Evolution has equipped us with an instinct to live that fuels a most
intense fear of D&D. In our culture, this fear is still managed mostly by
avoidance, denial, faith or media white-wash. (With whom would you rather have lunch: a minister, an undertaker, a forensic pathologist,
or none of the above?) Most of us would
prefer to avoid anything that vividly confronts us with our own mortality,
hopefully
assuming that we will die painlessly in our sleep or that others will make us
comfortable as we leave life. This approach avoids the
anxiety and confusion about D&D that can accompany planning for these
events.
I think that the decision to not think about D&D is OK.
You may be the kind of person who becomes so anxious or depressed when
thinking about D&D that the reduction in suffering at the end of life for
yourself and for those you care about is not worth the effort. I would feel even more comfortable with
your decision if you would consider revisiting the topic from time to time,
just to see if your reaction is different, or if there have been developments
in the area which might make a difference to you. So, the first question for
you to consider is...
I.1 Which of the following do you think are good reasons for you to avoid
thinking about or planning for D&D:
There is a good chance I
will die in my sleep.
There will be
medical or other means to prevent my suffering so there is nothing I need
to do except to cooperate.
There will be trustworthy professionals or capable relatives to make
plans and decisions for me.
I am a person who reacts
with strong, persistent anxiety or depression, and I would predict I would do so if I
continue to explore this subject
I are too afraid, or the
subject is too distasteful, depressing or morbid.
Other reasons:
If you do not want to pursue this subject any further, you can leave now or
after any one of the next three questions...
I.2 If you do not plan for D&D, it is more likely that
you will be kept alive as long as possible. Which of these beliefs that support
this approach apply to you:
Since both I and my relatives and friends believe in the absolute
sanctity of live and that any action or omission that shortens life is
wrong or against the will of God, it will be a good thing if I am kept
alive indefinitely, even if I am in a vegetative state or coma.
I believe that patients who appear to be unresponsive
actually are are aware of what is
going on around them; therefore, I will still be able to benefit from the
attention of relatives and others who spend time with me.
Since there is continuing controversy over
when a person is dead, brain dead, or in a permanently unresponsive state, I want to wait until these issues
are straightened out. I do not want to
put someone else in the position of having to take my life while I, by someone's definition,
am still alive.
Even if I would want to leave life
at the point that I couldn’t do anything or respond
to anyone, the only ways that people can legally help me to do this are to turn
off life support or to allow me to stop eating and drinking. In spite of
evidence to the contrary, both these methods seem as though they would be
very painful.
I.3 What are your reactions to the following scenarios which might occur if you
didn’t plan for the end of your life:
Since I will not have communicated my wish to be allowed to leave life
if I am unable to respond to anything or anyone (in a coma or permanently
unresponsive state, as defined by brain activity and behavioral testing), I will be kept alive indefinitely:
Since I will not have appointed someone to make medical decisions if I
am unable to do so, I will be kept alive indefinitely, regardless of my
level of functioning or brainactivity:
Since I will be kept alive regardless of circumstances, my relatives
and other people who care about me may suffer emotionally
and perhaps financially:
I.4 What are your thoughts about exploring D&D a little further by:
... proceeding further with the LLQ:
... talking to your doctor, lawyer and close relatives about
your end-of-life
decisions:
... keeping your eyes and ears open for reports of changes in way the medical
establishment can help ease suffering at the end of life:
... paying attention to reports that our culture is tolerating or
encouraging people to take control of what happens to them at the end of
life, rather than leaving it up to chance, the medical establishment, God,
or the natural course of events:
I.5 If you are going to stop
here: Do you think that any of the following could encourage you to continue
exploring D&D, now or in the future?
More time to get used to the topic.
Assurance that the physical and emotional suffering in the last stages of
life can be reduced to acceptable levels.
Learning a way to reduce the anxiety that makes thinking about D&D so
difficult.
The availability of
emotional support or advice from a professional or group.
Seeing reports in the media that that our
society is allowing people to have
more control over their own D&D, if they so wish.
For those of you who are young: As you get older, you will be reminded
more frequently that you that you will not live forever. You will notice the
increasing attention paid to end-of-life issues by the medical and
ethical professions and by the media. As you proceed through the stages of
your life,
you will face many challenging problems. Hopefully, the strength you gain from
meeting these challenges will make you better able to deal with the personal and social issues related to leaving life.
For all of us: Certainly, as time passes, D&D will become easier to
deal with. Many people are working on ways to change the experience so that it
is can be less painful physically and emotionally for you and for your
survivors. Many people want more choices, and many are working to deal with the
problems that having more choices will bring.
For those of us who are going ahead: Let’s face it. Most of us
don’t want to be here, beginning to consider something that is instinctually
frightening yet inevitable. But maybe something worthwhile will result from
trying to learn more about D&D and our reactions to it. Perhaps we will come
out at the end of the journey a bit stronger. So, let’s go ...