Brittany Maynard is dying on Saturday — maybe.
The 29-year-old woman, who is battling terminal brain cancer, declared her intent earlier this month to take advantage of Oregon’s Death with Dignity law and swallow pills that allow her to die in her sleep, rather than let her body be ravaged by the disease.
But regardless of whether Ms. Maynard decides to end her life this weekend, her story has reignited debate over the moral and religious implications of dying on one’s own terms.
“In a number of the religions … dignity is attached to humanhood. All human beings are made in the image and likeness of God, an indelible mark that is never lost and to which dignity is bound,” said Cory Labrecque, a bioethics researcher at Emory University’s Center for Ethics. “The worry for these faith traditions is not about a patient losing their dignity or their value. The worry is more about the implications of and what it ultimately means when there is a belief … that someone can actually come to a point when they no longer have dignity or value … and how we might translate our judgment on a ‘life not worth living.’”
Only five states currently have assisted suicide laws — Oregon, Washington, Montana, New Mexico and Vermont. About a half-dozen other states have introduced legislation, but many of them are unlikely to move forward, according to the Death with Dignity National Center.
A Pew Research survey of 16 major faith groups in America found that nearly all denominations, from Assemblies of God to the Southern Baptist Convention, oppose physician-assisted suicide or euthanasia, though faiths make some allowances for ending medical treatment so as not to prolong a natural death.
The Unitarian Universalist Association and the United Church of Christ support terminally ill people deciding when to die.
The Rev. Ignacio Castuera of the United Methodist Church this summer joined the board of directors for Compassion & Choices, whose mission is “helping everyone have the best death possible” and has partnered with Ms. Maynard to tell her story.
The Methodist church, like many other major denominations, “is quite divided on the issue,” Mr. Castuera said.
Mr. Castuera said he approaches the issue of assisted suicide by taking a page from the writings of theologian John Cobb, who said to look at death in a more Christian way.
“For me, that means that God is good, that a loving God wouldn’t want to see any woman or man writhing in pain,” he said.
Dr. Aasim Padela, director of the Initiative on Islam and Medicine at the University of Chicago, said the Muslim faith posits “some value” in the dying process.
“We don’t have a good sense of what’s happening. There might be something metaphysical that occurs that we don’t know about,” Dr. Padela said. “If we’re going to remove ourselves from that, that might be a problem.”
Rabbi Anson Laytner’s wife was diagnosed with a terminal form of cancer, and as a resident of Washington state, she took advantage of the Death with Dignity Act and was given a prescription to aid in ending her life.
“She got the medications she needed, but she never used them,” Rabbi Laytner said. “Just having them in her hand gave her some sense of control of what was happening to her. It allowed her to relax and say to us and to herself, ‘Well, when things get really bad, I’ll take this.’”
Rabbi Laytner said he was fully supportive of his wife obtaining the subscription, but understands its a decision that must be made on an individual basis.
“Where I personally come down on this issue is, I look at modern medicine, specifically dealing with advanced stages of cancer or other terminal diseases, not as helping the person to recover because they can’t, but rather, modern medicine in these situations becomes a means for prolonging the dying process,” he said.
“So from that perspective, for me personally, it becomes possible to say, ‘OK, death with dignity is a counterbalance.’ I have to acknowledge that technically goes against Jewish law because it’s hastening death, but it’s hastening death for a life that’s been artificially prolonged.”
Ms. Maynard was thrust into the spotlight in early October after an article about her decision ran in People magazine.
Earlier this year, she was diagnosed with a glioblastoma brain tumor and given just months to live. With the support of her husband — the two married last fall — and family, Ms. Maynard moved from California to Oregon, whose Death with Dignity Act “allows terminally-ill Oregonians to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose.”
According to the Oregon Public Health Division, since the Act was enacted in 1997, 1,173 people have had prescriptions written for Death with Dignity, and 752 people have used the prescriptions.
In a video posted on her website, Ms. Maynard said she doesn’t wake up every day and look at the bottles of pills, but knowing she has them gives her peace of mind.
“I can’t even tell you the amount of relief that it provides me to know that I don’t have to die the way it’s been described to me, that my brain tumor would take me on its own,” she said. “I know that it’s [the prescription] there when I need it.”
But not everyone sees Ms. Maynard’s choice as the right one.
“A time was appointed for our coming into this life, a time has been appointed for our passing out of this life, and we must always be good stewards of whatever time remains to us,” said the Rev. Tadeusz Pacholczyk, director of Education at the National Catholic Bioethics Center. “We shouldn’t attack the good of our life directly by, for example, taking a pill to kill ourselves, or allowing a physician to give us a lethal injection.
“Any time we treat an objective good as if it were an evil, any time we treat the good of life as if it were an evil to be directly extinguished, we are making a disordered and eminently unethical choice,” he said. “What Brittany is doing is motivated by fear and anger, not reason and wisdom. She fears suffering. She fears pain. She fears losing control. She supposes that by attacking her own life, she is gaining control over her life, but this is entirely false.”
Dr. William Toffler, national director of Physicians for Compassionate Care Education Foundation, which opposes physician-assisted suicide, said the idea of dying with dignity sends a mixed message.
“If killing yourself is supposedly ‘dignified,’why would you then not come to the conclusion it must be ‘undignified’ to live a whole life and die naturally?” Dr. Toffler said. “I think it’s a tragedy to cut a life short. The confusion of claiming that living your life with cancer is somehow undignified is an indictment of all those hundreds of thousands of people just in that situation.”
Dr. Toffler said his wife was one of those thousands diagnosed with terminal cancer, and the two of them lived their lives fully for several years.
“I had the blessing of taking care of my wife in those final months and years,” he said. “I would hope Brittany gives that gift to to her husband.”
Peg Sandeen, executive director of the Death with Dignity National Center, said Ms. Maynard’s story has triggered a wave of phone calls from people looking for resources on dying with dignity, whether it’s wanting to know their options or asking questions about terminal illnesses.
“There’s a death taboo in our culture,” Ms. Sandeen said. “This compelling, tragic story gives people a way to talk about it around the dinner table and with friends.”
Assisted suicide is divisive because it touches on mortality, faith and social norms, said Mildred Solomon, president and CEO of The Hastings Center, a nonpartisan bioethics research institute.
But Ms. Solomon said a story like Ms. Maynard’s, though poignant, only serves to show there’s a larger problem that isn’t being fixed.
“Brittany Maynard is a beautiful woman and an excellent spokesperson for the death with dignity movement,” Ms. Solomon said. “But once you start to think about this particular case, even if you support the legalization of aid in dying, aid in dying is not going to fix the way we manage death and dying in the United states.”
Assisted suicide isn’t the only route to dying with dignity, she said. While only a few people will choose assisted suicide for a terminal illness, all people will face frailty as they age.
“The main story from my point of view is that millions of people are dying only after years and years of debilitation and chronic illness,” Ms. Solomon said. “Yet our health care system is not designed for chronic care. We don’t provide logistical support to help people with all the medicines they have to take, social support needed in homes. It’s very acute-care and hospital centric. If we’re going to talk about death and dying in America, we need to be talking about redesigning the health care system.
“Death with dignity isn’t the only option. I’m not saying it shouldn’t be an option, but we need to bring attention to others options,” she said. “That’s a very compelling, heartfelt story, but we don’t have our eye on the story that’s going to affect millions of people.”