Euthanasia is the Death of Life

At first, it's hard to dispute:

Dementia patients don't contribute anything to society.

Sure, there are for-profit companies in the United States that charge families big bucks to help care for dementia patients, but these memory-care facilities merely illustrate capitalism's ability to find a business opportunity in the worst of circumstances.

Nevertheless, it's not as though the memory-care industry is one of those "too-big-to-fail" sectors of our economy.  Consider how much more money dementia and dementia care costs, beyond the pricetag for housing its victims.  Consider the lost time from work as family members provide care to dementia patients.  And beyond money, consider the emotional stress, as an incurable disease erodes a loved one's memory during the course of years and years.

Suppose you've had that awful meeting with your doctor, and you've learned your diagnosis.  If you had the option of physician-assisted suicide or euthanasia for yourself, would you take that route, instead of taking your own journey through dementia?

In the Netherlands, it's just become easier for you to opt out of dementia, by opting out of life altogether.  After all, what kind of quality-of-life can one have with dementia, anyway?  According to a report in World magazine, the Dutch believe there is an "unwritten moral duty" to help dementia patients avoid their agonizing death spiral.

For years, Holland has been at the forefront of legalizing suicide, cloaking the practice with euphemisms of medical expediency like "physician-assisted suicide."  Besides, it's not really euthanasia when people from a specific cohort of human beings can choose not to commit suicide, right?

Hey, it's not like Holland is methodically exterminating all of its dementia patients.

Yet there remains the fact that a specific cohort of people are being given the "right" to determine their own death.  So the stigma of euthanasia - a term we usually deploy when some despot tries to wipe out an entire race - remains in force, doesn't it?  After all, the Netherlands are crafting their death laws to accommodate a class of people:  people who medical professionals believe are nearing the end of their sojourn on our planet.  The age range of dementia patients can vary, but the concept of euthanasia for the aged and infirm can't be hidden.  If you can't contribute to society because of your health, your government will let you decide how you want to kill yourself.

And an itty-bitty little country in Europe is leading the way.

At least for now, Holland's liberalized euthanasia laws mandate that such end-of-life plans need to be set in place before the person receives their diagnosis of dementia.  Once a person is diagnosed, they will not be able to backtrack and file their suicide pact.  Good thing - we don't want people with memory problems deciding when they want to die.  But... "sane" people should be given that opportunity...

Does that make sense?

Towards the end of my father's journey through Alzheimer's, one of his hospice nurses told me, "you think the patient is the one who suffers most, but that's not really true."

I looked at her scornfully.  But she offered a pretty plausible explanation:

"Most dementia patients - especially as they get worse and worse - don't really understand that they have dementia.  They forget that they forget.  Sure, they get confused, and they get frustrated by their confusion, but then they forget that they were confused, and the frustration goes away."

And indeed, there is a cycle of confusion, frustration, and then forgetfulness that Dad and just everybody else with dementia goes through hourly.  One reason dementia patients sleep so much, it has been speculated, is that sleeping helps them avoid the confusion that sets the cycle in motion.

There's not a lot of physical pain in dementia.  In fact, one reason why dementia can last so long is because its victims usually have few other physical maladies that could otherwise kill them before Alzheimer's does.  For a while, towards the end, Dad was in considerable pain, but that pain was because we didn't realize his special wheelchair was creating a sore on his hip.  Once we got a cushion for his wheelchair, Dad's cries of agony stopped.  Dad also became quite weak, but that was from not eating.  And since nobody can survive for long without eating, it wasn't long before Dad passed away.

There would have been no point in killing him during this period of time.  It would have only shaved off several months of his life.  And whose suffering had been worse during this whole time?  His, or ours?

Ahh... that's the real dirty little secret behind euthanasia, isn't it?  We're not so much worried about the patient as we are our own selves.  We don't like watching our loved one's memory fade.  We don't like the impositions our loved one's care forces upon us.  We don't like paying for that care, monitoring that care, and not knowing how everything is going to work out.  How much easier it all would be if we knew the end process, and the end date!

