Assisted Suicide

I recently read a very touching story of an English couple who had gone to an assisted-suicide clinic in Switzerland to end their lives together. The wife, in her seventies, was a television producer, choreographer, and former ballerina. She had been diagnosed with terminal cancer. Her ailing, eighty-five year old husband, was a former BBC conductor and Verdi specialist.

Sir Edward Downes and his wife, Joan, both agreed to terminate their lives at the Dignitas clinic outside of Zurich.  Members of their family were at the  bedside of the couple and watched the elderly couple eventually die.

The arguments and fierce positions of those for and against this modern version of euthanasia continue to be intense.

Those critical of Dignitas have called its clients “death tourists.” And even Swiss politicians are becoming worried about their country being stereotyped as a death camp. Some who oppose the practice of allowing early terminal patients the choice to die still hold out for new cures. Others maintain that new-and-improved palliative-care practices and medications have eliminated the old horror-show stereotypes of  excruciating and unnecessarily prolonged deaths. And there is a moral gray area in allowing non-terminally ill patients  to commit suicide, even though their mental or physical disability is irreversible (the paralyzed rugby player Daniel James, 23, committed suicide at the Dignitas clinic last year).

But—and with any controversial topic there is always a “but”–what about those for whom there is absolutely no hope of ever being cured in their lifetimes, will never be relieved of pain-killing medications, have not yet been recommended to hospice, are still able to make a rational decision, or because of a freak accident, have had their physical lives almost totally annihilated as in the case of Daniel James, the rugby player? What about the elderly who have been diagnosed with a terminal disease and have made a choice not to put themselves or their families through the emotional suffering of watching them deteriorate daily? And, why should the state have the moral right to require that you stay alive when there is an air-tight impossibility of ever recovering from the last stages of your medical pathology?

To those who support euthanasia with very specific guidelines—the terminal and pain-bearing nature of the disease and the ability of the client to make a rational decision—mercy killing is a more humane way of gently allowing patients to freely remove themselves from the final stages of their debilitating physical conditions or because their physical and emotional lives bear little or no resemblance to an active, engaging life.

We're not talking about  a hernia, glaucoma, or a broken hip. Metastatic, terminal cancer to someone in their eighties is not a pathology that can be placed in the same category as a teenage sore throat.

Why can't a man in the last stages of Lou Gehrig's disease, make a kind of triage-choice to terminate his life? He knows that there is no possibility for remission and, if he does any research on his own, he knows,even more tragically,that the final stages of the disease can be a gothic nightmare.

While she is still able to make a rational decision, why can't a woman in the final stages of Huntington's choose to become a Dignitas client? To those of us who know what the last months, even years, of a Huntington's patient are like, there is nothing redemptive in forcing someone to go through that pain and suffering, no matter how many medications their systems can take.

The ethical difficulty in making either of these decisions is that more and more medicines are being discovered that can “slow the progress” of many terminal diseases. However, delaying the inevitable too often means a reprieve of a few months. It's not as if you're a death-row inmate who can use even a month to organize his case for an appeal. And some doctors are more willing to use a patient as a scientific experiment to see the effects of a particular drug than they are in allowing a patient to end their own suffering.

Even to those who remain convinced that active euthanasia is morally wrong, I believe there is something ethically persuasive about an elderly ailing couple choosing to terminate their lives. Perhaps their deaths live in the Romeo-and-Juliet imaginations of those who feel that a choice to die together is a final act of commitment and love. Perhaps there is some poignant analogy between this couple's choice to choose the way they wanted to end their lives, hand-in-hand,  in the same way that the Trade-Center couples chose to jump together from one of the World Trade Center buildings on 9/11 rather than face the excruciating agony of being burned alive. In the last act of their lives, they chose to give each other support and comfort in a final bonding act of love. “Greater love than this…” says the ancient text.

May they rest in peace.