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Recovering backpacker, Cornwallite at heart, political enthusiast, catalyst, writer, husband, father, community volunteer, unabashedly proud Canadian. Every hyperlink connects to something related directly or thematically to that which is highlighted.

Wednesday, 22 January 2014

Assisted Suicide and Pandora’s Box

I wrote this in June of 2012.  I still feel the same way.

“All we have to do is decide what to do with the time that is given to us.”
- Gandalf, Lord of the Rings

CFN – B.C Supreme Justice Lynn Smith has ruled that assisted suicide is legal.  In her ruling, Smith argues existing provisions in the Criminal Code that make assisted suicide illegal are an infringement against an individual’s rights to life, liberty and security of person.  In her view, right to life seems to include right to death; liberty includes the ability to impose the ultimate limitation on oneself and security includes the ability to permanently protect oneself against pain.
If you haven’t guessed yet, I’m not in favour.
There are plenty of arguments being made around the morality of assisted suicide and the Pandora’s Box we’ve opened  when we see death as just another treatment option (and in today’s reality of unsustainable healthcare costs, a less expensive one at that).  Of course, the defense of assisted suicide goes beyond financial savings, spilling out onto compassionate grounds and the issue of civil liberties.  If people don’t want to keep suffering, or if their families don’t want to see them carry on in unending pain, shouldn’t they have the right to put an end to it all?
Let’s consider the issue from a different angle.  As the Hippocratic Oath demands that doctors do no harm, let’s think about what happens when preemptive death isn’t an option.  If assisted suicide isn’t on the table, what then?  When jumping the gun on death isn’t a way out, we’re faced with the reality of confronting illness and its impact on both the sick and their social circles.  Illness is more than just a personal, biological affliction; unless you’re a hermit, illness is a social cross that gets borne by everyone.  From first-hand experience, I can tell you that living with illness is a brutal business for all concerned – the afflicted individual, their family and their community.
My father-in-law died from complications after a long, painful battle with non-Hodgkin’s lymphoma, a disease that slowly deteriorated his body and put unsustainable stress on his family.  When the father was at home, they never knew for how long it was for.  When he was in the hospital, they were never sure he would be coming home.  Despite all the uncertainty and the strains on their own lives, my wife, her sisters and their mom were always there for him, visiting him in hospital every day, making sure their father knew he still mattered.  Yes, there were days when the pain was too much, when they wished it would end.  It was on days like that my wife and her family were grateful for the support they received from neighbours, friends and family; cutting the lawn, occasionally fixing meals or just listening, but doing whatever they could to support the family so that they could, in turn, support their father.
The doctors never expected my father-in-law to last as long as he did, but then he was a strong man.  Much of that strength was drawn from those who supported him.  The stress that his family endured took such a toll that they still feel its effects acutely today, more than ten years after his death.  It should come as no surprise that we all donate annually to cancer research; we are committed to supporting the search for a cure to cancer so that, one day, no family will have to go through the same thing.
That, essentially, is the history of medicine.  There was a time when smallpox was a serious concern; now, after a global effort, it’s believed to be a thing of the past.  Families used to suffer the loss of loved ones to measles, mumps and rubella; all illnesses for which we now have a vaccine.  More broadly, we can look at physical conditions like blindness, limb loss, asthma or mental illness as challenges that have made life arduous but that collaboratively, we are finding answers to.  The Hippocratic Oath challenges doctors to find alternatives – not to end problems, but to create solutions.
There’s a Joss Whedon line (paraphrased from a Martin Luther King JR. quote) that comes to mind whenever I think about medicine and social services in general:
But what if no one is there to carry you?  Here’s another story:
A woman in her eighties is living in a senior’s home.  She has severe emphysema, a condition she developed after years of smoking.  She picked up the habit in her youth because advertising told her it was the cool thing to do.  As a result of the emphysema, this woman is now limited to a wheelchair – for her, the whole world has shrunk.  Everything from breathing, leaving her room, even eating has become a chore.  Her family doesn’t visit much – they would love to, surely, but they’re just so busy.  The boss only allows so much time off for family care, because he, too, has a bottom line to manage.
Recently, this woman was rushed to hospital, shrinking her world even further.  With everything a chore and nothing to live for, you can bet death is on this woman’s mind.  In fact, you could even say she is in a state of depression.  This lady’s kids worry about her from afar, hoping she gets better and confidently telling themselves she has the best possible care.  They tell themselves this while they’re taking a well-deserved vacation in the Europe.  Put the option of assisted suicide on the table for this woman, for her family – what position do you think they would take?  What has made this woman’s life unendurable – her illness, or the inattentiveness of her family?
Here’s another quote you might be familiar with – the stake.
Yet, we have developed treatment for leprosy, haven’t we?  We have developed things like prosthetic limbs, glasses, asthma pumps, chemotherapy.  There’s a great big push out there for a culture change in the way we understand mental health, including how our personal behaviours impact the state of mind of others.  None of this stuff has happened over night; it’s taken generations of collaborative effort, often on pieces of a bigger puzzle that will not be completed for generations, much less within a given contributor’s lifetime.  We might not cure cancer tomorrow, but if we give up on those who suffer from cancer today, we never will.
Call me stubborn, if you will – I’d take that as a compliment and attribute my stoicism to the good genes of my grandfather who survived the Holocaust.  My experience has demonstrated, time and again, that there is no gain – no progress – without pain.  If we’re not part of the problem, we have the chance to be part of the solution.   I believe in the value of individual sacrifice for the public good; be it donating blood, giving to a charity or not using your air conditioner excessively.  Giving back is a choice I have made; we all have to decide what to do with the time that is given us.
Putting assisted suicide on the table as a treatment option for illness is just one facet of an emerging public conversation about death.  Capital punishment is being revisited, too, partially in response to a recent, horrific murder.  All of this focus on death and endings will force us to reevaluate just how much and in which ways we value life.  The lid is off Pandora’s Box, indeed.  And what was it that was left inside that box?

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