Thursday, July 16, 2009

The Choice For Death

LONDON — He spent his life conducting world-renowned orchestras, but was almost blind and growing deaf – the music he loved increasingly out of reach. His wife of 54 years had been diagnosed with terminal cancer. So Edward and Joan Downes decided to die together.
Downes – Sir Edward since he was knighted by Queen Elizabeth II in 1991 – and his wife ended their lives last week at a Zurich clinic run by the assisted suicide group Dignitas. They drank a small amount of clear liquid and died hand-in-hand, their two adult children by their side. He was 85 and she was 74.

The deaths were a poignant coda to Edward Downes' illustrious musical career, and have reignited a debate in Britain about whether people should be able to help ailing loved ones end their lives.

The couple's children said Tuesday that they died "peacefully and under circumstances of their own choosing" on Friday.

"After 54 happy years together, they decided to end their own lives rather than continue to struggle with serious health problems," said a statement from the couple's son and daughter, Caractacus and Boudicca.

"They wanted to be next to each other when they died," Caractacus Downes told London's Evening Standard newspaper. "They held hands across the beds.

"It is a very civilized way to be able to end your life," he added.

Downes' manager Jonathan Groves said the couple were inseparable and would have reached the decision together.

Sir Edward would have survived her death, but he decided he didn't want to. He didn't want to go on living without her," Groves said.

One of Britain's most renowned conductors, Downes had a long and eminent career, which included years as head of the BBC Philharmonic and a five-decade association with the Royal Opera House.

In recent years he had become almost blind and nearly deaf, increasingly relying on his wife for support.

Joan, a former ballet dancer, choreographer and television producer, had devoted years to working as his assistant, but she was recently diagnosed with cancer of the liver and pancreas, and given only weeks to live.

Groves said he was shocked by the couple's deaths but called their decision "typically brave and courageous."

The double suicide is the latest in a series of high-profile cases that have spurred calls for a legal change in Britain, where assisted suicide and euthanasia are banned.

Under British law, assisting a suicide is punishable by up to 14 years in prison. But courts have become reluctant in recent years to convict people. No relative or friend of any of the Britons who have died in Dignitas clinics has been prosecuted.
(This is sure indicative of an officially mixed attitude towards assisted suicide.)

The Metropolitan Police force said it had been notified of the deaths, and was investigating. Charges are unlikely.

Despite evidence of changing attitudes, parliamentary efforts to change the rules have all been defeated – most recently last week, when Parliament's upper chamber, the House of Lords, voted down an amendment that would have relaxed the prohibition on assisted dying.
Sarah Wootton, chief executive of campaign group Dignity in Dying, said the couple's deaths showed the need to regulate assisted suicide.

"This problem is clearly not going to go away," she said. (It certainly isn't.)

"People should be able to make such decisions for themselves, but safeguards are the key," she said.

Peter Saunders, of the anti-euthanasia group Care Not Killing, argued that loosening the law could "put vulnerable people, many of whom already think they are a financial or emotional burden to relatives, carers and the state, under pressure to end their lives through a change in the law."

More than 100 Britons have died in Swiss clinics run by Dignitas since the organization was established in 1998. The organization takes advantage of the country's liberal laws on assisted suicide, which suggest that a person can be prosecuted only if they are acting out of self interest.
Roughly 100 foreigners – most of them terminally ill – come to Switzerland each year to end their lives. Some are healthy except for a disability or severe mental disorder. Typically they go to a room run by Dignitas, which provides them with a lethal drink of barbiturates. In five minutes they fall asleep – and never wake up.

Other countries, including the Netherlands and Belgium, and the states of Oregon and Washington in the United States, allow the incurably sick to obtain help from a doctor to hasten their death.


Depending on one's point of view, the Downe's story is somewhere between a fitting end to an incredible love story, or a willfully selfish act which condemns them to an eternal hell.

