The right to life versus the right to live.

In our modern technologically sophisticated age, the right to life has all but overwhelmed the right to live. Preoccupied with delaying death, the inherent value of life is often compromised. Earlier this spring, the media was suffused with coverage of Terri Schiavo, and, indeed, the Southern Medical Journal recently added its own voice to the debate. (1) Close on the heels of the Schiavo case came news of Pope John Paul II's ailing condition and his eventual passing just after Easter. A welcome relief from the divisiveness surrounding Schiavo, the late pontiff peacefully lived out his remaining days as a teacher, demonstrating how to live life to its natural end and to conclude it by dying with dignity. His simple message, "do not be afraid," (2) is particularly apt for this insecure world and is a teaching from which we can all learn not only in death but also in life.

A constant admonisher of unchecked progress, Pope John Paul II was not at odds with modernity but rather with a modernity which embraced a culture of death rather than one of life. "Marked by an attitude of excessive preoccupation with efficiency," such a culture of death has no time for the aged or the ailing. (3) Although medical advances have made it possible to live to an unprecedented age, they also have helped transform suffering into yet another affliction to be alleviated. In such a culture, not only is suffering turned anathema, so too are those who, in their infirmity, testify to its continued presence: suffering--and ultimately death--becomes a sign of failure.

To a culture increasingly preoccupied with instant gratification and consequently unwilling to endure suffering, John Paul's onerous life stood as a constant rebuttal. Once an avid athlete--a skier, swimmer, cyclist, and outdoorsman--John Paul must have been keenly aware of his own physical limitations and frailties, particularly as those frailties became increasingly restrictive and even debilitating. Among other medical difficulties, John Paul survived a near-fatal shooting to the stomach (1981), the removal of an orange-sized intestinal tumor and a cholecystectomy (1992), a shoulder dislocation (1993), and the replacement of a broken hip (1994), as well as an appendectomy (1996)--all of which were complicated by repeated bouts of influenza. He also suffered from crippling arthritis, and, in 1992, the first signs of Parkinson disease became apparent though his penetrating blue eyes were never clouded nor his sharp mind dimmed. Clearly, this was a man who knew the meaning of pain and suffering.

He was also a man who knew the meaning of life and living. Pain is painful before it can enlighten, and it is this face which presents itself as failure. There is, however, occasion for deeper understanding: in suffering, John Paul writes, "the person discovers himself, his own humanity, his own dignity, his own mission." (4) Rooted in relationship, neither purpose nor meaning can be lost to suffering--in fact, their truth can be realized in the very face of such adversity. Accordingly, as beings entrusted to one another, suffering is best met and understood communally: the most compassionate are often those who themselves have endured hardship. Throughout society there resonates an irrational fear of suffering, yet it is integral to both our mortality and our humanity. It is neither inhuman nor inhumane.

It follows that as suffering has become intolerable, so too has death. All too frequently seen as an interloper, death is viewed by many as suffering's nadir. Such apprehension belies an implicit discord in how our society understands life: the value is no longer in living life but in sustaining it. Gone is Plato's well-ordered life, wherein the physical, the intellectual, and the moral are tempered and directed (5,6); gone too is the responsibility to order one's life. By no means is death to be sought or its onset hastened, but neither is it--nor suffering--to be impetuously fled but accepted. After a long and arduous life, John Paul's final amen must have been, at least in part, a serene sigh of relief.

Perhaps John Paul spoke most emphatically on dying in the example he showed during his final days: over five weeks, he willingly underwent two hospitalizations, ventilatory support, at least one course of antibiotics, and a tracheostomy. Upon realizing the futility of these therapeutic measures, however, he resigned himself to death, requesting the removal of his nasogastric tube and refusing further life-sustaining measures. John Paul did not give up on living; rather, he chose to complete it. Having exhausted ordinary medical options, he refused to resort to extraordinary ones.

It must not be forgotten that humankind is mortal, and that, despite the best of medical technologies, death is inevitable. Acceptance of death should be natural: it complements our imperfect state of being. Life, even in death, should be dignified.

References

1. Paris JJ. To feed or not to feed: Terri Schiavo and the use of artificial nutrition and fluids. SouthMed J 2005;98:757-758.

2. The Vatican Web Site. Pontificate--John Paul II. Available at: http://www.vatican.va/holy_father/special_features/hf_jp_ii_xxv_en.htm. Accessed August 2005.

3. Pope John Paul II. Evangelium vitae [encyclical letter]. Written March 25, 1995.

4. Pope John Paul II. Salvifici doloris [apostolic letter]. Written February 11, 1984.

5. Plato. Republic. 442.

6. Plato. Gorgias. 506e.

Conrad C. Daly, MTh

From East Tennessee State University, Johnson City, TN.

Reprint requests to Conrad C. Daly, PO Box 70429, Johnson City, TN 37614. Email: [e-mail]

Accepted June 21, 2005