Showing posts with label William P. Densmore. Show all posts
Showing posts with label William P. Densmore. Show all posts

Tuesday, March 10, 2020

Exorcising toxic Trump: An intentional alternative in our back yard?




Hancock Shaker Village — photo by Massachusetts Office of Tourism, used under Creative Commons License



Presented to the Club on Monday evening, March 9, 2020 by William P. Densmore



I’ve been thinking a lot about furniture lately as my sisters and I assess the provenance and best disposition of fine furniture in our parents’ Worcester home. We’re learning that “dark furniture” isn’t very valuable anymore. Kind of like the stock market after today, and quite out of our individual control so not to worry. But thinking about furniture and value inevitable leads to the mass-market tag line for the Shakers furniture. Excellent, simple, stripped of vanity and excess — furniture.



But it is not Shaker furniture on my mind for tonight. Rather, I wish to digress in perhaps contrarian fashion to a set of difference considerations about the Shakers — their status as the longest running intentional community in America — an effort at utopia which has tested a set of values in many respects relevant not only to contemporary American society but as well perhaps to some of the attributes of the culture which occupies 1600 Pennsylvania Avenue.



Fifteen years ago I spent six months working at Hancock Shaker Village. Like most people, I knew about furniture and celibacy and that was about it. I learned somewhat more, but ever since I’ve wanted to spend a chunk of time digging into Shaker values and practices.  This talk is the result and it stems from sit-down interviews last month with five Shaker experts — and an admittedly fast literature review.



What I will highlight, using with attribution the words of my interviewees as well as published authors is this: The Shakers can teach our contemporary politicians, and maybe Donald Trump, much about gender equity, caring for “others,” housing and economic security and the management of dissent. Seventy-five years before emancipation, and 150 years before suffrage, Shakers were already practicing social, sexual, economic and spiritual equality. For the most part, the Shakers just lived their politics, although in 1852, Shaker elder Frederick Evans was proselytizing that women should have the right to vote.



There are multiple sources — from Wikipedia to scholarly volumes, to fill in the basic Shaker history so I’ll rewrite to a few sentences. Factory worker “Mother” Ann Lee and her husband arrive near Albany, N.Y., in 1774 from Manchester, England and after several frustrating years begin to attract converts to her Protestant-offshoot idea of a community that sees women as a natural representation of God after the death of Jesus. The three tenets: celibacy, confession and community. At its peak, the Shaker movement involved 6,000 members and followers at 19 sites from Kentucky east to Maine; only two (or is it three) members remain — at Sabbathday Lake, Maine.



Before declining, Shaker societies were organized around “families” with 20 to 150 members of each non-biological family and a total of two to 11 such families in each geographic society.



Scholars generally agree that Shakers grew (and prospered mightily) through about 1840 when a slow decline began as many male members — the “brothers” — found better work and life outside the community. Because Mother Ann believed chastity to be a necessary part of the faith, Shakers could only maintain communities by taking in new families, children or individuals. The Hancock Bishopric declined and in 1959-1960 the property was sold to what has become Hancock Shaker Village, a living-history museum.



Filmmaker Ken Burns wrote for his 1984 PBS video special, “Hands to Work, Hearts to God,” what I found to be the most elegant summary of the Shakers and here is a small part of it. Burns wrote that by the mid-1800s:


The Shakers were suddenly appreciated as successful communitarians when Americans became interested in communities, as successful utopians when America hosted a hundred utopian experiments, as spiritualists when American parlors filled with mediums and with voices from other worlds. They invented hundreds of laborsaving devices from the clothespin to the circular saw, which they shared without patents (some of these machines launched brilliant industrial careers for the men who borrowed them), nor were they frightened of useful inventions . . . They were admired and derided, imitated for their successes and ridiculed for their eccentricities. And they are enduringly appreciated for their contribution to American crafts and architecture

With thanks to Ken Burns, that’s the basic history and story line. Let’s now focus on these five aspects which, as I say, seem to teach us to varying degree about our political moment in ways I’ll assert.




