The ‘horrifying’, ‘brutal’ and unspoken truth of what assisted suicide is really like

Rather predictably, Lord Carey of Clifton, the former Archbishop of Canterbury, has popped up in the debate on assisted suicide to repeat a claim he made three years ago in the British Medical Journal that doctor-assisted death should be legalised because there is “nothing sacred about suffering, nothing holy about agony”. 

His remarks come in a letter to MPs following a meeting with Labour MP Kim Leadbeater whose Terminally Ill Adults (End of Life) Bill will be put to the vote at Second Reading on November 29. The letter is signed by other Anglican, Unitarian, and liberal Jewish leaders of the same mind. Even Islam is represented. The overall purpose is to demonstrate division among religious leaders, who for the most part are opposed to assisted suicide, and to create the illusion that one can be at the same time both devout and wish for a change in the law.

The signatories argue that “if a terminally-ill person does not wish to live out their last few months in pain, for what purpose should they be forced to do so, and in whose interest is that life being prolonged? It is not a religious kindness to force them to suffer on against their will”.

The message is: be kind and kill them. This, however, is not a Christian sentiment and has no basis in either Scripture or Tradition, the twin pillars of teaching. On the contrary, killing is forbidden explicitly by the Fifth Commandment of the Decalogue.

From the earliest beginnings of the Church this negative precept was considered as an inviolable expression of what in the mind of God is evil. Christians are not at liberty to break the commandments, St Paul reminded the Romans when he wrote that “it is not licit to do evil that good may come of it”.

Pope St John Paul II, writing in his 1993 encyclical Veritatis Splendor, explains that to suggest otherwise is to surrender to “teleological or proportionalist theories” which must be rejected because they attempt to justify immoral acts which, of their very nature, are incapable of being ordered to God and to the good of humanity, but are instead “intrinsically evil”. Among the examples of intrinsic moral evils offered by Gaudium et Spes, the Second Vatican Council’s document on the pastoral constitution of the Church in the modern world, are euthanasia and voluntary suicide. Suffering cannot negate the teaching of the Church. The alleviation of suffering is charitable, yet suffering is part of life, something we all experience in one form and another, and can have a redemptive value and action when united – or offered up – with Christ’s Passion and Cross. The only evil to be avoided at all costs, on the other hand, is sin.

Yet even in their appeal to end suffering with assisted suicide Carey and co are wide of the mark because they are peddling the myth that only a lethal cocktail of drugs or a deadly jab can deliver a beautiful and serene death. This is a romantic fantasy, the stuff of movies like Million Dollar Baby in which a single tear rolls down the face of Hilary Swank as Clint Eastwood disconnects her breathing tubes and injects her with a lethal dose of adrenaline. Sentiments of heroism and compassion rise irresistibly as she slips away and for her performance Swank won an Oscar for Best Lead Actress in 2005.

Disabled rights activists hated the film, however. They said it fuelled the prejudice that the quality of life of disabled people is “unquestionably not worth living”. Eastwood, the director, responded that the story was a work of fiction as fantastically over the top as “Dirty Harry” Callahan wreaking frontier-style justice from the barrel of a .44 Magnum. In other words, it wasn’t to be taken seriously.

That was an understatement. The story was make-believe because deaths of this kind are seldom like that at all. They are far worse.

California legalised assisted suicide in 2015 through its End of Life Option Act, which permitted doctors to prescribe lethal drugs to terminally-ill patients with the promise that an awful death could be avoided. Just a slug of “medication” and the patient keels over like Romeo in Verona.

The public was led to believe it was simple, painless and efficient. Except it isn’t, and in the autumn of 2020 Californian doctors who practised assisted suicide, fed up with dealing with distressed and agitated relatives, gathered to confront the reality of what such deaths are really like and to consider how they could improve them.

Dr Lonny Shavelson, a Berkeley doctor considered to be the leading practitioner of assisted suicide in the state, told MedicalXPress that time and again patients experienced lingering deaths.

“After two hours, people were starting to get concerned, and restless,” Shavelson said. “They wonder what’s happening. People start walking around the room, going into the kitchen. It disrupts the meditative mood. Between two and four hours – that’s not ideal. Anything over four hours we consider to be problematic. I was looking at what was happening and thinking, ‘This isn’t as good as it’s been hyped up to be’.”

