"My life, my death, my choice."

June 13, 2011 5:56 AM

Terry Pratchett starts process to take his own life. Sir Terry Pratchett, the fantasy writer who was diagnosed with Alzheimer's in 2008, said yesterday he had started the formal process that could lead to his own assisted suicide at the Dignitas clinic in Switzerland. The fantasy writer Terry Pratchett says he has received consent forms requesting assisted suicide but has not yet signed them. [Previously] [Previously]
posted by Fizz (132 comments total)

I don't even know how to feel about this.

:/
posted by elizardbits at 5:58 AM on June 13, 2011 [5 favorites]

Pratchett, the creator of the Discworld novels who was 60 when he was diagnosed, said his decision to start the formal process did not necessarily mean he was going to take his own life.

Yeah, but still... damn.
posted by Splunge at 5:59 AM on June 13, 2011

Wait..he has a movie and a book to finish and then he wants to off himself? Like shit is so bad he can't go on, except to complete the monumental tasks of film making and novel writing?
posted by spicynuts at 6:00 AM on June 13, 2011

As much as a world without Pterry will sting, it's hard to deny that I'd rather go as myself than as a mere physical shell. I can't imagine how hard it is for an author to feel one's articulation and ability to think well die over time.
posted by jaduncan at 6:00 AM on June 13, 2011 [1 favorite]

I don't even know how to feel about this.

:/

A little bit of this :-) and a whole lot of :-(
posted by Fizz at 6:01 AM on June 13, 2011 [5 favorites]

.
posted by clavdivs at 6:03 AM on June 13, 2011

Wait..he has a movie and a book to finish and then he wants to off himself? Like shit is so bad he can't go on, except to complete the monumental tasks of film making and novel writing?

More like not wishing to leave the loose ends hanging, surely. I'm really, really curious about the last book - writing knowing it might be his last literary words might make it fairly philosophical.
posted by jaduncan at 6:03 AM on June 13, 2011 [1 favorite]

jaduncan: " I'm really, really curious about the last book"

possibly it's Raising Taxes ?
posted by namewithoutwords at 6:06 AM on June 13, 2011

What loose ends? Won't he still have to make the decision on go day? It's not like he will end up in a coma on life support. Or do the forms give someone else the right to say it's time for him to go? Or do you mean leaving projects unfinished? If so, my point was, if he is of sound enough body and mind to do the all consuming and intellectually rigorous work of finishing a movie and a book, he clearly should not be near to the point of needing to off himself.
posted by spicynuts at 6:08 AM on June 13, 2011

possibly it's Raising Taxes ?

That would be an appropriate title for his LAST book. As we know there are only two things that are certain.
posted by Fizz at 6:08 AM on June 13, 2011 [5 favorites]

Okay, well, need to finish that letter I've been meaning to write to him damn soon.

Going to miss him.
posted by litleozy at 6:09 AM on June 13, 2011

I'm sure at some point Neil Gaiman will be asked by enough people to weigh in on this, and when he does, it will be wise and kind and will be the words that we all wanted to be able to say, because in general that's what happens with stuff like this.

In the interim, I am glad that he has the ability to pursue this option and to decide if it's right for him. We should all be able to make such decisions about ourselves and our lives, without the state coming in and telling us that unless we die by forgetting we've left the gas on, we've done something wrong.
posted by Medieval Maven at 6:10 AM on June 13, 2011 [26 favorites]

I can't imagine how hard it is for an author to feel one's articulation and ability to think well die over time.

"It reveals an author responding to something she feels is happening but cannot do anything about," he said. "It's almost as if the crime is not the double-murder-suicide, the crime is dementia."
posted by DU at 6:10 AM on June 13, 2011 [2 favorites]

Or do you mean leaving projects unfinished? If so, my point was, if he is of sound enough body and mind to do the all consuming and intellectually rigorous work of finishing a movie and a book, he clearly should not be near to the point of needing to off himself.

I did, and I have to say that:

a) you don't know how much of the work is assisted, or just how hard it is;
b) "should not" is awfully judgmental when talking about how much pain/watching their previous personality slip away another person can bear. Maybe he just wants to go out as himself. "My life, my death, my choice", as the title of this post states.

Compassion, as several of the discworld characters might point out, is good.
posted by jaduncan at 6:11 AM on June 13, 2011 [4 favorites]

I am saddened by this news and still respect Pratchett's desire to make his wishes abundantly clear while he is able to do so and can try as hard as possible to make sure they're iron-clad. You can sign hospice admission papers before you're admitted, arrange to be an organ donor long before it's necessary, line up wills and DNRs and power-of-attorney documents while you're young, healthy, and whole. I prefer to regard Pratchett's step in this spirit of preparedness and self-determination.

And still...a tear for the thought of him gone.
posted by MonkeyToes at 6:11 AM on June 13, 2011 [5 favorites]

"if he is of sound enough body and mind to do the all consuming and intellectually rigorous work of finishing a movie and a book, he clearly should not be near to the point of needing to off himself."

It's easy to say that looking at it from our perspective, but burdens weigh differently on different shoulders. Each individual decides for themselves what they can or cannot abide. It's not for others to say that you must trudge on, that your burden is still too light to put down.
posted by oddman at 6:14 AM on June 13, 2011 [3 favorites]

If a high profile author does this for well-understood reasons, maybe the US rhetoric on this topic might change for the good.
posted by DU at 6:15 AM on June 13, 2011 [4 favorites]

Argh blast thppt dammit.
posted by Potomac Avenue at 6:23 AM on June 13, 2011 [1 favorite]

Wait..he has a movie and a book to finish and then he wants to off himself? Like shit is so bad he can't go on, except to complete the monumental tasks of film making and novel writing?

Dementia is a slow and gradual process. There will be a point beyond which he will find it impossible to work. I doubt that's the point where he will choose to off himself though. He's just preparing as best he can for that later point where, honestly, not many of us would like to imagine ourselves.
posted by londonmark at 6:26 AM on June 13, 2011 [3 favorites]

I completely support assisted suicide.

