Monday, November 15, 2004

Martens' case shows need for right-to-die law

VICTORIA - It strikes me as cruel and wrong that if I am sick and suffering, with no prospects of recovery, I can't take practical steps to end my own life.
It's not a choice I would make for anyone else. And I applaud the efforts to improve palliative care, so death comes with less violence to dignity, and less suffering.
But surely each individual capable of making an informed, rational decision, has the right to decide when it is time to end their own suffering.
We have not really accepted that right in Canada. And it is time people were given the freedom to decide how much suffering they wish to bear.
I stalled on writing about the trial of Evelyn Martens, the 73-year-old woman zealously prosecuted for aiding and abetting a suicide, a charge that can carry a 14-year jail term. It's an issue that inevitably raises issues of belief not readily dealt with in 700 words.
Martens was acquitted this month after a long and trial and longer investigation. She was accused of helping two women commit suicide. One was a 64-year-old nun suffering from chronic pain from a spinal condition; the other was a 57-year-old woman suffering from stomach cancer, who had planned her own farewell for friends
The law is the law, and if prosecutors believed there was enough evidence to ensure a conviction they have a duty to lay charges. But the energy that went into this investigation was extraordinary. An undercover RCMP officer even pretended to be the goddaughter of one of the dead women, sobbing as she told Martens that she felt guilty about not being more caring, while secretly taping the conversation.
Suicide isn't illegal. We have accepted the individual's right to choose, at least in theory.
But practically we've robbed people of that right. Sick and weakened, how is someone to figure out the means, and gather the necessary materials? It's illegal for your doctor to provide you with effective drugs. It's tough to buy heroin from your sickbed. It's hard to find a self-inflicted death that doesn't also inflict pain on others. By the time you recognize the need, it is too late to arrange the means. (I was struck by a magazine article this year on doctors' training. The author, a physician, noted that almost all of the surgeons he had spoken to had their own means of exit in place, in case.)
It's not simple. People must be protected from moments of irrationality, or outside pressure.
But doing nothing is much crueler.
If we do nothing people will suffer in their last days, against their wills and in violation of the way they had lived every day of their lives. Or they will seek out the help of someone like Martens, with no controls or guidelines or safety.
It's not a question of throwing open the doors to all forms of assisted suicide.
Oregon has had a Death with Dignity Act since 1998, and 171 people - 30 a year - have chosen to kill themselves with legally prescribed drugs. Most of them have been cancer patients.
The safeguards ensure informed choice. The law allows the prescription of lethal drugs, but only if two doctors confirm the person has less than six months and is mentally competent to make the request.
The law is a good cautious first step.
Encouragingly almost one-third of the people who received a prescription for the lethal drugs last year didn't feel the need to use them; death came in way they could accept.
There are no simple answers.
But what are doing now is wrong.
People can decide they have had enough - when the pain, and the indignities and the hopelessness and the terror are too much. Or they can decide that each second is to be counted.
It should be a right to make that choice. And we are taking that right away from them, with crude and cruel laws.
Footnote: The Oregon law faces a challenge as a result of the U.S. election. The Bush administration has asked the U.S. Supreme Court to overturn the law, arguing that assisted suicide is not a “legitimate medical purpose” and that doctors take an oath to heal patients. Belgium and the Netherlands have different right-to-die laws.

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