Whether 'Tis Better To Suffer

by Rev. Dr. Edward Frost

Presented 2011 November 06 to the congregation of Mountain Light Unitarian Universalist Church in Cherry Log GA.

To be, or not to be, that is the question:
Whether 'tis nobler in the mind to suffer
The slings and arrows of outrageous fortune,
Or to take arms against a sea of troubles,
And by opposing end them? To die, to sleep,
No more; and by a sleep to say we end
The heart-ache, and the thousand natural shocks
That flesh is heir to: 'tis a consummation devoutly to be wished.

In this perhaps most often quoted of what is perhaps Shakespeare's best known play Hamlet considers the fragility of life; the all-too-brief light, brief as a spark, ending inevitably in death's nothingness – or perchance to pass into eternal dreams. "Ah, there's the rub."

As Hamlet speaks of death, he begins to muse on suicide – to consider if ending one's life rather than enduring life's pain might be the better course. "To be or not to be; that is the question. Whether 'tis nobler in the mind to suffer the slings and arrows of outrageous fortune, or to take arms against a sea of troubles, and by opposing end them? 'Tis a consummation," Hamlet says, "devoutly to be wished."

On the other hand, is it perhaps more "noble" to "suffer the slings and arrows of outrageous fortune that flesh is heir to?" In his essay "The Myth of Sisyphus" the existentialist philosopher, Albert Camus, plays on the theme of Hamlet's musing of "To be or not to be" as he wrote:

"There is but one truly serious philosophical problem, and that is suicide. Judging whether life is or is not worth living amounts to answering the fundamental question of philosophy. All the rest – whether or not the world has three dimensions, whether the mind has nine or twelve categories – comes afterwards. These are games. One must first answer [the question of suicide]."

These are the questions that lie at the heart of the continuing civic, philosophic and religious struggle with the issue of suicide – particularly the issue of assisted suicide. If we are suffering the agonies of illness and disease for which there is no cure, suffering most of us cannot imagine which, after months or years inevitably ends in death – should we not have the right to by taking action "take arms against them and by opposing end them? Should we not have the right to choose for oneself when it is good, and moral and timely to die and to seek the help of those who are prepared to help us die in dignity, in peace, safety and in the company of friends, loved ones and compassionate helpers?

At the present time, assisted dying is legal in only three states. Oregon was the first state to pass a "Death With Dignity" act, which authorizes physicians to provide lethal drugs. Washington and Montana have a similar laws.

An article in "CNN Health" says,

"The idea of allowing someone to end his or her own life is undoubtedly controversial. The article points out that in Gallup's 2011 Values and Beliefs poll conducted in March of this year 45% of Americans consider doctor-assisted suicide morally acceptable, – and 48% believe it's morally wrong. The article reported that the split was closer than on other hot-button issues such as abortion, having a child out of wedlock and cloning animals."

Frankly, I was surprised to read that almost half those surveyed considered doctor-assisted suicide morally acceptable, given the fact that only three states in any way condone it. Of course, I don't know where the survey was conducted: it might have been in those three states in which it is legal. What are the objections to assisted suicide? Obviously, not everyone believes that ending one's own life is "devoutly to be wished for."

One of the objections is that suffering is somehow "redemptive." We often read of someone's death as one who "suffered heroically" in his or her "battle" with a terrible illness. Here the wish to not suffer "the slings and arrows of outrageous fortune" but to oppose them, to end them, seems to be judged by some to be a selfish and even cowardly – ignoble choice – to end a life which, though lived in the fog of drugs and in terrible pain when the drugs wear off with shorter and shorter periods of relief which can only end in death prolonged. Either choice, "To be or not to be," to cling to life with all the palliative care that science and medicine can offer or by choosing to end the suffering – either choice may be courageous. It is not for us to judge the choice of others. We can only work to assure that those who suffer have the choice to bear it for their own reasons or to end it in their own time and by their own means.

Shortly after leaving the congregation I served in Atlanta the Associate Minister who had worked with me, The Rev. Suzanne Meyer, developed inoperable and terminal cancer. Another colleague was a constant companion to Suzanne in her last days. She writes, "Suzanne was in unbearable pain whenever the morphine wore off, and it was hell for those of us who loved her to have to bear it as witnesses from the outside, let alone how it must have felt to her." This, by the way, is another objection to assisted suicide – that the suffering person will be persuaded by that "hell" of those who can only stand by helplessly to end their lives, not for their own sake, but for the sake of their loved one.

