theoretically, the decision could be put into someone else's hands, but whose? I wouldn't want to put any family member in the position of having to decide that now is the time. The guilt and recriminations could cause their own life to become miserable.
I want to be clear that I am not talking about "Do Not Resuscitate" orders. I do not see the moral ambiguity with instructing medical personnel not to take extraordinary efforts to keep a person alive, when all hope for recovery and a meaningful life is gone. The problem I see is with taking positive steps to end suffering by ending life.
I am not afraid of death. I am afraid of dementia. The problem with letting nature take its course is that it will not cause me to suffer; it will make my loved ones suffer. The alternative is not one I'm ready to embrace at this point. Nor am I willing to rule it out.