Wednesday, August 29, 2012

Dying with dignity

A couple of months ago, British Columbia’s Supreme Court struck down as unconstitutional provisions in the Criminal Code dating from 1892 making doctor-assisted suicide illegal, on the basis that they violated the equality provisions of the Charter of Rights and Freedoms. Strictly speaking, the ruling applies only to British Columbia, but it’s still a precedent and has implications for other jurisdictions in Canada, and potentially beyond. It’s unclear yet whether the federal government, which is responsible for the Criminal Code, will appeal the decision to the Supreme Court of Canada.

The cat is among the pigeons, and judging from the response, it’s about time.

Recently, a doctor chimed in with an opinion piece in The Globe and Mail that was not well received in terms of the comments it garnered. If the response is representative, then it seems that most Canadians, like me, feel that this is a matter of personal choice and that compassionate medical assistance with this undertaking, far from being a criminal act, ought to be a human right.

My comment on the article, and a response to a couple of rebuttals made to my stance.

God damn it, why is this still even an issue this late in history? A person's life is his or her own. INEVITABLY, IT MUST END. If the time comes that he or she wishes a peaceful, dignified, and merciful closure, I feel it is arrogant, insensitive, and a willful failure of compassion to deny a human being that right. To insist he or she writhe in pain until the last ounce of strength has been wrung out by the tender mercies of nature, and his or her debasement is utter and complete, is medieval in its conception. It does not belong in a modern age where we have skills and knowledge that mean it doesn't have to be so.

To present doctors solely as "healers" is to blithely abdicate what every human being ought to be, even more fundamentally: compassionate. If human beings were immortal, there might be something to this position. But we're not. At some point, for each of us, "healing" becomes an unrealistic goal beyond the reach of our knowledge and technology. At that point, to make a fetish of the "healer" role is to sentence those entrusted to one's care to real, literal torture. This is not to wash one's hands like a surgeon. This is to wash one's hands like Pontius Pilate.

Not even a week ago, I faced the awful decision of having to euthanize a cat who'd been part of my life for ten years. He had inoperable cancer of the larynx, and he had reached the point where he could no longer hide the pain he was in. There were two options: consign him to death by slow starvation and the torture of his own body until his heart finally gave out because I didn't have to guts to face the inevitability of what was happening to him, or else to have the courage and humanity to give him a quick, easy, graceful end to his life and spare him the agony now closing in on it without relent. I did the latter. And while I was there and watching him pass away so easily, I wondered about my own end, and why my government and my society are too squeamish to allow me, or anyone else, to have what even a cat or a dog can have: human mercy and deliverance.

If it's a sin, that's between me and God. You let me worry about it. But don't condemn me to pointless horror because you can't face reality, or admit your limitations. Let's grow up, and bravely end the foolish taboo on this topic; put some provisions, procedures, and safeguards in place, and start making it possible for the inevitable to take place with dignity and meaning.

The responses here of Ailina and Ann Ig Norant reflect, I think, the attitudes that have held sway for too long. On the surface of it, they sound reasonable. But they're not thought out. What are the practical upshots of this "DIY" attitude to death? How exactly does a human being facing his or her own demise undertake the research to do it properly? Gunshot to the head? Drink drain cleaner? Hit the streets and try to score a sufficient amount of heroin to overdose? This attitude also opens the door to just anyone showing up to "help", and some of those people just might be self-interested... like those who stand to inherit; and let's not kid ourselves. That's been going on for thousands of years. Please, people. Think. Show some compassion, and really think about what you're saying.

I had a friend down in Texas who died in his mid-20s about ten years back of a horrible connective tissue cancer. But he held onto hope and fought it till the day he died, finally poisoned by his own liver. That was his choice to make, and I certainly respected and admired his courage. But he was young, and he had his whole life ahead of him. His father, substantially older, died two years later of throat cancer. His attitude was different. He was at the other end of his life, and once he knew there was no stopping it, he refused further treatment as pointless. His death came fairly quickly, but it was also needlessly ugly. He wished for, and ought to have had, the ability to choose his time, and to be able to say his good-byes on his own terms, with dignity. But people like Ailina and Ann saw to it that was an impossibility. The bills piled up, and he died miserably. And for what?

This needs to be job of professional people who understand pharmacology, know how bodies and brains react, understand dosages, and have experience with what chemicals have what effect in the body. The people chosen to administer, or, if a relative is chosen to perform the act, advise the administration of lethal agents, should be trained and licensed. There needs to be oversight, and it needs to be transparent and done in the light of day, not in dark corners.

It also needs to be said that murder is the unlawful killing of a human being, done against his or her will, just as the act of lovemaking becomes rape when done without consent. The key word here is consent. It's not murder if someone is asking for help to end his or her own suffering. It's merciful assistance. Getting hung up on abstract labels and ignoring the realities of what we're really talking about here has ruled the roost for far too long, and millions of human beings have suffered slow, torturous, lingering deaths at the whims of healthy people who put their own philosophical verities before the actualities of human suffering.