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Issue 06/23/11 - Vol. 42, Issue 24

Death with Dignity
by lyle e davis

Sometimes we need to take a walk away from our own backyard, our own neighborhood, our own nation, to get a feel for what others are thinking, what they are doing, what the body politic as well as the community of citiznes are dealing with, and perhaps, differently than we are doing.

Such is the case with the question of the “right to die,” and “assisted suicide.”

The BBC (British Broadcasting Corporation) has recently featured several articles addressing this question.  They make for interesting reading and can’t help but stimulate thought and discussion about what, to some, is a controversial question, to others, a matter of logical thought and action.

One recent article addressed the issue from the perspective of one involved family:

Police 'Consider' Robert Cowie's Dignitas Death

Police are trying to establish the circumstances surrounding the death of a Glasgow man whose mother took him to a Swiss clinic to die.

Helen Cowie told BBC Scotland's Call Kaye show she helped her son Robert, 33, commit suicide after he was left paralysed from the neck down.

Mrs Cowie, of Cardonald, Glasgow, said her son went to Dignitas in October and "had a very peaceful ending".

Strathclyde Police said they were not investigating the death at this time.

However, a spokesman added: "The matter is being given consideration in an effort to establish the circumstances."

Mrs Cowie said her son was paralysed in a swimming accident three years ago.

She told the radio programme: "His life was terrible, he was suffering every day.

"He was just a head, he didn't want to be there anymore. He had been a big, fit healthy boy.

"We asked him not to do it, but it was his decision."

Mrs Cowie said Robert had not been a burden to the family, but she agreed to help him because he was "really unhappy".

She described Monday's BBC documentary Choosing To Die, presented by author and Alzheimer's sufferer Terry Pratchett, as "brilliant" and empathised with the mother who helped her disabled son to die in the television soap, Emmerdale.
Mrs Cowie described the Dignitas experience as "wonderful, relaxed, peaceful and happy", and they listened to the Oasis song Listen Up as her son died.

The song includes the line: "One fine day I'm gonna leave you all behind. It wouldn't be so bad if I had more time."

She said: "We were in Zurich for four days with my three sons and his friend, and one of my sons said it was the happiest he had seen his brother in three years.

I would rather have been able to do it in this country. That really upsets me that I had to take my son to Switzerland, and I had to leave his body there and wait for the ashes to come back."

No-one would choose an industrial estate outside Zurich as the place to end their life. But that is exactly what some Britons are doing.
In Choosing to Die on BBC2, the author Sir Terry Pratchett went to Switzerland to witness the assisted suicide of a British man with motor neurone disease.

It was not just Sir Terry who watched Peter Smedley's final moments - the viewer had a front-row seat as well.

The organisation Dignitas has a building - surrounded by industrial units - where foreigners are helped to die. Swiss citizens can drink the lethal dose they provide in their own homes.

The final 15 minutes makes for very difficult, emotional and compelling viewing.

There were clearly very uncomfortable moments for Sir Terry who observed the cheery conversation between Mr Smedley, his wife and the two Dignitas helpers. "This is a pleasant place and they are pleasant people but what is going on here is not exactly medicine," he said.  

The video can be viewed here:
http://m24digital.com/en/2011/06/14/controversy-over-the-issue-of-assisted-suicide/

The documentary brings back memories of Dr Anne Turner who ended her life in Zurich five years ago. She had a progressive degenerative condition, supranuclear palsy.

Dr Turner invited the BBC to witness her last day in Switzerland. A camera crew traveled to interview her on the morning of her death, the interviewer asking whether there was anything anyone could say to change her mind.

But like Peter Smedley, she had a quiet determination and was unmoveable. Her story was turned into a film, "A Short Stay in Switzerland,” starring Julie Walters.

Like others who travel to Switzerland to die, Dr Turner wanted the law changed to permit assisted suicide in Britain. Many who have progressive disorders fear not being fit to travel, so they go to Dignitas earlier than they would have wanted.

In a related article, the BBC printed the following:

Sir Terry Pratchett is one of the most successful writers of the last thirty years. His fantasy novels have sold tens of millions of copies. He is still writing fiction, but now he is also dealing with and writing about a very personal fact. He has the incurable, degenerative brain disease, Alzheimer's, and he wants the right to choose the time and manner of his own death.