I can't imagine what sort of sticky-legal-wicket an assisted-suicide contract for an Alzheimer's victim could be. Primarily because, practically speaking, an Alzheimer's sufferer loses their ability to give informed consent long before the disease places them in such a debilitated position where suicide becomes a humane option.

In essence, such a decision would have to be put into the hands of others long in-advance, and I'm not sure how a court (or even how a legal system that allows assisted suicide) might come-down on the question.
posted by Thorzdad at 6:27 AM on June 13, 2011 [6 favorites]

I hate the thought of him leaving, but am thankful he has the option to choose to go with dignity.
posted by notashroom at 6:30 AM on June 13, 2011 [16 favorites]

if he is of sound enough body and mind to do the all consuming and intellectually rigorous work of finishing a movie and a book, he clearly should not be near to the point of needing to off himself.

If you've ever dealt with a loved-one who suffers from dementia/Alzheimer's, you will recognize how important it would be to make this sort of very important end-of-life decision far in-advance of the disease rendering you incapable of putting one's underwear on, let alone this sort of decision.
posted by Thorzdad at 6:32 AM on June 13, 2011 [17 favorites]

DON'T THINK OF IT AS DYING. JUST THINK OF IT AS LEAVING EARLY TO AVOID THE RUSH.

posted by schmod at 6:34 AM on June 13, 2011 [134 favorites]

I'll miss him. I can only hope, out of a selfish need to keep the guy alive, that he'll not kill himself until a cusp is reached.
posted by FormlessOne at 6:35 AM on June 13, 2011

My mother died from Alzheimers in 2001, which was before the US had developed an interest in palliative and hospice care. She literally starved to death in a dark room, alone, where she was kept from bothering everyone else with her screaming. Thankfully, we have better care systems in place now, but this is still a cruel and savage disease that no one -- not the patient and not the relatives, should have to go through. I applaud Pratchett's decision and hope it does make things even better for people diagnosed with this disease. My mother had it, he brother had it, and my dad's sister had it, so I am concerned. But I know that if I ever start to show the early signs of Alzheimer's, I will not show the later signs.
posted by Legomancer at 6:35 AM on June 13, 2011 [35 favorites]

As the article points out, 70% of people who sign up with Dignitas do not ultimately make the choice to die with them. If you're interested in leaving the option open, you need to complete the signup process while you actually can communicate. People with terminal conditions are well advised to do it early. He may have many years and books and movies left before his condition gets the best of him and he has to actually make the choice. He is not announcing his immediate departure by signing these papers.
posted by DarlingBri at 6:39 AM on June 13, 2011 [15 favorites]

Fuck.

I'd rather see him go when he decides to go, but a world without Terry Pratchett will be a little bit worse off. And that's quite a big little bit. I cannot but admire his stance in raising awareness about Alzheimer's and ascertaining publicly his right to determine when to die.
posted by ersatz at 6:42 AM on June 13, 2011

As the caregiver to my 105 year-old grandmother who is suffering from end-stage Alzheimers now, I'll echo Legomancer's sentiment regarding Pratchett's decision. Things are much better now, Legomancer but I know I wouldn't want to go through what Grandma's going through.
posted by buggzzee23 at 6:44 AM on June 13, 2011 [1 favorite]

I've never personally understood the cult status Pratchett's books have attained. I did try reading his Discworld novels, but they began repeating themselves early, so I stopped.

This article though - I don't know how to respond to it. As a writer myself, something about it makes me uncomfortable. I have no idea why. I don't think it's that I imagine myself being in his situation... it's weird. Also, it's 2am and I have been thesis writing all day, so maybe that's all it is.
posted by New England Cultist at 6:55 AM on June 13, 2011

If so, my point was, if he is of sound enough body and mind to do the all consuming and intellectually rigorous work of finishing a movie and a book, he clearly should not be near to the point of needing to off himself.

Is he supposed to wait until he's not of sound mind to make the decision - at which point, he won't be able (legally) to make it?

NPR did a long series over a period of years about someone who was diagnosed with Alzheimer's. It's an incredibly moving series.

I think this decision by Pratchett - to leave options open while he can - is sensible and forward-thinking. What a brave man.
posted by rtha at 7:02 AM on June 13, 2011 [2 favorites]

After watching a couple of relatives die ugly, painful deaths--even on hospice--I have become 100% pro-choice on ending one's life. We automatically assume that Pratchett plans to wait until his Alzheimer's has advanced to a certain point before he will presumably take the dignitas option.

If he decides to do it tomorrow, I support his right to make that choice.
posted by tippiedog at 7:10 AM on June 13, 2011 [14 favorites]

If a high profile author does this for well-understood reasons, maybe the US rhetoric on this topic might change for the good.

When he was in Australia recently he lobbied our Prime Minister about changing the laws. I saw him speak, and for the hour he talked he was clever and lucid and funny.

I don't want to think about a world without him in it. I respect his decision, and when he dies I hope he dies with dignity. His Death was always humane and a bit too kind for his own good, and perhaps his death will also be that graceful.

I'm not making much sense. The Discworld books have been comfort reading for me since I was a teenager, and I'm tearing up just thinking about this.
posted by Lovecraft In Brooklyn at 7:16 AM on June 13, 2011 [3 favorites]

Wait..he has a movie and a book to finish and then he wants to off himself? Like shit is so bad he can't go on, except to complete the monumental tasks of film making and novel writing?
posted by spicynuts at 2:00 PM on June 13

That isn't the way I read this at all. I think he's smart enough to know that he'd better get his Dignitas ducks in a row while he's still reasonably compos mentis. Then when he does need to pull the trigger, as it were, it should be relatively straightforward. This is exactly how I'd do it were I in his position.
posted by Decani at 7:20 AM on June 13, 2011 [3 favorites]

My brain understands but my heart cries out no.
posted by gomichild at 7:20 AM on June 13, 2011 [11 favorites]

