Listening to Ludwig Minelli talk about his work, it’s easy to forget
the 75-year-old lawyer is in the suicide tourism business.
The founder of Dignitas, the Swiss right-to-die organization, has the
stark statistics at hand. There are the 753 foreigners who have
visited the group’s Zurich flat during the last eight years and ended
their lives with an overdose of barbituates. And there’s the $6,500
service fee for clients, who go from age 20 to 95.
But Minelli says his group — aided by his country’s legalization of
assisted suicide — wants to help those trapped in what he calls “a
long, dark tunnel.”
v“This tunnel has two exits. The first is to go to the so-called
natural end with unknown pain in the future or to try to make a
suicide on their own, which is very risky,” explains Minelli of the
dilemma bringing hundreds of despairing foreigners to his organization.
“We make an emergency exit in this tunnel and the door is wide open,”
says Minelli of giving citizens from far and away — including Canada
— the chance to end their suffering with a prescription overdose.
Earlier this year, Elizabeth MacDonald, a 38-year-old wife and mother
from Windsor, N.S., who was crippled with multiple sclerosis, flew to
Zurich with her husband Eric and ended her life at the Dignitas
apartment.
In Switzerland, assisted suicides are legal as long as the agencies
that help arrange the deaths do it for “honourable reasons” and don’t
profit from the death, aside from charging basic fees. Dignitas is
one of three Swiss right-to-die groups that help arrange assisted
suicides.
Minelli says Dignitas is “helping many more people to live than to
help die, but the media are not very interested in living people as
they are in dead people.”
He says roughly 70% of the clients who get the approval through Swiss
law never follow through.
Clients often “discover that they have much more strength than they
ever thought they had.”
• • •
For many, Holland’s euthanasia law is the beacon for socially
progressive thinking about end-of-life care. For others, it’s a
symptom of a decaying and morally bankrupt society.
University of Manitoba ethicist Dr. Arthur Schafer calls the Dutch
law on physician-assisted suicide a type of “Rorschach test,” with
supporters and critics seeing what they want in the ink blots.
A patient age 16 or older must be “suffering unbearably” with no
prospect of improvement. The request must be voluntary, well-
considered and approved by two doctors. The lethal injection must be
performed by a physician, who is required to report the assisted
suicide to the local pathologist.
Since euthanasia was legalized in 2002, Dutch doctors face an
“avalanche” of strict legal controls, says a leading legal expert on
euthanasia in Europe.
For decades, doctors worked under a cloak of secrecy, reluctantly
giving fatal overdoses with no accountability, says John Griffiths,
professor of sociology and law at the University of Groningen in the
Netherlands.
In 2005, a state committee reviewed 2,883 cases of assisted suicide
to ensure all required conditions were met, including “unbearable
suffering.”
Today, doctors report 90% of assisted suicides and are subject to
medical disciplinary rules, an independent review panel and criminal
law, says Griffiths, co-author of Euthanasia and the Law in the
Netherlands.
Opponents of the Dutch model say legalized euthanasia encourages a
quick-fix solution to existential problems of aging, suffering and
sickness.
Critics also say the country should improve palliative care instead
of chipping away at the safeguards on euthanasia.
In 2005, a review commission ruled doctors, under strict conditions,
could end a patient’s life even if the person isn’t suffering a life-
threatening illness.
Critics say the change is the start of the slippery slope, where
patients can simply say they’re “tired of living” — the complaint of
Dutch politician Edward Brongersma, whose doctor-assisted death
prompted the review of the legal criteria.
Critics also point to the “Groningen protocol,” where newborns are
killed, with the parents’ consent, if doctors believe the baby is
suffering greatly with no hope of improvement. Every year, between 15
to 20 babies born with spina bifida — a defect of brain and spinal
cord deformities — are given lethal overdoses.
But Griffiths says qualifying for assisted suicide in Holland is “an
uphill battle.”
“Doctors hate performing euthanasia,” says Griffiths, noting the
overwhelming majority of people who seek death by lethal injection
are elderly, well-educated men in the final stages of cancer.
Griffiths said legalizing assisted suicide has ushered in an era of
“euthanasia talk.”
“There’s now the cultural possibility to openly talk about these
things,” says Griffiths.
Last year, an emotionally charged political debate erupted in the
U.K. when an assisted-dying bill was introduced in the House of Lords.
Modelled after Oregon’s Death With Dignity Act, the discussion on
Lord Joel Joffe’s private member’s bill in May 2006 came after
hundreds of submissions, thousands of letters and an unprecedented PR
campaign by the country’s mainline churches.
“It just seemed to me that what this is all about is human rights and
people to make decisions in relation to their own lives,” says Joffe
of adding another option to a country viewed as the world’s leader in
palliative care.
In the fevered run-up to the debate, a key question emerged — if
assisted dying were legalized, would vulnerable people feel pressured
to ask for help to die despite their wish to live?
Joffe says the bill was replete with protections — the patient would
need to be terminally ill, living with “unbearable suffering” and
required to ingest the medication by him or herself.
“It requires courage and determination by a patient to traverse the
array of safeguards,” says Joffe, a former human rights lawyer who
once represented Nelson Mandela in South Africa.
The opposition to the bill — which was originally introduced in 2002
— came in part from institutional medicine. In 2005, the British
Medical Association voted to adopt a neutral stance on physician-
assisted suicide, but later switched back to opposing the practice.
Joffe says the country’s Christian churches used the debate to “re-
establish their waning influence,” unleashed a media campaign of
“unprecedented ferocity.”
The bill was defeated by a vote of 150-100, but Joffe feels the 40%
show of support bodes well for a future attempt at changing the law,
noting polls show 80% of Britons support assisted dying.
donna.casey@sunmedia.ca
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