Is that an ending wider society is ready to accept?

Sir Terry has told Newsnight that visiting the Dignitas centre to make the documentary Choosing to Die has not changed his mind about assisted suicide.

In yet another of the BBC’s articles, they look at Dignitas, the Swiss firm that assists in suicides:
Dignitas: Swiss Suicide Helpers

Assisted suicide is illegal in many countries. Swiss charity Dignitas has gained a worldwide reputation for helping people wth chronic diseases to end their lives. Since it was founded in 1998, it has helped hundreds of people from across Europe to commit suicide.

This includes more than 110 people from the UK, the first of who was Reg Crew, in January 2003.

The organisation was founded by Swiss lawyer, Ludwig Minelli, who runs it as a non-profit organisation with the motto: "Live with dignity, die with dignity".

WHAT THE LAW SAYS:

Assisting a suicide carries a maximum sentence of 14 years imprisonment in England and Wales.

None of the UK cases handled by Dignitas has so far involved any criminal charges, but many have resulted in police investigations.
Several European countries have no crime of assisting a suicide: Switzerland, Netherlands, Belgium, France, Germany, Sweden and Finland.

It takes advantage of Switzerland's liberal laws on assisted suicide, which suggest that a person can only be prosecuted if they are acting out of self-interest. The law on suicide actually states:

"Whoever lures someone into suicide or provides assistance to commit suicide out of a self-interested motivation will, on completion of the suicide, be punished with up to five years' imprisonment".

Dignitas interprets this to mean that anyone who assists suicide altruistically cannot be punished.

Its specialist staff all work as volunteers to ensure there can be no conflict of interest.

They engage in detailed discussion about whether the patient's determination to die falls within the legal boundaries, and whether it is indeed the declared will of the patient.

Dignitas also provides a text for patients, which states their wish for assisted suicide in terms which cannot be misconstrued and which allows them to carry out their wishes even in the face of opposition, if necessary.
Once the decision has been made, the patient travels to Zurich where he or she is taken to a Dignitas flat.

The patient is given an anti-sickness drug 30 minutes before the lethal dose of barbiturate.

A camera is set up to record the patient take the drug themselves - firm evidence that it was not administered by clinic staff.

The barbiturate is a colourless solution, bitter tasting, and comes in a portion like a small glass of sherry.

The dose is three times the normal lethal amount required, based on the patient's weight.
The patient drinks it and then may take a sip of orange juice.

Within five minutes they lapse into a coma, and the heart stops soon afterwards, apparently leading to a peaceful and painless death.

The police are then called, a coroner comes, they question the witnesses and look at the video.

In his first broadcast interview for five years, Mr Minelli told the BBC earlier this year that he was motivated by helping people.

Ludwig Minelli, has told the BBC that suicide is a "marvellous possibility".

"I say suicide is a marvellous possibility given to a human being... to escape from a situation which is unbearable."

But the group's activities have stirred up controversy.

Swiss politicians have voiced concerns about the organisation's interpretation of the law.

Despite this, Dignitas has insisted it is right and has even called for the law to be clarified for the healthy partners of dying people.

Dignitas has also been criticised for accepting people who are not necessarily terminally ill. It helped 23-year-old Daniel James commit suicide last year after he was paralysed while playing rugby.

The handling of such cases has prompted resignations by staff at the clinic.

UK mental health charity Sane said Dignitas was offering a "seductive but dangerous solution to the feelings of anguish and hopelessness experienced by some people with mental illness".

Sir Terry Pratchett has said witnessing a man being helped to die for a controversial BBC film has not affected his support for assisted suicide.

In Choosing to Die, the 63-year-old author went to Switzerland to see a British man with motor neurone disease dying.

Liz Carr, a disability campaigner, said it was pro-suicide propaganda and that she was surprised the BBC had made it.
The BBC said Monday's film would help viewers make up "their own minds."

The programme, showed Peter Smedley, a 71-year-old hotelier, travelling from his home in Guernsey to Switzerland and taking a lethal dose of barbiturates given to him by the Dignitas organisation.

