Is it OK to Blog Your Battle with Cancer?

Should cancer patient Lisa Bonchek Adams just die already? That's the subtext of a recent op-ed from New York Times columnist Bill Keller that criticized Bonchek for blogging about her battle with the disease. Now Keller is facing ample online backlash for his piece, titled "Heroic Measures." But critics quick to rage against Keller for "bullying" and "shaming" are missing an opportunity to actually have a productive debate.

Diagnosed with breast cancer in 2006, Adams has been writing about her experiences online for the past several years. During this time, she's undergone aggressive treatment and participated in clinical trials of investigational drugs. Recently, things took a turn for the worse and Adams is now bedridden at New York's Memorial Sloan-Kettering Cancer Center. But she's still "doing as much as I can for as long as I can," as her Twitter bio states.

Keller isn't so sure this is the right strategy. When his father-in-law was dying of cancer in a British hospital, he was allowed to "slip peacefully from life." But here in America, "medical trench warfare ... makes an expensive misery of death," writes Keller. Rather than "endless heroic measures" to prolong fading lives, why not focus on palliative care that makes the end-of-life more livable?

In general, I agree with Keller. Many people agree with Keller — palliative care and the American way of death are increasingly hot topics. Overzealous end-of-life care can be ineffective, incredibly costly, and actually increase suffering for dying patients and families. It's certainly a contentious and sensitive topic, but not one considered verboten to write about. However, many feel Keller crossed the line by invoking Adams specifically (see Lisa Belkin at HuffPost Women; Greg Mitchell at The Nation; Gawker's Adam Weinstein). It's one thing to abstractly mutter about over-aggressive cancer care in America; another thing entirely to publicly criticize a specific, living individual for their medical decisions.

Though Keller never goes so far as to suggest Adams should stop treatment, he does write that her "warrior" approach may "raise false hopes" and "peg patients like my father-in-law as failures." It's clear that while he may "respect" Adams' care choices, he also thinks they're wrongheaded and possibly dangerous.

But as Keller himself notes, Adams' treatment choices are based largely on her desire to stick around as long as possible for her three children. One would presume Keller's father-in-law faced much different circumstances when he was dying of cancer. There will never be one right way to go about dealing with death, and it's ludicrous to equate the end-of-life decisions faced by an elderly man and a young mother.

Yet is it wrong to even discuss those choices in the first place? I don't think so. "Adams decision to live her cancer onstage invites us to think about it, debate it, learn from it," Keller writes, and I agree. That doesn't mean I support the idea of judging other people's medical decisions in general, nor Keller's conclusions about Adams in particular. But by making herself into a public chronicler of cancer care, I think Adams does open her decisions up for commentary. And by simply shouting into the Internet ether "how dare he!", opponents of Keller's view are turning this into yet another Internet outrage pile-on and missing an opportunity to have an actually interesting debate.