This is one of those stories in which the circumstances color one's perspective. One of those circumstances is that Dignitatis, as an outside provider, assisted in this dual suicide. Had the Downes chose to suffocate together in their car, it would be a different story. Society wouldn't be faced with having to make choices about a 'service' which assists an individuals death. We in the West do not deal well with death anyway, opting always for life or at least not doing any harm. The whole notion of assisted suicide violates both those notions. A lot of us can't seem to grasp the idea that forcing life on others might actually be harmful in an of itself.

This is not about a Terry Schiavo and what is appropriate end of life care for people dependent on others. This is about two elderly adults, facing terminal or very debilitating physical disintegration, freely choosing to end their lives---and the choice of others to help them.

People make this same kind of choice all the time, but they usually act on the choice alone. The Church's pastoral position is generally that people didn't really freely choose to commit suicide. In choosing death, they couldn't have been in their right mind, and therefore did not really possess free choice. However, when others choose to help them in this choice, those others are engaging in murder and part of the culture of death.

Catholicism's position says no one in their God given right mind chooses death, or chooses to avoid terminal suffering. Life is too valuable a gift, even when it's a cross and reduces one to a dehumanized state. At that point one's life becomes an opportunity for the exercise of compassion in the people who love the incapacitated person. The Downes case says just the opposite. The compassion is exercised in helping them with their choice to end their lives together with some dignity.
I think we in the West have made dieing with any kind of dignity very difficult because we are obsessed with avoiding and denying death. Somehow the very fact we die is a failure. Those who love us can feel excessively guilty at their own failure to keep us alive. This is especially true with suicide.
One of the questions I think needs to be given more consideration is what the Downe's decision really states. Is it legitimate to have a view of death which is morally positive, and not always and everywhere morally neutral or negative. Will society support an individuals free choice to embrace death even when they need assistance to accomplish that choice.

Britain seems to be brain locked on this question. Laws, never enforced, are still on the books and legislation to change them is still being blocked. A religious view of death as sort of the ultimate evil to be avoided is still alive and well in secular society. But when the will to enforce the law is absent, this generally signals changing, if officially unrecognized, attitudes. Britain may not want to admit it, but it does seem that semi officially there is a changing attitude to death and dieing that says one can choose dignity in death over a longer life.

One of the last conversations I had with my mother was one I never expected. I lived out of state and was home for a holiday when out of the blue she asked me if it was OK to want to die and not live any longer. She had a long history of lung and heart complications which had been recently compounded with an insulin dependent form of type II diabetes. She was going blind. She was not ennobled by her suffering, ill equipped to deal with it, and tired of watching herself deteriorate to the point she was completely dependent on my dad, who himself was not young and visibly going down hill.

I told mom I had a difficult time believing that God meant death to be avoided at all costs since it was God Himself who originally determined life would have an end point. It seemed to me it was man who determined that life at all costs superseded death. Probably because the whole concept of heaven being vastly superior to earth would lead people to purposely seek to end their lives in order to experience heaven. She laughed and laughed and laughed.

She said she wasn't looking forward to experiencing heaven as she didn't really have a clue about what that was about, but she was looking forward to not experiencing pain. Then she asked if I really thought there was an afterlife. Absolutely, I said and I also told her I thought individuals could live a long enough life in which their real business was no longer about living, but about dieing. Besides, we were far more than our bodies and preparing for death meant getting in touch with that aspect of our totality. That part would let her know when she was ready.

She thought about that for awhile and then told me she thought she was close to being there. She told me two other things. The first was to make sure my dad and my brother and sister would honor her request for no heroic measures. They were to let her check out. The second was to make sure there would be no more helicopter air flights to hospitals because she was terrified of flying in helicopters and that would surely kill her. We both laughed at the inconsistency in that. Both requests were honored and she died in my dad's arms.

I suppose she could have been kept alive longer, but it was time. In a sense she opted for passive suicide, embracing her death and not running from it--except for the helicopter thing. The choice facing society is about the rights of individuals to choose death and official legal compliance in that choice. Like the article states it is a question which isn't going to go away.