I've heard many people say that they wouldn't want to put their loved ones through such a horrible experience as caring for a dementia patient.  Yet death - and the process of death - is a part of life, isn't it?  For what else are our loved ones here, anyway?  Just for the fun times, the good times?  Is that all life is about?

Is life about having lots of money left over after you die?  Is life about not having to watch a loved one suffer?  Is life only about productivity, vitality, and having a good memory?

Even if you don't believe in the sanctity of life, and the authority God has over deciding when life begins and ends, consider the practical application of euthanasia:  If not God, or "fate," or Father Time; who else gets to decide when you die?  Who decides when your vitality is over?  Who decides when you are a drain on society?  Who decides when the pain is too much?

There's no avoiding the raw reality that euthanasia is a slippery slope, and once you've set one foot upon it, there's no going back.  It's death-creep.

That's why Holland is getting it massively wrong.  Life is not for us to abort, either before a human being is born, or before their natural end comes.  We can't simply impose our wishes on any human life's most basic milestones through political whim, legislative posturing, or platitudes about suffering. Or cost accounting.

If the definition of a progressive society is one that wants to cannibalize itself, then we've gone through thousands of years of civilization for nothing.
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By the Way:  After posting this essay, I learned that a distant relative of mine, who I never knew, died from assisted suicide last fall in Finland.  In addition, according to a Finnish cousin of mine who works as an elder care professional, Finland's out-of-pocket costs for elder care, despite its socialized medicine, are climbing rapidly for individual patients.  My cousin bluntly wonders if, eventually, "natural death" may be a luxury only the rich can afford.  I hadn't thought of it that way.  Looks like we'll need to take better care of our old people, and put our money where our moralistic mouths are, so euthanasia won't become more cost-effective than natural death.

Responding with Care to Transgenderism

Mention the term "transgenderism" to virtually any evangelical, and watch their eyes roll.

Our eyes roll either with contempt, confusion, or conflict.  We're contemptuous of people who have different problems than we do.  Or we're confused about how somebody could claim to be so sexually mixed-up.  Or we're conflicted about the proper way to respond, especially if we find out a co-worker, close friend, or a loved one is struggling with transgenderism.

Few evangelicals react in a sanguine fashion, or with compassion, or confidence that the Bible can address an issue virtually all of us find at least bizarre, if not impossible.

After all, doesn't the Bible teach that God created man and woman?  And just man and woman?  Doesn't biology assign body parts based on whether you're a man or a woman?  Sure, sometimes our emotions and desires can get a bit confused, can't they?  But transgenderism doesn't really exist, does it?

According to a growing body of respectable science, the phenomenon of transgenderism does indeed possess at least a baseline of credibility.  Noted evangelical scholar Dr. Anthony Bradley recently wrote an article for World magazine encouraging evangelicals not to dismiss the topic out of hand.  While much remains unproven about transgenderism (which the scientist in Bradley prefers to call "gender dysphoria"), enough studies have been conducted and evaluated to lend credence to the notion that we Christ-followers need to treat people struggling with this condition with dignity.

Not that we promote transgenderism as a viable, legitimate lifestyle that, in and of itself, honors Christ.  Transgenderism represents a manifestation of "the fall of man," otherwise known as the moment when sin entered God's creation. Numerous other sexual and psychological conditions besides transgenderism exist in stark contrast to God's prescribed intentions for how we exercise our sexuality and emotions Biblically.

In his article, Bradley argues that believers in Christ need to remember that we're all sinners, and each of us struggles with a variety of issues that do not honor God.  Yet even as we struggle with sin, we generally confer a certain amount of dignity to each other in terms of not denigrating ourselves based on our sin nature.  We look to the grace and mercy that God provides His people as validation of our inherent worth to Him - or at least, we like to say we do.

However, when it comes to sexual and psychological aberrations, we tend to become cynical.  We tend to mock, and be derisive.  There's something about these types of unBiblical propensities that we think qualifies them as being fair game for scorn or prejudice.  After all, why don't we treat heterosexual adultery the same way we treat homosexuality?

