Tuesday, December 13, 2011

Reflection Paper

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When my grandmother found out she had cancer in her bladder, she was offered two choices. She could undergo aggressive chemotherapy, which, for a woman her age, had almost a 0% rate of survival. Or she could have her bladder removed entirely she would almost certainly survive�but she would have to live with the indignity of carrying an external bag for urine with her all the time.

Being who she was, my grandmother chose the chemotherapy and a year later, she died. It was difficult for all the members of her family and, in particular, my grandfather who was her primary caretaker while she slowly starved to death in her own living room. None of us would have minded, I think, if she had a bag for urine. Her absence in our lives is frequently noticed.

The questions that arose in my mind went something like this what was her obligation to us when she made her decision? Was it selfish of her? Is it selfish of us to expect her to choose the option that makes life best for us? Who can decide when quality of life outweighs its duration? What does this mean for quality of life v. sanctity of life decisions in a broader sense?

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For my grandmother, having her bladder removed would have been an inconsiderable surrender of dignity. She had long prided herself on her independence and fortitude. In her mind, I think the decision was something like if I can’t keep my bladder, life will not be worth living.

Because there was an infinitesimal chance that she might survive, it was not exactly euthanasia. But where are we to draw the line? In choosing not to have her bladder removed, she essentially forewent a procedure that would have saved her life.

Clearly, she believed that she should be allowed to decide. Most people in her position would also want that option. Our reasoning is that we want to be able to control the fate of our own bodies. I believe that most people internally understand that there is a point at which they would rather die than continue to live under their personal definition of unbearable conditions. To do this is to concede that there is something more important than life itself. If we construe this to be a right, than she was only as selfish as anyone who asserts a right is.

However, some might argue, rights end when they conflict with the rights of others, or some such formulation. Thus, one could reformulate the question as doesn’t the sick or dying person owe something to those who care about them and have a right to their consideration?

If we assume that my grandmother did not want us to be unhappy, all else equal, some consideration was probably given to this question. On the other hand, if we also wanted her to be happy, perhaps the consideration cancels out. Or perhaps, since it is after all her life, our consideration of her trumped her consideration of us.

Ultimately, for me, I ethically concluded that perhaps the need for such decision-making on a personal level, makes any sort of absolute moral standard in these cases wrong. Each of us has our own idea of suffering. Each of us must weigh what our remaining time alive is compared to the minimum quality of life we are willing to tolerate.

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