  1. Gender relationships

  2. Caring for others, and the infirm

  3. Housing and economic security

  4. Focusing on quality, and science

  5. Managing dissent






GENDER RELATIONSHIPS 



When it comes to gender relationships and society, perhaps we might invite Elizabeth Warren’s input, or perhaps some of the many women who have described relationships with Mr. Trump. I think its fair to sale we have some work to do in figuring how we value and engage women in leadership in America. The Shakers have much to teach here.



Glendyne R. Wergland of Dalton is one of the four Shaker experts I spoke with last month at HSV. Her 2011 University of Massachusetts Press book, Sisters in the Faith, draws together document research to show — as one reviewer has written — that Shaker communities achieved a remarkable degree of gender equality at a time when women elsewhere still suffered under the legal and social strictures of a traditional patriarchal order. In so doing, Wergland finds, the reviewer writes, that the experience of Shaker women served as a model for promoting women’s rights in American political culture.



Deborah E. Burns is an editor at Storey Communications in North Adams and the author of the 1993 Shaker Cities of Peace, Love and Union: A History of the Hancock Bishopric, which she took three years to write at the request of HSV’s first president and lead founder, Amy Bess Miller. Burns was one of the people I sought out for guidance on interpreting the Shakers for contemporary America. Burns believes the equality of women with men in managing and holding leadership roles in the Shaker church was a reason for its balance and stability during the growth years “in a way that we just never have had in our country.” When men slowly drifted away from Shaker societies in the late 19th century, a greater proportion of women stayed, Burns says, because for them, the stability of Shaker living was as good or better than the outside world. “The communal system and the segregation of sexes took a lot of clutter out of the brain,” Burns says.



University of Alabama-Huntsville history professor Suzanne R. Thurman expands on this view in an excerpt from her book, O Sisters Ain’t You Happy, published in 2002:


Attacking the patriarchal basis for most of American family life, the Shakers cleared the way for a new society where relationships were built on love and choice, not duty and obligation, and where traditional female characteristics were upheld as normative for society . . . . women took on positions of responsibility, made choices about their bodies and their lifestyles, and were empowered by Shaker religious practices. 

Prof. Thurman says Shaker women understood the community-building features of communal, non-biological families, that still well-nurtured and educated adopted children or children of other members. As Burns reports in her scholarship, the evidence was that Shaker-raised children tended to be excellent students, their schools in Hancock were praised and sought by non-Shaker parents. Continues Prof. Thurman:


[A]s the Shakers and their reformer counterparts debated the merits of life in community and life in the biological family, as they analyzed and discussed what constituted the “best” and most “normal” kind of relationship, they touched on issues that have vexed human society for centuries. The Shakers came down squarely on the side of . . . the transforming power of communal life.



CELIBACY, CHOICE , CLIMATE AND POPULATION



Because much focus is on celibacy when we consider the Shakers, on the grounds that it was a sort of “failure mode” for the survival of the community, I’ll mention that briefly here by saying there are contrarian views. The Shakers themselves wrote that most people left communities not because of sex but because they found it in other ways hard to put aside self-interest in favor of community interest. By not bearing children, Shakers could be sure that anyone in the faith had chosen to be there. If Shakers were recruiting converts today, they could also make the argument that celibacy is a possible rational choice in a world that scientists — apparently not Mr. Trump — see as threatened by climate change and overpopulation.



Scholars Elisa J. Sobo and Sandra Bell, (writing in their book, Celibacy, Culture and Society: The Anthropology of Sexual Abstinence (2001) report that around 1900 some Shaker writers also . . .


. . . Maintained that celibacy (specifically as freedom from marriage), was an important inducement to women to enter membership, first, because marriage sometimes licensed the physical and sexual abuse of women; second, because abstention from marriage facilitated community, and therefore egalitarian, property ownership. They argued that when women are given the opportunity to eschew economic dependence on men, they become men’s equal in all spheres of life.



HEALTH IN BROADEST SENSE



In Shaker communities there was health-care for all, a lesson for today’s society. As well, there was a focus on healthy eating and living — something Shaker societies might have been better able to enforce than we are today.



Here are three examples:




  1. HSV and other sites have examples of adult-size cradles, potty chairs and other accessibility and mobility devices for the elderly. 

  2. Dwelling houses had areas designed as “infirmaries” and the social covenant included care for infirm and elderly members according to need. There brethren who functioned in roles as doctors.

