My Grandfather Died with Dignity

My Grandfather died last October. In some sense, his death wasn’t a surprise—at almost ninety, he’d dealt with increasing health issues and not-infrequent hospital visits for years. What was surprising and traumatic was that, just earlier in the week, he’d seemed to be entering a relatively healthy period. But what started as a check-in for his heart arrythmia rapidly turned into the last news we wanted to hear: he had contracted pneumonia (which required restricting fluids) but also a blood infection (which required increasing his fluids to allow antibiotics to be effective). Two fatal conditions that were impossible to treat concurrently, and sepsis soon set in. Within hours of feeling unwell, Grandpa Tom had deteriorated until it was clear his last hours had come. I drove as fast as I could to be by his side in the hospital.

Grandpa Tom and I shared a special connection whose severance has left a hole I doubt will ever be filled on this side of eternity. When I was a child, he made up songs for me and my brothers, built us toys and a treehouse, and always bought us a happy meal after play time at the park. No matter how small my part, he was there to see my high school plays. In my college years, I had the privilege of worshiping with him and my grandmother in church. He was there when I proposed to the woman I’d marry, and to this day I wear the wedding band, once his own, that Grandpa Tom passed to me. At every major milestone of my life, he was there to cheer me on and show me love.

I now think that part of what made our relationship so special was that, as my mother’s stepfather, Grandpa Tom wasn’t even part of my biological family. His life was a picture of the gospel: after alcohol abuse led to a failed marriage that estranged him from his children, Grandpa Tom had a dramatic conversion experience and found deliverance from the anger and alcoholism that had so hardened his heart. He knew better than most of us that he wasn’t perfect and that he needed a savior—his faith seemed so real to me because he was open about the ways he’d struggled and failed. Never once in his life did I know a Grandpa Tom who boasted, “Thank the Lord that I am not like those other people.” Always his confession was, “Lord have mercy on me, a sinner.”

This redeemed Tom found a new family through meeting my grandmother—who herself had suffered divorce—and married her Christmas day of 1985. Here again, the gospel shines through. In Christ, God grafted the gentile nations’ wild branches onto the cultivated tree of Israel and created a new family with ties stronger than blood relation. Grandpa Tom’s marriage to my grandmother grafted him into my family, and his branch bore abundant fruit in the love he had for his grandchildren.

In the last years and months of his life, my grandfather had gradually become less and less able to care for himself. My grandmother was a nurse by training, and her tireless care for him was itself a testament to the tireless, sacrificial love of Christ, the Great Physician of our souls. My parents undertook to renovate their house to accommodate the mobility assistance he needed, and my mom sacrificed much of her own time and energy to ensure that he received the medical care he needed to hold onto life as long as he could. For all involved, that care was a heavy burden. To care for someone in decline is to devote more and more effort for less and less improvement, and the time to enjoy any improvement that does occur gets shorter and shorter with every bout of illness, every defibrillation to restore a regular heartbeat.

In the months since Grandpa Tom has passed, I have returned again and again to the question of what it means to die well. In recent decades in the West, most fiercely now in Canada and Northern Europe but with parts of the U.S. slouching in that direction, “Medical Assistance in Dying” (MAiD) has become more and more ubiquitous. A catchall term for euthanasia and physician-assisted suicide, MAiD has metastasized in recent years. From a narrow treatment offered those with imminently terminal conditions and in unbearable pain, MAiD is urged upon those whose primary care would be too expensive, who suffer from treatable mental illness, or who find themselves on the brink of homelessness. They are told by kind doctors, with excellent bedside manner and with the authority of the major medical associations and the approval of government health services, that MAiD will allow them the autonomy to die with dignity instead.

A recent medical journal article sounded a klaxon’s blare on Canada’s MAiD regime. It relates the true story of a man with “hearing and cognitive disability” who suffered from depression and was involuntarily admitted to a psychiatric hospital as a suicide risk. Forty days after his admission, he was offered euthanasia. Over his family’s objections, the hospital staff killed him. The man’s MAiD application listed “hearing loss” as the medical diagnosis justifying his request to die. No regulatory or criminal investigation has occurred.

What is most distressing about the MAiD conversation in Canada is that despite politicians’ promises that rigorous safeguards will allow doctors and healers to kill only those patients who “really” need to die, the medical establishment is actively subverting even those safeguards. In Q&A at a 2021 training session by the Canada Association of MAiD Assessors and Providers, a physician asked Dr. Kevin Reel—the president of the Canadian Bioethics Society—what a doctor should do if a patient sought MAiD “because of socioeconomic reasons.” Dr. Reel replied that of course the physician didn’t have to administer MAiD, but he would “have to refer the person onto somebody else, who may hopefully fulfill the request in the end.” I shudder for those who, unlike my grandpa, lack loved ones to advocate for even basic social assistance and are instead funneled through a bureaucracy of death.

