Continuing our discussion about end of life, the topic today is about the quality of life and when should we decide to end things.
So, I used to think of quality of life as the main factor for deciding whether to continue or not. As you know, I’m helping somebody who’s going to end their life at Dignitas and I’ve been trying to help him think about when the right time is to make this decision. Imagine that you have options between a very miserable life, very good life, or neutral. Where are you in that? If you are on the positive side, that’s great. If it’s both positive and negative, it’s complex. If it’s just negative, it’s easier.
I thought that what people should do is take the pluses and the negatives and if you’re in the plus side all day then you’d choose to stay alive. If you’re in the negative side all day, then it’s time to end things. If you’re in both the plus and negative sides, it’s a complex computation of what to do (one day I might go into my thoughts about this). This particular guy’s quality of life is mixed but leaning more positive. So, it’s not positive all the time and it’s also not negative all the time. When I thought about the mix, I thought that it was pointing to staying alive for a bit longer until the mix gets worse.
But in discussions with him, I got the feeling that he thinks his current state of functioning is a disgrace to his own history. He said that if he had a different history then maybe the way he is now, would have been acceptable for somebody in terms of pure quality of life for a bit longer. Not for much longer but for a bit longer. He said his autonomy, his freedom, the ability to do things, the pride he had in himself and in his body, his ability to do his job, and the pride he took in providing for his family were a lot of the things that built his life. He said that the chapter he is in now is positive if you look at it by itself, but it’s a disgrace—he used this word—to his old self. He said that enters his computation. It’s not just about the moment; it’s about the fact that he feels that staying alive now is taking away from who he was.
I don’t know how to settle this thought. It’s still complex and I’m still thinking about it. But it means that when elements that build somebody’s identity (autonomy, pride, providing, a job that he loves, etc.) are taken away, it creates a negative feeling even though it’s relative. If he didn’t have the comparison this would have been fine, but he cannot help but think of it relative to the past.
And that feeling of betraying his old self—betraying what he always thought, believed, wanted to do—adds another component of making life unbearable. It’s a very complex thought. It’s very hard for me to put myself in his shoes and try to get a sense of whether I would feel the same or not. I don’t know. I do know that he has a lot of conviction around that thought.
I thought I’d share it with you and if I ever learn more about this, I will return to it.
Thoughts about death are very sad. But I hope you don’t find it only sad. It also helps us think life. About the positive things.