Terry Pratchett: my case for a euthanasia tribunal

I'm so glad he has this option available to him, but will miss his writing, wit and wisdom terribly. :(
posted by zarq at 7:23 AM on June 13, 2011 [1 favorite]

I am only glad that Terry Pratchett has the wherewithal now to finish what he wishes to and to make his wishes known. One can only make hay while the sun shines. I am happy the sun is still shining on Mr. Pratchett.
posted by Sophie1 at 7:24 AM on June 13, 2011

WHAT CAN THE HARVEST HOPE FOR, IF NOT FOR THE CARE OF THE REAPER MAN?
posted by sophistrie at 7:27 AM on June 13, 2011 [34 favorites]

Note: The Guardian article was posted yesterday and Terry Pratchett: Choosing to Die will air tonight at 21:00 on BBC 2.
posted by bjrn at 7:30 AM on June 13, 2011

My dad had Alzheimer's, but my mom didn't... so who knows what my chances are. As a creative person, my biggest nightmare would be to be that sort of living death -- unable to paint, write, play music, and not even knowing I had ever done those things. If I am ever faced with this decision it will be very simple for me to choose death, and I'll be able to make that choice with joy. I certainly don't want to die, but by God I want to be conscious and aware when I have that experience. God bless Terry Pratchett. I know precisely how he feels and I back him 100%.
posted by Guy_Inamonkeysuit at 7:31 AM on June 13, 2011 [2 favorites]

I'll miss him. But I'm glad he gets to go as he wants, when he wants, and that he's spent so much of his last years fighting for people who aren't was wealthy as he to have those same rights.
posted by sotonohito at 7:35 AM on June 13, 2011 [2 favorites]

It's a shame Pratchett isn't more popular in the US. Not just for the obvious reasons, but also because this is a conversation America really needs to have, and a major celebrity choosing to die is the best way I can see that happening.
posted by skymt at 7:36 AM on June 13, 2011 [3 favorites]

Here's a Frontline episode which details an assisted suicide at Dignitas.
posted by anthropoid at 7:42 AM on June 13, 2011

Over five years, I watched my grandmother slowly lose her personality and mind. The last time I saw her before she died last year, she was an empty shell who didn't speak or even react to anything I said. Early in the process, while she was still lucid enough to realize what was happening, we had a long talk about death and dying. She had been working for a year to get all her affairs in order, and she told me she was ready to die. She said that she was fully aware of what her fate was likely to be, and that she didn't want to end up like some vegetable but didn't think she really had a choice. As I visited her in her hospice bed, comfortable enough but definitely not aware of my presence, I really wished that she would have had a choice, much as I railed against it at the time when she brought it up.

Good for Pterry, is all. I'm glad he has a choice, much as I don't want him to go either.
posted by gemmy at 7:42 AM on June 13, 2011 [4 favorites]

I'm not even a bit ambiguous about the larger issue here -- choosing how we die seems to me to be such an obvious right that it constantly shocks me that anyone could ever have the gall to intervene -- but I am so, so very conflicted about this instance. Pterry is ... a treasure. Losing him will be a blow to literary humour.

>

(., shifted)
posted by ChrisR at 8:11 AM on June 13, 2011

I know it's not happening yet, but I'm really sad.

Welp. I hope it's a fine adventure, Sir Terry. I know you'll meet it well.
posted by gc at 8:12 AM on June 13, 2011

What a sad fate.

I am not a Terry Pratchett fan, maybe that is why I focus more on the message. As I see it, the assisted suicide people are trying to control what we cannot control. Death is frightening, sad, ugly and painful. Assisted suicide may take out the pain, but the fear, sadness and ugliness remain the same. Pain is a strangely relative thing, and to a large extent, we can control it's effects. (Please don't start comparing palliative care with assisted suicide, if it seems like the same thing, it's done wrong. Obviously, a terminally ill patient can be treated with higher doses of morphine than an injured football player. Your loved person is not dying from an overdose).

People die alone, in pain, in hospitals. Or in hospitals tied up with tubes and surrounded by stressed out staff, noise and bright lights along with scared family. Or scared and alone in nursing homes or small apartments. Those are all horrible fates. But is the solution to that problem really assisted suicide?

The nun study may point to some other ways of dealing with dementia. (The spiritual stuff is not for me, but each to her own).
Googling, I found this article on assisted suicide. It raises some relevant questions.

On a more personal note: my grandfather was one of those who died in a horrible, painful way ten years ago. I suppose that was the zenith of inhuman treatment of terminally ill patients. But even though he had insisted all his life that he would prefer suicide to [what eventually happened to him], and he had the means to end it, he didn't. He struggled till the last moment, while we all fought the doctors to get them to help him with the pain. For me, that was a lesson in many ways: we may have all sorts of ideas about death, but we have no idea how we will actually cope with it. Death, even death alone in a room, is part of your life. Preparing for death is maybe not so much about grand plans and Swiss clinics, as it is making sure you have lived in a way that someone can be there for you when you need them. (Even back then, my grandfather could have had far better care if he had shared his diagnosis with the rest of us, even my grandmother didn't know the facts). And finally, doctors and nurses are human beings. They are far from perfect. I would never entrust my death with someone outside my family.

As a family, we learnt from that experience, and we have lost family members and been through some near-misses since then. It can be done very differently.
posted by mumimor at 8:34 AM on June 13, 2011 [5 favorites]

However, whenever you go: godspeed, Terry.

and now I will retreat to the corner for a cry
posted by ArmyOfKittens at 8:37 AM on June 13, 2011 [2 favorites]

One man's opinion: People that seek out assisted suicide are by definition insane. This is why suicide is technically against the law -- to protect people from themselves.

We can't ever know what's happening inside the brain of someone in the advanced stages of Alzheimer's, but we can tell when higher brainwave functions are happening. Perhaps there is a chance we dream?

Godspeed, Mr. Pratchett. Your decision is yours. But if it were up to me...
posted by Cool Papa Bell at 8:39 AM on June 13, 2011 [1 favorite]

Is he supposed to wait until he's not of sound mind to make the decision - at which point, he won't be able (legally) to make it?

