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Friday, October 11, 2013

Legally assisted suicide


A programme I saw not long ago that made me think deeply. In my position you won’t be surprised. 

   A British man and his wife were entering a clinic in Switzerland. I noticed that as he entered, he looked for a secure hold on the door frame as he passed through, and by his gait, I knew immediately that his problem was neural.

   I was already aware that he’d come to that clinic to die, on that day. After all, that was what the programme was about. He was terminally ill, and his future was bleak, without hope of relief. He’d made a decision to do so, by the process Switzerland is now famous for, (or infamous, whichever way you look at it).

   Assisted suicide is its real name, but it's wrongly called euthanasia. That term has been hijacked, which is a pity. Euthanasia means nothing more than a “good death”. 

   Hands up all those who want a bad death? Not a lot, I see. However you want to die, whether by Dylan Thomas’s not going gentle and fighting in rage all the way, or by slipping quietly away in peace, you surely want what you regard as a good death.

   I'd like to see the unhijacking of the term, euthanasia. Let's unhook it from Assisted Suicide. Well, I will, but probably it will remain confused with many other things: suicide without any help from anyone else, encouragement to suicide, assisting someone else to die illegally, unnatural death of one sort or another right through to murder  everything that doesn't leave you to controlled palliative care but leads to premeditated death tends to be called euthanasia. 

   When people argue about it, they are often talking about different things. It annoys me sometimes that they don't agree at least what they're arguing about, and just muddy the waters.

Australia: Source
   Two things I want to clarify at this point. I do not seek assisted suicide for myself, but I'd like it to be available to anyone else who’s terminally ill (by any reasonable definition of the term). I don't want to get into discussion about suicide pacts by couples and the like right now, either.

   My focus here is on something more limited; legally assisting in the death of a person of sound mind but with a terminal illness – because they’ve reached a point that they want to die.

   That's exactly what this chap had come to Switzerland to do. He and his wife entered the clinic and sat down side by side in a lounge chair. He talked with his wife and the medical staff there about the process – not for the first time, obviously. This was the culmination of an extended discussion he’d had with them over a long period of time, after talking with his personal doctor. He had fulfilled their strict conditions.

   His wife was hesitant, but she had decided long before to support his wishes. She'd seen what he'd been through up to this point. Her acquiescence was an act of love.

   At one stage, when asked how about her feelings, she said she wished that he would have stayed so the family could have one last Christmas together, but she knew he felt he had had enough.

   I thought she was very brave.

   So this was the day. The process was unhurried and calm. He was given plenty of time to face exactly what he was doing, or to change his mind now that he was on the brink. Then came the irrevocable moment of decision. Once he had drunk this clear liquid, that would be it. Really it.

   He shared some chocolate with his wife and made some little joke to lighten the moment. I think part of the reason for the chocolate was that the liquid he was about to swallow was very unpleasant-tasting. There seemed a lot of it, but he’d been warned not to stop once he’d started. One last little kiss shared – a rather formal one, given they were surrounded discreetly by medical personnel. He smiled at her, gulped the liquid down.

   Within seconds, he laid his head on his wife’s shoulder, snored quietly and peacefully for no longer than a minute, gave a little convulsive movement, and his breathing stopped. The medical staff took his weight gently from his wife’s shoulder and proceeded with the preliminary formalities of declaring him dead.

   As far as I recall, his wife was very calm. She didn’t cry. After some time, she got up, and quietly walked out of the door. She was going back to England shortly after. I think his body was going back home on the same flight.

   I confess my first thought was how eerie it all must have been for her. She had walked in with her husband who had a few minutes before been smiling nervously and talkative, and she now walked out alone, knowing her husband was dead. She would get in the car, alone. Have a single seat on the plane.

   It was a premeditated act, a choice of death over life. Just how could she have felt?

   I can't imagine. Some state of numbed shock, surely, now that it had come to pass.

   He had found the peace he was ready for. I'll never begrudge him that. I'm not sure how long it would take her to do the same.

   I hope it wasn’t long.

[to be continued, I intend.]

