Choices

by Tricia Dower

Sarah Palin’s VP nomination has highlighted social, religious, and legal issues around abortion. Should a woman be allowed to choose whether to continue a pregnancy or not, or does the embryo she carries have the right to live no matter what?

Equally as controversial is this social, religious and legal issue: should people who are terminally ill receive assistance in ending their lives if they so choose or must they wait for their bodies to shut down?

Although your rights differ by province, Canada generally recognizes Living Wills, sometimes called Advance Care Directives or Representational Agreements. They allow you to specify whether or not you want to be resuscitated if your heart stops or go on life support if your brain fizzles. I had a lawyer draw up such a directive in 1995 after seeing my father die without one. But is it enough?

Not for some. Last week, I attended a meeting of Dying with Dignity (DWD) whose new managing director had come out from Toronto to introduce herself. She had a slide presentation designed to carefully step us through the organization’s mission, goals, principles, and services. But the meeting quickly became contentious when several people in the audience interrupted with objections to her assurance that the organization fully counsels people on their options and that DWD was doing all that it could to expand those options. Wisely, the director abandoned the canned speech in favour of addressing their concerns.

One elderly woman said, “I’m here to learn about how to get assistance with ending my life. I know all about putting a bag over my head, but I want something better.”

She was referring to the method of offing yourself with a bag full of helium from a machine you rent to fill party balloons. Although no one’s come back from the dead to verify it, dying that way is said to be quick and painless. But you have to do it yourself, because it’s against the law for anyone to help you, and it does take some skill.

Others in the room wanted to know: When will we get what they have in Switzerland, the Netherlands, and Oregon? Namely, physician-assisted suicide. And what is Dying with Dignity doing to get Canadian law changed to allow it? The answer—that DWD is working quietly behind the scenes to influence government— didn’t satisfy everyone.

It’s a delicate situation for Dying with Dignity and other Right to Die organizations. They can’t be seen to be assisting with suicide, either. DWD promotes its work in strengthening hospice and palliative care services and offering counseling to people who are terminally ill. The best it can do while staying within the law is to urge Canadians to ask their MPs to put the issue on the federal agenda. DWD's managing director told us they’re embarking on a government relations and public advertising campaign designed to stimulate discussion about “expanding end of life choices.”

Sitting in that room, I could feel the urgency that those much older than I have about this matter. Someone said, “The Boomers will make it happen,” and someone else responded, “I can’t wait for that.”

Personally, I want to know that I have a choice, whether I exercise it or not. A few months ago I watched a simulation of the helium bag technique and got a lump in my throat projecting myself into that moment of decision. It can’t be one you make glibly. You would have to be in extreme pain or so fearful of the pain that’s to come to fit a bag over your head and turn the valve on a helium tank. It’s more natural for us to want to live than to die, so what’s the risk in allowing a doctor to ease our exit when we’re clearly on our way out?