“The public think that you take a pill and you’re done,” said Dr Gary Pasternak, chief medical officer of Mission Hospice in San Mateo. “But it’s more complicated than that.”

Although some patients die relatively quickly, many do not. Some hang on for six or nine hours, sometimes days.

In 2019 a patient in Oregon took 47 hours to die from a lethal cocktail and previously another man, a lung cancer sufferer named David Pruitt, ingested his entire prescription of lethal drugs and woke up after 65 hours. “What the hell happened?” he asked. “Why am I not dead?” He declined to attempt suicide again and died naturally a fortnight later. Another patient is known to have taken four days and eight hours to expire. These few cases have come to light in what remains a highly secretive practice.

Yet the truth has an uncanny knack of finding its way to the surface. When it does, it is often horrifying. Dr Brick Lantz, an Oregon orthopaedic surgeon and state director for the American Academy of Medical Ethics, in 2021 warned the British Parliament about the “brutal” and “not infrequent” failures of the drugs used in assisted suicide. “There was a nurse at the bedside of one [patient] who ended up putting a plastic bag over the patient because the patient wasn’t dying.” 

It hardly comes as a surprise that the first user of the Sarcopod assisted suicide machine was found with strangulation marks on her neck, another likely victim of a botched assisted death.

There are other problems. Record-keeping of assisted suicide deaths in Oregon is practically non-existent yet it has been established that scores of patients have experienced complications such as seizures or regurgitating some of the lethal dose.

A similar pattern has emerged in neighbouring Washington State, where a third of assisted suicides endured lingering deaths, while dozens of others suffered often unspecified “complications”. Many end up dying from asphyxia.

It’s the same for continental Europe. Dr Bernadette Flood wrote to the British Medical Journal after she reviewed literature about complications with doctor-assisted dying in the Netherlands in particular.

“A number of medicines used in assisted suicide and/or euthanasia were previously used in executions,” she wrote. “The use of medicines during executions has been described as ‘inhumane’ with reports of people feeling ‘burning’ sensations throughout their bodies prior to death.’

She concluded: “The process of assisted suicide and/or euthanasia cannot guarantee a peaceful, pain-free, dignified death.”

Indeed they cannot. Claud Regnard, a retired consultant in palliative care, writing in a new book called The Reality of Assisted Dying: Understanding the Issues, said that the available data revealed about one in five assisted suicide deaths involve complications. The problem is so bad that Oregon has experimented with four different combinations of drugs in the last eight years.

Given the shocking incidence of protracted painful deaths, the temptation to permit death by lethal injection will increase, but the available evidence of the suffering of patients here is equally horrific. It is covered up and most comes from the execution of death row prisoners using identical drugs. A major problem is the sedatives working at a slower rate than the cardiotoxins and muscle relaxants injected to stop the heart. The condemned are not asleep when they are killed, but experience death in paralysis where they are unable to express the acute agony and distress that they feel.

Such facts are treated as dirty secrets by the advocates of assisted suicide and euthanasia both in the UK and overseas because they lay bare the myth that such deaths are somehow a humane and dignified alternative to good palliative care.

Little wonder that they want to hush it up. A Survation poll has found that at least 78 per cent of respondents expressed deep concern about assisted suicide becoming law if such deaths involved “patients sometimes taking up to 30 hours to die, with vomiting, regaining of consciousness, asphyxia and seizures” among the complications. Suddenly, when apprised of the facts instead of aggressive propaganda, it is discovered that an overwhelming majority are opposed to doctor-assisted death.

The best way to deal with the problem of suffering at the end of life is with high-quality palliative care. Britain has been a leader in developing this but, following in the example of other jurisdictions, assisted suicide will surely undermine such progress because a lethal cocktail is a much cheaper option than months of good care. Out will go real patient choice when people find they are left to pick between either a potentially botched suicide or the tragedy of a natural death unsupported by caring physicians and the right drugs.

The people who advocate assisted suicide may end up with their Hollywood death. But it will not be of the dreamy romantic kind that made Eastwood look cool and Swank tragically beautiful. It will be more in the horror genre, in which evil triumphs, fear reigns and innocent people die horribly and in pain.

The post The ‘horrifying’, ‘brutal’ and unspoken truth of what assisted suicide is really like appeared first on Catholic Herald.