One night recently, during a dinner table conversation, an attractive, cultured, well-educated friend in her late sixties declared with surprising finality, “If I had stage-four pancreatic cancer, I’d put a revolver in my mouth and go night-night.” She was reacting to a newspaper article we had all read about a 66-year-old woman in Sequim, Washington, who, in the final stages of a terminal illness, chose to die by way of doctor-assisted suicide, now legal thanks to the passage of a new state law. We all agreed that the Death With Dignity Act sounded better than a revolver in the mouth. The law passed last November with 58 percent of the vote, making Washington the second state, after Oregon, to legalize assisted suicide, which is a crime elsewhere in the United States and many parts of the world. (What’s the punishment for assisting a suicide? Hanging?)
Death has become a curiously popular topic with many of my old friends, emphasis on “old.” Aging has a way of redefining inevitability—of throwing into stark relief our right to die, something we had always taken for granted. If we believe in the right to life, shouldn’t we likewise accept that people have a right to dispose of that life, regardless of health considerations, whenever and however they want? Apparently not. The pro-life movement rejects freedom of choice in all its insidious forms. This being the case, it becomes a contest of wits to see how we can subvert law and custom.
For as long as we’ve had politicians who believe it’s their job to define and redefine what we can do with our own bodies, suicide, assisted suicide, attempted suicide, and euthanasia have been incredibly controversial acts responded to badly by the authorities. In ancient Athens, Plato believed that a person who committed “unacceptable” suicide without permission of the state—heaven forbid—should be buried without a headstone or marker on the outskirts of town. In France in 1670, a criminal ordinance fashioned by Louis XIV ordered that suicide victims be dragged facedown through the streets, after which they were thrown on garbage heaps. Beginning in 1879, people who attempted to kill themselves in England were sentenced to two years of hard labor. Legal views on taking one’s life range from the absurd to the unspeakably cruel. In Pakistan, girls who are raped customarily kill themselves. Jews traditionally celebrate the mass suicide at Masada, even though Judaism forbids self-mutilation.
This summer in Austin, police and prosecutors stumbled and stammered as they searched for justice in the heartbreaking case of 52-year-old Kim Yarbrough. Kim was charged with murder—specifically, with causing the death of her 62-year-old invalid husband, Lloyd, by injecting his feeding tube with an assortment of prescription drugs, after which she unsuccessfully tried to take her own life. The ultimate nightmare isn’t death; it’s failing at death’s door, waking up alive, and realizing your last best hope for peace is gone. Especially if you’re handcuffed to the bed.
The story of Lloyd and Kim will move you to tears, unless you’re someone who believes that only God has the right to end suffering. As detailed by reporter Andrea Ball, in the Austin American-Statesman, Lloyd and Kim met in the early nineties, dated for a time, then married in 1997. Lloyd had his own woodworking business. Kim worked in a gem store and was a competitive swimmer; they traveled together to swim meets. Life appeared good until 2004, when he was diagnosed with non-Hodgkin’s lymphoma, a cancer that attacks the immune system. After extensive chemotherapy, radiation, and a bone marrow transplant, Lloyd’s cancer seemed under control. But in the summer of 2007, he got encephalitis, a viral infection that causes the brain to swell, and he lapsed into a coma. When he woke, he couldn’t walk or talk or swallow or go to the bathroom without help.
Kim placed Lloyd in a private rehabilitation center, but eventually their insurance ran out. She turned to Medicaid and moved him into a nursing home. Like most aging couples, they had talked about the indignity of dying in such a place. Lloyd had watched his mother waste away in a nursing home and had told Kim that he didn’t want to end his life that way, so she brought him home and did the best she could. In her blog, Kim wrote of being overwhelmed by depression and despair. “I wonder if I will ever change Lloyd’s diaper without feeling the pain of what has been lost,” she wrote. In a later entry, she mused: “Everybody dies. Some people don’t live all that long. It’s not so tragic. Why should I try to keep living through all this?”
