Let us say two people are in identical circumstances, same pain, same prognosis, same mental condition. Two doctors and a judge (and anyone else you care to add to the process) agree that the patients are both of sound mind and both in a condition where assisted death would be given if asked for. One goes for it. At that point the other person (who doesn't want to die) is now in the position of being able to die if they ask for it, but actively choosing not to. They have been given an "out" but chosen not to take it and they know it and all their carers know it and any people who are negatively impacted by their condition know it. That would put tremendous pressure on that person, even if nobody encouraged them.
I'm not trying to be flip but I know this will come out as flip: if the person is willing to
not die, or
to die based on other people's expectations or loneliness or begging or whatever, then
they actually don't want it; they are allowing it to be at least partially someone else's decision. In that situation, they haven't let go enough to choose death.
In the Pratchett documentary there is one moment where the elderly woman tells the interviewer (with her husband sitting next to her...) the she doesn't
want him to go, but she understands why he feels that way and accepts his choice. It's a beautiful moment in many ways. Underlying it is the awareness that if he really wanted to go badly enough he could take matters into his own hands and go the messy nasty way instead of the gentle and easy way.
I think that part of what's going on with our societal response to self-termination is that we don't want to make it easy on the person, so that they'll think twice about us and choose to stick around. I know one person who has stuck around through several suicidal meltdowns simply because her only acceptable options for ending herself are so unpleasant to herself. I am absolutely positively sure that if you gave her a bottle of phenobarbitol she'd chug it within 24 hours. By making it so that she's got to cut herself or choke herself or drown herself or jump ... society raises the cost of her ticket out of here to unacceptable levels. We keep her in our lives by denying her an exit that isn't painful or unaesthetic or threatening.
On that point I have flopped and flipped many times. I think that a willingness to face a messy death shows committment and a true desire for it. I know this because I once had a loaded .45 pressed against my own eyeball and what backed me down was the nagging awareness that I was making excuses not to do it. It'd upset my housecleaner. Someone would have to clean up. That sort of thing. Gradually I came down from it with the realization that if I were far enough gone to do it, I'd also be far enough gone not to care about the housecleaner or anyone else. And that became my new benchmark for despair: clearly I felt bad, but I didn't feel bad enough not to care about my housecleaner. I will say it wasn't because I really cared that much about the housecleaner; it was really the awareness
that I was making excuses that made me realize I hadn't hit bottom yet. That was useful.
So, in your example - I wouldn't worry about it. If the person wants to die, they'll die. If they want to live - even if they only want to live a teeny little tiny bit - they'll find an excuse to live another day. And maybe the one after that. And even the next one.
Pratchett talked beautifully about how he planned to pass (the brompton rd cocktail: pinkillers and alcohol, with his favorite piece of music playing) but instead, he died of 'normal' things you die of when you're suffering from Alzheimer's. I believe I know how that could have happened. I would sit there in the chair with my glass of drugs and some tequila, and hit "Play" on Schubert's Trio in E flat (op 100) and.... suddenly, I wouldn't want to die out of a world that has such music in it. I could wait another day, and listen to the Schubert piece again. And even the next... The first time I planned to die what stayed my hand was pizza. I realized I could have pizza, and die tomorrow. For someone to pull the trigger, they have to have discarded all the desire for the beauty that still remains to be squeezed from life. And, when they get there, they know. Peer pressure or the tyranny of hope will not affect them. I am sure Pratchett, whose life was full and beautiful, hung on until the alzheimers' got him because: pizza. Schubert. I believe he was a fan of great whisky. What depths must one reach before whisky loses its hold? When you're that far down, it really is time to die.
If somebody could come up with as solution to this dilemma (and I don't think there is one as it's not a matter of safeguarding or getting the procedure right) then I would probably be persuaded to switch back to pro.
The reason I dawdled around with the exposition above is because I wanted to gently point out that your switching between pro and con was a way of understanding or making the excuses we make to put death off until tomorrow. There's nothing wrong with that. But for the person who is truly ready to die, the certainty you're not feeling - they certainly do.
It unsettles me because the scene is so beautiful, but the moment in the Pratchett documentary when the man slugs down his phenobarbitol: there is no hesitation at all. There is no fear. There is no apology. His wife's reaction is one of the most heartrendingly human moments I have ever seen.
Remember my decision has absolutely nothing to do with "the sanctity of life" or "the sin of suicide" or any religious doctrine (I am in no way religious). This is to do with protecting the vulnerable from being put under (unintentional) pressure.
Understood. I was railing at the religious aspects of it because I do believe that a lot of societal attitudes are influenced by religion's hatred of suicide (suicide ruins the whole 'afterlife' scam) That is also unintentional pressure. Or, rather, intentional. It is intentional that the only means of killing herself available to my friend are all nasty and messy and ugly. The compulsion and pressure goes in both directions. We want to force people to live by making their death extra nasty, it seems.
