When Enough Is Enough

For the last few days, my cat Emily seemed unwell - lethargic with little appetite, frail and disoriented. I took her to the vet last night hoping for the best - a UTI - but trying to be prepared for the worst. Her labs showed that it was indeed the worst - kidney failure. The vet laid out the treatment options for me: more tests, exploratory surgery, hospitalization with IV fluids and pain medication, appetite stimulants, injections to be administered at home. But all of this would only buy her a little more time, and potentially cause her even more pain and distress in the meantime. The decision seemed clear to me - I didn't want to prolong her suffering. With me by her side stroking her fur, Emily was administered a cocktail of drugs that stopped her heart - and she was gone.

Since my diagnosis twenty-one months ago, I've had plenty of opportunities to contemplate my own death in the abstract. When I wrote my living will before my surgery, I was forced to consider the act of dying in more practical terms in order to define how I would want to die if I was so far gone that I was unable to make decisions or communicate my wishes. But a scenario that I hadn't really considered was one in which I could choose my own death. My strong conviction that euthanasia was the right choice for Emily made me wonder - would I choose the same for myself?

I know where I stand philosophically. I've never had a strict interpretation of the sanctity of life - in fact, prolonging life on principle, in the face of unbearable suffering, seems the very definition of immoral to me. And clinging to life out of fear of death, even when the quality of that life is severely compromised, has always struck me as tragic.

However, having a potentially fatal disease changes the argument from conceptual to extremely personal. One of my support group friends told me once she has known from the start what she would do if her cancer metasticized - move to Oregon. Starting next month that move would no longer be necessary. On June 9, SB 128, the "End of Life Act", will go into effect in California, making us the fifth state in the U.S. to allow physician-assisted suicide. So this option will become readily available to the unlucky one in eight of us early stage breast cancer patients whose cancer recurs. Will we choose it? That remains to be seen.

Living is always preferable to dying - until the day that it's not. When is enough, enough? Perhaps there's no way to know until that day comes.