Instead, Bradley advocates for Christ-followers "to be a community offering hope instead of shame."  Not hope that things like transgenderism can become mainstream, but hope that Christ can provide freedom from the relentless confusion and urges that a follower of His who struggles with transgenderism inherently faces.  After all, if you don't believe that Christ is Who He claims to be, your struggles with transgenderism stem from it not being mainstream, or widely accepted as a viable lifestyle.  Bradley doesn't believe transgenderism is a viable lifestyle.  But he does believe that people who want to honor God with their lives should be able to rely on their community of faith for support in prioritizing Christ and His truth, no matter the challenges to doing so.

And I agree with him.  

I have a distant acquaintance who has embarked on a journey of gender reorientation. He's the former boyfriend of one of my best male friends.  Like me, Bradley approaches this issue not through theoretical distance, but as the friend of an actual person struggling with transgenderism.  But I haven't really known how to react properly until after reading Bradley's article.

As Bradley exhorts, this is a topic from which the evangelical church should not shy away.  Nor should we paint the people struggling with it in broad, discriminatory brushes.  Unfortunately, when a topic seems extreme and difficult to understand, it becomes a lot easier to treat with derision.  But we're talking about real people living real lives here.  And these are people who are just as valuable as you are, and I am.  Which means we can't be so dismissive of them, right?

Okay, so yes; it's a fairly complex subject, and Bradley lists no less than 15 reputable studies for us to consult as reference material if we want to learn more about its many nuances.  But can't we address this without earning a doctorate in psychiatry?

No matter the causes or manifestations of transgenderism, doesn't the Bible still have the answer?  After all, if every time we ran into a complex question, we'd have to run to a highly-educated expert, why does God expect each of His followers to have an answer for the hope that supposedly resides within us?

So let's think about this for a moment.  What is the answer for transgenderism as a viable lifestyle?  It's that God created man and woman, right?  And since God created man and woman, our own personal experience with the life He's given each of us individually involves a responsibility to honor God with that life.

How do we know whether we're a man or a woman?  In this context, I'm not convinced that's the question we should ask.  Instead, how about asking whether God is honored by what we feel, or how God has designed our most intimate features?  After all, God doesn't make mistakes, but on occasion, He does challenge us in extraordinary ways to put His glory - and the things that give Him glory - above our own preferences.

Personally, I think our society gives too much credence to sexuality when it comes to defining who we are.  We are trained to forget that sexual intimacy isn't a God-given right.  Some of us will never be married.  Some of us will have to relinquish our sexual impulses and be content with celibacy.  Perhaps that celibacy will be necessary because God does not reveal a suitable opposite-gender spouse to us.  Or perhaps that celibacy will be necessary because there is something inside of us that is sending confusing messages - for whatever reason (biological, social, sin-based, etc.) - to our psyche.

No, it's not easy.  No, it's not fun.  But lots of things in life are neither easy nor fun.

One of my many problems in my own life is that I try to figure out why I can't be or do what I think I want to be or do.  Sometimes I have to simply allow myself to receive the peace of God that is beyond my understanding (Philippians 4:7), and the only way to do that is to relinquish my drive to understand things that maybe God doesn't want me to understand.

That's a very counter-cultural perspective to hold these days.  Especially when we still need to be loving, patient, kind, and gentle with others - even with people who may be experiencing something as conflicting and confusing as transgenderism.  Oh yeah - and we're also supposed to be self-controlled!  But not contemptuous.  It's the Fruit of the Spirit at work, even when we don't understand what our brother or sister in Christ may be going through.

