This is a letter I have written to Brittany Maynard, a young woman from California who in April of this year received the terrible news that she had terminal brain cancer. Brittany made headlines when she announced that on November 1st she would take her own life by overdosing on medication in order to avoid the horrible death cancer had in store for her. To fulfill this decision, Brittany and her husband have moved from California to Oregon where euthanasia is legal.
Dear Mrs. Maynard,
It is now October 31st, and I have been thinking for the past week about what I was going to say to you, or if I should say anything at all. I don't know you. I don't know your husband. I don't know your family or your friends. In no way am I acquainted with anything about you, nor do I live anywhere close to you. If not for the news, you would never have existed to me, and since consciousness is the only lens through which we experience reality, this is important, because this means that there are so many out there who have your same condition that I know nothing about, that do not exist to me, that have not entered my consciousness, and it is only by a chance glance at the news that I know of you, and so I write to you.
There are not many similarities between you and I. I'm a single college-age male in my early-20s, living in Texas on a Ramen noodle diet, and you are a married woman nearing 30 living in the West Coast on what I assume is not a Ramen diet. But despite what are probably vast differences in our personalities, realities, and lifestyles, I wanted to write a letter to you just as one human being to another.
Mrs. Maynard, at the forefront of my mind right now is the question "What makes life worth living?" There's a multitude of answers one can give to this question, but I imagine that a relatively silly answer someone could give, if asked the question, would be "Breathing." We would realize this is a silly answer, because breathing is not what makes life worth living, it is merely what makes life possible. To say breathing is what makes life worth living is like saying wood is what makes a table worth having. Raw ingredients themselves do not solely comprise use-value. The things we could list that make life worth living would be things like: love, hope, memories, excitement— or even more specifically children, good food and drink, holidays, travel, sex, the list could go on. It is our experiences which make life worth living.
Why do I make this point?
For two reasons: The first reason is the main one, and that is, the reason for which you are choosing to end your own life. You have brain cancer. Because the brain is the only way in which we can experience, it is reasonable to say that once the brain is damaged sufficiently enough, that which makes life worth living is destroyed. The "you" that is your personality, your quirks, your feelings, your desires, and your beliefs, dies with the decay of the mind, and all that remains is the shell of you still "breathing". But secondly, I feel I must address indirectly as I speak to you, the primary group of people who would dispute all that I have said thus far. No doubt this group of people have also written you letters, and have likely raised their voices (rather loudly) about what they think of your decision.
A belief in myths can bring color into some people's lives, and as long as those people handle their belief in myths with some level of propriety and decency, I haven't a problem with their imaginations. But when these people take their belief in their favorite myths to such seriousness that they demand people in agony, such as yourself, not stop their own suffering, or worse, plead with the government to force another person to live in suffering, "morally repugnant" doesn't quite cover their desires. Not as well as the phrase "sadism in the name of virtue" at least.
Mrs. Maynard, I am a young man, but not much younger than you. I am 23 and you are 29. Neither of us have been alive as long as others have, yet, I do feel that I (and you) have been alive long enough to form ideas and values based on available evidence and reason. Having said this Mrs. Maynard, allow me to share my perspective with you. It is irrational, in my opinion, to believe something without evidence. Not only irrational, in fact, but potentially dangerous. Of course the promoters of various myths have their unique sets of "evidences", but such "evidences" are only convincing to those who already want to believe in these myths, and so, when I refer to evidence, I am speaking of course of the fruits of scientific inquiry. With that in mind, let me say that I have yet to hear of a peer-reviewed study suggesting that any part of us "goes on" after the brain dies. So far as I am knowledgeable, there has been no peer-reviewed research published to suggest that the brain isn't all there is to consciousness, and so until such research does come to light, I believe that the brain is all there is. When the brain dies, as far as we know, that's it. To ask if there is life after death is like asking "What happens to the flame when the candle goes out?"
I say this not to be cold in my approach to your decision. In fact, I could not write the above paragraph with any stronger a reverence and respect (and reluctance). Rather, I say all of this, because I hope to bring you the solace of reason amidst the possible voices of callousness coming your direction from the mouths of the superstitious. It is my hope that established knowledge can bring greater comfort than fearful conjecture about "what lies beyond". Prolonging suffering for the sake of an after-death fairy tale is— if I may be blunt— stupid. There is no indication in any of the sciences that consciousness, or "life", extends beyond the death of the brain. There is no evidence for a "soul", "will", "energy", or "unique force" that is separate from our bodies, specifically our minds, and which lives on beyond our death. No doubt what I am expressing is the opposite of what you likely have heard from proselytizers, fanatics, and moral busybodies since the news of your decision broke. And thus I will conclude my second point by saying that just as I would advise an individual not pay any mind to the musings of the delusional in an asylum, so I advise you not to pay any mind to the musings of the delusional outside of one. In other words, I hope you do not indulge those who tell you that bad things await you in another life if you decide to end your suffering on your own terms. They don't deserve your time.
