Assisted Dying – Should it be legalized?

Today’s post takes on a more sombre mood. Yesterday on my way to work I passed by a sign advertising a debate about assisted dying that was open to the community. Seeing as my alternative option for the evening’s activities revolved going to a bar I decided instead to attend the hot topic debate.

It is currently illegal in England to assist with suicides, although multiple attempts to introduce bills to legalize the act have been made. Interestingly, a YouGov poll found that 75% of the British public agreed with the proposal of the Assisted Dying Bill, which is to be debated sometime this year. I wasn’t quite sure what the status of assisted suicide is in Canada but a quick search showed me that Quebec was the first province to pass the bill just recently – June 2014.

The bill that’s under proposal would follow that of Oregon’s assisted dying bill, called Oregon’s Death with Dignity Act , which would legalize physician-assisted dying under very strict restrictions:

-The consenting individual must be over 18 years old

-They must have been diagnosed by a physician with a terminal illness that would kill the patient within six months

-The request must be made by the terminally ill individual

-The request must be confirmed by two witnesses, one of whom is not related to the patient

-The patient’s diagnoses must be confirmed by two physicians

-The patient must be free of any mental illness that could impair judgment (if a physician believes the patient’s request is motivated by depression or coercion then a psychologist’s evaluation would be required).

The debate was held at Bath URC and I was surprised by the amount of people who showed up for the debate. One quick glance around and I can safely say I was by far the youngest one in the crowd. The two guest speakers were:

1. Sophie Pandit, who supported her mother’s decision to have an assisted death at Switzerland’s Dignitas Clinic, and

2. Dr. Nigel Rawlinson, who works at Dorothy House hospice care.

Sophie relayed her experiences of watching her father die ‘naturally’ of Progressive Supranuclear Palsy (PSP), an incurable degenerative disease involving the gradual deterioration and death of specific volumes of the brain. She spoke about watching her father lose functioning of his body parts and apologized for using the comparison of her father looking like an Auschwitz prisoner when he neared his final days, his body just skin and bones due to his inability to drink or eat. When her mother, Dr. Anne Turner, got diagnosed with the same disease years after she knew right away that she wanted to be in control of her own death. When Dr. Turner first explained to her family how she wanted to plan her own death they were all shocked and against the idea. Without the support of her family, Dr. Turner attempted suicide by overdosing on drugs and placing a bag over her head. She failed in her attempt and it was at that moment that her family realized how important it was for her to not experience her final days in as much misery as her husband. That was the pivotal moment where Sophie made the choice to help grant her mother this last request and thus her research into assisted suicide began.

They ultimately decided to enrol Dr. Turner into the Dignitas Clinic, based in Zurich. The requirements to be accepted by the clinic are that one must be of sound judgement and must also submit an in-depth medical report that establishes the patient’s condition. The patient him/herself must decide on their own free will that they want to die and the patient must be in a good enough condition to take the lethal overdose themselves. Having someone else administer the lethal dose would otherwise be known as euthanasia, a completely different topic.

Sophie’s tale was a little heart-breaking to hear but she seemed to take great comfort in knowing that her mother’s last days were spent as *her mother*, not a soul-less body that was just waiting to shut down. I later discovered that this journey was turned into a movie called ‘A Short Stay in Switzerland‘ and was nominated for numerous awards including the BAFTA Award for Best Single TV Drama and Best Actress! I definitely need to put it on my must-see list.

Dr. Rawlinson took on the view of helping patients stay as comfortable as possible until the body naturally shuts down. Admittedly religious, he clearly stated that his talk and discussion points were of a secular point of view. He stated that as a doctor, it’s difficult to imagine being put in the decision of ending someone’s life when the body is still fully functioning. He also stated his views of the slippery slope argument – if you allow a bill to assist those who are terminally ill to die what’s not to push the bill even further to allow those with manic depression or severe mental problems to also end their life?

After the two talks the audience was given the opportunity to discuss amongst each other our viewpoints and to see what brought people to the talk. The free coffee/tea and cookies/cake was a nice way to get everyone talking! I went to the talk solo but joined a group of people and it was interesting to hear the different points of views. There were two priests (female, if that’s of any relevance) in my group who, surprisingly, were pro-assisted dying. It was interesting to hear them state that so much of the bible is up to one’s own interpretation and that it was of their views that terminal human suffering isn’t something they felt was right. Actually, of the 5 people in the group I was the only non-religious one there and every single one was on the pro side.

I can’t say that this is a topic I’ve given a *great* deal of thought to but my initial instinct is that yes, I am pro-assisted death. I believe that in circumstances where one is terminally ill, suffering, and is just playing the waiting game of what day is going to be their last day then yes, who are we to say “no, you’re not ready yet, you need to wait until your organs naturally fail or your heart naturally gives up.” To force someone to unnecessarily suffer seems inhumane.

That being said, I do understand that there is a slippery slope effect. Why is it only terminally ill patients who get this ‘way out of life’? What of those who don’t have the capacity to live a good quality of life? My friend, who is a nurse who works in a nursing home, thinks this law should be extended to the nursing home patients as well. She cares for patients who have no will to live, who are alone and have no family who come visit – basically, people who are just vessels with a beating heart. They don’t know when they’re going to die but they wouldn’t mind if it was the next day. i.e. They *want* to die. We (as in Canada) are running out of space to care for the ageing population.

Is this a morbid and sick solution that could take care of multiple problems?

As the discussion progressed I thought of something else that could be an issue. I wanted to ask the panelists their thoughts but was too shy to speak in front of the whole crowd. I fully understand that the assisted death needs to come from the patient and it is *their* decision to make. But what about the ripple effect of how it would/could affect other people? My worry would be that those closest to them may not have the capacity to handle this decision and in the patient’s passing, something negative could occur. Should close family members be required to go through some kind of counselling to properly prepare for this drastic event? Or should it be up to the patient to know the consequences of his/her actions and how others will be affected? Are patients being selfish by wanting an ‘easy’ way out or is it the patients’ loved ones who are being selfish by not letting them end their suffering?

I was intrigued with the figures stated during the talk. Interestingly enough, since the inception of the Death with Dignity Act in 2013, a total of 1,173 people have been prescribed with the lethal medication. Of the 1,173, 752 patients have died from the medication – so only 64% have gone through with the act. At Dignitas, of those who are ‘approved’ and given the green light to be assisted, 70% do not return. It appears that people are comforted with the fact that *if* they want to go they have that option. The option is viewed as an insurance in case things take a turn for the worse and life becomes unbearable.

People speak about death like it’s a horrible thing, that it should be a hush hush topic to be put on the backburner. A topic that people don’t want to talk about – but why? Death is natural. Everyone is born and everyone will die. To be clear, I’m only referring to ‘natural’ deaths when I speak about death not being horrible. Those who have had a long and fulfilled life shouldn’t have to fear the inevitable. I find it strange that if I bring up death, say speak about my ageing grandmother whose health is rapidly on the decline and whose end may be drawing near, some people will respond with “no, no Hazel, don’t think about that! I’m sure she’ll be around for awhile!” While some might call this positivity, I call it disillusionment and an inability to face reality. If I talk about wills and what would happen *if* something were to happen to me/parents/whoever I’m sometimes faced with “Why are you even thinking about that? Nothing’s going to happen!” Really!? Death will happen. Prepare to accept it.

I’m so glad I attended the debate and very happy that the City of Bath opened up this topic to the public. It’s something that needs to be openly discussed and it definitely gave me some food for thought – feel free to fuel my thoughts and let me know how you feel about the topic.

Ciao ciao,