But Suzanne's companion, The Rev. Melanie Morel-Ensminger, writes,

Everything in me screams out that that pain was not in any way redemptive. It was, instead, the exact opposite – it was reductive. A person in that kind of intense, unrelieved pain, with no end in sight except death, is not gaining character or spiritual power or anything else. They are losing their humanity and their personhood, they are struggling without meaning and without purpose and with no end except death.

Having been with so many people in that struggle personally I don't need to be convinced of what has seemed to me be to be "struggle without meaning." If there is some kind of heroism or nobility in it I cannot imagine what it could be. "What's wrong with lying peacefully in bed," my colleague writes, "Saying good-bye to loved ones, listening perhaps to music or sounds of nature, and then quietly and with full humanity letting go as the breath stops? Why," she asks, "is struggling in pain, crying out, face distorted, tears flowing, family members helpless and distraught, considered more authentically human?"

In a powerful, deeply compassionate PBS documentary called "The Suicide Tourist" (which you can access online),a man suffering in the final stages of ALS (Lou Gehrig's disease) says "As you experience yourself draining inexorably away you come to see yourself as an empty shell, existing mostly to take in and excrete fluids." He finally made arrangements with one of the four legal assisted suicide organizations in Sweden and died peacefully with their help with his wife by his side.

There are, of course, many people – that fifty percent or so – who believe that there is a lot wrong with ending one's own life – assisted or not. There are powerful and perhaps immutable religious objections that, like the issue of abortion may never be resolved. For many people, the answer to the question "Whose life is it anyway?" Is simple and beyond question. For believers, our lives are not ours alone but belong to God – and it is the gravest of sins to deliberately end them.

The Roman Catholic Council of Bishops does not object to palliative care and supports patient's final directives that no "heroic measures" (an interesting way to put it) be taken to prolong their lives. But the bishops draw the line at suicide, reaffirming the doctrine that suicide is a sin, that life, no matter how unbearable, is a gift of God which no one can set aside without fear of sin from which there may be no redemption. Other religious bodies support palliative care but most also embrace the doctrine that life belongs to God and no one has the right to end it – or to assist in ending it.

The man with ALS, in discussing his decision to end his life, said "I have decided that it is my time – my time to die. I know there are some who object to my decision, but, then, who's life is it?" I find it interesting that in Hamlet's soliloquy he does not include God in the dilemma "To be or not to be." "That is the question," he says, and he apparently assumes that it requires a human answer. But the traditional religious conviction is that since God breathed life into Adam the breath of our life is the gift of God – even when that breath is noisily drawn by a machine, whether the sufferer would choose to have that breath drawn or not.

Generally speaking, I believe it is pointless to argue against belief – unless that belief involves violence or oppression against others. But I find it difficult to understand the nature of a God who demands that a person of faith continue to prolong life into weeks and months of excruciating pain. The traditional answer to questions of "God's will" is either that we have no answer – that God has his reasons and that we cannot always know them; Or, that God requires the prolongation of suffering to prove or demonstrate the faith of the sufferer.

In the play, "J. B." by Archibald MacLeish based on the biblical book of Job, God has inflicted all manner of suffering on Job. He strips Job of all that he had possessed as a formerly rich man and afflicts him with horrendous sores that caused him to sit on an ash heap and scrape at them in agony. All his suffering, according to the narrative, is for God to prove to Satan and to Job's skeptical friends that Job will remain faithful to God no matter what abominations God piles on him. Finally, J.B.'s long-suffering wife has had enough of this contest between divine and human will and says to her husband, "Curse God and die."

We should note that the biblical story of Job is derived from one of the oldest narratives in human history. In the ancient narrative the story ends with the faithful one continuing in his agony. But the Hebrew writers, in adapting the story, gave meaning and purpose to enduring suffering by providing an alternative ending in which Job is redeemed from his suffering and all his possessions are multiplied ten-fold as reward for his faithfulness.

"Whether 'tis nobler in the mind to suffer the slings and arrows of outrageous fortune…" In my mind, there is no nobility in such suffering.