The issue of transgenderism can be bizarre, yet we followers of Christ need to respect how our response might or might not honor the One Who created each of us.
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Here's the list of resources recommended by Dr. Bradley:

• Balen, Adam H., et al. “Polycystic ovaries are a common finding in untreated female to male transsexuals.” Clinical Endocrinology 38.3 (1993): 325-329; 
• Bao, Ai-Min and Swaab, Dick F. “Sexual differentiation of the human brain: Relation to gender identity, sexual orientation and neuropsychiatric disorders” Frontiers in Neuroendocrinology 32 (2011): 214–226; 
• Coolidge, Frederick L., Linda L. Thede, and Susan E. Young. “The heritability of gender identity disorder in a child and adolescent twin sample.” Behavior Genetics 32.4 (2002): 251-257.; 
• Dessens, Arianne B., et al. “Prenatal exposure to anticonvulsants and psychosexual development.” Archives of Sexual Behavior 28.1 (1999): 31-44; 
• Dorner, Gunter, et al. “Genetic and Epigenetic Effects on Sexual Brain Organization Mediated by Sex Hormones.” Neuroendocrinology Letters 22.6 (2001): 403-409; 
• Gooren, Louis “The biology of human psychosexual differentiation” Hormones and Behavior 50 (2006): 589–601; 
• Green, Richard. “Family cooccurrence of “gender dysphoria”: Ten sibling or parent–child pairs.”Archives of Sexual Behavior 29.5 (2000): 499-507; 
• Hare, Lauren et al. “Androgen Receptor Repeat Length Polymorphism Associated with Male-to-Female Transsexualism” Biol Psychiatry 65.1 (January 1, 2009): 93–96; 
• Hines, Melissa, Charles Brook, and Gerard S. Conway. “Androgen and psychosexual development: Core gender identity, sexual orientation, and recalled childhood gender role behavior in women and men with congenital adrenal hyperplasia (CAH).” Journal of Sex Research 41.1 (2004): 75-81. 
• Lentini, E. et al. “Sex Differences in the Human Brain and the Impact of Sex Chromosomes and Sex Hormones” Cerebral Cortex 23 (October, 2013): 2322-2336; 
• Meyer-Bahlburg, Heino FL. “Transsexualism (“Gender Identity Disorder”)–A CNS-Limited Form of Intersexuality?.” Hormonal and Genetic Basis of Sexual Differentiation Disorders and Hot Topics in Endocrinology: Proceedings of the 2nd World Conference. Springer New York, 2011; 
• Rametti, Giuseppina et al. “Effects of androgenization on the white matter microstructure of female-to-male transsexuals. A diffusion tensor imaging study” Psychoneuroendocrinology 37 (2012): 1261—1269; 
• Savic, Ivanka and Arver, Stefan. “Sex Dimorphism of the Brain in Male-to-Female Transsexuals”Cerebral Cortex 21 (November, 2011): 2525—2533; 
• Swaab, D.F. “Sexual differentiation of the human brain: relevance for gender identity, transsexualism and sexual orientation” Gynecol Endocrinol 19 (2004): 301–312; 
• Zucker, Kenneth J., et al. “Psychosexual development of women with congenital adrenal hyperplasia.” Hormones and Behavior 30.4 (1996): 300-318

One Shell of a Sculpture

Show and Tell
 

Good grief.  With all of the stupid politics our partisan brethren and sisteren keep making me write about, it's too easy to forget that life isn't about elections or public opinion.

Which is a good thing, actually, since public opinion probably wouldn't consider today's installment of "Show and Tell" any kind of genuine art.

But I kinda like to think it's some sorta sculptural thingy.  Can you tell what it is?

Okay, I'll give you a clue. The white plinth is actually an upside-down plastic birdbath, with the birdbath part facing the ground, and its base sticking up in the air, topped by a circular concrete stepping stone.

And atop the concrete disc is an old sea shell.

Still wondering what it is?  Well, it's not supposed to be a brain teaser.  It's just a little something I created for our backyard to symbolize two memories that we have of my dearly-departed Dad.

The birdbath he purchased years ago, after a couple of concrete birdbaths kept getting broken by raccoons who insisted on climbing up in it to bathe.

Unfortunately for Dad, what the concrete birdbath lacked in flexibility, this plastic birdbath lacked in sturdiness.  I don't know how many mornings I'd wake up - usually the first one up - go out into the kitchen to make my coffee, look out the window, and see the plastic birdbath tumbled on its side, with muddy paw prints all over it.  Yes, the hollow base of the plastic birdbath was full of sand, but that was insufficient to withstand three or four raccoons trying to wash their dirty little paws.