This is exactly the question I was asking in the last sentence of my comment. Are these papers giving someone else the authority to make the decision, based on instructions he writes while he's still lucid?
posted by spicynuts at 8:40 AM on June 13, 2011

One man's opinion: People that seek out assisted suicide are by definition insane

One man's insanity is another's clear-minded, thoughtful, painful, self-determination.
posted by elizardbits at 8:46 AM on June 13, 2011 [31 favorites]

I hope he doesn't forget to fill out the paperwork. That would be my worry.
posted by Eideteker at 8:46 AM on June 13, 2011

mumimor: Preparing for death is maybe not so much about grand plans and Swiss clinics, as it is making sure you have lived in a way that someone can be there for you when you need them.

I'm glad your life is constructed in such a way that you think this will work out not only for you, but for everybody else, too. My husband and I are 39 years old. We have no children. We will not have any children. Even if we had them, that doesn't guarantee anything: I live an ocean apart from mine, and he lives an ocean apart from his. We will care for each other in our old age, but one of us will be left standing, and realistically standing alone.

Painful, isolated, lingering deaths are not a punishment for people who failed to live lives made joyous by near family bonds and deep lifelong friendships. If I am diagnosed with a terminal disease that ends in a way I find unacceptable, I am on a plane to Switzerland. I am not entrusting my care and dignity to strangers in a choice of broken healthcare systems when I can no longer advocate for myself. Not happening.
posted by DarlingBri at 8:49 AM on June 13, 2011 [48 favorites]

Terry Pratchett argued for the legalisation of assisted suicide in the UK back in Feb 2010 at the Richard Dimbleby lecture. It's 48 minutes long, but it's definitely worth watching the whole thing. Due to the effects of his disease, he asked Tony Robinson to speak his words for him, but it's no less powerful.
posted by ArkhanJG at 8:49 AM on June 13, 2011

I guess at some point you reach the end of cake.
posted by The Whelk at 8:58 AM on June 13, 2011

Note, the video above is the same lecture that zarq linked to the text of in the guardian.
posted by ArkhanJG at 8:59 AM on June 13, 2011

Alzheimer's is tragic for everyone involved. The victim becomes a walking memorial to themselves, reminding people of their better days, and offering an ever-decreasing hope that you'll see them when they're lucid and their memories are intact. Once the sadness of the loss isn't as prominent, people around the victim can feel a lot of other things - if a family member takes on the primary caretaker role, they can feel resentment that they are shouldering all this burden, not that they get to spend more time with a person who is slipping from reality. Visiting family and friends go on little walks, talking and hoping for a moment of the person they knew, cutting their visits short when it's clear that their friend is gone. Such visits can feel like an obligation instead of valued time together.

The scariest thing I've see related to Alzheimer's is the comparison of a healthy brain and the brain of a person with Alzheimer's Disease. According to the current Wikipedia summary, life expectancy with Alzheimer's is 7 years. 10 years is great. 14 years is amazing. But life at those extremes? It's not for me, and I don't wish it on anyone.
posted by filthy light thief at 8:59 AM on June 13, 2011 [1 favorite]

I'm glad your life is constructed in such a way that you think this will work out not only for you, but for everybody else, too.

Darlingbri, I certainly hear what you say, and I was worried about that as I wrote the comment. Some of my elderly friends who are in similar situations to yours have organized themselves against it. For me, that would be a better solution. But obviously, I respect your choice.

However, my point was more that somehow, we have arranged our society in a manner that is not good for us. I'm not advocating a revolution. More just wondering how we look for solutions to the problems we have created for ourselves.
posted by mumimor at 9:01 AM on June 13, 2011 [2 favorites]

As someone who has seen two grandparents die of Alzheimer's, and is currently helping with a father suffering from the late stages of the early-onset version of the disease, I'm with him 100%. I hope I have a similar option if I ever need it.
posted by Johnny Karma at 9:03 AM on June 13, 2011 [3 favorites]

WHAT CAN THE HARVEST HOPE FOR, IF NOT FOR THE CARE OF THE REAPER MAN?

And... now I'm crying. Fuck.
posted by kmz at 9:09 AM on June 13, 2011 [3 favorites]

Pratchett is my favorite writer. There is something about the philosophy on life, treating other people, and looking at the world that he has interwoven into his stories that has really resonated with me in a way I can best describe as both life changing and life affirming in a way that I haven't found in any other authors.

His leaving is going to hurt me in a way I suspect that I haven't felt before, so in order to deal with the heartbreaking lump in my throat that the very idea of this is giving me, I'm going to choose to believe that "starting the formal process" involves him turning to a hooded figure, saying "I'll let you know..." and getting the response,

WHENEVER YOU ARE READY, SIR.
posted by quin at 9:14 AM on June 13, 2011 [25 favorites]

Preparing for death is maybe not so much about grand plans and Swiss clinics, as it is making sure you have lived in a way that someone can be there for you when you need them.

Right. It can mean having a daughter who knows your mind, and is strong enough to follow your wishes. It also means having a doctor understanding enough to leave a syringe and the medicine cabinet in youir room unlocked. In addition, both of these people have to be willing to face criminal charges. Maybe this is not such a great way to run a railroad.
posted by bonehead at 9:16 AM on June 13, 2011 [9 favorites]

I have never met him and don't know him at all.

However, I am so damn proud of Terry Pratchett.

How many of us have the courage of our convictions? Really, at the end, doesn't desperation and fear destroy so many of us? Choosing to exit at the time that's right - that's brave. Hanging on until there's nothing left - that's just so much easier. Clinging on until you can't make the decision - that's the pure definition of horror to me.
posted by Hugh Routley at 9:17 AM on June 13, 2011 [1 favorite]

People that seek out assisted suicide are by definition insane.

By whose definition? Yours? You're saying that suicide is never rational, and can never be rational? I disagree. Yours opinion, therefore, requires you to declare me insane as well, for believing that suicide can be a rational and reasonable choice for a sane person, and I don't think you can support that.