It speaks to the bondage we still have in our country— bondage to our ancestral puritanism, bondage to widespread fundamentalism that still grips a vast majority of our nation, bondage to those who dream of theocracy— that you had to move away from your home to a state that would allow you to make the decision to end your suffering. That you cannot die in your own home, but must move elsewhere because of the laws of our country, should cause every American to hang their heads in shame. Until we have the right to end our own suffering, until we have the right to die as well as live, how can we say we are truly "free"?
Having discussed with you the question "What makes life worth living?" and the two subsequent reasons for why I brought such a topic up, I wish now not to waste any more time with philosophy, as you are soon to die and to continue any further with talk of ideals and beliefs would be insensitive.
I wish instead to spend the rest of this letter to tell you how brave and full of courage you are. This afternoon I tried my best to put myself in your shoes, though even my best effort could never come close to what you are enduring. Here's what I felt when I tried to imagine myself in your place:
At first I thought of my loved ones. I thought of my only sister and I thought of my parents and grandparents and aunts and uncles and cousins. I thought of my best friends.
Then second, came the memories. I thought of my mother and me, and my memories of us when I was a little boy. I thought of my first snow-covered Christmas when I was 5 years old. I thought of my first fight when I was 12. I thought of my first kiss at summer camp when I was 13. I thought of my travels to Asia and of living abroad in East Africa. I thought of the Army. Many memories flooded my mind.
After memories, came the thankfulness of simple everyday pleasures. A cold Dr. Pepper, a steak hot off the grill, going to the movies and buying that special movie theater popcorn, speeding down the highway with the windows down, reading, writing as I am doing now... so many simple pleasures!
But the moment when putting myself in your shoes becomes difficult, is when I realize that the one thing I cannot think of is the mystery of the future. It occurs to me that if I was to take my life tomorrow, I could not think about the future in the context of my being in it. This is the drastic difference between those of us who know not when we will die, and those like you who do. When people like me look back on our memories, like our first kiss or first snow-covered Christmas, part of the magic of doing so is with the possibility that the future will bear moments as magical as our past. When people like me look into the faces of our siblings or our parents, we do so with the curiosity of what the future will be like with them— what they will look like, how will their personalities change, etc. Not so, with those who know that the time of their death will be soon. And that is why I say it takes a profound bravery for those, like yourself, to choose death with dignity in the face of degeneration and suffering. Because you are looking back at your own magical memories, you are looking at the faces of your own loved ones, and you are, willingly, confronting the reality that no more magical memories will be made, and you will not grow old with those you love, they will live without you, and you are acting on that confrontation— which is not something that everybody can do.
Suicide is not always an act of "cowardice", or "selfishness", or any of the other ridiculous labels people have attributed to the act. Sometimes it is selfless, as in times of war when a man dies to save his friends. Sometimes it is an escape, for a person whose mind has always been tormented by mental illness and who simply cannot find relief from their inner "demons". Sometimes suicide is a way to be spared from imminent suffering, such as when someone finds themselves about to be a captive of a terrible regime. Sometimes suicide is a way to alleviate suffering that already exists, as I would imagine is the case you find yourself in at the present moment.
It is my fervent "prayer" that you do not now, nor tomorrow, feel guilt for the decision you have made. Nobody else knows your suffering. Nobody else can tell you— if they have any ounce of real morality— how you should handle your brain cancer. Such presumptuous "righteous" arrogance is beyond what I can fathom. No Mrs. Maynard, don't feel guilty. Feel brave. Because you are.
As long as I am being honest with you Mrs. Maynard, let me confess the obvious. I am not writing this letter only for you to read. By posting this letter on my website, it is my hope that others will read my words to you, and understand that such a personal decision as the one you are making is only yours to make, and nobody should dare question that fundamental right.
I will not say "Rest In Peace" because I think that statement meaningless, but what I will say is that I hope your passing is quick, painless, and peaceful. I hope that you die in the arms of the man you love, the person with whom you have— no doubt— shared your innermost secrets and intimacies with. I hope you draw your last breath with much warmth and love surrounding you, and I am happy that you will be able to do so with all of your mental faculties, fully aware of that warmth and love. Furthermore I give your family my condolences. It's never easy. I hope that they will remember you as you were before the cancer. I hope your parents remember you as the little girl giggling on the swing. I hope they remember you as a teenager freaking out about school dances. I hope they remember the beautiful young woman walking down the aisle in her wedding dress.
I suppose what I said at the beginning of my letter to you was slightly dishonest. There is life after death... in the memories of those whom we loved while we were alive. As long as they love us, how can we truly be "gone"?
I am so happy that you will get to die with dignity, and I hope, very much, that one day this will be a country whose majority supports decisions such as the one you are making.
October 31st, 2014
Update/November 2nd, 2014: Mrs. Maynard died with dignity yesterday, surrounded by her friends and family. You can find her obituary at Compassion & Choices.