Even now, upside down, the underside of the plastic birdbath has fresh, raccoonish pawprints on it! 

Nevertheless, whenever Mom and I look at this new creation, although technically we see an upside down birdbath, we also see an object that Dad used to fuss over almost daily; either by going out and setting it back upright and re-filling it, or by sweeping leaves out of the water if the birdbath had managed to remain upright and full for an extended period of time.

Of course, during our brutal Texas summers, sometimes the water evaporated so quickly, Dad would have to refill it daily.

As for the shell - what some might call a "conch" - it was something the previous owners of our house left when Mom and Dad purchased it.  We don't know where it came from, but like all shells of this size, it reminds us of the ocean.  This particular shell is fairly old; newer shells have a pink hue inside; this one has just a faint suggestion of pink.  It's mostly white, while within its tiny cracks and crevices, black decay has set in.  There's also a sizable hole in its underside.

Even though it and us are a long way from any ocean, we've kept it all these years, and it helps us recall those wonderful summers in Maine after Dad retired, when he and Mom spent a lot of time up there in idyllic coastal Sedgwick.

Still... it is art?

Well, I'll admit:  It's not anything I'd pay money to see, or that I'd buy.  Yet it has value to Mom and me because every time we look at it, we know the things - and the person - that it represents.  Anybody wandering into our backyard would likely consider it a bit weird, or at least unimpressive.  But then again, Dad wasn't into show at all, or impressing other people.  Besides, he himself liked to repurpose objects after their original use was no longer necessary.

Dad graduated from Brooklyn's prestigious Pratt Institute, which has a world-famous design school.  Some of the stuff I've seen their graduates produce looks a bit weirder than my modest assemblage, and I'm sure that stuff costs a whole lot more.

But even the most snotty-nosed critic from the elite cultural salons and clubs of avant-garde New York can appreciate at least one quality of this piece:  it's green!  Environmentally-friendly art.  Keeping stuff that otherwise might be considered garbage out of our precious landfills.

Reduce, reuse, recycle; right?

Memory Loss Beyond Dementia's Victim

Dementia has claimed yet another life that I have known.

A long-time family friend passed into Eternity this morning at a local hospital after suffering a fall on Saturday.  She was the mother of six, a grandmother, a retired schoolteacher, and the sister of another lady who's struggling with dementia.  Their mother died from it years ago.

Technically, our friend who died this morning likely did so from complications of her fall.  Yet it's also likely that having dementia did nothing but destabilize her sense of balance.  Indeed, as dementia continues to corrupt its victims' brain, motor skills and balance can become casualties of one's deteriorating mental capacity.

This particular family friend didn't have dementia for as long as my Dad did.  I'm not sure she was on any of the medicines that can help minimize some of dementia's worst symptoms.  Compared with my Dad, this family friend was fairly docile during her illness, and was able to remain in her home.  She and her husband were blessed with the loving resources of a large family, although the strain on her husband's face whenever I saw him was distinct.

She and her husband attended my Dad's memorial service back in October, and while she looked gaunt, with the telltale dark and stony face of dementia, she seemed relatively functional.  Although she could no longer remember my name, she acted as though her brain was telling her she knew who I was, so she'd grin broadly and giggle nervously around me - and around anybody else she'd known for years but were now nameless to her.  At Dad's memorial service, there were a number of those friends.

Last summer was the last time she and her husband visited Mom and me at our home.  While her husband and Mom chatted about all sorts of things, she nodded her head, smiled, laughed, and heartily echoed her agreement whenever there was a lull in the conversation.  Nevertheless, it was uncomfortably obvious that she really didn't know what her husband and my Mom were talking about, even though their topics of discussion - church, families, nostalgia, and even (oddly enough) funeral homes - should have otherwise been within her realm of comprehension and contribution.

Finally, she jumped up and began to touch everything - EVERYTHING! - in the living room where we were.

