Tuesday, March 5, 2013

Last Rights

How can it be that it’s legal to kill yourself, but a crime to help someone take her own life? Ruth Goodman’s recent posthumous letter to the Globe and Mail editors and Sandra Martin’s profile offer important perspectives on those questions. So if a person is that miserable, why doesn’t she simply go ahead and take her own life?

It turns out that it’s not so simple for people with serious disabilities. But neither is it an easy matter for those of us who in old age have become frail or have minor disabilities. Imagine this situation:

You are a seventy or eighty or ninety-year-old. Imagine that you have a disease that is physically painful. You cannot use the toilet or dress yourself without help. Your eyesight and hearing are both failing. Maybe you suffer from only one of these conditions, or you might have several more. Your mind works well, but you feel closer to death than to life. You decide to end your life, but now you are faced with the challenge of how to do it.

You want to ask your doctor to prescribe whatever will enable you to die at a time you choose. But you’re afraid if you ask for it, the doctor might try to hospitalize you. So you have to ask someone else what you need. But anyone who answers your questions could be arrested and jailed for assisting you.

The Internet might provide answers. But suppose you don’t know how to access it. Or your fingers are in too much pain or your vision too poor to make it feasible. You have heard that there are some areas where it is legal for doctors to give patients a drug that will help them die, under certain narrow circumstances. You wonder what they give to patients who choose to die and you call an organization that promotes death with dignity, and ask what substance those doctors prescribe. You are told that information can’t be given out.

Maybe you’ve heard of the Australian book that answers many of your questions, but it has been banned in that country, and you don’t know where it is available. If you somehow manage to find it, it will tell you what drug those doctors prescribe for the patients who qualify. If you can find a way to get the pills, you could mash them up, but how many do you need? You’re afraid you won’t be able to do it right. If it is difficult for you to swallow (a common problem with some illnesses) taking many pills will surely be a challenge. Midway through the process you might vomit or fall asleep.

But anyway, the book tells you it’s best to take the drug in liquid form. You feel as if you’re getting somewhere–until you encounter still another road block. Though the liquid form is available in a few countries it is not legal in Canada or the U.S. So you’re back to square one. But let’s say you manage somehow to acquire the liquid. The book says the seal on the bottle is hard to remove. If your hands are weak or curled up with arthritis, how will you open the bottle?

Those are just a few of the obstacles that legal and other institutions have put in the way of anyone who wants to take control of her death on her own terms. And even if you manage to overcome several of those barriers, you will almost certainly need help at one step or another. If you tell your children or close friends what you plan to do, they may be horrified, try to talk you out of it, hide information from you, and decline to help. And never mind that it is legal for you to take your life, if they do assist you, they will be subject to arrest and jail. Catch 22 is alive and well.