  3. When members were sick, it was understood that other members of the community would take on their work until they recovered. 




Thus, unlike 30 million Americans with no health insurance, and millions without sick pay, a sick or infirm believer could rest, receive care and attention for as long as needed, without worry of financial loss or neglect to the duties of the farm. As for Covid-19 — Burns says there are no accounts of any contagions sweeping a Shaker community, but there are accounts of infirmaries taking in people with flu or pneumonia-like symptoms.



Shakers grew and profitably sold medicinal herbs — they made their own herbal tinctures. Some Shaker orders willingly adjusted food preparation to members who chose a vegetarian diet, wrote June Sprigg in her 1975 book, By Shaker Hands. Children studied physiology, a weekly hot bath was encouraged.



Sprigg added:




To keep themselves healthy, the Shakers used wisely all four earthly elements for their heavenly goal — air, fire, water and earth. Translated into health terms, that meant good ventilation; the use of static electricity as the latest in rheumatism treatment; extensive and progressive plumbing systems; and a sensible diet, herbal medicines, and for the most part no liquor or tobacco. Besides these measures, Shakers slept at least seven hours nightly and exercised not only in their work but in their worship, too [by dancing producing a healthy sweat]. 



HOUSING AND ECONOMIC SECURITY



Housing, homelesslness and economic security loom large as American issues, especially for millennials. For Shakers, these were off the table as concerns. Once a person had stayed long enough in a Shaker community to want to join the faith, they turned over all of their assets but in exchange for doing the community’s work, they were sheltered and fed.  In their own way, Shakers also addressed homelessness; they took in people in need, including widows and orphans. They sheltered and fed fugitive slaves. One might assume that they would be inclined to operate today as welcoming communities for able-bodied and committed immigrants.



Among the scholars I spoke with, one observed that millennials and retirees in the Berkshires and elsewhere are now considering alternate living arrangements, and micro-communities of like-minded people to help with gardening, household responsibilities childcare and bills. What might be learned about the mechanics and challenges of co-housing as practiced by the Shakers, this scholar asked? In the Shaker community construct, your children would be taken care of by brethren and sisters, and you could “age in place” with similar care. Another scholar asked: With the world’s resources now seen as finite, will it be necessary to think of housing and living in less individualistic fashion?



Said one of my interview subjects at HSV:


Millenials are thinking more broadly about how we can live together, in smaller spaces, more sustainably, holding possessions longer so we can consume less. We are rethinking our worldmaking, creating a landscape more intentional and sustainable, in its essence very Shaker. They built a world and a vocabulary for themselves like no other community in this country.

Intergenerational mixing in intentional communities is an ideal spawned by the Shakers (and other communal societies) that should be re-imagined, says Deb Burns. When might the campus of a recently closed college be envisioned for such a purpose, she suggests, balanced in age and genders.





FOCUS ON QUALITY — AND SCIENCE



Until the Industrial Revolution took hold, an important Shaker ethic contributed to their economic prosperity — a focus on quality in everything they made. Shaker brethren who traveled the countryside selling their packaged seeds were eagerly awaited because the seeds’ were clean and reliable. Furniture and devices built more than 200 years ago in dwellings and work buildings still work today. But eventually, scholars say, the ability for factories to turn out goods faster and cheaper became a competitive challenge to the ethic of high quality.



Yet the Shakers actually believed in science, and used inventiveness to maintain their admired position in agriculture and related fields for as long as possible.  Shaker elders considered whether to permit the introduction of labor- and time-saving devices. After initial caution — requiring a six-month period of consideration when a new such idea was offered — they ultimately decided their faith accepted that useful inventions should be encouraged even though they might impact lifestyle. They did not patent some early inventions. Paraphrasing the Wikipedia entry:



Their industry brought about many inventions like Babbitt metal, the rotary harrow, the circular saw, the clothespin, the Shaker peg, the flat broom, the wheel-driven washing machine, a machine for setting teeth in textile cards, a threshing machine, metal pens, a new type of fire engine, the common clothes pin, the first screw propeller, a machine for matching boards, numerous innovations in waterworks, planing machinery, a hernia truss, silk reeling machinery, small looms for weaving palm leaf, machines for processing broom corn and ball-and-socket tilters for chair legs.





