Mrs. S. had lived with progressive emphysema for years. During her last admission, she was brought gasping for breath into the emergency room of a local hospital. The staff asked if she wanted help breathing. She nodded her head "yes," and she was put on a respirator. Her niece arrived at the hospital hours later. She showed us her aunts Living Will, which specified no breathing machines. We followed her wishes. She died comfortably with her niece and daughter at her side.
Contrast Mrs. S.s situation with people who are in nursing homes, unable to converse, walk, or eat, and whose lives are maintained with feeding tubes and aggressive care when they develop pneumonia or bedsores.
We have recently seen the death of Jackie Kennedy Onassis, who asked to leave the hospital, stop her treatments for cancer, and stop antibiotics so she could die as she had lived, privately and with dignity. Richard Nixon had a Living Will that specified he wanted no "heroics." He, too, was allowed to die as he wished. Decorated Vietnam veteran Lew Puller and Kurt Cobain, lead singer for Nirvana, ended their lives by suicide. Dr. Jack Kevorkian gives people the means to end their lives before their diseases do. Washington State recently overturned the ban on assisted suicide. Clearly as a society we are repeatedly challenged with life-and-death issues.
I have journeyed with persons who are ill, their families, and the staffs who take care of them. And I am a religious person committed to the sanctity of life. Some of the ethical principles involved in seeking guidelines about life and living and death and dying include autonomy or self-determination, beneficence, non-maleficence, fidelity, and justice.