Death centered

Death centered

 Office of the Dean May 19, 2020

UCI alumna and bioethicist Margaret Battin has dedicated her life to end-of-life issues

By Lisa Fung

Margaret Pabst Battin spends a lot of time thinking about death.

As one of the nation’s top bioethicists, Battin, a distinguished professor of philosophy at University of Utah and UC Irvine alumna, examines moral dilemmas that take place in a number of fields. But she is perhaps best known for dealing with end-of-life issues.

Though she didn’t initially plan to specialize in this field of study, Battin, who goes by “Peggy,” found from an early age that she was drawn to ethical problems and the difficult choices that surround them. When she was 21 and her mother was dying of liver cancer, she was surprised to find no one ever mentioned “death” or “dying.”

“It was this sort of conspiracy of silence,” Battin, 79, says. “I remember a doctor saying, as the downhill course continued, ‘Well, this is just a little downturn, but she’ll be up and around by spring.’ He knew that wasn’t true. We knew that wasn’t true. The patient, my mother, knew that wasn’t true. But that was the kind of thing that was said.

“My takeaway was, when able, a patient should be able to have some say in how their death goes.” 

Speaking from her home office in Salt Lake City, Battin’s voice is warm and welcoming as she apologizes for the stacks of books and papers piled around her. On the wall behind her desk hangs a large painting, one of six panels modeled after a Bronzino portrait of the goddess Venus with her son, Cupid, that was painted by the wife of a UCI professor.

“When I came to Irvine, I’d never heard of bioethics – nobody had. There wasn’t such a field, or it was just beginning in some other places that we didn’t know about,” says Battin, who earned her M.F.A in fiction writing from UCI in 1973 and Ph.D. in philosophy in 1976. “It wasn’t until I had finished graduate school and came to Utah that I first was even aware of this new field.”

Today, UCI has its own home where medicine and humanities meet. The Center for Medical Humanities was launched in 2018, a partnership between the School of Humanities, the Claire Trevor School of the Arts and the School of Medicine. Scholars involved in the center bring humanistic perspectives to medical issues. The school even offers students a minor in medical humanities through the Department of Philosophy. But back when Battin was attending UCI, this integration of disciplines was only a fledgling concept. 

Chance brought Battin to Southern California. After completing her bachelor’s degree in philosophy, magna cum laude with honors, at Bryn Mawr College, Battin was preparing to attend graduate school at Yale. Instead, she ended up getting married and moving with her first husband to Irvine for his job. In the evenings, she began taking fiction-writing courses.

While attending a cocktail party, she fell into a conversation with Peter Woodruff, a philosophy professor at UCI, who queried her about her original plans to continue her education and learned that she had planned to attend graduate school in New Haven. “He said, ‘Do you by any chance have your application papers around?’” Battin says, laughing as she recalls fishing them out of a box she had moved across the country and giving them to him. “Within three days, I was admitted to the program.”

By now she had two young children and was taking a full graduate course load in philosophy, but she wasn’t ready to give up her writing. So, she went to the dean to see about concurrently pursuing an M.F.A. in fiction writing.

“It took an extra year, but I think it was amazingly useful; I’ve always thought of it as preserving my sanity,” she says. “Philosophy was this dry but rigorous field – reference theory and Spinoza. But the fiction writing degree had a required reading list of all the great literature. So, you’d read Spinoza in the daytime and then read and write fiction in the evening, and it keeps you sane.”

As it turned out, Battin’s fiction writing proved to be more than just a creative outlet. One of her short stories, “Terminal Procedure,” was included in The Best American Short Stories of 1976 and a year later, “Dead Slow” was named to the honor roll of the same annual volume. Her 1977 short story “Robeck” was adapted into the play “Winter” by Julie Jensen, produced in Salt Lake, Chicago, Berkeley, and Sea Ranch, California, four decades after it was first published.

Battin’s budding writing career could have led her down a different path, but, she says, “it turned out I had been writing stories about things like people who manipulate each other or promises that are not kept or animal experimentation or death and dying kinds of stories. They’re all the kinds of situations that you focus on in bioethics.”

