Death, Dignity, Drugs, and Liberty

The general feedback from everyone is that this blog is depressing. I'm also getting folks saying that it's amazing I'm able to stay objective while writing it. I'm not sure how to take either of those except to say that when I'm writing it, I don't want to be depressing, I want to make sure that the posts are information-dense so I don't waste anyone's time. I also don't feel very objective when writing it. Again, it's a matter of making sure the information is there for anyone who takes time to read it and generalizing it enough that it is useful instead of maudlin.

Having said all that, let me give you another few paragraphs of depressing and impersonal information.

How you feel about this post will be directly affected by how well you can accept these stipulations:

1. Many cancer patients live and die in misery. This is unacceptable.
2. Your greatest liberty is the choice to do what you will with your life, so long as it does not directly harm someone else.

We have a huge problem in our society, a pathological cultural desire to dictate to others how they should conduct themselves and how they should live their lives. A lot of folks will call that kind of situation a nanny state or paternalism. It's an attitude pervasive around the world to varying degrees, usually contingent upon the apparent strength of one or more religions in the socio-political economy of a government's legislative branch. I know that's a lot of weaselly op-ed words in one place, pointing a finger at a single cause for a systemic set of symptoms, but there you have it. The voyeurism of the early American Christian is still with us today, yet we deny it (as we also deny death) on a daily basis.

I'm going to make some of you mad, but I want to throw a third stipulation out there.

3. The only true sin is to do injury to someone who hasn't injured you.

I know it's hard to swallow, considering the way most of us are brought up, but it is both the ultimate repudiation of injurious voyeurism as well as the reason to cease nanny state interference in the lives of its citizens.

If you can answer this question by saying something other than "none":

"What business is it of mine how anyone else lives their life, so long as it doesn't hurt me?"

without mentioning a religious text or a convoluted legalism based upon a religious text, I will be surprised.

Now let's move on, with those three stipulations in mind. Let us accept that people are responsible for themselves, and that it is none of our business what they do so long as they do not injure us. Accepting that premise, let's now look at some of the ways cancer patients are negatively affected by those who can't or won't accept those stipulations.

Over the years, national drug policy has been driven by fear instead of by science. This means that there are still people out there who think that Reefer Madness is a real thing and who refuse to allow the gummint to end a failed war on drugs.

How does this affect cancer patients?

1. Increased regulation of narcotics/pain killers makes those drugs more expensive.
2. Demonizing of palliative care doctors makes it harder to get the prescription.
3. FDA, DEA, and state rules for prescriptions makes it harder to deal with the pharmacies.
4. Marijuana's mixed legality (and continued assault by the federal government) means that an otherwise low side-effect method for alleviating pain is unavailable to millions who suffer.
5. Societal perception of painkiller and narcotic use negatively stigmatize those who use them.

Folks who believe in the war on drugs are often blind to their misapprehension, mostly because they don't realize (or they are willing to ignore) how much pain it causes, either from the above points, or by increasing drug violence and property loss by exponentially increasing the apparent value of otherwise easily acquired materiel. Now, I know that families can be destroyed by drugs and alcohol. I know that kids should be protected from both until they're able to make good decisions about them. I also know that human nature will put pleasure seeking above other behaviors in most of the people who are susceptible to it. The ignorant will just have to understand and internalize that criminalizing drug use and ruining lives based on it will hurt families far more than accepting human nature and offering stigma-free treatment for addiction instead. You can't save people who are intent on destroying themselves, but you can offer them a way out and you can minimize their negative impact on society in the meantime. Most importantly, you can offer them a humane future, regardless of their foibles, or allow them the dignity and liberty to choose death on their terms.

So that's the next reason to dislike what I'm going to say if you disagree with the three stipulations.

It is the right of any adult to choose the time of their death.

I'm sorry, but it really is. It's not your decision. It's not your place to tell them they should or shouldn't. It's fine for you to say, "I would never do that," or "that's so selfish, I can't believe they'd leave their family like that," but that's the extent of your ability to participate in the discussion. You, the legislature, the clergy, the psychological profession, and the rest of us have no right to tell someone that you have decided that they can't end their own suffering (objective or subjective) on their own terms.

I can climb down from my libertarian stump and say that I understand the fear my generation and the generations that bracket it had drilled into us. I know it's difficult because I suffered from the same misapprehensions. I know it's difficult to turn the puzzle around a little bit to see where the gaps are and how to fit the next piece into it. Please do it. The pain we create by forcing these flawed concepts of moral behavior onto others is not just a philosophical thing, it's a tangible and deadly thing that hurts and kills on a daily basis.

Rethink the situation and consider doing something about it. Write your Governor, Congresscritter, Senator, or President and suggest that we should make life easier for folks in pain by repealing the ludicrous laws that make it difficult or illegal to treat people's pain. Consider doing the same and ask them to repeal the laws that rob people of their dignity and humanity by making it against the law for a wife to hold her terminally ill husband's hand while he intentionally overdoses to escape the pain of his disease.