In May, in a quiet ceremony attended by a few close friends and neighbors, Lloyd and Kim renewed their wedding vows. She wore the same white, summery dress she had been married in twelve years earlier, and Lloyd was dressed in the same gold Hawaiian shirt. He sat in his wheelchair, of course, unable to walk or even say “I do.” District judge Jon Wisser, who had presided over their original nuptials, said the words for him, and the guests repeated them. When Kim pledged her love, Lloyd kissed her hand and hugged her hips, his eyes flooding with tears. Three weeks later he was dead, and Kim was charged with murder. She is currently free on $20,000 bond.
In late July, two months after Lloyd’s death, the Travis County district attorney’s office was trying to figure out how to proceed. “It’s an ongoing investigation,” an assistant DA told me. On the advice of her attorney, Kim won’t talk about the charges against her. I got the impression that no one wanted to prosecute her, but what to do about the law that makes what she did patently illegal? As things stand, the authorities have no wiggle room.
We often hear about people like Lloyd and Kim—ordinary people caught in the ordinary attrition of life, facing the pain and agony of death, trying to decide what to do. I’ve been in that situation a couple of times, first, when my son Mark died of leukemia, then again when Phyllis, my wife of nearly thirty years, died of lung cancer. Like most people, I did nothing. I simply waited for the end. In both instances, it came blessedly soon, but I will never forget the helplessness and loneliness of the wait or the mounting conviction that there had to be a better way, that we owed it to victims and survivors alike to provide options.
There are movements in a few states to legalize doctor-assisted suicide, but not in Texas, where the pro-life dogma is so powerful it’s nearly killing us. I know the arguments against euthanasia: It devalues human life; it can too easily and inappropriately become a way of containing health care costs; physicians shouldn’t be involved in directly causing someone’s death. Some opponents fear a slippery slope effect—that a law intended to permit terminally ill patients a way to die in peace can become a handy escape route for people who are merely depressed or momentarily ticked off. Most of these arguments are specious. Though it is perfectly rational to want to avoid the pain and suffering of a terminal illness, the act itself nearly always seems irrational from the outside. One of the strangest double suicides on record took place this summer in the North Texas town of Henrietta, which has been in shock since a disastrous prairie fire destroyed the neighboring town of Ringgold three years ago. In the aftermath of the fire, the Reverend Eldon Earl Johnson and his wife, Linda Kay Johnson, were steadfast and strong, ministering to their flock and helping rebuild the Ringgold Baptist Church, which sustained smoke damage. Then, at the very moment when everyone should have been celebrating life, the Johnsons walked to the railroad tracks and calmly prepared to be hit by a train.
Surely we can do better. We could start by thinking of death as a commodity—something you might trade on the stock exchange, like pork bellies. A Swiss lawyer named Ludwig Minelli founded the suicide-facilitating organization Dignitas, which is headquartered in Zurich, and plans to open other clinics where people who are terminally ill or have severe physical illnesses can lie down in a comfortable room and sip a lethal cocktail of barbiturates. (One anti-euthanasia advocate has termed it “sort of a Starbucks for suicide.”)
Minelli’s clinic got international attention recently when one of Britain’s most celebrated cultural figures, Sir Edward Downes, flew to Zurich and checked in with his wife. Lady Joan Downes, a 74-year-old former choreographer, ballet dancer, and television producer, was in the final stages of terminal cancer. The 85-year-old Sir Edward, once the principal conductor of the BBC Philharmonic Orchestra and also the associate music director of the Royal Opera House, at Covent Garden, in London, wasn’t terminally ill, but he was nearly blind and deaf. The couple’s children watched in tears as their parents drank a small amount of clear liquid, then lay down on adjacent beds, holding hands. “Within a couple of minutes they were asleep, and they died within ten minutes,” reported their son, Caractacus Downes. “They wanted to be next to each other when they died.” They had spent 54 years together and decided to end their lives when and where they desired, rather than struggle helplessly to the same inevitable result. “It is a very civilized way to end your life,” Caractacus said. “I don’t understand why the legal position in [the U.K.] doesn’t allow it.”
Scotland Yard says it’s “looking into the circumstances” of the deaths of Sir Edward and Lady Joan. How predictably officious. How stupidly arrogant. How disappointingly reminiscent of the attitude of lawmakers and law enforcers in Texas and elsewhere. Are they so obtuse that they don’t understand that this shouldn’t be their call? Maybe we should explain it in simple terms, as we would to a child: Be patient, my little ones. Your time will come.