Sir Terry, who made the film to establish whether he would be able to die at a time and in a way he wanted, said seeing what Dignitas did had not changed his mind.

“It is up to you to decide whether his last moments are deeply moving, distressing, or rather ordinary.”

Asked about the sanctity of life, Sir Terry responded: "What about the dignity of life?" Lack of dignity would be enough for some people to kill themselves, he said.

He added that he believed the right to an assisted suicide should extend to anyone over the age of consent.

He also accused the government of "turning its back" on the issue of assisted suicide.

"I was ashamed that British people had to drag themselves to Switzerland at some considerable cost," he said.

The BBC denied the screening could lead to copycat suicides and said it would enable viewers to make up their own minds on the subject.

Charlie Russell, the documentary maker and Director, of Choosing to Die:
   
"I believe it should be possible for someone stricken with a serious and ultimately fatal illness to choose to die peacefully with medical help, rather than suffer," he told BBC's Newsnight. He went on to say the decision to film Mr Smedley dying had been given a lot of thought.

"As a film maker I felt it was the truth and unfortunately we do all die," he said. "It's not very nice but that's what happens to us all."

Ms Carr said: "I, and many other disabled older and terminally ill people, are quite fearful of what legalising assisted suicide would do and mean and those arguments aren't being debated, teased out, the safeguards aren't being looked at.

I?want to see much more emphasis put on supporting people in living, than assisting them in dying.”

Right Reverend Michael Langrish Bishop of Exeter
"Until we have a programme that does that, then I won't be happy to move onto this wider debate.

I want to see much more emphasis put on supporting people in living, than assisting them in dying."

He said: "The law still enshrines that sense of the intrinsic value of life. But the law ultimately is not there to constrain individual choice. It's there to constrain third party action and complicity in another person's death.

That remains illegal. There may be ameliorating circumstances that can be taken into account. But the law remains clear and is there to protect the vulnerable."

Debbie Purdy, who has multiple sclerosis, went to court to protect her husband from prosecution if he accompanies her to Dignitas.

She said in a debate after the programme: "Politicians haven't kept up. Lawyers and judges have been the only people who have been prepared to defend my rights ... and my right to life and the quality of my life is the most important thing to me."

In the last 12 years 1,100 people from all over Europe have been "assisted to die" by Dignitas.

A spokeswoman for the pressure group Dignity in Dying said it was "deeply moving and at times difficult to watch".

She said: "It clearly didn't seek to hide the realities of assisted dying. In setting out one person's views on assisted dying, it challenges all of us to think about this important issue head on and ask what choices we might want for ourselves and our loved ones at the end of life."

She said the current legal situation in the UK meant "not only are people travelling abroad to die, but there are also those who are ending their lives at home, behind closed doors, or with the help of doctors and loved ones who are helping illegally."

Dignity in Dying is calling for an assisted dying law with "upfront safeguards".

But Alistair Thompson, a spokesman for the Care Not Killing Alliance pressure group, said: "This is pro-assisted suicide propaganda loosely dressed up as a documentary."

Campaigners claim it is the fifth programme on the subject produced by the BBC in three years presented by a pro-euthanasia campaigner or sympathiser.

Mr Thompson said: "The evidence is that the more you portray this, the more suicides you will have.

The BBC is funded in a different way to other media and has a responsibility to give a balanced programme."

The BBC denied it was biased on the issue and a spokeswoman said the documentary was "about one person's experience, Terry's journey exploring the issues and the experience he is going through. It is giving people the chance to make their own minds up on the issue," she added.
A Ministry of Justice spokesman said: "The government believes that any change to the law in this emotive and contentious area is an issue of individual conscience and a matter for Parliament to decide rather than government policy."

What About America?

The Supreme Court rendered its decision on the New York and Washington cases, on 1997-JUN-26. They found that the average American has no constitutional right to a physician assisted suicide. The vote was 9 to 0, an unusual, unanimous decision. Thus, the New York and Washington laws which ban such suicides are constitutional. On the other hand, the court implied that there is no constitutional bar that would prevent a state from passing a law permitting physician assisted suicide. Oregon has done exactly this. So, the battle must be fought on a state by state basis. Chief Justice Rehnquist wrote:

"Throughout the nation, Americans are engaged in an earnest and profound debate about the morality, legality and practicality of physician-assisted suicide. Our holding permits this debate to continue, as it should in an democratic society."