Watching a cancer patient (pancreatic burns you like a torch) destroy a big strong man, who lingered a week past the point where he couldn't move or talk or think - all I could think was that our collective fear of the reality of his cancer forced us to prolong his agony unnecessarily. There was no one who thought he might get better. There was going to be no miraculous cure. He asked me for a gun and I told him no. Because society would have punished
me too. There are levels of unhumane manipulation going on at every point in the situation.
Having said that I believe assisted dying should be illegal and assisting a suicide should be illegal i.e. against the law, that does not mean that I think that assisted dying or assisting a suicide are morally wrong.
.
I can see many situations where the moral thing to do might be to assist someone's wish to die.
One of my fathers' colleagues fought in WWII on the Russian front. I was a foolish early teenager when I was around him and started asking him about the war. Finally he looked at my father and said, "should I?" dad nodded, and he told me simply, "the worst part was shooting our friends when their tanks brewed up. We didn't mind shooting the Russians."
That's a situation in which the dying don't even have a voice; you make the decision from the outside and you act. 4 years ago I put down my two best friends ever - my dogs. I made the decision for them. They trusted me.
The point is that if we're willing to make those decisions without consulting the person we are killing, we ought to be rather more comfortable if they
invited it. To me there is no difference between a severely wounded soldier who knows he is going to die, asking a buddy for a bullet, or a late stage cancer patient who knows that he's just as severely wounded and his death will be just as gruesome. The medical corpsmen in WWII used to say "one to kill the pain, two to kill the patient" of the morphine ampules. There have been a
lot of morphine overdoses in wartime. I contextualize cancer as a war, too, but that's just because I've seen that battle lost twice in the last 3 months.
Several people have been taken to Dignitas to die, as far as I know no relative has been prosecuted. In some questions they have been arrested and questioned but (and please correct me if i'm wrong) nobody has been charge, tried and convicted.
.
This is because the police and CPS have some leeway in the decision to prosecute. If they see a case where a husband helped his wife to die and from the facts make a decision that no jury is likely to convict or that the case would not be in the public interest, they won't press charge.
Also, Dignitas' process needs to be acknowledged for its excellence. They have an experienced psychologist consult with the about-to-die. Repeatedly. The process will not go forward without a high degree of certainty that there is no wavering or coercion or even anxiety.
I daydreamed once about going (I am very healthy) and just explaining that I wanted to die while I was near my peak and just beginning the decline; that I was bored and restless, that ... uh.. I know that they'd see the way I eye the pizza and know that I wasn't ready for it, yet.
Joseph Heller's brilliant "Catch-22" posits that it was possible to get our of the air force on a medical discharge if one was insane. Of course the problem was that anyone who wanted to get out of the air force could not possibly be insane. Insane people would want to stay in the airforce. Dignitas has created the Catch-22 and I think that's actually a very good control against what you're worried about. Dignitas can say "clearly you are not in your right mind, because nobody in your condition would want to die just out of anomie.
enied:"
On the other hand if they have a case where the husband stood to gain and there were serious question marks over the husbands actions, were his actions selfless or was there financial gain at the back of his mind? Then the CPS could prosecute.
I wouldn't worry about that so much. There are husbands who take such matters into their own hands for the wrong reasons anyway. Someone who's willing to manipulate someone into suicide via assisted suicide would find it easier to manipulate the person into suicide at home in private. "Look, honey, I got you the vodka and sleeping pills..."
As an aside, hypoxia with a simple disposable oxygen mask and a cylinder of nitrogen or helium gas would be my preferred way. Easy to get the parts, easy to set up and painless.
That one scares me. The oxygen mask can slip as your body thrashes about, and then you just wind up with an IQ of about 50 for what's left of your life. I know a young man who hanged himself and was rescued by a roommate after he had cut off all the blood to his brain for a bit more than 2 minutes. The good news is he's alive and well and no longer suffers bouts of depression. The bad news is that he's not the same person; suffering massive brain trauma has made him a kind of shambling wreckage that is able to walk about and do menial work. Gone is the tortured poet; so in a sense he killed himself but at the same time he survived. No simple oxygen mask; use a heavyweight garbage bag liner full of nitrous oxide and a heavy duty velcro strap.
- - - Updated - - -
I think that it is good to be accompanied in the death, if the death is inevitable. Die with dignity, avoid the big suffering, the agony. However it is a subject terribly complex
Yes! This, 1000 times yes!
I remember reading about a young person who shot themself because they were being bullied by a classmate. And all I could think was "dang it! why did you shoot yourself without shooting
them first!?!?!"
