Culture Wars and the End of Life

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“I would like to propose that the end of life be sanctioned as a culture war-free zone.”

Perhaps you were following the heart-wrenching story that’s been coming out of the state of Ohio this summer. (Part 1, Part 2, and Part 3) It involves the odyssey of John Arthur and his partner of 20 years, Jim Obergefell. John is in hospice care; he is in the final stages of amyotrophic lateral sclerosis, or ALS, a progressive neurological disease, which robed him of his ability to walk, talk, and which will very soon kill him. John and Jim wanted to marry before John died, but Ohio prohibits marriage between same-sex people. Their only option was to travel to another state, one that would allow them to marry.

culture_warsWhen the Supreme Court struck down DOMA (the Defense of Marriage Act) last June, Jim and John knew they had a very brief window of opportunity to codify their relationship in the same way as any loving heterosexual couple might. They chose to travel to the state of Maryland to be married, but getting there and back would be a daunting task. John needed a medical transport plane that could accommodate his stretcher, a trip that would cost some $13,000. Undeterred, they appealed to friends and family for help. Their appeal was met by enormous generosity and, in a matter of days, all the necessary funds were raised.

By mid-July all was ready. Jim and John along with a nurse, two pilots trained in emergency medicine, and John’s aunt, Paulette, an ordained minister, boarded a Lear jet in Cincinnati for the short flight to Baltimore. The marriage ceremony, which took place on the airport tarmac, and in which John and Jim exchanged rings, lasted only seven and a half minutes. A champagne toast followed. And after just 56 minutes on the ground they were headed back to Cincinnati. A triumph of the human spirit, I dare say.

John and Jim’s marriage license could change many things about John’s end of life care and the disposition of his estate after his death. Health insurance, for example might be less of an issue now that they are legally married. Their marriage license might very well open doors to other legal remedies for numerous other thorny problems from Social Security benefits, income and estate tax and probate concerns to the federal Family Medical Leave Act. But none of this has been tested. No one yet knows what federal benefits a same-sex couple might qualify for if they live in a state that doesn’t recognize their marriage. And what are the implications for a couple, who leaves their state of residence, one that bans same-sex marriage, to marry in another state, one that allows it? It’ll be years before it’s all sorted out.

Within days of this headline-grabbing wedding, a federal judge in Ohio ordered state officials to recognize Jim and John’s marriage. When John dies his death certificate must acknowledge Jim as his spouse, so stated the decree. However, just one day later, Ohio Attorney General Mike DeWine appealed that judge’s ruling. And so the legal limbo continues. John won’t live to see the end of this and maybe a lot of us won’t either.

I can’t help but think about how this culture war is further complicating John’s already difficult dying. And I’ve had to ask myself: What about the professional people who attend John as he dies? Surely each of them has an opinion as to the morality, and the legality of Jim and John’s marriage. Will they be able to do their job as well as respect Jim and John’s marriage and the privileges it bestows on them without letting their personal prejudices get in the way? A tall order that!culture-wars

Despite all the new marriage equality laws, on both the state and federal level, the issue of compliance remains an open question. Here in the state of Washington, for example, we’ve had marriage equality since late last year. But there have been several high-profile cases lately where wedding venders have refused service to same-sex couples as they plan their ceremony. A florist refused, on religious grounds, to provide flowers to one of her long-time customers, a gay man, when he asked her to supply the arrangements for his wedding. Similarly some wedding officiants, caterers, and venue managers, because of their religious scruples, have also been refusing service to same-sex couples. Even some state registrars wanted an exemption, on religious grounds, from providing same sex couples a marriage license. While these things are disconcerting and bothersome to say the least, they are not a matter of life and death. One can always find another florist or caterer, right? The same cannot be said of palliative and hospice care.

Can a doctor, pharmacist, nurse, social worker, or attendant deny care or respect for the intimate relationship(s) of one of their patients, on religious grounds? Can a parent or other family member interfere with the care of a dying relative, or usurp the rights of a dying person’s spouse simply because the spouse is of the same gender as the person dying? Right now, I believe, the answer is an unqualified, “yes.”

That’s why I would like to propose that the end of life be sanctioned as a culture war-free zone. Dying is hard enough without having to worry about who will be honoring whom and what as we die. I believe that we all ought be offered a refuge from such worries at the end of our lives. If the culture wars must continue, as I know they will, let them rage somewhere other than where our life, or the life of someone we love, is ebbing away.

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