The conversation around MAiD puts front and center the questions of what makes life worth living and, by implication, in what circumstances a life might no longer be worth living. In the modern Western ethos of entrepreneurial individualism, the cardinal virtues include efficiency and productivity. As Justin Hawkins reminds us, our cultural fixation on accomplishment and achievement has influenced the way we view the moral worth of those who cannot achieve or accomplish. Old age and chronic illness increase our dependency on others; each simple cold or stumble on the stairs can become a greater and greater battle for lesser and lesser recovery. The moral hazard here is for the suffering to view their struggles not only as a reduction in their own value and dignity, but for those charged with their care to take offense at being asked to sacrifice their autonomy and capacity in the service of those dependent on them. Those so affronted could be tempted to ask, as Canada’s healthcare system writ large is doing right now, “why should I forego what makes my life valuable for the sake of one whose life is becoming less and less valuable?” In the moral logic of accomplishment, efficiency, and productivity, giving someone the option to die eventually imposes upon them an obligation to die.

Against this account of human value, or any other account that ties human dignity and rights to capacities or properly functioning mental systems, Nicholas Wolterstorff has defended an account of human rights grounded in God’s love for us. God does not love us because of our capacities. God does not love us because we can do everything on our own. In fact, God loves us despite the fact that we cannot do anything on our own. In Wolterstorff’s account, human rights ultimately derive from our duties to respect one another as objects of divine love, a love that pulls us to will the good of others and not to ignore their plight as an offensive inconvenience.

Grandpa Tom’s love for me started in a time of joy turned immediately to fear and trembling. I was born prematurely and whisked to the NICU before my parents even knew if I’d survive the night. My parents and grandparents could only wait and pray as I lay in the NICU and fought to live. Grandpa Tom often told me how, when he visited the hospital and reached out to me as I squirmed among tubes and monitors in the incubator, I grabbed his finger and held fast—and that he knew from my tiny grasp that I would make it through.

When new life comes into the world and finds itself threatened by premature birth or a congenital defect, our response is to care for that life, and to pray for those radically vulnerable newborns like me who needed the sacrificial love of others to have a fighting chance. Our response is to reach out into an incubator and pray that they cling to us, holding on for dear life. Newborns’ dignity is not a result of their independence, their abilities, or even their ability to function properly. Their needy weakness does not diminish their value. It is an invitation to us to expand our capacity for love and sacrifice beyond what we previously thought imaginable. The sleepless nights my parents and grandparents spent in the NICU to hold me to life through love, prayer, and faithful presence is a testament to these truths. That I am alive today is due entirely to those who rebuked the temptation to tie dignity to ability and accomplishment.

Grandpa Tom died with dignity. He did not die with dignity because he retained his autonomy to the last moment. He did not die with dignity because he spared his family the burden of caring for him. He did not die with dignity because my family had the means to secure him palliative care. He died with dignity because, as his actions bore witness to me as a newborn, every life is dignified. He died with dignity because he reminded us in his last years and months and days and hours that love for others, not the capacity for achievement or productivity, is true virtue. Love is a virtue whose exercise is most called for when people like Grandpa Tom face their time of most dire need. Grandpa Tom’s dignity amidst his dependence on others was a loud rebuke to the arrogant pride that says, “I matter because I can take care of myself.” If we only have eyes to see it, the inconvenience and frustration and grief of caring for others should reminds us of Christ’s words, “Apart from me, you can do nothing.” Grandpa Tom’s declining health before his death forces us to confront this truth, and in doing so testifies that dignity is not a matter of independence.

By the time I arrived at the hospital last year, Grandpa Tom had lost his ability to speak. But when I reached out to him, a man struggling to breathe among tubes and monitors in a hospice bed, he grabbed my hand and held fast. Time’s arrow had wound itself into a circle, and our places had been exchanged. Just as Grandpa Tom knew from my newborn grasp that I would make it through, I knew from his dying grasp that he would, too. Grandpa Tom had helped love me into a place of strength as an infant, and I knew that Christ had loved him into a place of strength in death. As I used a sponge soaked in water to wet his lips made dry by rasping breath, I could not help but recall Christ’s agonized cry, “I thirst,” that was answered mockingly with a sponge soaked in vinegar. Christ, the man of sorrows who seemed stricken and rejected by God, used his physical suffering and helplessness to redeem all our suffering, which Paul tells us is not an affront to our dignity but a way to unite us with Christ in his ultimate victory over death. Grandpa Tom now waits with the Lord in victorious rest until the day of resurrection. On that day he will receive a glorified body that will never be prone to pneumonia or sepsis, where his glorified heart will always beat in rhythm with the angels’ hymn, where God Himself will be the sunlight, and where every tear will have been wiped away.