The Right to Die

We are blessed in a country that has some really superb medical care. Our ability to save lives is quite astounding. But I wonder lately if we have forgotten that along with a right to live comes a right to die. When does our ability to "save lives" become something more harmful than helpful? Between my clinical rotations in the ICU and my work at a rehab hospital, I've been thinking a lot about dignity in life and death as of late. Today I took care of a patient in the ICU who had her wishes to be allowed to die denied. She had DNR (do not resuscitate) orders on her chart, but when it came time to make the call whether or not to intubate her, her wished were overruled by her family. And it only takes a few minutes in that room to feel your heart break for her. Because of the tubes in her mouth and nose leading to her stomach and lungs it is impossible to talk to her, but one look in her face and you know what she wants. She is totally with it, oriented, and still she has no say in what is happening to her. Tubes, wires, and fluids are entering and exiting her body from all sides, a ventilator is breathing for her and modern medicine looks anything but heroic to me. As I walked up to the side of her bed, she tapped her hand on the rail and I reach my own down to cover hers. She gripped it tightly, as if holding on for dear life, silently screaming for help. Her expression was pained as she shook her head. And I can't help but wonder how things like this happen. The whole point of advanced directives are that people can determine what kind of heroics they do and don't want and can make the decision to die naturally. But fears of lawsuits, and family members who can't let go keep medical providers from truly keeping the Hippocratic oath to "do no harm."
I'm learning that it is often more heroic to let someone go than to try and save them. When life has lost it's quality and there is no longer any goodness and dignity why do we continue to prolong the inevitable? And when does medicine move from using the gifts God has given us to playing God? However did man gain the ability to not just to decide when to take live, but also when to give it? I've always known, or at least for some time now that I wouldn't want to be kept alive when my quality of life has deteriorated to the point where everything that makes me ME has gone away.
Yet as much as these circumstances bother me, I also feel I must recognize that saving or ending lives is not nearly as cut and dry as I once thought. And it brings me to questions like, "How do we quantify life?", "What is the greatest good we can do?", "What would I be willing to put upon my family and what would I undertake if it was one of them?", "Is there a reason to be alive if one can no longer LIVE life?"
I don't have the answers. I am finding that my views of death are changing though. It is always sad, especially for those left behind, but I recognize that it is a natural event, a necessary part of life...and that for many the right choice.