MANAGING DISSENT



In reviewing five aspects of the Shakers that I suggest may be relevant to our current culture and politics, I come to the final one — the management of dissent. How might this compare with contemporary politics?



One scholar says that the Shakers viewed men as representing power and women as representing wisdom. It must have been wisdom which defined what would happen when a Shaker community resident need to be dismissed. The problem was managed through constant attempts at rehabilitation, scholars say. Sometimes breathren or sisters would leave the community, only to be welcomed back. Most the time, they would leave with abundant food of gifts. In extreme case, they might have their personal effects removed to the street, however. Sometimes an individual Shaker would challenge the authority of elders, and such charismatic leaders could be asked to leave, or be ejected. “It was very tense and anxious,” says Deb Burns. “But that’s what it was, trying to give the person a chance.”





SHAKERS — NOT APART FROM US



I want to wrap up with three views about why the Shakers matter, and with a poem.



First, the Shakers were in many ways not so different from the rest of us, from other people of their era, writes Joseph Manca, a Rice University art-history professor in a new work of scholarship published just last year by University of Massachusetts Press and entitled: Shaker Vision: Seeing Beauty in Early America. He writes:


In many ways, Shakers lived sensuously: They ate well, they swam regularly in their ponds and lakes and in the ocean, and they danced and sang ecstatically. They viewed landscapes, watched sunsets, pretty rains, rainbows, comets . . . enjoyed the sight of green fields, snow-covered ground and the colors and shapes of fruit on vines and limbs . . . enjoyed pretty faces and bodies, marveled at freaks of nature and admired well-made and colorful buildings.

Second, even if a day comes when the last Shaker is gone, their societies will continue to influence American thought, writes College of the Holy Cross Prof. Joanne Pierce, in her reflection “Why the legacy of Shakers will endure,” published at The Conversation online in 2017. She cites values of cleanliness, honesty, frugality, economy efficiency, quality, simplicity, hard work, debt avoidance and humility affecting social reform, agriculture, technology and innovation. She continued:


[The] Shakers’ rejection of ‘the world’ does offer us today some insightful reflections on contemporary issues such as their pacifism when confronted by terrorism; their mutual love and respect in the face of gender and racial divisions; and their cheerful blending of prosperity and simplicity as a response to the wasteful nature of many materialistic cultures.

Third, in 1977, then-Williams College President John W. Chandler wrote the foreword for Shaker Literature: A Bibliography compiled and annotated by Mary L. Richmond, published by Shaker Community Inc., distributed by University Press of Nebraska, Chandler wrote:


The alienating character of modern work, and questions about the potential for extended non-biological family communities as possible superior to nuclear, biological families drive contemporary interest in the Shakers, Chandler suggests. “Similarly, the Shaker denial of private ownership in favor of communal property attracts those who believe ownership to be a root cause of social injustice.

Chandler wrote that for all these reasons, and for the Shakers commitment to sexual balance their place in history is secure.



There is an untitled poem by Shaker Mary Whitcher, of the Canterbury, N.H., site, in the 1993 Penguin Book Simple Wisdom: Shaker Sayings, Poems and Songs. I read it now as advice to 1600 Pennsylvania Avenue:


Be slow to anger, slow to blame,

And slow to plead thy cause.

But swift to speak of any gain

That gives thy friend applause.




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Wednesday, December 6, 2017

Fatal Choice: Choosing no longer to live




Photo by Alberto Biscalchin, used under Creative Commons Licens



Presented to the Club on Monday evening, Dec. 4, 2017 by William P. Densmore






One day in March, 1981, a short obituary appeared in the Chicago Tribune about a fatal choice — the suicide of Earl Russell Marshall, of Tulsa, Oklahoma. It mentioned that Mr. Marshall was a supervisor at the Tulsa maintenance base of American Airlines.



Colleagues of Mr. Marshall at American Airlines had also made a fatal choice two years earlier, a choice primarily responsible for the deaths of 271 people.



Those 271 people had been passengers May 25, 1979 on an American DC-10 jumbo jet which dropped an engine and crashed on takeoff from Chicago O’Hare International Airport. The engine had been worked on at American’s Tulsa maintenance two months earlier. The day after his death, Mr. Marshall, then 47, was to have been questioned by lawyers for the aircraft maker.



