October 2005 | Whole Health
A Tricky Distinction: Death and Dying
by Alicia Priest

For a society that acts as if life is endless and its members immortal,
it's remarkable how much we're hearing about dying these days. Not
death, but dying. It's a tricky distinction.

Most often what we see in popular culture is sudden, violent and brutal
death: gunshots, explosions, car crashes. The other way we like to
think about death-especially our death-is that fantasy where we
either go to sleep and never wake up or drop dead from a massive heart
attack. If only it were so simple. Anyone who works with the
institutionalized elderly or who cares for an aging, ailing parent
knows those two ways of exiting this world are rare.

What most people experience is a slow, steady deterioration brought on
by illness or aging. Both lead to a loss of mental and/or physical
abilities, increased dependency, and an often bleak, degrading, and
painful final stage of life.

It's our culture's flagrant disconnect with this reality that makes
films such as Quebec's The Barbarian Invasions, America's Million
Dollar Baby, and Spain's The Sea Inside so unusual. These films focus
on physically incapacitated individuals who reach a rational decision
to end their lives but need help doing so.

In real life, end-of-life issues have been much in the public mind with
the controversy surrounding Terri Schiavo, the brain-damaged Florida
woman at the centre of a bitter legal battle between her husband, who
wanted to remove her feeding tube, and her parents, who did not. While
the media frenzy that ensued triggered a torrent of right-to-die
discussions, hers was not a right-to-die case. Schiavo was incapable of
choosing her fate. Her circumstances revolved around complex ethical,
legal, and family rights.

Nonetheless, now may be a good time to revive the complex, messy, but
essential subject of legalized euthanasia. It's a topic that won't
go away, despite our unwillingness to deal with it. Given the fanatical
American political climate, the rapid aging of a huge number of baby
boomers, and the non-stop barrage of medical machinery designed to
sustain life at all costs, we'll be hearing a lot more about
euthanasia in the near future.

On a personal front, a close friend recently grappled with these
questions when her ailing mother swallowed a cache of sleeping pills
she'd been hoarding for who knows how long. A vibrant, vivacious
lover of life, she'd had a stroke and wanted out of her prison-like
existence. It made me wonder how many other families suffer similar or
worse situations.

Most Canadians know of Sue Rodriguez, the Victoria woman with ALS
(amyotrophic lateral sclerosis) who, 15 years ago, fought in the
Supreme Court to have a legal right to assisted suicide. She lost.
Fewer people know of Russell Ogden, the former SFU criminology graduate
student who, in the early 1990s, studied assisted suicide in the
Vancouver AIDS community. When Ogden published his thesis, he was
abandoned by the university and hounded by legal authorities who
insisted he reveal his sources. He has never done so. Ogden found that
unregulated euthanasia was happening without medical supervision of any
kind. Under these conditions, he concludes in a recent interview in
Scientific American magazine, "Euthanasia is happening in horrific
circumstances, similar to back-alley abortions." About half of the
cases he studied initially failed and resulted in greater suffering.

euthanasia-fact or fiction-involve those trained in the healing
arts. Although physician-assisted suicide is legal in a number of
places-Holland, Switzerland, and in Oregon where it's called the
Death with Dignity Act-it is viewed as murder elsewhere. That
situation drives assisted suicide underground, making even
communicating about it a societal no-no.

Victoria writer Anne Mullens says the lack of open discussion about how
best to die benefits no one. Mullens is the author of a thoughtful and
informative account of the right-to-die debate called A Timely Death:
Considering our Last Rights. The book won the 1997 Edna-Staebler award
for Creative Non-Fiction.

"One of the things that was said to me during the research of my
book-which I really have hung on to and is one of my major
beliefs-is that, when there's no record keeping, no law, no
guidelines, and everything's done in secrecy, things can be much more
problematic," Mullens says. "That's where the abuses can happen.
That's where the real slippery slope is."

Doctors in Holland told Mullens the greatest value of euthanasia is not
the act itself but the cultural permission to talk openly about life
and death. When someone feels comfortable telling their doctor about
their wish to die, explains Mullens, the doctor can ask, 'Why now?
Are you in pain? Maybe we can do something about that'."

Nobody could pretend the conversation to follow would be easy. But,
ironically, talk about dying can sometimes result in extending life a
little longer.

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