Lethal Agency

Inhabiting a body is an experience rife with indignity. Youth slips away. The cumulative effects of wear and tear start to catch up with us. Over time, our bodies require an increasing amount of care and management.

To add insult to the inevitable injury, we find ourselves in the heart of Western society! Youth and beauty are exalted, leaving in their terrible wake a stream of people unjustly deemed useless, past their prime. 

Life is clung to with pitiful desperation, as we move our elderly into facilities to wait out their days and diminishing sanity assembling puzzles. We spend endless sums of money buying a few horrific months of life for our sick and dying. Quantity is blindly pursued, with no consideration for quality.

Curious about those who buck this trend and engage with the deeply unsettling idea of what various movements call ‘hastening death,’ I sought out people who take a different approach to suicide.

I spoke with Katherine and Oscar (names changed to protect their identities), a couple in their early 70s, who have long been involved in the Right to Die movement to ask about their approach to life, death, and their own eventual demise.

EE: First, thank you both so much for speaking with me on such a personal topic. To start, can you please tell me about your ideological orientation toward suicide?

K+O: Ultimately, from a philosophical point of view, we believe that people have the right to control the timing and circumstance of their own death.

In our mind, it’s really the mirror image of a woman’s right to choose. In fact, one of the primary champions of medical aid in dying in Canada started out as a maternal infant physician.

One of the issues in this movement is whether we want to use the word suicide. We usually say ‘hasten death’ or ‘final exit.’

EE: That’s an interesting distinction. And this kind of thing must exist in a somewhat murky legal space as well, no?

K+O: Oh absolutely. Euthanasia, for example, specifically is when someone else administers the drug or injection. And we don’t do euthanasia in America, even in states that allow doctor-assisted suicide. The patient has to ingest the medication themselves. There’s actually a big controversy in California, which does have Right to Die law. You know, what if someone can’t swallow? What if someone has ALS and can’t swallow? So, they’ve developed needs to administer the medicine rectally. And the patient can push the button and then it’s absorbed. 

All of which means this movement is walking a very fine line. Our organization, for example, nests under freedom of speech law. For example, I can tell someone a list of supplies they would need to perform such an act, in this case obtain canisters of nitrogen gas, I can tell someone exactly how one would assemble those supplies to accomplish their exit.

In fact, the mission statement of our favorite organization is oriented around education: to educate qualified individuals in practical, peaceful ways to end their lives.  

EE: How did you both come to this decision for yourselves?

K+O: Well, I remember my grandmother talking about the Euthanasia Society, which was a British organization that no longer exists, with great gusto. So, she introduced the concept to me as a child. 

But what I saw with my parents, and what I don’t want to happen to me is as I age, is they turned inward more and more. They had less and less agency in their own care. It became more and more complicated to keep up with their medicines, keep up with their doctor appointments, just remember when nap time was, and have the aide fix their instant oatmeal. 

Incrementally, over time, their ability deteriorated to judge the quality of their own life had disappeared. And this isn’t to criticize, but to say that, having seen them in that state, I may want to do something differently than that for myself.

What I think we both feel is if we had a diagnosis of dementia, the clock is ticking. We’re going to cut that short long before any significant loss of agency.

EE: And what is your plan, if I may ask?

K+O: Our plan is to take charge and anticipate before we lose agency, at a time when we feel we’ve accomplished what we want to do. But it’s such an immense comfort we knowing we have all the equipment, right here in our apartment. We know we both can do it by ourselves.

We try to do a practice every month and it’s amazing how hard it is to get ourselves to do those practices. There’s still such resistance to drag out this equipment and force yourself to go through it.

How could I possibly be planning this? But I think it’s important to do it. To remain familiar with it.

EE: Do you harbor any hesitations? Are there any days you falter in your convictions?

K+O: Now that we have a grandson in our lives, and having moved to the same block as him and his parents, really complicates the decision. How can we tear ourselves away from him? If we let ourselves become fall in love with this baby, and we have, how will we protect our agency? That was one of my issues in deciding whether or not to move so close, why I didn’t think we could do it, because it might interfere with our plans. And yet we’ll have to say goodbye to him and every one we love so much at some point, it’s just tasting it a little bit.

EE: Why do you think suicide is so fraught and frowned upon, from a societal perspective?

K+O: Some people have personalities to hide their aging issues. They don’t want to show it. It’s somehow shameful. They’re ashamed of slowing down or ashamed of the pain they’re feeling or the disability they’re experiencing.

Another conundrum arises when people have the desire to hasten death outside of the traditional categories of a constellation of clinical conditions, physical illness, dementia, or irremediable pain. It’s OK, a legitimate individual choice, to hasten death simply because one’s life is complete.

When people can’t back their mortgage payments for example. It starts to get a lot thornier. The elephant in the room here is capitalism. And not only the medical pharmacological establishment either. It’s a function of bottom-line driven organizations that people don’t really have control over. Now again, there’s a loss of autonomy. And we can’t hold an individual hostage because of society’s failures.

EE: Thank you both so much for your time.

K+O: Well, let’s not end on a morbid note! Because really, it’s about embracing life. It’s about flourishing and thriving with your life as it is now, and not being consumed with fear and worry. It enables you to move forward through the aches and pains of getting older more gracefully. To be happier. I really think it’s about life. It’s about life, not death.

Living well, dying well.

We’d much rather stay alive, but that’s not given to any of us.

-Eve Ejsmont