The airline said Marshall had no involvement with the accident aircraft. The Tulsa World newspaper talked to Mr. Marshall’s widow in 2004, 25 years later. “He had very bad guilt feelings, and the accident gave him something to attach his feelings to,” Marilyn Marshall to the daily. ‘He was a casualty of that crash.”



DC-10 maker McDonnell Douglas Corp. and American sued each other after the crash and the National Transportation Safety Board investigated. The companies and the government learned that a maintenance work shift ended on one of the nights the DC-10 was in Tulsa and the crew left a 15,300-pound wing engine and attached pylon hanging overnight partially disconnected from the wing – and supported only by the forklift’s hydraulics. The result – a hidden, 13-inch crack formed in one of the three attachments of the engine to the wing.



During the O’Hare takeoff roll at the start of a Los Angeles flight, normal engine thrust broke the attachment, the engine shot forward, rotated over the top of the wing and separated from the aircraft – severing lines of all three independent hydraulic systems vital to control. The plane rolled to the left and crashed. It remains today the highest death toll of any single U.S. aviation disaster.



It was a fatal choice that American Airlines made, to remove the 13,477-pound GE jet engine and 1,865-pound pylon in a single procedure, because it saved 200-man-hours per aircraft engine overhaul, and reduced to 27 from 79 the number of disconnects of lines and cables.



McDonnell Douglas didn’t recommend it, but it also didn’t tell American not to do it that way.



Another fatal choice



I know all this because I was an editor for Chicago Lawyer magazine in 1980 and 1981 and I covered the lawsuits about the crash – I still have hundreds of pages of moldy legal depositions in our basement that contain detailed testimony about the forklift procedure. And ever since, I’ve been fascinated by the safety decisions we make and do not make, and the consequences, and how we assess or become even aware of those consequences.



As a nation, and species, we make policy decisions that involve fatal choices.



For example, we make the fatal choice to allow global climate change to progress, and already we can see migrations, floods, arctic melt, atmospheric and food-security challenges arising. Each of us can think of more such choices for humankind. It seems as if the more distance the policy from our own personal lives and the more people who are at risk, the more likely a fatal choice is made almost without transparent forethought or balancing of costs and consequences.



Another choice. Predawn on Dec. 2, 2017, the United States Senate cobbled together a 500-page document of tax changes, and some completely unrelated matters, scribbled amendments in illegible page-border handwriting, and approved and sent it to the House on a 51-49 partisan vote. There were little or no committee hearings and no time between amendments and a final bill.



One of the provisions of the bill, if it becomes law, is predicted to result over time in 13 million Americans losing their current health-insurance coverage. That’s clearly another fatal choice. Because some of those 13 million Americans are likely to die, or at least die sooner, as a result of coverage decisions by governments and health insurers. Has the United States Senate just become a “death panel”?



It is here – in the domain of health and medicine – that I want to dwell a bit tonight to consider a fatal choice that will affect us all. Some of us will leave here tonight believing the particular fatal choice I’m thinking of is ours to make. Others may well think it should be – indeed is in fact — up to a higher power. I want to argue that the truth lies somewhere in between, that the truth will be different for each of us, and that the sooner we think about it for us and our loved ones, the better – for us and for society.



I’m talking about how we exercise compassion and care near the end of life – a point we shall all reach, perhaps unexpectedly, but more likely with some warning and time for thought and reflection.



Each of us has the opportunity to make a fatal choice about the time and manner our life is to end. Thankfully, life is good enough that most of us don’t choose suicide as did American Airlines supervisor Earl Marshall. But we do make make choices in daily life which could be fatal. We engage in hazardous sports or recreation, unhealthy or excessive eating or drinking. We smoke or become addicted to pain-killing drugs. We own guns.



As we age, there will inevitably be things that will draw us nearer to death. As much as we make decisions as a society, and live as individuals in ways that involve fatal choices, why wouldn’t we do the same as the very real probability of death draws near? At the point where we draw nearer to God, we seem oddly to be more willing than ever to suspend any consideration of whether and on what terms we choose to be alive.



