sailing off this mortal coil
On Friday 10th July, 2009 the distinguished conductor, Sir Edward, and his wife, Lady Downes, climbed on to separate beds in the Dignitas clinic in Switzerland. They took a fatal dose of barbiturates and quietly died. Their family was present.
Lady Downes had terminal cancer and Edward Downes was losing his eyesight and hearing, a particularly severe blow to someone who had devoted his life to music. To me it was a good ending to a productive life. The police interviewed, but have not as yet charged their two children for the crime of ‘assisting a suicide’. To quote the statement made by their children.
After 54 happy years together, they [our parents] decided to end their own lives rather than continue to struggle with serious health problems. They died peacefully, and under circumstances of their own choosing, with the help of the Swiss organisation Dignitas in Zurich
I’m not religious. I do not believe in a God. I see their action as being sensible, rational and in a lot of ways they had a good, dignified ending. To me it seems crazy that Britons, who have reached the rational end of their lives, not only have to travel to a clinic in Switzerland to end their lives, but that those that travel with them, risk being prosecuted in the UK for ‘assisting suicide.’ It would seem logical that a person, when their health is deteriorating should be able to choose to end their life in dignity in the UK, as they can in more rational places, such as Holland, Switzerland and the US state of Oregon.
I am not suggesting that anyone should be pressured into terminating their lives. I respect the right of religious people not to want to be a part of this process. I would fight aggressively to stop any kind of pressure on the disabled or infirm to be given the impression that they are being selfish to want to remain alive. However, if I found that I had Alzheimer’s I would want to terminate my life at the point where I was still rational, before my personality went and my relatives became strangers in a confused and frightening world. As I would if it seemed that I was going to end up in a nursing home where, to paraphrase a friend’s view: ‘I couldn’t walk, feed myself properly or wipe my bum’.
This would however be my personal choice. At Dignitas I would be the person who put the beaker to my lips with the sedatives that would end my life. I would prefer the method, blocked by Canberra, used in the Northern Territory of Australia, where a doctor sets up a device to administer a general anaesthetic first, followed by the terminating chemical. In the end it is the client who presses the button that leads to the end.
I am not advocating this ending for others – it would only be for people who had made a rational, personal choice, with no outside pressure or manipulation. I respect that religious people may think that their God’s ‘gift of life’ should not be taken away. On the other hand they should, possibly with some sadness, respect my right not to believe this.
At present in this country aiding and abetting suicide is a criminal offence punishable by up to 14 years’ imprisonment. At present eight cases of people who have helped others to commit suicide have been referred to the Crown Prosecution Service and none has been prosecuted. Although it has been suggested that it is not in the public interest to prosecute in these cases we all know that at some point there will be a case, where a vulnerable spouse or partner, will be taken to court and humiliated by the process.
An attempt to clarify the law was made by Debbie Purdy, a multiple sclerosis patient who wanted to clarify whether relatives would be prosecuted under UK law for accompanying relatives to kill themselves abroad. This was rejected by the appeal court. Her hope was that she could end her life holding her husband’s hand, without him facing prosecution.
In July, 2009, an attempt was made by Lord Falconer to clarify the legal ‘no man’s land’ of accompanying a person to going to the Dignitas clinic by proposing an amendment to the Suicide Act. This modest proposal was severely attacked by church and disabled groups.
The debate both in the Lords and on TV was swung by disabled people claiming that they did not want to be forced to kill themselves, and that if assisted suicide came to be Britain, they would be pressured into so doing and that the status of handicapped people would be downgraded.
This is a false argument. The numbers of people organising their own death is likely to be small. In all cases, bar Switzerland, at least two independent doctors must be consulted. In Holland a psychiatrist is also consulted if there are any doubts about a person’s mental state.
Also because of this threat of prosecution, and the fact that people do have to travel abroad to organise the process, means that many have actually killed themselves earlier than they would have done if they could have organised the assisted in the UK. There is the fear that they would be to frail to travel. In Oregon and Brussels the death usually occurs at home, which gives a lot more dignity.
I have known two people, who have made a medical will, demanding that doctors do not intervene to save them. In both cases they were in pain and their lives had little dignity. I have also known a number of people, such as my mother, who died of lung cancer, who would not the option of assisted suicide.
To conclude: our cat, Kafka, grew old gracefully. Then one day she slowed down. She ate less and was obviously in some pain. The vet said there was some growth near her stomach. We agreed that she should come back home and spend some more time with us. When it became obvious she was suffering I took her back to the vets and calmed her, as the vet gave her a quick injection and she went to sleep and gently died. Why should a rational human not have the same dignified entrance as a pet?
The Death with Dignity process in Oregon
criteria
The law states that, in order to participate, a patient must be
- 18 years of age or older
- a resident of Oregon
- capable of making and communicating health care decisions for him/herself
- diagnosed with a terminal illness that will lead to death within six (6) months.
It is up to the attending physician to determine whether these criteria have been met.
The following steps must be fulfilled:
- the patient must make two oral requests to the attending physician, separated by at least 15 days
- the patient must provide a written request to the attending physician, signed in the presence of two witnesses, at least one of whom is not related to the patient
- the attending physician and a consulting physician must confirm the patient’s diagnosis and prognosis
- the attending physician and a consulting physician must determine whether the patient is capable of making and communicating health care decisions for him/herself
- if either physician believes the patient’s judgment is impaired by a psychiatric or psychological disorder (such as depression), the patient must be referred for a psychological examination
- the attending physician must inform the patient of feasible alternatives to the Act including comfort care, hospice care, and pain control
- the attending physician must request, but may not require, the patient to notify their next-of-kin of the prescription request.
A patient can rescind a request at any time and in any manner. The attending physician will also offer the patient an opportunity to rescind his/her request at the end of the 15-day waiting period following the initial request to participate.
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