[Do we all agree that not every moral problem has a solution, that situations arise in life in which it seems impossible to say exactly which ethical principles apply or how they apply? In a piece on vivisection, G. K. Chesterton deals with such situations by laying down the rule that if you feel you would have to do a horrible thing in a certain situation, you should wait until you are actually in that situation, but not sanction or legalize the horrible action beforehand. Chesterton’s argument is followed by a familiar example of a desperate situation that seemed to call for desperate measures. It comes from Mary Tyler Moore’s autobiography in which she describes how she—with her doctor husband’s help—tried and failed to euthanize her brother, who was dying of a rare and particularly insidious form of kidney cancer. Does Moore’s experience lend support to Chesterton’s thinking on this matter?]
There is no ethical necessity more essential and vital than this: that casuistical exceptions, though admitted, should be admitted as exceptions. And it follows from this, I think, that, though we may do a horrid thing in a horrid situation, we must be quite certain that we actually and already are in that situation. Thus, all sane moralists admit that one may sometimes tell a lie; but no sane moralist would approve of telling a little boy to practise telling lies, in case he might one day have to tell a justifiable one. Thus, morality has often justified shooting a robber or a burglar. But it would not justify going into the village Sunday school and shooting all the little boys who looked as if they might grow up into burglars. The need may arise; but the need must have arisen. It seems to me quite clear that if you step across this limit you step off a precipice.
Now, whether torturing an animal is or is not an immoral thing, it is, at least, a dreadful thing. It belongs to the order of exceptional and even desperate acts. Except for some extraordinary reason I would not grievously hurt an animal; with an extraordinary reason I would grievously hurt him. If (for example) a mad elephant were pursuing me and my family, and I could only shoot him so that he would die in agony, he would have to die in agony. But the elephant would have to be there. I would not do it to a hypothetical elephant. Now, it always seems to me that this is the weak point in the ordinary vivisectionist argument, “Suppose your wife were dying.” Vivisection is not done by a man whose wife is dying. If it were it might be lifted to the level of the moment, as would be lying or stealing bread, or any other ugly action. But this ugly action is done in cold blood, at leisure, by men who are not sure that it will be of any use to anybody—men of whom the most that can be said is that they may conceivably make the beginnings of some discovery which may perhaps save the life of some one else’s wife in some remote future. That is too cold and distant to rob an act of its immediate horror. That is like training the child to tell lies for the sake of some great dilemma that may never come to him. You are doing a cruel thing, but not with enough passion to make it a kindly one.
There was no mistaking the words when he called me one day to say good-bye. He had stashed hundreds of painkillers, and had tried to end his life by taking (I can’t say overdose, because he’d been overdosing on prescription drugs daily for a year or more) enough to kill himself. He fell asleep before he could ingest enough to finally end his pain. He felt he could do it again, this time with some improvements in the technique.
I asked, “Will you wait for me to be with you? I don’t want you to be alone.” “How long will it take you to get here?” “I’ll be there tomorrow afternoon,” I said, and then I called Robert.
We arrived at John’s house and entered his bedroom, he was sitting in the only piece of furniture that didn’t hurt him—a recliner chair covered with pillows. His face was beyond white. His skin was almost misty.
It was impossible to hug him—he hurt too much in so many places. He whispered, “Hello,” and said he was glad we’d come. Robert asked to see what pills he had collected. There were Dilaudid, Valium, Percocet, Halcion, enough to fell the giant that he was—and, of course, the morphine pump.
There wasn’t much to say, and when he extended his hand, I silently gave him the first batch of pills and water, which he took until he couldn’t stand the taste anymore. He asked me to mash them into ice cream, the only food his stomach could tolerate.
Robert called the company that held a code for the pump that would increase the dosage of morphine. He programmed the added infusion, while I spoon-fed the potion. Even as he approached stupor, my brother was crying out from the pain.
We called Mom and Dad to come. We sat, all of us, including John’s caring helper, Michael; a mixture of sadness, anticipated relief, and fury.
After a half hour, the pump’s dosage was increased again and Robert took my hand, saying, “Here he goes, Mary.” We watched him so intensely that he must have felt it because his head rolled to one side, but still he kept breathing.
A half hour later, my father got up from his chair and said, “I’m going home.” After he left, John’s eyes opened for a moment and he said, “This isn’t the way I thought it would be.” I gave him some more of the mash, spiked even further, and Robert pressed the button, again.
Five hours later he was still alive and still in pain. I could not believe that he was living through it, nor could Robert. It had taken a lot for Robert to overcome his instinct to cure but added to his guilt, now, was sorrow at having let John down.
As John slowly came around, I called his oncologist to confess our deed and beg for advice. He was not surprised at the attempt we’d made, nor its failure. John had been given so much medication over the last five years that his body was now impervious to drugs. The doctor made me feel better when he said, “There’s a pain specialist I’m going to put you together with.” I just wished to God he’d done it earlier.
John went into the hospital, and a brilliant doctor named Jason Hymes began custom-tailoring John’s pain management. It went so far as to surgically sever the sensory nerves in his arm on one occasion, and a portion of his spinal nerve toward the end.
He was able to come home for two months in relative comfort until shortly before Christmas, when breathing became difficult. He was readmitted.
We were told he could be placed in the ICU where his life might be extended for a few weeks by machines, or we could make him comfortable in a private room and let him go at his own pace. We chose the latter for him at his request.
Christmas Day, usually the source of so much anxiety in our family —a tradition of drinking, arguments, and disappointments with one another—was spent in John’s room at the hospital. Mom and Dad brought a turkey, mashed potatoes, peas and onions, plates, forks, a carving knife, and cranberry sauce in a cardboard carton. Aunt Bertie was there, as was John’s daughter, Carole Ann, with her fiancÚ. We sang carols, exchanged presents, and shared our dinner with some of the nurses who let us use their kitchen. John had had me buy presents from him for everyone.
As Robert and I sat holding John’s hand, at one point, he told us he had seen God that morning, that he appeared before him and said, “John, you’re going to a place where you’ll feel normal.” He was so happy there was a place, at last, called home. He had no more fear.
Later that night, after a long silence with just Robert and me in the room, John said out of nowhere, “Mary, let me go.”
He died the next morning at three a.m.. He simply stopped breathing.
It is a blessing that he was finally able to face death with serenity, to go so willingly. Had we been successful in our earlier attempt to help put an end to his suffering, he would have run blindly into death, instead. There’s no question that John’s moving into his Creator’s arms was the better death to experience. But, if I could have forced the end of his pain, were I asked to do it today, again, I would.
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