Not that she necessarily wanted to look at anything, however.  She didn't inspect what she touched and picked up, like she was interested in what it was, or curious about how it was made; she seemed to simply have a compulsion to touch it.  So she moved quietly around the room, picking up curios, picture frames, candles, glass vases, pillows, and photo albums.  She didn't look at the pictures, or browse the albums; she simply moved them about just a bit.

At first, her embarrassed husband began to apologize for his wife's odd behavior, but Mom and I cut him off.  Although having to touch everything in sight wasn't one of the ways Dad's dementia exhibited itself, he'd been in a memory-care facility long enough for Mom and me to understand that some dementia patients are extraordinarily tactile.

And dementia patients can also possess surprising strength and agility, despite their frail appearances.  When our friend picked up some of our heavy glass vases, I tried to suppress little gasps of apprehension over whether her dubious grip could hold the deceptively weighty object, but our friend displayed a deceptive nimbleless of her own as she'd lift one object while setting down another.

Indeed, like many hallmarks of dementia, it can seem contradictory how a dementia patient's brain can focus on and process one function, yet otherwise completely fail at another function.

Along one wall of our living room, a grouping of over a dozen framed photos is displayed.  And wouldn't you know it, but our friend shuffled over there and picked up each one!  She didn't look at any of the photos, although Mom tried to tell her who was in each photo, since our friend would have otherwise known most of our family members.  No; she'd pick up each frame, and then set it down again - but not exactly where it had been.  Before she was finished, every frame had been raised, briefly held aloft, and then replaced askew.  It was actually somewhat comical to watch.

I remember that when they got ready to leave, her husband had to help her into their car, even though she was fully ambulatory.  She simply didn't seem to understand the mechanics of sitting in an automobile so a seatbelt can stretch across your chest, even though she'd spent her life driving.  She used to pilot a huge Ford station wagon - white, with that fake woody applique on its sides! - all over Texas.  But now...

After they left, I spent 15 minutes straightening everything she'd rearranged.  But I didn't care.  Considering all of the far more destructive ways dementia can make its victims act, our friend's tactile obsession was far preferable.  Nevertheless, we did hear from the family - and I'm sure you can imagine as well - that living with such a compulsive behavior pattern on a daily basis was extremely exhausting for them.

It's not that dementia patients with such an obsession go once around a room and touch everything.  They keep going around the same room, and throughout the house, touching and touching and re-touching and re-touching, often moving things from one place to another - and then back again.  You can understand how things might get lost; Dad re-arranged his desk drawers constantly, and was constantly misplacing things.  Few items may get broken in the process, surprisingly, but that's little comfort when your loved one starts accusing you of stealing what they've misplaced.

Dad developed an obsessive pattern of trying to "fix" our expensive grandfather clock, and now it neither keeps proper time nor chimes in sequence with the quarter-hour.  A family member of a fellow resident at Dad's memory-care place told me their family had come up with the idea of getting some junked appliances for their father to "fix" every afternoon in their garage, so he'd stop trying to "fix" the real, functional appliances in their home.

As for our family friend who passed away this morning, I wonder if her lifetime spent straightening and tidying-up after six kids and classrooms full of students contributed to her dementia-fueled compulsion for touching everything in sight.

Maybe, but...

My purpose in telling you these things about our family friend is to describe for you one of the many odd ways dementia can express itself within its victims.  The risk in doing so, however, is that you'll finish this essay with a lopsided impression of our family friend as a compulsive, fidgety, overly-tactile weirdo.  Oddly enough, none of these characteristics stand out in my memory of her as she was back before her dementia set in.

Yet that's one of the problems of dementia:  by the time a dementia patient passes away, it's become hard to remember the way they were, all those years ago, when they were in their right mind.  Recent, emotionally-laden memories of our loved ones as they've suffered through years of raw dementia are what's seared into our mournful minds.

Perhaps it's in this way that dementia victimizes more than just the patient; all of us who knew the patient can be deprived of the reality of the person who used to exist, before dementia took its toll.

"Gone, but not forgotten," as they say.  But in the case of dementia's victims, we really have to work at it.