14 comments:

  1. Thank you for this thoughtful and strangely comforting post, Denis. I know that personally, I would enjoy the closing years of my life much more if I could choose when to bring it to a close. To die peacefully and with dignity, having said farewell to those around me, like the man in your story. Many would like to choose the time and manner of their dying, others would not. It should, however, be a matter of individual choice; a choice currently denied to the silent majority - for reasons that elude me - by a noisy minority.

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    1. For the person who is terminally ill, at least, I agree with you as to timing and manner of death. The reason why this is denied in Australia seems to me to be that the small, rather quiet [I find] but highly influential minority who carry the day have an unshakable belief in the utter sanctity of life under all circumstances and ignore the fact that doctors have a legal responsibility to follow this through no matter how much torture they put those people through who have not made their wishes known with a legally valid end-of-life document.

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  2. A first reaction (and I will spend more time reflecting upon it, as I have now for years) is that in Denis' telling of it, he describes the husband's experience of death in just one sentence, then writes several paragraphs musing on the wife's state. This is very natural, and is perhaps exactly why there is so much angst about the subject?

    And on the euthanasia/assisted death 'demarcation' that Denis suggests, I support both, but confess to far less apprehension about having to do the former than witnessing the latter. This is just a personal view, but something I have contemplated from time to time.

    kvd

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    1. The reason I dismissed the husband’s death in a sentence was that he was able to have his wish fulfilled and his part in the proceedings thus ended. But the wife would be the one to deal with living following his death. I was musing on how strange it would feel to be taking part in the experience. So often the focus is on the person who is dying.

      As I said, I would hope she could now make for herself whatever life she chose, as quickly as possible after the process of grieving was dealt with.

      I was not disapproving of his decision to get it over with if he had insufficient quality of life to want to keep going. I was trying to put myself in the place of a living, loving person who’d gone in the door with a live partner and left shortly after with one who was dead as the result of a calculated decision.

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    2. Yes, I understood that Denis. I agreed with what you wrote, and was not criticising, more just 'discussing with myself' why it is that we (myself included) seem to place more emphasis upon the effect upon the survivor than the wishes of the deceased.

      And also it was way too early in the a.m. for me to attempt the philosophical :)

      kvd

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    3. That's fine. I understood you were mulling it over.

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  3. The wife did not cry but I did and I'm sure she did later.

    What a gift to the world this TV program was (when? where?) and so too this post. It is a moment in life that we struggle to imagine accurately and to dwell upon.

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    1. I'm sure she'd be happy for him - both of them I hope - that his suffering was over. It's certainly what I'd want.

      The program was on SBS a couple of months ago. I don't know if they could supply details. I t was handled very well.

      Thanks, Dave.

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  4. Another beautiful post, Denis, highlighting the fact that all of our decisions create ripples. I have heard quite a number of people who suggest this decision should, sometimes, as it was done in the past, be left to doctors who would juggle pain relief and the risk or probability of death. I do not think they should be left with their personal ripples either. Thank you for your insights. Anne P.

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    1. Anne: you raised a number of issues that I have on the agenda for the next part, concerning doctors and seeing it from their point of view, which is something not always thought about. Their reactions vary enormously. I’ll save it till then but I'm not surprised it was you who raised these.

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  5. I have no idea about this situation and what is right and what is wrong. Among the hardest dilemmas and, like most of them, something that should be entirely within the right of each individual to decide, I think.

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    1. I don't believe in right and wrong in these circumstances but I agree with you. What I'm concerned about are the other parties affected by the decision and what I feel strongly is the need for the feelings of the terminally ill person and those directly affected to be considered by them all in the decision. Ultimately it must be the person’s decision but I'd hope they’d take into account more than their own views. Again, I'll come back to this next time.

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  6. A sensitive story handled well by both SBS and your post. I think they were both very brave, and agree it must all have been very strange and difficult for the wife. Not least as well with the sort of comments/questions/subtle criticism she might face from friends and family and colleagues back home.
    I was surprised how quick the process seemed from reading this - don't know what else I expected though.

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    1. Good points looking from the wife’s point of view and reactions to her acceptance. There will always be critics no matter what.

      You were right in the interests of accuracy to raise the point about the brevity of the timing. Tracey raised it too. There were two potions. To keep it simple I didn't mention the first which was about an hour before the one I referred to in the story. I mentioned only the second.

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