A Death So Sweet

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After being acquitted four times, Dr. Jack Kevorkian, who is seventy years old and by his own admission has helped 130 terminally ill patients to die, has been found guilty at his fifth trial, by a jury in the North American state where he was born (Michigan), and sentenced to ten to twenty-five years in prison. In protest, “Dr. Death,” as he has been baptized by the press, has declared a hunger strike. By a curious coincidence, the same day that Dr. Kevorkian stopped eating, the state of Michigan forbade prison authorities to force-feed prisoners on hunger strikes: now all they can do is explain to the strikers in writing the possibly lethal consequences of their decision. With impeccable logic, Kevorkian’s lawyers are asking whether the state’s official position on hunger strikes isn’t the same as “assisted suicide”—in other words, the same crime for which the famous doctor is serving time.

Although his lack of humor and his single-mindedness have made him seem somewhat macabre in television appearances, Jack Kevorkian is a true hero of our age. His campaign in support of euthanasia has helped bring a taboo subject out from under wraps and into the public light, and caused it to be discussed worldwide. With his “crusade,” as he calls it, he has opened many people’s eyes to a monstrous injustice: that terminally ill patients who endure unspeakable torments and wish to put an end to their nightmarish lives are required to continue suffering because of a legalism that proclaims a universal “obligation to live.” This is, of course, an intolerable violation of individual sovereignty and an instance of state interference with a basic human right. The decision whether or not to live (the fundamental problem of philosophy, as Camus wrote in The Myth of Sisyphus) is entirely personal, a choice the individual should be able to make freely and without coercion, with the assurance that his decision will be rigorously respected; the consequences of the act, after all, concern only the one who undertakes it.

Such is the case when those deciding to end their lives are people who are able to do it themselves and don’t need to be “assisted” this is, perhaps, the most lamentable of the tangle of hypocrisies, paradoxes, and prejudices that surround the euthanasia debate. The legal prohibition of suicide hasn’t prevented a single would-be victim from shooting himself, taking strychnine, or leaping into the void after he or she came to the conclusion that life was no longer worth living. And no one who has survived a suicide attempt has been sent to jail for breaking the law that human beings must live. Only those who are not physically able to act on their will to die—terminally ill patients in a state of utter decrepitude, or in other words, those who are forced by the law to bear the most physical and psychological torment—are condemned to comply with the bureaucratic prohibition against dying by one’s own hand. Dr. Jack Kevorkian had been battling this stupid cruelty for three decades, knowing that sooner or later he would be defeated. His case goes to show that on certain subjects, like euthanasia, Western civilization still carries a considerable baggage of barbarity. (Religion, that perennial adversary of human freedom, must bear the blame.) After all, it is no less inhuman to withhold death from a sane person who is requesting it because life has become a burden than it is to snatch away the life of someone who wants to live.

Nevertheless, despite the massive blindness and lack of understanding that plague any discussion of euthanasia, some steps have been taken in the right direction. The Netherlands is the world’s liveliest example of a liberal democracy, in matters of drug use, the rights of homosexuals, and the social and political integration of immigrant minorities: a country that experiments, renews itself, tries out new formulas, and isn’t afraid to seriously play the freedom card, in all social and cultural spheres.

I often think of a television documentary I saw in Monte Carlo two years ago, when I was judging a television competition. It was far and away the most impressive program, but since its subject was a serious affront to the religious convictions of some of my colleagues, we couldn’t give it the prize, mentioning it instead in the final ruling as a notable entry in the controversial debate over euthanasia.

The characters weren’t actors; they played themselves. At the beginning, an old sailor who had run a little bar in Amsterdam and who lived alone with his wife, went to see a doctor to tell him that the pain he was suffering due to an incurable degenerative disease was steadily getting worse and that he had decided to speed his death along. He had come to ask for help. Could the doctor provide it? The film tracked in meticulous detail the legal procedures that had to be followed in order for the assisted death to take place. The Ministry of Health had to be informed, the patient had to submit to a medical examination by practitioners other than the one who had diagnosed him, and his desire to die had to be approved by a Ministry officer responsible for determining whether his mental state was sound. The death takes place at last, on camera, in the sick man’s home, where he is flanked by his wife and the doctor who administers the lethal injection. At every point in the process, even instants before death, the patient is informed by the doctor about the progress of his illness and asked again and again whether he is sure about his decision. At the most dramatic moment in the documentary, as the doctor administers the final injection, he tells his patient that if he changes his mind before he loses consciousness, all he has to do is raise a finger and the doctor will suspend the operation and try to revive him.

Since this documentary—which has been shown in some European countries and banned in many others, generating heated debate—was filmed with the characters’ consent and is promoted by associations that defend euthanasia, it has been accused of being “propagandistic,” something it certainly is. But that doesn’t lessen its authenticity or persuasive power. Its great merit is that it shows how a civilized society can help a person who views death as a form of physical and moral liberation to take the final step, while at the same time ensuring that all the necessary precautions are taken so that the decision is a genuine one, made in a state of perfect lucidity, with a full understanding of its significance. And, of course, it shows how science can try to help alleviate the pain and trauma of the passage from life to death.

A horror of death is deeply rooted in Western culture, mostly as a result of the Christian idea of transcendence and the threat of eternal punishment for the sinner. In certain Asian cultures, like those steeped in Buddhism, death is understood as a continuation of life, a reincarnation in which the self is changed and renewed but never stops existing; in the West, however, death means the absolute loss of life—the only life that a human being personally lives and has evidence of—and its replacement by the vague, uncertain, and abstract life of a soul whose nature and identity are always slippery and difficult for even the most ardent believer, with his earthbound faculties, to grasp. That is why the decision to end a life is the most serious and tremendous decision a human being can make. Many times it is made in a fit of irrationality, confusion, or delirium and isn’t a choice, properly speaking, but in a certain sense an accident. For someone who is terminally ill, however, that is never the case, because his very helplessness and the physical impotence occasioned by his condition grant him time, perspective, and ample circumstances in which to weigh his options calmly and decide after proper reflection. For the 130 unhappy souls whom Dr. Jack Kevorkian broke the law to help die, he was an angel not of death but of peace and compassion.

Madrid, April 1999