I realize it's one man's opinion, but if it's yours, you might want to really reconsider it. No opinion can be wrong, but that one is definitely dumb.
posted by rusty at 9:17 AM on June 13, 2011 [12 favorites]

I don't think I've ever read any of his books, but I am always encouraged for the health of society when someone high-profile and well-loved makes a rational statement about taking control of the end of their life.

In addition to the Pratchett video above, there is How to Die in Oregon, which I don't think I've seen linked around here: review in Salon, page at Sundance website, review in the NYTimes, and the film's own site.
posted by crush-onastick at 9:17 AM on June 13, 2011 [2 favorites]

If a high profile author does this for well-understood reasons, maybe the US rhetoric on this topic might change for the good.

I'm with you, but I'm not holding my breath.

A Good Death (PDF) by William Vollmann (Nov. '10 Harper's).
posted by mrgrimm at 9:20 AM on June 13, 2011 [1 favorite]

As an aside, people maybe should not kill themselves just because their losing whatever made them special. Instead, the medical profession should attempt to define objective standards that apply across the board.
posted by jeffburdges at 9:29 AM on June 13, 2011

People that seek out assisted suicide are by definition insane.

We're free to define words however we want.
posted by John Cohen at 9:31 AM on June 13, 2011 [6 favorites]

I've really read almost no Pratchett but I was deeply moved by this.

> One man's opinion: People that seek out assisted suicide are by definition insane.

Um, as a grammarian and a logician, I would say that you should not be making claims about a definition in a statement of opinion. The definition of suicide says nothing about insanity; the definition of insanity says nothing about suicide.

Numerous cultures throughout the world and history have considered suicide under certain circumstances a perfectly acceptable and noble act.

In fact, I'd say that seeking assisted suicide is the very essence of sanity. Someone believes that it's their time to die, so they get professional help, knowing that they are already impaired. Right on!

Statistics are very clear that most people who investigate start the process of assisted suicide do not go through with it - because they are counseled out of it, often, but often just because knowing that the option is there is very reassuring - "I won't have to deal with more pain than I can bear," or "I won't become a drooling vegetable."

> Instead, the medical profession should attempt to define objective standards that apply across the board.

"I'm sorry, you're not in enough pain for us to allow you to kill yourself, and we wish we could give you more pain medication, but you don't want to be an addict, do you?"

Why can't doctors instead attempt to set some standards for "informed consent" and then simply let competent people decide for themselves? It is after all their death, not the doctors'.

I'm the one that's gonna have to die
When it's time for me to die
So let me live my life the way I want to.

posted by lupus_yonderboy at 9:43 AM on June 13, 2011 [3 favorites]

Oh, and here's a

. . .

for Sir Terry (the dots signifying his ongoing transition to a post-life state).
posted by lupus_yonderboy at 9:47 AM on June 13, 2011

Awwwwwww, crap. Now I am getting misty-eyed too.

This makes me think of a few years back when a very good friend passed away due to throat cancer, and did it with amazing style and grace. It seemed he held on long enough for everyone to say goodbye.

I also know this disease terrifies me as I am physically rather unimpressive, with all kinds of joint issues and RSI and hypertension and not terribly co-ordinated, and have always prized the relative functionality of my brain. The loss of that function scares me more than the loss of limbs.

The day Pterry passes on, by his choice or not, a little bit of joy will pass from the world and that is wrong. There's not enough out there any more.

And, FWIW, I am afraid I would follow his path if I had the choice in his situation.
posted by Samizdata at 9:48 AM on June 13, 2011

"the assisted suicide people are trying to control what we cannot control"

people should have the right to die when and how they choose, without consideration for anyone else's moral qualms about it.

knowledge of our own inevitable mortality is a fundamental part of the human experience, and the ability to have complete control over that element of our human experience is something all able-bodied/ healthy people with resources *already have*. a dignified death remains the preserve of the privileged.

it is only the projection of our own collective societal guilt and unease with death, which prevents us from allowing people with disabilities or illnesses from access to the same.
posted by wayward vagabond at 9:54 AM on June 13, 2011 [4 favorites]

People that seek out assisted suicide are by definition insane.

Interesting. I've heard the argument that people who kill themselves in more traditional, unassisted suicides are by definition not of sound mind, and the argument that the remedy for this is better mental healthcare. I don't agree with this but can see the logic: if you are profoundly depressed or traumatised, modern solutions like medication and therapy, applied well, in abundance and with compassion can vastly improve quality of life for a significant percentage of people who are suffering.

I'm not following the argument for people who have terminal illnesses, however. If you're already getting the best palliative relief and therapeutic support the world can offer, things have no hope of getting better and will in fact only get worse, how is opting out of that by definition not sane?

Pratchett has been consistent, articulate and public in his views. Nothing I have read indicates that he is not of sound mind except, using your reasoning, that he wishes to choose his own death. That's some inherently flawed and extremely dangerous logic there.
posted by DarlingBri at 9:56 AM on June 13, 2011 [7 favorites]

We can't ever know what's happening inside the brain of someone in the advanced stages of Alzheimer's, but we can tell when higher brainwave functions are happening. Perhaps there is a chance we dream?

We can tell when higher brain functions are not happening. Try wikipedia on Alzheimer's. It will show you pictures comparing healthy brains and brains affected by AD. "Gross atrophy" is what those pictures show -- shrunken, withered brains. Parts of the brain that are gone do not have higher brain functions. For added fun, PET scans show less activity in the brain tissue that is left. Patients with advanced AD do not dream. Their higher brainwave functions are gone. If our thoughts and memories make us who we are, the person is gone. AD is gradual death, and a point comes where we must say that the person is dead, no longer to be found in the walking body that remains.


People that seek out assisted suicide are by definition insane.

You're saying that the continued breathing of the body trumps anything else we value. That's rather sad.
posted by justsomebodythatyouusedtoknow at 9:57 AM on June 13, 2011 [18 favorites]

One man's opinion: People that seek out assisted suicide are by definition insane.

