A chance to talk about assisted suicide

2014-08-25 09:20

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Most of us don’t want to think about dying. Or we fantasise about “slipping away quietly at home in our sleep” surrounded by family and friends.

But in reality, less than 10% of people succeed in dying peacefully at home.

On August 16, Mario Oriani-Ambrosini courageously took his own life at home.

Thus he ended his seventeen-month journey towards dying. In April last year, he was diagnosed with stage 4 lung cancer.

His public engagement with his dying became his final act of political service to his country – a brave and challenging contribution to a critical debate: What does it mean to be human in terms of quality of life? And what does it mean to be able to die with dignity?

In February, he introduced a bill to Parliament, The Medical Innovation Bill, which included the proposal “to legalise the use of cannabinoids for medical purposes”.

Oriani-Ambrosini said: “What this paperwork stands for is?...?that there is no rational argument for continuing to deprive medical marijuana to people like me who need it.”

This is not new knowledge. It’s ancient knowledge. Two decades ago, when my late husband Joe Slovo was facing his own death from cancer, he used marijuana. Oriani-Ambrosini’s courage is to make this a public issue.

Oriani-Ambrosini valued autonomy and consciousness; those were cornerstones of what he considered quality of life for himself. The progression of his illness steadily eroded this quality.

In his parliamentary tribute, Mangosuthu Buthelezi described how Oriani-Ambrosini had lost “his lungs, his mobility and his eyesight”.

He was not able to eat and was dependent on an oxygen machine.

What Oriani-Ambrosini still had was his mind. He valued his consciousness and had spoken in Parliament about not using morphine because of its mind-dulling effects.

In full consciousness, he decided to hasten his imminent death and terminated his life.

I am angry that Oriani-Ambrosini had to end his life violently, with a gun.

I am angry that Craig Schonevogel first failed to commit suicide; and second time round, alone in his room, careful not to incriminate his loved ones, he swallowed almost four dozen sleeping pills, pulled a plastic bag over his head, and tied it around his neck.

I sincerely hope he suffocated when deeply asleep.

It doesn’t have to be this way.

I am angry and I also admire their courage to bring their personal tragedy to public attention.

People should not fear abuse of the policy of assisted dying.

In all the countries where this policy is in place, there are stringent oversight measures. In Oregon in the US, where the law permitting assisted dying has been in place since November 1994, the evidence is that the option of legal assisted suicide offers people peace of mind – and that for every 100 terminally ill people who gain approval, only a handful actually use the option.

Parliament has been quiet on the possibilities of having access to medical marijuana and the choice to die peacefully. It is time for us to debate them. Ambrosini has given us this opportunity.

The changes we need in our society

» The first change would be for doctors and healthcare workers to be trained to be comfortable with having “end-of-life” discussions.

In a 2010 survey of 1?000 doctors in the UK, as many as two-thirds responded that they were ill at ease with having end-of-life discussions with their patients.

Healthcare training needs to balance life-saving training with a readiness to help people die better deaths. Medical aid schemes could play a supportive role by having a recognised code to reimburse doctors for such consultations.

»?Encourage every citizen older than 18 to have a living will, also known as an advanced directive, in place. In La Crosse in the US state of Wisconsin, physicians there have campaigned since 1985 that every adult should consciously sign off on their end-of-life preferences.

There are various benefits including peace of mind for oneself and clarity for the family on what to do in case of emergency. There seems to be a positive impact on longevity, and data indicate end-of-life healthcare costs are reduced.

»?Strengthen the legal standing of the living will document. In South Africa, it merely serves as a guideline for doctors and does not need to be complied with as is the case in other countries.

»?A new legal dispensation that sanctions assisted dying. According to Wikipedia, assisted dying involves a doctor “knowingly and intentionally providing a person with the knowledge or means or both required to commit suicide, including counselling about lethal doses of drugs, prescribing such lethal doses or supplying the drugs”.

The hastened death may be aided by a physician and is sometimes called voluntary euthanasia.

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