Monday, March 9, 2015

What about assisted suicide's impact on those left behind?

The following article was published in the Montreal Gazette on March 9, 2015.

By Derek Miedema:

“No man is an island” said John Donne. We are not only radical individuals. Our lives and our deaths have profound consequences for those we love and those who love us. How we die is not solely our domain, but touches families, friends and our communities.

The makeshift roadside memorials and ghost bikes chained to light posts on busy city corners remind us that how one leaves the world lingers long after the last breath. Suffering does not end at death — not for those left behind.

When the Supreme Court of Canada struck down the prohibition on euthanasia and assisted suicide in the name of personal autonomy, it did not address the suffering of grieving families. In fact, the court’s decision last month introduced further tensions within families with a suffering loved one.

Assisted suicide adds a whole new dimension to the dying process for families and friends of the seriously ill. Choosing whether or not to kill yourself could never be described as simple. Take this example from Washington State: Attorney Margaret Dore recounts the story of a client in the state of Washington where assisted suicide has been legal since 2009. The client found herself caught in a family feud over whether or not her ailing father should take a prescribed lethal dose to kill himself. The adult daughter was distraught and the family divided. Worse still, her father lived his final months caught in the middle, unsure whether he should kill himself or not.

In situations like this, the dying family member can feel like a burden on his loved ones. The sad reality is this: The option of assisted suicide transforms the feeling of being a burden into consideration of a duty to die.

Sometimes, that duty to die can be imposed by someone outside the family, leaving individuals and family members to defend their right to life.

Last year, my own twin brother, severely handicapped from birth, was admitted to his local hospital with pneumonia. A family member stayed by his side, but during a few hours that he was alone, a purple bracelet appeared on his arm. Since the medical staff wouldn’t volunteer what it meant, my mother inquired about it, and was told it indicated a “do not resuscitate” order. My severely handicapped brother can’t speak and eats through g-tube. His doctors, without input from our family, labelled him better off dead than suffering from pneumonia. The possibility that my brother could be left to die in a hospital terrifies my family. It complicates caring for and protecting him.

You may think that my brother has nothing to do with the Supreme Court ruling. The court’s decision opens assisted suicide to anyone who consents to have help to commit suicide, and has a “grievous and irremediable medical condition (including an illness, disease or disability)” that causes continued suffering they don’t want to endure.

The court clarified their word choice: “ ‘Irremediable,’ it should be added, does not require the patient to undertake treatments that are not acceptable to the individual.” Note also that the court’s definition of suffering may include both physical and psychological suffering.

Once that broad access to assisted suicide is accepted by society and by enough doctors, it’s not a big leap to my brother’s situation. Such a change in law would empower those who think that death is better than life for young and old alike when are handicapped or chronically ill and for people who are elderly and infirm.

Suffering in life and death are already difficult to navigate. Adding the option of help to kill yourself will complicate both even more.

Derek Miedema is a researcher with the Institute of Marriage and Family Canada, based in Ottawa.

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