Oregon is the only state to legalize doctor-assisted suicide, which came into effect in 1997. Since that time, there have been 341 reported cases where doctors provided lethal doses of medicine to patients to end their lives.

Oregon voters have upheld the "Death with Dignity" law three times, and Sattenspiel says it is the state's duty to inform patients of all their legal options.

Back in 2008, FOX News reported some terminally ill patients in Oregon who turned to their state for health care were denied treatment and offered doctor-assisted suicide instead, a proposal some experts have called a  corruption of medical ethics.

Since the spread of his prostate cancer, 53-year-old Randy Stroup of Dexter, Ore., has been in a fight for his life. Uninsured and unable to pay for expensive chemotherapy, he applied to Oregon's state-run health plan for help.

Lane Individual Practice Association (LIPA), which administers the Oregon Health Plan in Lane County, responded to Stroup's request with a letter saying the state would not cover Stroup's pricey treatment, but would pay for the cost of physician-assisted suicide.

"It dropped my chin to the floor," Stroup told FOX News. "[How could they] not pay for medication that would help my life, and yet offer to pay to end my life?"

The letter, which has been sent to other terminal patients throughout Oregon, follows guidelines established by the state legislature.

Oregon doesn't cover life-prolonging treatment unless there is better than a 5 percent chance it will help the patients live for five more years — but it covers doctor-assisted suicide, defining it as a means of providing comfort, no different from hospice care or pain medication.

The states of Washington, Nevada, Wyoming, Utah, California, and Alaska have all considered and debated physician-assised suicide.  In some states, California, for example, the proposed legislation got through committee but, to date, has not been passed by the legislature nor signed by the Governor.  The debate goes on in the other states.

Probably the most famous American  individual involved in physician-assisted suicide is the late Dr. Jacob “Jack” Kevorkian, commonly known as “Dr. Death,” an American pathologist, and euthanasia activist. He is best known for publicly championing a terminal patient's right to die via physician-assisted suicide; he said he assisted at least 130 patients to that end. He famously said, "dying is not a crime.”

Beginning in 1999, Kevorkian served eight years of a 10-to-25-year prison sentence for second-degree murder. He was released on parole on June 1, 2007, on condition he would not offer suicide advice to any other person.

Kevorkian started advertising in Detroit newspapers in 1987 as a physician consultant for "death counseling." His first public assisted suicide was in 1990, of Janet Adkins, a 54-year-old woman diagnosed with Alzheimer's disease in 1989. He was charged with murder, but charges were dropped on December 13, 1990, as there were, at that time, no laws in Michigan regarding assisted suicide. However, in 1991 the State of Michigan revoked Kevorkian's medical license and made it clear that given his actions, he was no longer permitted to practice medicine or to work with patients.

Between 1990 and 1998, Kevorkian assisted in the deaths of 130 terminally ill people, according to his lawyer Geoffrey Fieger. In each of these cases, the individuals themselves allegedly took the final action which resulted in their own deaths. Kevorkian allegedly assisted only by attaching the individual to a euthanasia device that he had made. The individual then pushed a button which released the drugs or chemicals that would end his or her own life. Two deaths were assisted by means of a device which delivered the euthanizing drugs mechanically through an I.V. Kevorkian called it a "Thanatron" (death machine). Other people were assisted by a device which employed a gas mask fed by a canister of carbon monoxide which was called "Mercitron" (mercy machine).

Kevorkian died this month, on June 3rd, at the age of 83.

Another well known organization, the Hemlock Society     still exist; one, the Hemlock Society of San Diego retains the Hemlock name and is a former chapter of the Hemlock Society USA which ceased to exist after a controversial name change to End Of Life Choices on June 13, 2003, and then shortly thereafter, a merger with Compassion in Dying and consolidating on the name Compassion and Choices.

The San Diego Office may be contacted by calling and leaving a message at (619) 233-4418, or
send an email message to ...
HemlockSanDiego@gmail.org

The issue remains a controversial one and is not likely to be resolved soon.  That it will continue to be discussed, however, is not in question.  It is a topic that simply will not die.