By the time she received her Ph.D., the job market had tightened and her only option appeared to be a one-year position at University of Utah. “I can remember a couple of faculty members surrounding me as I was looking out in confusion over the railing around the edge of the building where the Philosophy Department is, up on the top floor, saying, ‘You have to take this job; it’s really important,’” she says. “Well, it’s only a year – I’ll be back.”

Not long after she arrived in Utah, Battin was among the 15 to 20 faculty members assigned to teach a course in Intellectual Traditions of the West. There, she caught the eye of Brooke Hopkins, a Harvard-educated English professor who also had arrived in Salt Lake that year.

“It’s these coincidences that make up so much of what happens in your life,” she says.

Battin stayed on at the university after receiving a prestigious National Endowment for the Humanities fellowship, which led to her tenure-track position.  She and Hopkins fell in love, eventually marrying in 1986.

“He was quite outgoing. He was very tall – he was 6-foot-5. He would stride all over the campus and everybody knew him,” she recalls, smiling at the memory. “But his central trait – and this was the one thing I tried to carry forward from him – he was always more interested in other people than himself.”

For the next two decades, the pair led an idyllic life. “We traveled a lot; we went all sorts of places. We danced a lot. We spent time in cafes,” she says. “And we both worked hard at our academic jobs.”

But all of that changed in 2008 when Hopkins was involved a bicycle accident that left him paralyzed from the neck down.

“It was a beautiful crisp day in November,” Battin says, her voice growing softer and heavier. “I normally went biking with him, but that particular day, I had a little cold or something and there were some talks in the philosophy department, so I didn’t go. As he was coming downhill after his ride, there was a bike racer coming uphill. They collided around a blind corner.”

Hopkins was thrown from his bike, flipping over the handlebars and hitting the ground helmet-first. A flight nurse happened to be jogging by and resuscitated him. For two years, he remained in the hospital before moving home. “It changes your life. It deepens your relationship,” says Battin, who continued to work while arranging round-the-clock care for her husband, ventilator-dependent but with no head injury at all.

As a pioneer and expert in bioethics, Battin is regularly called on to present lectures, testify in courtrooms and meet with lawmakers grappling with the tough legal issues surrounding assisted death. And while she and her husband had long talked about her research and end of life issues, now the discussion was personal and her own convictions would be tested.

“He had written a letter to all of his caregivers, family members and his doctor and had them all sign it, saying, ‘this is what I wish – I’m not quite ready yet, but I want you to know that this is my wish. There will come a point I can see that where I will have had enough,’” Battin recalls.

When that time came in 2013 and he made a formal request to his physician to have his ventilator discontinued, she says, “I think I was the main foot-dragger… But he was quite certain in his own mind. So, you’re lying in bed next to him at one moment, still talking, and then, they dial things down, and he is dead. And you can’t turn it around anymore.”

She pauses.

“It didn’t change my mind. I still think people ought to have a choice,” she continues. “What has changed is my sense of how complex and how difficult it is for every family that goes through this.” 

Nearly a year after his death, in a moving TedMed talk, Battin recounted their lives together before and after the accident and his decision to end his life. Today she still lives in the house she shared with Hopkins and continues her teaching, research and advocacy.

Now, with the coronavirus pandemic, the bioethics issues that have been such a large part of her life have come to the forefront across the country and the tone of the conversations have changed. 

“In particular, the thing I think about the most is: What do we owe patients who are de-prioritized for treatment?” she says. “If we’re triaging patients for access to ventilators or medications, there’s some people who get the ventilator, get the new treatment, and there are people who don’t. What do we owe those people? That never gets talked about.”

In her role as professor, she is often asked to give advice to her students. “If you’re confused about something, seek advice from many sources, then choose whatever seems to fit you the best,” she says. “Everybody has a different idea of who you are and what you should be doing. They have different pictures of you and the future you. It’s generous of them to have those pictures, but they don’t necessarily exactly fit.”

Once the shelter-in-place requirements are lifted, Battin is looking forward to returning to the normalcy of life. That means teaching, traveling, hiking in the foothills near her home, and finishing two books she is working on. She recently marked the birth of her second great-grandchild.

And there’s the matter of her cluttered office.

“You’d think since I spend so much time in my office Zooming, I’d clean it up in the background. I think I’m resigned to knowing that my office will always be messy” she says, laughing. “I’d rather be working on a new project than cleaning up after an old one.”