Autonomy or Worthiness? How to Find Dignity in Death

 
 

There is dignity in living and dignity in dying, because the concept of “dignity” is inseparable from our humanity. Even when our autonomy is lost, all people can still undergo suffering and death with a noble and dignified serenity.

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It was gray and raining the day we buried my grandmother.

When the prayers ended, my mother asked me to retrieve one of the red roses for my grandfather to put on the casket, as he made his last goodbye to his wife of fifty-three years. I remember feeling at a loss as I set about trying to find one flawless rose for him. My grandfather was always bringing my grandmother red roses, each one a token of his enduring love. How could a single rose be fit to assume the symbol of his faithful heart, able to love through both life and death?

I recalled this powerful moment when I read Dr. Aaron Rothstein’s essay, “All Death is Death Without Dignity.” He asserts that the “Death With Dignity” movement has found itself making an ultimately incoherent statement. Death has no dignity, he argues. Rather, it is the life that we led that is dignified. “The people we have chosen to become,” he writes, “and the ways in which we have chosen to spend our lives are the only things that matter at the end.” Death itself, he argues, is ugly and agonizing.

I wonder. Dr. Rothstein’s own thesis seems to be built upon a mistaken understanding of the word “dignity.” There is dignity in living and dignity in dying, because the concept of “dignity” is inseparable from our humanity. This is true even during the process—and indeed the very moment—during which the soul is separated from the body of a human being. We get a glimpse of this reality in the innate sense that we must respect dead bodies—even the dead bodies of people whose lives were not admirable.

Dr. Rothstein writes, “If we want our loved ones to retain dignity in death we ought to look at the lives they lived.” This is certainly true—a life well lived is a key component of a dignified death. But it seems that we are missing the whole picture of a person’s life if we do not also include one's very death as an attribute of dignity one can merit.

We need not look far to see that our culture has a perverse view of death. On one hand, our culture embraces certain kinds of death, such as legalized abortion, euthanasia, and physician-assisted suicide, classifying them as “merciful” or “empowering.” Pope St. John Paul II calls this mindset the “Culture of Death,” in his encyclical, Evangelium Vitae. On the other hand, Americans reveal their interior disgust with and horror at death as they deck their lawns with bloody zombie corpses and skeletons in anticipation of October 31st. Ironically, our culture desires certain kinds of death and yet is repulsed and terrified by death. It’s no wonder such a statement as “death with dignity” could so incoherently refer to “choosing how one dies.”

Recasting "Dignity"

Before considering whether or not death has dignity, we must define the term. Two years ago, Brittany Maynard grappled with this question as she faced a particularly horrific form of brain cancer, glioblastoma. Tragically for her—and for all Americans—she ultimately decided that, to her, dignity meant “autonomy” or “control.” She wrote on the day she died, “Today is the day I have chosen to pass away with dignity in the face of my terminal illness, this terrible brain cancer that has taken so much from me … but would have taken so much more.” She decided to try to outsmart death: instead of letting it dictate what would happen to her, she would dictate the terms of her own death.

The Brittany Maynard Fund was taken up by Compassion & Choices, which advocates and provides aid for those seeking to end their lives. They write, “Every person deserves to reduce suffering at the end of life and die in comfort and control, with dignity.”

Brittany’s heartbreaking story paints a bleak picture for us. Dr. Rothstein also gives us a sorry image in the story of his patient. Metastasized cancer, a courageous fight, and humble submission give way to a lifeless corpse, mouth agape, with flies buzzing round. In death, this man has forfeited everything, losing completely his control and autonomy. Where is the dignity in that? No matter how we come to that final moment, whether we expedite the process or not, Rothstein writes, death is ugly, terrible, and tragic. No one can outsmart that.

Dr. Rothstein, of course, means to argue against the “Death with Dignity” initiatives by pointing out this unifying principle—if one may call it that—among all who die. But what is dignity, really?

Etymologically, “dignity” derives from the Latin adjective dignus, which means “worthy.” On this understanding, then, we all have dignity simply by being human. By virtue of being rational animals endowed with an immortal soul, we have a certain kind of dignity that can never leave us, even after we have died. However, there is a superadded dignity to a death well-encountered. This dignity is ascribed, of course, to the person, not to death, which is in itself a great evil.

“Worthiness” is a kind of integrity, which probably accounts for why people may be tempted to equate it with autonomy: physical integrity. But if we look beyond the physical—if we see man as not only a composition of limbs and eyes but as a person who is capable of loving and sacrificing—our idea of integrity and worthiness takes on a larger meaning. Dignity, then, is found not only in our external actions, but even in our passions (which, Aristotle instructs us, are things that happen to us). I posit, then, that true dignity is the worthiness and integrity with which a person both acts and receives the actions of outside forces. We can act well and receive well in the face of good and evil.

The question is, then, what makes us worthy of dignity during and through those final moments?

What Is Death Well-Received?

Death will come to all. Every set of sparkling, laughing eyes will one day be shut; all flesh will harden and turn to dust. If we judge from appearances, this is an ugly picture. But looking beyond the physical aesthetics, we can find not only a life well-lived, but a death well-died.

Perhaps it’s easiest to see this from a Christian perspective. As Christians, the first place we look when we think of death is the cross upon which Christ willingly died in order to end all true death, the death of the spirit. His death was at once the greatest evil and the greatest good, because by enduring temporal death, He brought us eternal life. Though belief in Christ may not be shared by all, purely human images speak of this same self-sacrificial truth. Think of Antigone suffering execution so that she could bury her brother. Sydney Carton dying in the place of Charles Darnay. A soldier dying in battle for his country. There may be no physical beauty in these scenes, but there is a beauty that transcends what the eye can see.

We call this love. And while these pictures show dignity in an extreme way, the transcendent experience of love and courageous reception of the agonizing evil that is death is an image we find in many deaths around us.

This dignity does usually correspond directly with goodness merited by a life well-lived, but it would be overlooking the glory of the “home stretch” to say that dignity does not extend to death, and even beyond. In particular, those who would defend the sacredness of human life must look beyond the external horror of death to see a different reality.

My grandmother’s death was when I learned to revere death, even as her passing shook me to my core with grief. My grandmother certainly lived a life worth emulation, but she died in a way I hope to emulate as well. As she died, her courageous, loving heart affected the whole family in a transcendent way. It was a time of forgiveness and grace. The love she showed us during life seemed more powerful even as her beautiful life ended.

Death is surely an awful thing, but it is not an isolated concept. It happens to people. Even when our autonomy is lost, all people can still undergo suffering and death with a noble serenity that can truly be called dignified.

Margaux Killackey is the Deputy Assistant Director at the James Wilson Institute on Natural Rights & American Founding.

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