Now, there are people in this group — clergy — who have spent infinitely more time than I thinking about divine intervention and life. So I just have to credit and borrow from a Nov. 7 sermon by The Rev. Sarah Stewart of the First Unitarian Church of Worcester, Mass., whose sermons, by family connection, I receive by email. It helps me to illustrate the fatal-choice nuance I’m driving at.



Rev. Stewart wrote about God’s hand in retelling this joke:


Once upon a time, a man was shipwrecked and flailing around in the sea. He kicked his feet and waved his arms and cried, "O God, save me! I'm going to drown!" And lo and behold, a helicopter spotted the wreckage and flew in low over the man. A ladder uncoiled from the belly of the copter and a rescue worker made his way down. "Grab my hand!" the rescuer shouted.



"No, God will save me!" the man replied. No matter what the rescuer said or did, the man refused to take his hand and be pulled to safety. The rescuer watched in utter dismay as the man slipped beneath the waves. The man came to his senses in Heaven. Dry, warm, and comfortable, he walked toward God, who was hanging out in her favorite chair by the fire. "Hey God!" the man said. "I prayed! I was faithful! Why didn't you rescue me?!"



"Buddy," said God, "who did you think sent the freaking helicopter?"

Here’s why I like Rev. Stewart’s retelling of that story. Because it teaches that God works in many ways, and in ways that you may not even see as divine in the moment. And it teaches that God works in ways that may appear patently secular – the rescue helicopter. And in ways that you have to choose to actively embrace – take hold of the rescuer’s hand.





I think that’s an important aspect of what happens as we age. We may think we will be OK if we just go about our life and assume that God will take care of everything. There will be no pain, no reckoning with family, no diminished quality of life, and if there is, that’s what God intended. That sounds too much to me like the man who just waited in the water until he drowned.



So that’s my little sermon, and I tell it, because the rest of this talk, which is about choice, and a fatal choice at that, is about something still controversial and I want you to know my point of view so you can filter what you hear. My view is that active personal engagement with our fate, whether or not in consultation with God, is appropriate in politics, in life, and in the lead up to death.



A couple of months ago, I wrote an op-ed piece in The Berkshire Eagle. The headline was shortened a bit for space, and it was fine, but the one I had proposed was this: “Right-to-die debate about four words – burden, control, religion and choice – not suicide.” A surprising number of people spoke to me about that piece and how they had been moved to thought by it. It was published Sept. 26, 2017, the same day the Massachusetts Legislature’s Joint Committee on Public Health conducted a hearing on Beacon Hill on Senate Bill 1225 and its twin, House Bill 1194: “An Act Relative to End of Life Options.” Sometime before Feb. 7, 2018, the committee will have to decide if it will refer the bills to the House and Senate for floor votes. It has refused to do so for many years, just letting it lapse.



On Saturday, something happened which may cause the bill to be voted on. At their fall meeting, the Massachusetts Medical Society house of delegates voted 152-56 to end the society’s long-standing opposition to what it has called “physician-assisted suicide” and to adopt a neutral stance. Now, it is calling it “medical aid in dying” and the resolution adopted says that “the act of a physician writing a prescription for a lethal dose of medication to be used by an adult with a terminal illness at such time as the patient sees fit will, if legalized, be recognized as an additional option in the case of the terminally ill.” It says it will train doctors.



The medical society acted after it conducted and reported results of an online survey of a statistical sample of its nearly 25,000 members. A total of 12% responded. Sixty percent of the survey respondents supported “medical aid in dying” . . . the practice of physicians giving terminally-ill adults prescriptions for self-administered lethal medications. The same percentage – 60% — wanted the society to stop opposing physician-assisted dying.



You notice I just said physician-assisted dying, not suicide. Much as in the history of the abortion debate, that one-word shift in terminology is at the center of polarized views. Massachusetts Citizens for Life and the Catholic Church use “suicide.” The Denver-based Compassion & Choices group (formerly the Hemlock Society) and Portland, Oregon-based Death With Dignity National Center -- the two advocacy nonprofits in favor of letting physicians prescribe fatal medication to a willing and competent patient with six months or less to live — both avoid the word suicide.



That’s worth a digression. What do we mean by suicide? That’s simple, you might say. It’s the willful taking of your own life by some overt means. There is no other single English word for that act. “Took her own life,” perhaps. What if you willfully do something very dangerous and it results in your death – driving way too fast as an example? Would your death be deemed a suicide, or an accident? Does intent matter?



