Dying In Geneva

By AM Sunday, June 26, 2011

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This seems to me quite a reasonable and sensible decision for someone with a serious, incurable and debilitating disease to elect for a medically-assisted death by appointment – Terry Pratchett

The Swiss clinic Dignitas which provides people with the means to acquire a peaceful and dignified death first caught my attention a few years ago. Long prior to that I understood the perspective of recently deceased Dr Jack Kervorkian. I vaguely recall writing a poem in prison lauding his endeavours to assist the terminally ill determine how their lives would end.

When Dr Anne Turner decided to bring her life to a close at Dignitas in 2006 and brought the issue of the right to die under the public spotlight, I firmly believed she made the correct decision for her, and I was not well disposed towards those who sought to pillory her for the path that she had chosen. Her case was captured in the film A Short Stay In Switzerland.

It seems a cruelty inflicted on any terminally ill citizen that they should have to travel to distant Geneva in order to seek the death they feel they need in order to be freed from whatever life-demeaning condition afflicts them. Were the same facility available in Ireland terminally ill people could die surrounded by those they love and in the comfort of their own home. Travelling to a flat in an industrial estate in Switzerland, a country perhaps never visited before and only now to die in, seems deeply callous.

The fantasy author Terry Pratchett did a considerable job in putting together the documentary Choosing To Die. He travelled to the Dignitas clinic to film 71 year old Peter Smedley end the life that had so blighted his existence since motor neurone disease first began its colonisation of his body, totally devaluing the quality of his life. Smedley described his illness as a ‘beastly, undignified business.’ Pratchett, who was in the room with Smedley at the end, was himself diagnosed with Alzheimer's three years ago and argues, ‘I know the time will come when words will fail me. When I can no longer write books, I'm not sure that I will want to go on living.’ While there is more to life than writing books, should he be told it is not his right to choose?

I watched Choosing To Die with my ten year old daughter. It was difficult viewing; the central character is no actor who gets up after he dies, shakes himself down and retires to his makeup room. I found it awkward when Smedley was denied water which he requested after taking the lethal concoction of barbiturates that would end his life. There may have been good medical reasons for this but if the process of terminating one’s own life is something which must be carried out autonomously the denial of water appeared to violate that. It seemed an interventionist act aimed at hastening his demise.

Throughout, Pratchett’s travelling companion looked distinctly ill at ease, clearly disapproving of the course of action taken by Smedley. I found it difficult but not for the same reasons, I being in agreement with his course of action. While Peter Smedley died relatively peacefully on camera, there was a paradox at the heart of his decision that I understood but was discomfited by. He was so rational that it seemed there was still purpose in life, that somehow it was wrong to cut it short. Yet in order to make the decision and be permitted to carry it through by Dignitas staff he had to be totally rational.

My daughter too found it disturbing. She cried as she watched Peter Smedley’s life depart him. I have wondered since if I made the right decision in allowing her to watch it. But I feel it is important to introduce children to some of the difficulties and challenges of life. I want her to see human life as characterised by real life dignity rather than by some spurious ethereal sanctity. She believes it was a worthwhile exercise and tells me that she thinks about death in a different way now, seeing that choice is important. At the same time she believes more effort should be put into finding cures.

At heart, the issue is about individual self determination, freedom to choose, the determining principle. Some have a problem with the human ability to self determine, thinking in the fashion of the former bishop of Rochester, Michael Nazir-Ali, that ‘life is a gift and it has infinite value and we are not competent to take it, we do not have the right to take it, except perhaps in the most extreme circumstances of protecting the weak.’ But he also has a problem with gays exercising the right to choose so his comments amount to little more than biblical prejudice. And the bible can no more determine how we live and die in modern democratic secular societies than the rulebook of a golf club.

There seems no justifiable reason why people should be forced to hold onto a limiting, debilitating life when they no longer want to. Whatever reservations I may have about Dignitas, and the facilitation of dying, its method seems much more reliable and humane than some of the DIY suicides which can be so messy and absolutely devastating for the loved ones left behind.