Choosing to Die: When suicide becomes an option

One of my favorite authors, Sir Terry Pratchett, has requested the paperwork to visit the Dignitas clinic in Switzerland and engage in an assisted suicide. Terry Pratchett has Alzheimer’s, and does not wish to prolong the suffering for himself or the people he loves. His battle has sparked a debate in the UK about assisted dying and an individual’s right to choose when and how they would go.

In an interview with Pratchett in the Daily Mail:

‘I believe that if the burden gets too great, those who wish should be allowed to be shown the door,’ he said. ‘In my case, in the fullness of time, I hope it will be in the garden under an English sky. Or, if wet, the library.’

While I would mourn the loss of a brilliant man and exceptional author, I unreservedly support Pratchett’s right to make this decision and face his end with the peace and dignity he desires.

Sadly, death and dying is something we hate to talk about, especially the idea of dying by our own hand. This needs to change.

Choosing Death

I love dogs. One of the few problems with my affection towards these beasts is their sweet, furry lives are considerable shorter than our own. I’ve had to make the decision three times to euthanize one of my dogs when they were suffering. It was crushing for me, but each time it was the right decision and I was with them in their final moments. Nobody questioned my right to do provide this release for these creatures I loved. We offer animals a basic right to die when their pain becomes too great that we do not afford to people.

My grandfather, who moved next door and helped raise me when my father died, went into cardiac arrest while being prepped for surgery. The doctors informed us he was essentially brain dead. Faced with the choice of keeping this energetic, big-hearted man alive on machines or letting nature take its course, we opted to disconnect him from life support. He had no Living Will, but the hospital staff was supportive and backed our decision. We knew it was what he would want, and I held his hand as he died. At some point death is the correct next step for us all, and nothing can come from fighting it.

A decade later, my grandmother began suffering from dementia, and following a stroke grew steadily worse. By the time this wonderful woman died, she was in a state of confusion and fear that I could barely stand to see. She didn’t recognize anyone, could not take care of herself, and called out to imaginary faces and friends long dead. Far before that horrible state, when her mind was still there but the symptoms had begun, when her future was clear and she was present enough to understand it, what would she have done if given an option to end her life? Unfortunately society only leaves one path open to someone like her – the slow slide into madness and helplessness. When faced with a grim or painful future, why should we dictate how each individual chooses to face it?

A few years ago a local Phoenix businessman committed suicide. His death was a shock to everyone who knew him, but what surprised me most was how quickly the news it was a suicide was replaced with news he had “died unexpectedly”. Suicide is such a stigma, such a taboo, that we refuse to acknowledge or discuss it. Would he have gone through with it if he had felt he could talk with someone? We will never know because he faced the same silence on the topic that swallowed up his own actions. I’ve intervened twice with friends who were depressed and contemplating suicide, but only was able to act because they discussed it with me. How many suicides could be stopped if the person felt they could talk about it openly and honestly with people they cared about?

These are all choices, all with their own complexities. Death isn’t always the answer, but we can’t help each other if we’re afraid to talk about it.

Death is part of Life

Terry Pratchett writes the brilliant Discworld books, and Death is a character in most of them. Astride his skeletal steed, Binky, and speaking IN BOOMING CAPITAL LETTERS, Death struggles to understand the living as he carries on his duties. He is not compassionate, he is not cruel, he simply Is. He is a wonderful character, and Pratchett has received letters from terminally ill readers around the world who say it brought them comfort in what they now face.

Pratchett has now taken his views on death out of the realm of fiction and worked on a documentary titled Terry Pratchett: Choosing to Die, which recently aired in the UK. Choosing to Die examines the complex issues of assisted dying and follows the journey of Peter Smedley to the Digitas Clinic in his own quest to die. Peter suffered from motor neurone disease that was relentlessly removing his ability to function. Peter drinks a glass of barbiturates that Dignitas prepares for him, and dies while his wife sits next to him, holding is hand. Peter’s actual death was captured on film and shown in the documentary.

CNN discusses the reactions to Pratchett’s documentary, which range from “harrowing” and “powerful,” to “disgraceful” and “heartbreaking.” It’s about what I would expect from a topic this powerful and bottled up. I would love to see Choosing to Die air in the US to help spark the conversation here, but don’t have high hopes.

We need to be able to discuss death openly, and understand when and how someone should be allowed to choose their own way of exiting this world. We need to separate those who are facing a lifetime of suffering, from people who are simply in a dark place and feel there is nowhere to turn. Until we remove the stigma around choosing to die, and understand that it is a choice many people contemplate for all sorts of reasons, those things cannot happen.

• If you are contemplating suicide, call the National Suicide Hotline at 1-800-273-8255. Talk with someone.
• If you want to dictate how you should be treated in the event you are no longer able to make decisions for yourself, set up an Advanced Health Care Directive, also known as a Living Will. Consult with a lawyer about this or any other will or estate plan to ensure things are handled correctly.
• Talk with your family and loved ones about what you want to happen when death is imminent, and make them aware of any documents/wills you have created.
• If someone you care about tries to talk with you about death decisions, LISTEN TO THEM. It may be uncomfortable and scary, but this is not a topic to ignore.
• And, if you get a chance, watch Choosing to Die. It’s a powerful documentary no matter what your current view of assisted suicide.

Then get back to Living.