If it matters, then we need a new word, or a new understanding of suicide that is without judgment, spiritual or otherwise. Because as our society ages, there will be many people for whom active management of their end of life trajectory could seem appealing. We choose medical procedures, or not, as the man in the joke chooses to reach for the rescuer’s hand, or not.



Did the man in the water commit suicide by not reaching for the rescuer’s hand? He must not have thought so. Interestingly, on Oct. 30, the American Association of Suicidology, whose membership includes mental health and public-health professionals, came out with a policy statement saying that medical aid in dying “is distinct from the behavior that has been traditionally and ordinary described as suicide.”



Colleen Creighton, the suicide-prevention group’s executive director had this to say: “The American Association of Suicidology is dedicated to preventing suicide, but this has no bearing on the reflective, anticipated death a physician may legally help a dying patient facilitate.” She added: “We believe that the term ‘physician-assisted suicide’ constitutes a critical reason why these distinct death categories are so often conflated, and [the term] should be deleted from use . . . in suicide, a life that could have continued indefinitely is cut short. PAD is not a matter of life or death; it is a matter of a foreseeable death occurring a little sooner but in an easier way, in accord with the patient’s wishes and values vs. death later in a potentially more painful and protracted manner. In PAD, the person with a terminal illness does not necessarily want to die; he or she typically wants desperately to live but cannot do so; the disease will take its course.”



Use of the word “suicide” implies an ethical or spiritual judgment of intent by the speaker. I say: “Judge not that ye be not judged.”



The judgment varies around the world. Of 28 developed countries, seven permit some sort of assisted dying and three – Belgium, The Netherlands and Columbia, do not forbid euthanasia – the medical killing of a patient suffering from an incurable and painful disease or in an irreversible coma. The District of Columbia and five states, California, Oregon, Washington, Colorado and Vermont – have enacted laws making doctor-assisted dying by prescription legal. (SEE MAP) Montana did so by court decision. Some 34 other states are considering it. In Massachusetts, governments in Amherst and Northampton last month adopted assisted-dying resolutions. Cambridge and Provincetown did so last year.



Two U.S. Supreme Court actions are relevant here. In 1997, in Vacco vs. Quill, the court ruled 9-0 – with six separate opinions. It upheld a New York state law making doctor-assisted death illegal, distinguishing it from palliative care to alleviate pain that has the ancillary effect of hastening death. The 1997 opinion did not rule on the opposite – a state affirmatively permitting doctor-assisted dying. In the second action, the U.S. Supreme Court this fall declined without comment to review a state appeals court ruling in a Minnesota case which fined Final Exit Network Inc. $30,000 for violating a state statute. The action let stand a lower-court interpretation of the Minnesota law to prohibit the giving of written information to 57-year-old Doreen Dunn that she allegedly used to learn how to take her own life using a helium hood. Final Exit is a nonprofit that for decades has been providing information and support to people who wish to end their own life. By not taking the case, no legal precedent is established. Says Final Exit’s attorney Robert Rivas, who provided a copy of his organization’s Supreme Court appeal: “Until our case in Minnesota, every case on point has held that pure speech cannot sustain a conviction for assisting in a suicide.”



The Mass. Medical Society change in position is similar to what happened in California before that state enacted, and Gov. Jerry Brown signed in 2015, the California End of Life Option Act, making California the fifth state to legalize doctor-assisted death. The California law took effect June 6, 2016, and in its first six months, 258 individuals started the end-of-life option process — 191 were prescribed life-ending drugs and 111 used them. That’s out of 183,265 deaths in California during the same period. That 0.0006 of total deaths – or six-one-hundredths of one percent.



This year, Oregon marked the 20th anniversary of its law taking effect. Over the 20-year period, only about 2,000 Oregonians have requested a prescription. One of them was Brittany Maynard, a 29-year-old California educator who moved to Oregon to take advantage of the law when she was diagnosed with inoperable brain cancer. She was very public about her fatal choice, which drew international attention. Her mother is now on the Death with Dignity board, and her widower husband testified on Beacon Hill in September.



