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Is Enough Ever Enough? - Page 3

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The Right-to-Die Debate

In many ways, the current debate over the right to die mirrors the dispute over abortion rights, with the two conflicting sides of the argument being labeled “pro-choice” and “pro-life.” While pro-choice organizations, like the Final Exit Network, generally believe that terminally ill individuals who are being kept alive by modern medicine should be given the means to “die with dignity” if they choose, those on the pro-life side generally believe that no one should be able to choose the timing of their own death. One of the most prominent pro-life spokespeople within the healthcare community is Ira Byock, a physician who focuses on hospice, palliative, and end-of-life care. The author of Dying Well and a frequent guest on television and radio programs, he regularly works with people who are terminally ill, many of whom seriously consider ending their lives. He believes firmly in the importance of asking people how they feel about death and listening to their perspectives on dying, but he insists that “helping a patient or client to end his or her life is never right.” According to him, doing so always results from countertransference: “It occurs when the therapist or doctor can’t imagine anything else to do for this person.”

Byock feels that for a psychotherapist to assist a client in ending his or her life is essentially to reinforce the person’s sense of helplessness and hopefulness. He adds that seriously ill people already have the means of ending their lives, so by requesting assistance, they’re really requesting affirmation. “For me to affirm this for them, I must be unable to imagine some other way to support or care for them; I must be devoid of an ability to see them as being able to be helped or having some semblance of hope,” says Byock, “and that’s not my job. My job is to always find ways to help people who are suffering, and always be able to help them perceive something tangible, valuable, to hope for in the future—even if it’s only to die gently and for their families to be supportive.”

Like Byock, Dincin thinks that healthcare professionals’ work with dying patients can be easily distorted by their own personal feelings about dying. Considering the prospect of his own death, Dincin says, “I’m married, and it’s a sad situation for us to contemplate, but there’s no question that my wife supports my attitude and whatever decisions I’d make, even if it would make her grieve.” He adds, “I have very big news for you: everybody dies. Everybody knows it at some level, but they don’t really take it in, and take it seriously. When you have to, it changes your outlook on life, and you come to look at things differently. You begin to decide what’s worthwhile and important to you.”

It would be a big step forward if psychotherapists could move away from the stance that death is always terrible, says Dincin. “I think that it shouldn’t be looked upon as a failure of the medical system if someone wants to die under such circumstances, but rather, a positive.” He isn’t advocating that anyone take his or her own life, he insists, but is promoting more openness to the option, without the stigma. “I’ve been with a number of people who’ve taken their life, and without exception, they’re overwhelmingly grateful and relieved. They’re really relieved to be out of life.”

Dincin thinks that, as a profession, psychotherapy has a responsibility to take a deeper, more thoughtful look at death, and that it’d be a great advance in healthcare if more therapists could become experts in end-of-life care. According to therapist Faye Girsh, an advocate for the right to die, such expertise begins with having more knowledge about the issues surrounding end-of-life care and terminal illnesses, and more awareness of the resources available. “It’s important for therapists to know what the organizations are, what the books are, and what kind of counseling to provide for such individuals, so that terminal patients don’t have to have the anxiety about whether their deaths will be difficult, prolonged, painful, or whether they’re going to lose control.”

Jordan Magaziner, a graduate of American University’s School of Communication, is editorial assistant of the Psychotherapy Networker. Contact:

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