A matter of life and death

The suicide of a friend or a relation is a tragedy, but it is not unreasonable. Friedrich Nietzsche wrote in Beyond Good and Evil (1886) that, “The thought of suicide is a great comfort: it’s a good way of getting through many a bad night.” For some, suicide is anathema. For others, it is a gentle release from suffering.

Ramón Sampedro (1943-98) was a ship fisherman from Galicia, Spain, who became a quadriplegic in a diving accident at the age of 25. For the next 29 years he fought for the right to an assisted suicide. He was physically unable to commit suicide without help. Arguing that suicide was a right, he sought legal sanction in the courts of Spain, where his case attracted country-wide attention. He published a notable book of poems and his story became widely known following the release in 2004 of the film Mar adentro (The Sea Inside), in which the lead role was played by actor Javier Bardem.

Assisted suicide is where the patient actively takes the last step in his or her death. The term “assisted suicide” stands in contrast to “active euthanasia” where it is important to distinguish between providing the means and actively administering a lethal medicine. It’s a difficult distinction in practice. For example, Swiss law allows assisted suicide, while all forms of active euthanasia (like lethal injection) remain prohibited. Some jurisdictions declare that a person dying as a result of physician assisted suicide does not commit suicide, ensuring that terminally ill people opting for assisted suicide do not have reduced insurance claims compared to people dying naturally.

In recent years, voluntary euthanasia – the practice of ending life in a painless manner – and physician assisted suicide have been the focus of great controversy, culminating in the legalization of some forms of voluntary euthanasia in Belgium, Luxembourg, the Netherlands, Switzerland, and the U.S. states of Oregon and Washington. Why voluntary euthanasia should be a matter of state rather than federal legislation is an interesting question.

The “right to die” implies that a person with a terminal illness or in such a serious condition as to render life untenable should be allowed to commit suicide. The concept is sometimes referred to as dying without pain. The question of who, if anyone, should be empowered to make these decisions is central to the debate. Ethicists are unclear whether the right to die is universal or only applies under certain circumstances – such as terminal illness. Swiss lawyer and human rights activist Ludwig Minelli and American author and bioethicist Jacob M. Appel have argued that all competent people have a right to end their own lives. It has even been suggested that the right to die is a useful litmus test for the overall freedom of a given society.

I was reminded of this sensitive and controversial subject two years ago when Sir Edward Downes (1924-2009) ended his life. He was a highly respected English conductor, associated from 1952 with the Royal Opera House, London, and from 1970 with Opera Australia. He had a long professional relationship with the BBC Philharmonic Orchestra and the Netherlands Radio Orchestra, and a special interest in Russian music after learning Russian at the insistence of Sir Georg Solti. In the field of opera he was recognised as an eminent conductor of Verdi. Eighty-five years old, almost blind and deaf, with his wife suffering from terminal cancer, they joined hands in the presence of their son and daughter to commit assisted suicide at the Dignitas clinic in Switzerland.

It sounds like a despairing act. Yet, contrary to what many people think, it takes great courage to commit suicide. In the night-time of despair, it may look like a wrong turning, a mistake without remedy. Yet, in the daylight of rational thought, it moves beyond the scope of good and evil (as Nietzsche foresaw) to embrace a sentiment found in Measure for Measure, Shakespeare’s much misunderstood play about death:

“If I must die,
I will encounter darkness as a bride
And hug it in mine arms.”

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