An assisted suicide kills more than one victim

Causing the death of an individual with an incurable illness remains a crime in Britain. Laws prosecuting those assisting in the suicide of another person were challenged by Diane Pretty, a British woman with advanced amyotrophic lateral sclerosis (Lou Gehrig's disease). She wanted to end her life with assistance from her husband. Her lawsuit sought to guarantee that her husband would not be prosecuted for helping her to die. After losing her case in England, she appealed to the European Court of Human Rights and soon became the focus of a debate about assisted dying in Europe. This appeal failed as well and Mrs. Pretty died without assistance on May 11, 2002. This article was published in the Opinion Page of USA Today on June 4, 2002. It has also been translated into Spanish and Afrikaans.

Diane Pretty, an ordinary British wife and mother of two ended her life in an ordinary way last month. According to her doctor, Ryszard Bietzk, her death was "perfectly normal, natural and peaceful". It might have been different had her request for assistance in dying been granted 13 days earlier by the European Court of Human Rights. Near the end of her difficult three-year illness, Pretty campaigned for a right to die, and lost. Reading her obituary, which was widely publicized in Europe, I could not help recall my own first encounter with assisted suicide, the issue that refuses to die.

Soon after I completed my clinical training as a cancer specialist, a colleague asked me to see a young, HIV-infected man in consultation. For a New York City hospital in 1990, the case was straightforward. He looked fit, without the marked physical wasting that can affect persons with advanced AIDS. He had developed a few thick, dime-sized purple splotches on his back and left arm, the typical skin lesions of Kaposi's sarcoma. I took his history and completed a physical examination, then began to discuss his illness. Before long, he interrupted my spiel. "Look," he said, "all I want to do is die. Can you help me?"

What? Jack Kevorkian and his "suicide machine" were in the headlines, thrusting into our collective imagination a notion that I for one had never entertained. Perhaps those stories, which I had read with detached antipathy, had induced my patient to think about ending his life. More than a decade since my first encounter with the issue of assisted suicide, it still confuses and seduces the sick and their doctors.

To the insensitive eye, my patient looked healthy, not particularly distressed or anxious. He had no pain or difficulty breathing. He was recovering and could expect to return to work. Yet he found his life unbearable, and wanted to be done with it. Perhaps others might have felt compelled, even obligated, to help him end his life. When suffering, moral or physical, is relentless and overwhelming, ending it all might seem like the merciful thing to do. But I can't help feeling that mercy of this sort is misguided.

To advocate physician-assisted suicide is to deny that human suffering has value, and to affirm that the absence of things unpleasant is a necessary condition for a life worth living. Sooner or later, each of us will experience suffering. To shrug it off or run away is to retreat into an imaginary utopia. We need to face it courageously, and try to glean its purpose. Like dark brushstrokes on life's canvas, suffering adds beauty and richness to a portrait.

Until the Renaissance, paintings had a flat, two-dimensional quality. Then, using the technique of "chiaroscuro," artists began representing their subjects' brightness and darkness in powerful new ways. Their works gained an unexpected perspective and depth that more accurately reflected reality. Suffering is to life what chiaroscuro is to painting. Both help us appreciate subtle yet important realities: truths that are easily overlooked yet provide a more accurate and realistic picture of our world.

The shadows and light of suffering offer us a chance to see ourselves as we truly are - frail, needy, too often consumed with things we own or do.Suffering may reveal life's most profound meaning. A common motive for requesting assisted suicide - and arguably, the cause of the greatest possible suffering - is loneliness: the indifference of others, the sense of not being valued or wanted, of being neither loved nor lovable. From such suffering, we learn that human beings discover their identity and dignity by loving unconditionally and experiencing unconditional love in return.

The sick and frail, the elderly and vulnerable, the disabled and terminally ill, can unleash that powerful force of unconditional love. We can give our time and energies to others for no reason other than because they are worth the trouble. The word "compassion" comes from the Latin root meaning "to suffer with." Assisted suicide kills a human being, but there is another victim. Our humanity - the capacity to suffer with the most vulnerable members of our society - dies as well.

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