Sunday, May 15, 2011

How to Die in Oregon

Physician-assisted Suicide or Death with Dignity.  It's legal in Oregon. 

In the most thought-provoking movie I saw at Hot Docs,  How to Die in Oregon takes a hard look at the practice of physician-assisted suicide in Oregon.  And I mean a hard look.  The film opens with a man drinking the physician-prescribed deadly dose and the camera zooms in as he slips into a coma with his family around him.  A physician has prescribed the lethal dose; a volunteer mixes the Seconal into a glass of water; the patient drinks it himself.  The volunteer asks two confirming questions before handing over the drink.   "Are you sure you want to do this?  You know, you can change your mind." "Can you tell me what will be the result of drinking this mixture?"  Physician-assisted suicide is different from euthanasia in that the doctor does not administer a lethal dose; the patient has to be physically able to drink the liquid dose.

In the movie, we come to know Cody Curtis, an active, attractive, elegant, woman with a positive attitude, a caring husband and two children, who is suffering from terminal liver cancer.  She wanted to choose to die with dignity when the pain became intolerable.  Is it a sign of great moral courage to endure such pain in a hopeless situation when there is an alternative?  Clearly Cody didn't think so.  As Cody says near the end, "I don't ever want to have a night like that again".  

Doctors also face a tough dilemma when asked to prescribe a lethal dose for their patients.  Is this prescription at variance with their Hippocratic Oath or is it the ultimate good they can do their patients?  Cody's doctor was conflicted about this, but concluded that she owed it to her patient to give her freedom of choice.  

One of the reasons director Peter Richardson chose to focus the movie on Cody was because the doctor was willing to be included.  But he also included a statement by another doctor arguing vehemently that prescribing a lethal dose just couldn't qualify for doing no harm to a patient.  Opinions are fervently held on both sides of this question.  Richardson told us at the Q and A that he filmed 16 patients who had filled the lethal-dose prescription, but most did not use it.  Clearly just having the prescription in the drawer is comforting to many.

Cody postponed her original date when she was still feeling quite well;  she laughed about having to replace the the jewellery she had given away.  However, she knew the time had come in December.  Cody doesn't quite make Christmas as she'd hoped, but she does teach her son how to prepare the traditional Christmas squares.  When her husband asks where the cheque book is, she exclaims "I've been trying to tell him about that for 35 years!"  We watch through a lighted window as we hear the quiet conversation of Cody, her family, and her doctor as Cody achieves her peaceful end.

The movie followed the citizen-led push for a physician-assisted suicide law in Washington, led by a woman who has lost her husband in an ugly and painful death by brain cancer.  He did not have time after his diagnosis to establish residency in Oregon so he could not opt for physician-assisted suicide.  His wife pledged to him that she would fight for the law in Washington, and it ultimately passed by a significant majority.  Other states are considering adopting this law.  Laws for assisted suicide have been proposed more than once in Canada.

How To Die In Oregon won the Sundance Grand Jury Prize and was third in the People's Choice Awards at HotDocs (How good must those first two be!).  The movie was funded by HBO and will thus be available widely.  

What a strong movie.  Besides developing great affection and respect for Cody Curtis, and shedding some tears, I got thinking about end-of-life choices.  With the coming aging of our society, and the ability for medicine to keep us alive longer, this is a question that will be challenging many of us. 

 Would I want a 'get out of pain free' card, when faced with prolonged, futile suffering?  I would.  What do you think?

1 comment:

Rohan Jayasekera said...

I'd want the "card" too.