One of the things that most struck me about the Bill Moyer's PBS-TV series "On Our Own Terms: Living With Dying", was the almost constant repetition of the word "control": control of pain, control of where one dies, control of how one dies, control of the whole process of dying itself.
Control is one of those things, no, perhaps at times the only thing, that seems to insure our dignity, our sense of being a person, our sense of self-worth. That fact of life over which we have the least amount of control -- the inescapable fact that each of us must die -- is the point at which we are most determined to try to still control things. Lose that battle and in more than one way, we seem to have lost our very selves.
No wonder then, as medical science and practice have found more and more ways to prolong our lives, we have become determined to make sure that our lives will remain, up to the very end, worth living. We very rightly protest the prospect of being kept half-alive indefinitely, a comatose "living vegetable", or perhaps even worse, fully alert yet immobilized by pain. So it should be no surprise that efforts to allow for physician-assisted suicide elicit a certain amount of sympathy. Unable to control the certainty of death, to be able to deal with it on our own terms -- even to the point of taking our own life as a last resort -- seems to be the final reclamation of the sense of self.
But perhaps it is "self" that is the heart of the problem. At least that is how the higher religions see it. For example, Buddhism teaches that we need get rid of the illusion of self and all suffering will cease. Or put another way, along more biblical lines, it is only in dying to our lower self that a higher self (the "soul" or "spirit") can emerge. Yet, we are complex beings having body, mind, and spirit, with one element largely dependent on the other. Without a sound body, for example, it is difficult to maintain a sane mind. Nor (despite some folk traditions) should insanity be equated with sanctity. Nevertheless, when it comes to spirituality, it is the self-centeredness of our minds, expressed in our obsession with "control" over everything, that most probably most stands in the way of growth and freedom of spirit.
No doubt that in the face of increased longevity, new means must be found to reduce unnecessary pain and suffering. Intelligent and responsible medicine should have no need for assisted suicide. But at the same time, we should be under no illusions as to where the real problem lies. If the major task through most of our life is acquiring a sure sense of self, the main challenge in leaving life is having enough faith to let go of it.