Please note this article contains spoilers and may best be enjoyed following your engagement with the show.
At the age of 74, Bartholomew Kennedy is terminally ill and has already endured a long battle with cancer. He has outlived his first wife and also his partner, and Bart now resides with his son and grandson after moving from a nursing home. With the help of his caregiver, Chloe, and to his family’s surprise, Bart decides to pursue assisted death so that he may have autonomy over his choices and die with dignity.
Assisted death, previously referred to as assisted suicide or physician-assisted suicide, offers terminally ill adults of sound body and mind the choice of how and when they will die. The loss of autonomy at the end of one’s life, the loss of ability to participate in enjoyable and meaningful activities, and illness-related suffering are three of the main reasons a person might request assisted death. In an article about why a patient might choose to seek out assisted death, hospice and palliative care nurse Angela Morrow writes, “If a person cannot control the illness, they can at least control how they die.”
For the loved ones of a terminally ill individual, however, assisted death can be just as–if not more–upsetting as enduring their natural death. Because of the high cost of insurance, hospice care, and medical treatment, family members might feel guilty for not being able to do enough to keep their loved one alive and at ease. Patients sometimes feel that their illness is a burden on their family and causes emotional and financial stress.
In order to request assisted death, an individual must make two verbal requests and one written request to their physician. The two verbal requests must come at least 15 days apart. After this, a person will undergo extensive medical and psychological evaluations and counseling with family members before they are granted the right to self-administer prescribed medicines to voluntarily end their life.
The push to legalize assisted death in the United States dates back to 1902 and has been met with much resistance. Opponents argue that assisted death should not be necessary in the face of improved hospice and palliative care, that it violates the Hippocratic oath, and that it could lead to a “slippery slope” phenomenon around morally and ethically dubious uses of euthanasia. As of 2022, assisted death is legal in only 11 of the United States, the first being Oregon in 1994. It is worth noting here that Georgia, where the Kennedy family lives, is not one of those states, but for the purposes of the play, it is suggested that Bartholomew would have access to this end-of-life option.
As mentioned previously, a person’s decision to pursue assisted death can be particularly challenging for their loved ones. We see this with Maxwell, one of Bart’s primary caregivers, who struggles to accept his father’s decision. The role of the caregiver has been under a spotlight recently due to the COVID-19 pandemic, as families’ living situations changed and the illness and loss of loved ones became all too common. A caregiver can be an “informal” caregiver, such as Maxwell, who provides assistance to his father, based on their familial or personal relationship. A “formal” caregiver is someone who is paid for their services and frequently has received training in providing care, such as Bart’s nurse Chloe.
Caregivers, although they are not always immediate family, form close relationships with their patients as they assist them with daily medical needs, complete household tasks, and communicate with family about the status of their condition. If the patient has no next-of-kin, the caregiver might also help finalize legal and practical arrangements before death. As such, it can be an emotionally stressful role and one that can lead to burnout. Recently, more resources have become available for caregivers to help ensure that they are supporting themselves, including caregiver networks and support groups where individuals can speak to others in similar situations. Though it can be a rewarding role, it is one that also comes with many mixed emotions, which the experiences of both Maxwell and Chloe illustrate well.
“Being a Caregiver.” John Hopkins Medicine. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System.