Terry Pratchett himself tackles this at about 25 minutes in on the Dimbleby Lecture.

"...and I remember that coroners never used the word "insanity". They preferred the more compassionate ­verdict that the subject had "taken his life while the balance of his mind was disturbed". There was ambivalence to the phrase, a suggestion of the winds of fate and overwhelming circumstance.

In fact, by now, I have reached the ­conclusion that a person may make a decision to die because the balance of their mind is level, realistic, pragmatic, stoic and sharp. And that is why I dislike the term "assisted suicide" applied to the carefully thought-out and weighed-up process of having one's life ended by gentle medical means.

The people who thus far have made the harrowing trip to Dignitas in Switzerland to die seemed to me to be very firm and methodical of purpose, with a clear prima-face case for wanting their death to be on their own terms. In short, their minds may well be in better balance than the world around them."
posted by ArkhanJG at 10:06 AM on June 13, 2011 [8 favorites]

if you are profoundly depressed or traumatised, modern solutions like medication and therapy, applied well, in abundance and with compassion can vastly improve quality of life for a significant percentage of people who are suffering.

A significant percentage -- what about those for whom medication and threapy do not provide relief? True, depression can make a person think there is no hope when in fact there is hope. However, some people who are mentally ill (severe, untreatable depression) commit suicide for perfectly rational reasons, having made an accurate assessment of their future quality of life. Such a person is in a position similar to a person who chooses Dignitas to escape chronic, incurable physical pain.

The problem is that neither they nor we can know with certainty whether recovery really was impossible. There's no blood test for mental illness. We can't be absolutely sure there was no hope. That's why suicide by the depressed always feels wrong, even when it might have been right.
posted by justsomebodythatyouusedtoknow at 10:09 AM on June 13, 2011 [1 favorite]

Is it suicide when the other option is also a death? Seems more like ordering soup instead of salad, but you still have to eat the sandwich.
posted by TwelveTwo at 10:10 AM on June 13, 2011 [13 favorites]

"Assisted Suicide" happens all the time, as it is. My maternal grandparents were both given mercy doses when the time came, and my mother's insisted the same be arranged for her. Legalised euthanasia could have helped my dad go with much less pain, too, and more on his own terms, rather than choking on stomach cancer juice. What would legalization accomplish? Removing the stigma, and allowing medical professionals and families a chance to talk about it all openly. This isn't Futurama-style suicide booths here.

Thinking this "insane" suggests more that you haven't been in situations that would've shown you how sane it really could be.
posted by jtron at 10:19 AM on June 13, 2011 [8 favorites]

People that seek out assisted suicide are by definition insane.

This strikes me as needlessly rigid, not to mention naive. Sometimes suicide is irrational; sometimes it isn't. I guess if thinking this way gives you some comfort (and illusion of control), and you're not in a position to make policy, well, okay. But it doesn't display much thoughfulness or appreciation for the subtlety and complexity of how humans are in the real world.
posted by rtha at 10:21 AM on June 13, 2011 [1 favorite]

if you are profoundly depressed or traumatised, modern solutions like medication and therapy, applied well, in abundance and with compassion can vastly improve quality of life for a significant percentage of people who are suffering.

Not always. I know many people who have been on the counseling-and-medication road for years. For the most part, their depression isn't any better. It's just the meds keeping them just-numb-enough to function. But they're certainly not better.

And access to such measures is highly dependent on one's ability to either afford the treatment out-of-pocket, or afford the insurance and co-pays (if your insurance will actually pay for the level and duration of treatment you might require. Many policies restrict you to a limit number of visits to a counselor, and will not pay for open-ended meetings with a psychologist or psychiatrist.)
posted by Thorzdad at 10:26 AM on June 13, 2011 [1 favorite]

Some of the discussion here is starting from a place that assumes that naturally suicide is the worst of all options in all cases, that there's no such thing as a good death, and thus that the social acceptance of suicide is pathological. That may be a moral stance one can take, but there's nothing objective to it, and its not a stance shared by everyone; and I don't just mean that there's a small minority of secular humanist liberals fighting for euthanasia, but that outside of Western-Abramamic culture (i.e., Jewish/Xian/Islamic, all of which have strong prohibitions on suicide), suicide may not be assumed a priori to be a bad thing.

(there's a whole history to be written about how early anthropological literature on "primitive" cultures' death-related practices were used to support their status as "uncivilized" and justify their colonization)
posted by LMGM at 10:26 AM on June 13, 2011 [3 favorites]

Relevant reading link.

I feel for the guy, since dementia tends to be how my relatives die. We all circle the drain for a decade or so. It's torture to watch, and I don't want to do it myself even if I won't have any family when the time comes, which is likely.

The real kicker here though is picking what time to die at. You want to enjoy as much of life while you still can, while still taking yourself out while you still have the ability to choose to do it. That strikes me as a very slippery slope to worry about every single day: how much longer can I stay before I can't choose any longer and the worst happens to me and my loved ones? I wish him well in making that decision, I don't know how the hell I'll make it when I have to.

Terry can afford to do this in Switzerland and not have to worry about how to do it to himself or have his family get arrested. And in America, well...I guess at least there's Oregon.
posted by jenfullmoon at 10:32 AM on June 13, 2011

He aten't dead yet, and I'll be glad for every day that he aten't.
posted by Fleebnork at 10:37 AM on June 13, 2011 [1 favorite]

One way I think about the decision , and this is not to trivialize it, but it's a bit like deciding when to leave the bar or a party for the night. You've had a good time, and there still might be fun to be had, but you're tired and tipsy and if you stay longer there's a good chance of it becoming decidedly un-fun. Best to leave before you start puking everywhere or start ranting drunkenly or falling into a depressed boozy stupor.

And besides, everyone has to leave eventually. Better to do it on your own terms rather than get kicked out and have to take an onerous way home.
posted by jtron at 10:40 AM on June 13, 2011 [9 favorites]

knowledge of our own inevitable mortality is a fundamental part of the human experience, and the ability to have complete control over that element of our human experience is something all able-bodied/ healthy people with resources *already have*. a dignified death remains the preserve of the privileged.

it is only the projection of our own collective societal guilt and unease with death, which prevents us from allowing people with disabilities or illnesses from access to the same.

