Tuesday, June 14, 2011

Choosing to die

"When I die I want to go peacefully in my sleep like my grandfather, not kicking and screaming like his passengers"

It's rarely I mention a TV show on the blog (unless you count my recent praise given to The Walking Dead - a less tactful blogger might make comparisons about that post and this one) but I felt that I simply had to comment about the harrowing, thought-provoking and wonderful BBC2 show that Tara and I watched last night; Choosing to Die, a documentary by Terry Pratchett.

Sir Terry, himself well publicised as suffering from a rare form Alzheimers, took the opportunity to look into "Society's last taboo", namely that of Assisted Dying through the work of the non-profit Swiss Organisation Dignitas (not to be confused with VERITAS, unless you're planning on travelling to South Arizona and throwing yourself from a high-energy astrophysics telescope).

Although at many times painful to watch, it was an excellently made documentary that was far from the pro-suicide propaganda that many of its critics have claimed. Terry, himself pondering whether to end his life with Dignitas, was the perfect choice to host the documentary - sceptical, caring, honest and altogether human. 

The show explored both avenues available to the terminally ill or for those who illness is beyond cure and whose conditions will only worsen will ever passing day - for those who don't wish to be a burden on their families or those who dread the day they simply will no longer have the choice of ending their life in a dignified manner.

When my mother went into the hospital for the last time in February of 2010 Dad and I were faced with the difficult decision of what we would do if Mum was ever in the state when she'd be forced to stay in hospital for the rest of her life or would be permanently bed-ridden at home attached to a ventilator. We already knew the answer but didn't want to say it out loud to each other. Mum was in no position herself to make such a decision; oxygen starvation had left her permanently confused and in the visits over the last week of her life it was apparent that Mum wasn't really there. There was someone lying in her bed who looked like her and on occasion spoke like her, but the strong willed fiery woman who was my Mum had died the week before when she was first taken in and resuscitated from near death.

Kept alive in her bed solely through a brand new untested ventilator and having to wear a suffocating mask for most of the day so she could even breathe, I believe she had a rare moment of clarity on the night before she died. She was bored of this existence and knew she was dying and chose not to wear the mask for sleeping that night. I believe, even in her confused state, that she knew that this would kill her, but this would be her last act of defiance. She'd taken away the decision from Dad and I and I love her dearly for it. From an undignified last week in hospital, wired up with ECG monitors, drips and breathing tubes, she'd taken the dignified way out. Which, bringing me back to the documentary, is something I think we're all entitled to.

Terry met a number of people during the course of the documentary; The wife of the Belgian writer Hugo Claus who "died singing" (People have threatened that I might go the same way, usually after they've heard me sing) and two men who were going to Dignitas. Andrew, 42, a sufferer of multiple sclerosis and Peter Smedley who had Motor Neurone disease.

Terry interviewing both made for upsetting enough television - both were Dead Men Walking, after all - but both were resolute in their decisions. Despite looking well Andrews life sounded miserable - every day worsened his condition - and he was incredibly matter-of-fact about this (most fundamental of) life changing decisions he could make. He had made two previous suicide attempts which had failed, and Dignitas had emerged as the only solution.

Peter Smedley was as English as a Union Jack teapot with a beefeater Tea Cosy. He and his wife were old fashioned, honest and utterly charming. He was virtually chair-ridden, the motor neurone disease rendering him incapable of the simplest of movements without aid. His wife didn't fully agree with his decision, but respected his opinions.

We were shown the room where Dignitas performed their assisted deaths. Located in an Industrial estate in view of the Alps, the anonymous blue chalet resembled nothing more than an Ikea showhome. After saying his last farewells to Andrew ("See you on the other side") Terry prepared to do the same with Peter in the little blue house that Dignitas built.

We watched Peters last moments throughout which he remained brave with the kind of stiff upper lip that only the English can achieve. The method of assisted death is via a huge overdose of barbiturates that the patient has to administer themselves; One glass of liquid is drunk to ensure that the body doesn't reject the drugs, another with the overdose itself. ("Shall I drink the second one now, dear?", "Thats entirely up to you, dear").

Peter drank from the first container and then sat down on a chair, his wife sitting next to him. A short while later he drank his lethal overdose whilst his brave wife held him. He had a small swiss praline chocolate to remove the bitter aftertaste and prepared to die. A brief two seconds of discomfort in which, semi-concious and quite distressed, he asked for water - none was given - and then he drifted off to sleep, snoring noisily. And then his heart stopped.

The showing of Peters death wasn't gratituous and he definitely wasn't coerced into his decision - in fact, in all fairness, I imagine his wife and family had tried at length and simply given up trying to convince him otherwise - Dignitas themselves seem to have very strict criteria over who they'll 'accept' - and it all made for utterly captivating television. Sir Terry stood outside in the garden after the event as the snow fell, a lovely poignant moment. Through tears he announced, "It seems right. It's the right kind of snow".

Terry Pratchett has signed up with Dignitas now. This doesn't mean he's on the next flight out, but that when the time comes - "when he can no longer write", in his own words - which due to his illness is now solely through dictation - the option is available. Indeed, more than two thirds of people who sign up with Dignitas never go back; the fact that they have this option open to them gives many a new lease of life.

The show (and the inevitable controversy it was bound to provoke) seems to have had the designed effects. As as today in the news, it seems to have opened the whole topic up for discussion again. It's something that needs discussion.

I do not fear death. I had been dead for billions and billions of years before I was born, and had not suffered the slightest inconvenience from it.
Samuel Clemens

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