But if it eases the minds of the dying and their loved ones to believe God has some purpose in it, in their presence I can only keep my deeply religious objection to it to myself and minister as best I can. Some object to any form of assisted suicide, whether by the assistance of compassion in dying organizations or, even where the law allows, by physicians, because they fear that assisting the terminally ill and suffering to die we would be stepping on that proverbial "slippery slope" and the reasons for choosing to die would become less and less compelling. In time, so the objection goes, assistance in suicide could become easily available to anyone who simply wants to die.

But those of us who argue for change in the laws against assisted suicide are not by any means arguing for helping people to die who are simply literally "bored to death" with life. We are not even speaking of helping people to die who, they feel, have lived long enough and want to end it before the infirmities of aging take their toll. We are not even considering helping people to die who suffer from mental illness – perhaps persistent and life-sapping depression. Organizations such as "Final Exit" and "Compassion and Choices" are not going to consider helping people to die who have decided they cannot answer Camus' question of whether or not life has sufficient meaning to endure it. The issue of assisted suicide is by no means a contention that suffering or disabled people ought to die. The issue, again, has to do with whether or not one suffering greatly from a terminal illness ought to have the right to choose to die – to perhaps die with the assistance of a physician or with the assistance of such organizations as Compassion & Choices, Final Exit or the Hemlock Society.

A compelling reason for working toward legalizing these organizations is that it really is not as easy to end ones life as one might think. I recall the tragedy of an aging theology professor and his wife who decided to end their lives together. They shared a lovely candlelit dinner then lay down on their bed side by side and drank what they believed to be a lethal poison. Sadly, the poison did end the life of the professor but did not end the life of his wife who survived with irreversible brain damage.

Assistance in dying by compassionate and knowledgeable people is essential because suicide is not easy, as the theme song of the movie "Mash" claims and the consequences of botching the task can be tragic. What we wish for those who are convinced that their lives have become unbearable is that they have the right to choose to be assisted in dying, dying peacefully with compassionate befriends and perhaps with loved ones by their side as their journey ends.

In 1988 the annual General Assembly of the Unitarian Universalist Association adopted a "Death With Dignity" Resolution. The Resolution began in relation to the first of Unitarian Universalism's Seven Principles: "That we affirm the inherent worth and dignity of every person and that we are] Guided by our belief as Unitarian Universalists that human life has inherent dignity, which may be compromised when life is extended "beyond the will or ability of a person to sustain that dignity; and believing that it is every person's inviolable right to determine in advance the course of action to be taken in the event "that there is no reasonable expectation of recovery from extreme physical or mental disability."

There are several "Whereases" and "Be It Resolved" in the Resolution but I believe the essence of it is: "That Unitarian Universalists advocate the right to self-determination in dying, and the release from civil or criminal penalties of those who, under proper safeguards, act to honor the right of terminally ill patients to select the time of their own deaths; and – BE IT RESOLVED: That Unitarian Universalists, acting through their congregations, memorial societies, and appropriate organizations, inform and petition legislators to support legislation that will create legal protection for the right to die with dignity, in accordance with one's own choice."

Again, the issue here is choice. And it is every bit as profound a religious choice as it is for the Roman Catholic Council of Bishops – because the choices before us, whether they have to do with choosing to die or a woman's right to choose have to do with our theological and philosophical convictions about the nature, source and, literally in the end, the "ownership" of human life. I insert here a passage from a letter Rev. Meyer wrote to her friends in her final days:

My health failed me in the end," she says, but my friends did not. I never felt abandoned by God, or punished; in fact, my cancer brought me closer to God by bringing me closer to other people's suffering. My greatest life-long fear was that I would die sick and alone in some indifferent institution. Thanks to my loving friends, I never felt alone or isolated. I was overwhelmed by the love of friends. Through them I caught a glimpse of heaven.

"To be or not to be. That is the question."

May we stand for the right and freedom to freely choose the answer for ourselves.

I used the following passage as closing words in the Service in which this sermon was delivered. It is from a sermon by the Rev. Kathleen McTigue, Senior Minister of the Unitarian Universalist Congregation of New Haven.

"There is no absolutely clear place for us to stand on this issue. We have to walk with supreme care, respect and compassion, and be prepared to struggle mightily for clarity in each singular case. But we have to begin to shine a light here, to talk about it, to tell our stories, to open our hearts to all the contradictory and sometimes painful realizations that arise. We have to find ways to push forward laws that more truly reflect the realities we are now living – the realities we are now dying."