I'd say it is exactly opposite: it is our collective unease with death that leads us to wish we could get over it already, and not distress ourselves or others with all the ugliness of dying.
Able-bodied /healthy people who commit suicide are usually seen as mentally ill.

This has a lot to do with how health-care deals with dying Atul Gawande's famous article outlines the very real issues here. Even if the situation in Europe, including the UK is not as bad as in the US, one has to be very strong as an individual to be allowed to die. Hospitals have strong legal and political reasons for treating people far beyond reason. I can understand how that leads to the idea of assisted suicide.
posted by mumimor at 10:44 AM on June 13, 2011

Terry won't be leaving us quite yet. He's scheduled to appear later this summer at the North American Discworld Convention in Madison, Wi.
posted by Captain Ligntning at 10:51 AM on June 13, 2011 [1 favorite]

I wish he wouldn't, though wishes aren't really the operative thing here. On one hand, I understand there are certain things that if taken from me or inflicted on me I might well want to respond by dying. On the other hand, control is a pretty fleeting thing anyway, and in general we live the given life, and not the planned, and I don't know that personal dissolution by Alzheimer's should be regarded as so terrible as to make personal dissolution by death a better choice.
posted by weston at 10:52 AM on June 13, 2011

As an aside, people maybe should not kill themselves just because their losing whatever made them special. Instead, the medical profession should attempt to define objective standards that apply across the board.

As an aside, people maybe should stop telling other people what they should do to their own bodies.

"the assisted suicide people are trying to control what we cannot control"

Ridiculous. People have been "controlling what we cannot control" forever. The simplest way (and one of the most painful) is to stop eating and drinking.

A lotta religion in here ...

I don't know that personal dissolution by Alzheimer's should be regarded as so terrible as to make personal dissolution by death a better choice.

You don't, but it's not your choice to make.
posted by mrgrimm at 10:54 AM on June 13, 2011 [6 favorites]

Suicide is everyone's right.
posted by Captain Ligntning at 10:56 AM on June 13, 2011 [9 favorites]

My selfish-bastard side wants him to go on writing books forever--literally--but even my selfish-bastard side isn't enough of a selfish bastard to want to impose the pain and misery onto any random person of feeling parts of themselves slip away, let alone someone who has brought so much joy and comfort to me and so many others.

I hope that he gets to die with his sword in his hand.
posted by Halloween Jack at 10:58 AM on June 13, 2011 [3 favorites]

Hospitals have strong legal and political reasons for treating people far beyond reason.

If they have "strong...reasons" then they're not "beyond reason".

I hope that he gets to die with his sword in his hand.

Say, you know what swords are good for...
posted by The Tensor at 11:09 AM on June 13, 2011

Two sets of reason...
If a hospital gets considerably more money from "trying to save a life" than for helping the terminal patient and his/her family with the best possible palliative treatment, that is reasonable from an economic point of view. But hardly from a medical/health point of view.

Since dying is difficult, these situations are difficult each and every time. There is no standard procedure. Part of my grandfather's problem was that he refused to accept he was dying. He insisted on a medical procedure that was both useless and painful. Lots and lots of patients go through this in their last weeks and days.
Even though my grandfather had planned for suicide, it didn't at all seem relevant for him at that hour. He was alive - he wanted his life saved, not ended. But the hospital could have done differently. They could have told the truth - to him and to us, and they could have given him the appropriate treatment, rather than the one he wanted. But that would have meant no specialists, no expensive procedures, no hospital bed. Just help and care at home.

There is an equivalent example in the Gawande essay. Very sad.
posted by mumimor at 11:25 AM on June 13, 2011

Actually, my grandmother claims she heard the doctors saying: "We need to keep our cash-cow alive". Always take what she says with a grain of salt, though...
posted by mumimor at 11:28 AM on June 13, 2011

First, trying to extrapolate from the for-profit US system to a not-for-profit system like the NHS says more about misplaced incentives and bad economic signaling in your particular system. That line of thinking isn't very transferrable to OECD contries outside the US.

Secondly, just because your grandfather rejected his option, as was his right, doesn't imply that others won't. And the the families of those who would prefer that we don't treat our dying less humanely than we treat our pets aren't forced into the choice of honouring a loved one's request at the potential cost of going to jail. And further, that the health care professionals aren't forced to cover-up for them.
posted by bonehead at 11:40 AM on June 13, 2011 [2 favorites]

The day Pterry passes on, by his choice or not, a little bit of joy will pass from the world and that is wrong. There's not enough out there any more.

I have to say that I don't agree with much of this. If there's one thing that the character of Death makes absolutely, unmistakably clear, it is that a world without Terry Pratchett is inevitable, as is a world without you, or without me. It's not wrong, or right. THERE IS NO JUSTICE. THERE'S JUST ME.

What he has been able to do, though, is to provide an art that will survive his mortality. His work won't go away when he does. The world keeps going, and other people add to the chain of human experience. There's not going to be less joy. There's just going to be different joys, and different sadness.

I'll mourn his passing too, when he goes; there are very few authors who have had such an impact on me as he has. But the world is not crumbling to dust just because we are. We would do better, I think, to celebrate each other while we can and as best we can, and to remember that new joys are always available for those who care to look. For example, in the mid-90s, there is a slightly-torn book wedged between huge tomes in the fantasy section of a Mumbai bookseller's. It has a very busy and weird cover of scythes and horses, and it says "MORT" on the front. Intrigued by this pune, or play on words, I take it down off the shelf and begin to read. New joys happen all the time.
posted by Errant at 11:46 AM on June 13, 2011 [15 favorites]

First, trying to extrapolate from the for-profit US system to a not-for-profit system like the NHS says more about misplaced incentives and bad economic signaling in your particular system. That line of thinking isn't very transferrable to OECD contries outside the US.

