Saturday, May 23, 2009

Gabrielle Carey - You Do Not Have the Right to Die

I disagree with the argument and the title of this article - if we have any rights at all, the right to determine how and when we die is at the top of the list. Making euthanasia illegal is dumb, but making it immoral is wrong, especially to the families of those suffering from terminal illness.

I would never support a healthy, depressed person's decision to suicide, but that is not the issue in this article. Euthanasia is an act of supreme compassion (as was no doubt the case when my mother died, or was eased into death, due to terminal cancer), and to frame it in terms of all the people on the earth who are struggling to live is just wrong-headed, and a false argument.

I'm posting this article, even though I disagree with it, because I think this needs to become a matter of conversation in our culture. Only two states (Oregon and Washington) allow physician-assisted suicide, but it happens far more often than you might think - and it should not be criminalized - nor thought of as a moral offense.

You do not have the right to die

  • Gabrielle Carey
  • May 11, 2009
Is suicide an act of selfishness? Illustration: Judy Green

Is suicide an act of selfishness? Illustration: Judy Green

When most of the world is fighting to live, is suicide the ultimate act of selfishness?

Three scenarios: a 17-year-old girl, traumatised after a break-up with a boyfriend, overdoses on painkillers; a 45-year-old woman, dying slowly and painfully from pancreatic cancer, is given a lethal shot of morphine by her husband; a 64-year-old man, devastated by the sharemarket crash, hangs himself.

The teenager, fortunately, gets found out, and is bundled into an ambulance; her stomach is pumped and she is monitored in hospital for several days. Luckily, there is no permanent liver damage. The woman with cancer, now mercifully dead, leaves behind a bereaved husband. But as well as the grief, he has to live out the rest of his life with the guilt that it was he, in the end, who killed his beloved wife. Should he or shouldn't he have done it? The 64-year-old man, destroyed not by the current financial meltdown but by the 1987 crash, was my father.

One is an attempted suicide; one an assisted suicide, one a successful suicide. It is said that for every suicide, on average there are eight people left behind who are seriously and often permanently damaged. When it comes to my father's suicide, I am one of those eight. Twenty-one years later I have concluded that suicide is — not always but often — an act of anger and revenge; ultimately an act of selfishness. This may, or may not, apply to the broken-hearted 17-year-old. That is not my line of inquiry right now. The point about her is that we are glad she was found; we are glad she was forced into an ambulance and we are glad her liver is not permanently damaged. We are very, very glad that she is still alive. A teenage girl does not have the right to die.

But the woman with pancreatic cancer, who had been dying so slowly and painfully? Surely she can choose? Intellectually, it is an easy answer. But how many people, chorusing with "Yes, of course she has a right to die", have accompanied a loved one during the sometimes long and intense process of dying? How many of them really understand that there is only one experience comparable to this, and that is being in labour, painfully waiting for a baby to be born? How many of them really understand how difficult it is to ask a dying loved one, "Do you want to die now? Will I give you the morphine?" It's the equivalent of asking a woman in labour almost anything; she is in so much pain, how reliable are her answers? (This last comment is made by someone who gave birth to both her children at home, without drugs, and who is a great supporter of a woman's right to choose.)

In the end, putting this abstract right to die into permanent action is often the responsibility not of the person dying — who is far too drugged up to make any rational decision, let alone inject themselves or swallow a lethal dose — but of a family member, someone who loves them very much. And this is not a responsibility to be taken lightly. Firstly, of course, assisting someone to suicide is illegal. More importantly, however, it is a decision that the loved one, the one who remains living, has to live with forever.

And the 64-year-old man, depressed about his losses? Did he have a "right to die"? Do all those men, right across the US, who are killing themselves now as a result of the financial crisis, have a right to die? I don't think so.

I have had many years to contemplate how I might have prevented my father's death. By forcing him to see a doctor (he hated doctors) who might have prescribed anti-depressants? That might have seen him through the worst of his depression and then out the other side. But what if the doctor had recommended a psychiatrist? And what if the psychiatrist had recommended scheduling him because he was clearly such a high suicide risk? Would the family have agreed to admitting him, against his will, so that he could be monitored day and night? Would we have been able to save him from himself? I don't know. But I suspect that, if someone had walked into my father's house at the right moment, and had seen the rope he was preparing, had realised the extreme torment he was suffering, and had taken him by the hand, led him away, talked to him, kept him close, told him that he was loved and wanted and needed, he might well still be here today. I also suspect he would have wanted that. That he would have enjoyed getting to know his five grandchildren. But, of course, I don't know for sure.

Unlike my father, whose final act I now consider to be cowardly and selfish, when my mother was suffering intensely she behaved quite differently.

On being offered a lethal dose that could have saved her from undergoing brain surgery at the age of 80, she politely accepted the poison but then went away and decided against taking it. Given the choice of being or not being, she chose to be. Like my favourite literary character, who was also a woman in mourning, my mother, in the end, said yes I will. Yes. Or in Samuel Beckett's words from The Unnamable: "You must go on, I can't go on. I'll go on."

The phrase "the right to die" is so easy to say. In many circumstances, it seems so rational, even moral. But when I think of trying to explain the notion to my friends and family in the impoverished Mexican village where I lived for a number of years, I am certain I would meet with expressions of complete bewilderment. Their struggle for life is so all-consuming that the notion of the right to die would be beyond comprehension.

The right to die is clearly much more of a concern among the wealthy and highly educated of the developed nations.

Naturally, you might argue — because we are wealthier and healthier, because we live longer, because we are provided with more life-saving drugs and surgery, we are also, as a consequence, confronted with this problem of choosing when to end our lives.

But I put to you that perhaps the choice itself is just another First-World luxury. A privilege, like so many privileges of the wealthy — something that poses as a symbol of self-determination and freedom but ends up, paradoxically, to be yet another source of suffering.

Gabrielle Carey is a writer and novelist. Her new memoir Waiting Room is published by Scribe.

For help or information, visit, call Suicide Helpline Victoria on 1300 651 251, or Lifeline on 131 114.


Gary Stamper said...

So we have a more complicated issue: A 14 year old boy who will surely die if he doesn't receive treatment, but refuses, apparently based on how sick it makes him. His mother supports his decision, but a judge steps in and says, that because he's underage, he doesn't have the right to refuse teratment. Does the mother's support give him that right? I wish I had time to flesh this out, but wanted to raise the issue in light of your article.

Anonymous said...

I'm afraid I don't agree with the sentiments of this article, either. The writer has only experienced one side of the issue and seems unable to relate to the other side at all. Would her views on the topic be any different had she been the one who was suffering?