I recently heard that a former coworker had passed away. The news took me by surprise, as I had not known that she was ill. I was told she had cancer and had made the choice to let it run its course without treatment. Earlier in my career, I probably would have questioned this decision. Why refuse treatment, when it’s available? Why not do everything possible to “beat” the cancer?
I do not know the details of her illness, or at what stage the cancer was diagnosed, but I realize that she made an informed choice and that it was her prerogative to do so.
There are some things life brings our way that are beyond our control. We may not be able to prevent events from occurring, but we can choose our responses to them. Even when we make a choice that we later regret, we can choose to learn from our mistake rather than wallowing in regret.
On a societal level, we can make choices that are for the greater good. We did not choose to experience a pandemic, but we do have a choice about the way we react to it and do our part to control the spread of the deadly virus and the misinformation related to it. As individual citizens living in a democracy, we exercise our choices in casting our votes during an election, but we do not choose the overall outcome—we accept it. At least that is the expectation.
In medical ethics, the principle of autonomy asserts that individuals have the right to make informed decisions about their care. As health-care workers, we are trained to save lives, and our tendency is to want to do so at all costs.
My former coworker did not choose to have cancer, but she chose how she wanted it treated—or not. She made the right decision for herself, though it may not have been the appropriate decision for someone else. Some may say she chose to die. It may be that no treatment would have prolonged her life, or treatment may have interfered with her quality of life. She chose to live the rest of her life the way she wanted to. Rather than say she chose death, I would say she chose life. She exercised her freedom to choose. And that’s the way it should be.