Oregon annually surveys the use of its law and over 20 years it has determined that of four end-of-life issues, pain control was the fourth-most cited reason for choosing medical aid in dying (25.2%). The other concerns were losing autonomy (91.6%), loss of dignity (78.8%), and less ability to engage in activities making life enjoyable (89.7%).



Unless you believe that suicide is an eternal sin, and that hastening your certain death with a pill is in fact suicide, as judged by others, you may have a fatal choice to make. Death and dying are profoundly personal challenges and one needs to appreciate the love and compassion expressed by those with many views, including our families. But we certainly can plan our options for time and manner of death.



It is no longer a taboo subject. In 2014, the state of Massachusetts adopted regulations requiring doctors, nurses, nursing homes other health-care providers to be equipped to provide end-of-life counseling. The Department of Public Health published the seven-page: “Know Your Choices: A Guide for Patients with Serious Advancing Illness.”



Blue Cross & Blue Shield of Massachusetts is a key backer of a nonprofit initiative called the Massachusetts Coalition for Serious Illness Care (maseriouscare.org), which meets annually. And longtime Boston Globe columnist Ellen Goodman, a Pulitzer Prize-winner, was among founders of The Conversation Project, dedicated to helping people talk about their wishes for end-of-life care. Doctors, hospitals and estate lawyers can help with advanced-care planning concerning the timing of palliative care, hospice care and life-sustaining treatment options. 




For physicians, the fatal choice is not so simple professionally, even assuming that prescribing death-inducing medication is legalized in Massachusetts. The oldest versions of the Hippocratic Oath say, in common translation from Greek, “Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course.” However, the vast majority of U.S. medical schools do not ask their graduates to subscribe to a version with words anything like that. And some ethicists argue even the little-used version is mis-understood. Ethicists note that heavy, constant doses of morphine to reduce severe pain – often prescribed for patients with terminal illnesses -- is justified because the main purpose is to relieve pain, with the deadly effects of morphine an ancillary result.



For physicians personally, the fatal choice appears easier. Surveys and reports find that physicians, faced with intrusive, death-prolonging care with no hope of beating a terminal illness, opt out of such care for themselves. This inclination was summarized in a 2011 essay by a University of Southern California family-medicine professor, Ken Murray, MD, who wrote: “[D]octors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little . . . I cannot count the number of times fellow physicians have told me, in words that vary only slightly, ‘Promise me if you find me like this that you’ll kill me.’ ”



In the Berkshire Eagle op-ed, I spoke of four words – burden, control, religion and choice. I wrote about my father’s 2013 death, and his wish to not become a burden on his family. That’s something that weighs heavily on the elderly.



Concerning control -- the author and research physician Atul Gawande, in his PBS Frontline[1] documentary aired in 2015 — and in his book, "Being Mortal" — talks about the fears we all face as we confront the possibility of our own death. One of the greatest is the fear of losing control – your body or mind gives out and you can no longer do the things in life that give you pleasure. Is it OK to make the fatal choice if you feel you are burdening others and you don’t want to be? Should you decision be intertwined with faith and religion?



The fourth word I talked about in The Eagle was choice.



On Oct. 5, 2015, when Gov. Edmund G. Brown Jr., a former Catholic seminarian, signed the California law, he wrote at the end of his signing statement these words:





In the end, I was left to reflect on what I would want in the face of my own death. I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn't deny that right to others."



More than 15 years ago, I visited a dear elderly friend – the wife of a former co-worker who had been a widow for many years. She was bedridden in a local nursing home. She could no longer live home alone, had been a vigorous, independent walker and couldn’t any longer. I had been encouraged by her daughter to stop in. As we talked, an aide brought her a plate of food and my friend actively waived her off. It was obvious to me that she did not want to eat. She was cheerful and peaceful. I spoke with her daughter, who spoke with the nursing home. A few weeks later, she died. Voluntary stopping eating and drinking – VSED – is one way to go which doesn’t require drugs or anyone’s permission.



While our corporations, our government, our society, make choices in war, health care, aircraft maintenance, the environment . . . without the best consideration of the fatal consequences, at the end of life, let’s all resolve to equip ourselves with the knowledge and support of our loved ones, and our own information resolve, to each make our own . . . fatal choice – with or without divine intervention.



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