  1. This is a very emotionally charged topic for me, one that really gets the adrenaline flowing and some very harsh and judgemental attitudes pouring forth.

    Firstly, we can be sure of one thing - if the catholic church says it is wrong, it probably is not wrong. The catholic church position on assisted suicide is obviously wrong. Same as it is in the Brazilian rape case.

    In my opinion, there is nothing wrong with a person choosing to end their life. God gave us free will and freedom of choice. NOT free will "except when ..." and NOT freedom of choice "AS LONG AS ...". Freedom to live, and freedom to die as we choose. A small fact that the Catholic Church chooses to selectively ignore.

    The catholic position that a person who chooses to die is not in their "right" mind is also wrong. Why is a person who wants to die in their "wrong" mind, and one who rapes children in their "right" mind?

    My time is not that far away now and I am looking forward to it. After reading this article, I'm thinking about taking my last vacation in Switzerland. At least that way, I can be as far away from the Catholic Church as possible.

    The last thing I want is some self-righteous ass getting involved and mucking up the process when it is time. That is one of the reasons I have chosen to leave the catholic church ... again.

  2. Carl, leaving the Church is also a choice made from free will, and we are told such a choice is not necessarily made in our 'right' mind. Hell and disobedience and all that.

    The one thing I do know about this planet and our lives on it, and this is also affirmed in scripture, is that it's about free will and our choice to exercise it.

    Coercing choice from either notions of secular relativism, or religious fundamentalist beliefs about truth, is not choice. It's coercion.

    Jesus knew all this and always gave people a choice. He never hatefully condemened them or tried very hard to change their minds. One either had ears to hear and eyes to see, or they didn't. He didn't seem to have a personal or ego vested interest in being perceived as right. Some other people do.

    Forgiveness without predjudice, I guess, is everything. I don't think I'm there yet. But there seems to be time for me to get there. That's a good thing.

  3. This is some story Colleen. I can certainly feel for the Downes and their decision to stay married for 54 years and to die together holding hands. The two became one in life and in death. I don't think this was a "willfully selfish act" at all. Their time was up and they moved on.

    I think it was Mother Theresa who said that death was like walking through another door. This couple wanted to walk through that door together and I think it is understandable.

    Thanks for sharing the story about your mom. I've been missing my mom lately. She died of Alzheimer's. It was so sad to see her go that way.

    I really see nothing wrong with making a decision to check out in a dignified way especially when one is ready and knows their life is essentially all over due to a terminal illness and death is inevitable anyway.

    Carl, I totally agree with your comment.

  4. Colleen, this is an important topic which needs to be discussed more openly and honestly, as you have here. We are all on the same journey, a journey to death. We should be able to think about it and discuss it without fear or embarrasment. Your mother's experience, of reaching a point of looking forward to an end, is shared by many, even without pain.

    The church's attitude, that no-one in their right mind would choose death is a classic example of the circular reasoning devoid of empirical evidence so typical of academic theologians. No-one in the right minds could make such a choice, therefore if such a choice is made, they clearly were not i their right minds. Q.E.D.

    Sound theology should be rooted in prayerful reflection on lived experience, as well as in Scripture and Magisterium. Telling our true stories about death is one way to introduce some form of rationality into the discussion.

  5. Terrence, one of the consequences of our inability or refusal to deal with the reality of death, is our lack of appreciation for our elders. Rather than honoring them for the lives they've led or the wisdom they've garnered, we have a nasty tendency to hide them away as we force them to live longer than many may want.

    My dad died at home watching a Red Wing hockey game. That was so fitting. His big fear was being forced into assisted living. I think that once he got it in his head that that might be a possibility he just decided to check out doing what he loved best--cheering on the Red Wings. Or maybe God decided it for him.

    My daughter and the other grand children just loved listening to his stories, and it didn't matter if they tended to be the same stories. It's that generational connection which is so important about families and so under sold in our culture. Families are not about procreative sex, they are about generational connections.