Secondly, just because your grandfather rejected his option, as was his right, doesn't imply that others won't. And the the families of those who would prefer that we don't treat our dying less humanely than we treat our pets aren't forced into the choice of honouring a loved one's request at the potential cost of going to jail. And further, that the health care professionals aren't forced to cover-up for them.

First: I live in a country with a public health system. To imagine economy does not play a role in the management of our hospitals is optimistic or naïve. Whatever you want.

Second: I am not among those who believe we treat our pets "humanely". Killing someone who has no rights and no language fits poorly with my understanding of the word humane.

I have no definite opinion on this issue. Rather, I am trying to express a position of doubt. Of accepting the experience of unpredictability and lack of control we have in certain situations. Not for religious reasons (I am an atheist). For humane reasons.

Everyone should have access to end of life counseling and palliative care if needed. And no one should die alone in a hospital room. But could we please start fulfilling that goal (and there are many, many miles to go) before jumping to the next conclusion?
posted by mumimor at 11:56 AM on June 13, 2011

As long as he doesn't lunk himself in front of a tube train on a Friday afternoon he's cool with me.

I've not read any of his books, but anecdotally I can report that no-one makes as many other people laugh out loud in public as he does. On buses, in coffee shops, on park benches, etc. What a marvellous gift to relay. I don't really care if he's repetitive or overly prolific, really. I suspect that the world will be a little less joyous without him. A very bad thing.
posted by tigrefacile at 12:17 PM on June 13, 2011

What would legalization accomplish? Removing the stigma, and allowing medical professionals and families a chance to talk about it all openly. This isn't Futurama-style suicide booths here.

OTOH, in the US context I still don't think I can trust Humana or Blue Cross or any other American health insurance company when "Give the patient a single dose of an inexpensive drug" is in their bag of tricks as a potential solution to so many chronic and/or expensive medical problems.

Because they are nasty, nasty fuckers, they are the enemy, and it would not surprise me in the least to see coverage for palliative care or other expensive care for (mostly) old people to quietly disappear or functionally disappear. Oh, yes, we cover hospice care, but at this facility here that happens to be all booked up! What a coincidence. Oh, of course we cover hospital care for terminal conditions, but stays longer than 5 days require approval using this special form that's guarded by a pack of velociraptors.
posted by ROU_Xenophobe at 12:25 PM on June 13, 2011 [4 favorites]

Is it suicide when the other option is also a death? Seems more like ordering soup instead of salad, but you still have to eat the sandwich.


This really made me laugh in an otherwise serious and heart-wrenching discussion. Thanks.

PS: I can't even begin to say how much I love Discworld and how big a part of my adolescence they were (Mort, Soul Music, Guards! Guards!...). They shaped the kind of books I read, my sense of humour, a love of the absurd and fantasy. I'm glad that Pratchett is doing this, and that by the time I'm looking Death in the face it's an option. My husband spent a long time caring for his Grandmother who has Alzheimer's, and has already said that I'm to shoot him if ends up with Alzheimer's. I'm hoping there be an option that doesn't end with bloodstains on the carpet.
posted by NoiselessPenguin at 12:33 PM on June 13, 2011 [1 favorite]

I'm hoping there be an option that doesn't end with bloodstains on the carpet.

[Mouseover for spoilers.]

Knowing this makes me happy, as if I'm ever in a tragically similar situation, I'd like to be aware that I have painless, effective, easy-to-obtain, non-horrific methods available if I ever decide that I need them.
posted by quin at 12:59 PM on June 13, 2011 [2 favorites]

weston: "I don't know that personal dissolution by Alzheimer's should be regarded as so terrible as to make personal dissolution by death a better choice"

Someone with advanced enough Alzheimer's isn't *in* there anymore; the person they were is effectively dead already. Before they quite reach that point, they are continually frightened with no ability to understand the fear. They may become combative, malicious, or desperate enough to injure the people around them in their fear. They do not recognize their loved ones or their surroundings; everything is strange and terrifying.

Eventually, a person with Alzheimer's becomes a huge drain on the people around them. They need 24/7 supervision--a lot of them don't sleep well, and so you need to be constantly alert for them to wake up in the middle of the night and try to wander off. They need to be diapered. They need to be medicated, led from place to place (if they still walk), fed, and bathed manually. These needs are expensive, difficult, stressful, and misery-inducing for the people who loved them and now have a constant reminder that their loved one is gone, but lingers.

I don't think anyone should have to go through that. If I were diagnosed with progressive dementia, I would damn well find a way to stop my life before it reached the stage of constant fear, much less the walking meaty shell stage.
posted by galadriel at 1:03 PM on June 13, 2011 [11 favorites]

Let me add this: If you are around an advanced Alzheimer's patient for a few minutes, you will *hope* the person is not in there anymore.
posted by Legomancer at 1:08 PM on June 13, 2011 [4 favorites]

The first time that I read anything by Pratchett was Good Omens, the joint effort with Gaiman. The past few years I have watched the various Discworld movies and animations and they helped get me through chemo with a smile some years back . I'll probably start on the Discworld books at some point even though I usually don't read that genre.

It's rotten bad luck that Mr. Pratchett has been struck down but we all pass away. Looking over Mr. Pratchett's life and his works how can you not feel joy for the man and what he brought to the world? We tend to focus on how a person dies but perhaps we should just remember how they lived. Pratchett lived well.
posted by Poet_Lariat at 1:20 PM on June 13, 2011

This is ....not unexpected. But painful nonetheless. 4 weeks ago I struggled to make the same decision for myself, because the conditions of my disease made me believe that I no longer had the quality of life necessary to keep on living. I ultimately chose to section myself rather than do anything rash and after a hospitalization and outpatient program which studiously avoided the mention of death or suicide I don't really know how to respond to this. I'm currently conditioned to put my fingers in my ears at the mention of "triggering" ideas, but on the other hand, this is Pterry, man. I don't really want to live in a world without him and his wit, but do I really want to live in a world where his self and wit have withered away yet we force his body to live without dignity? I feel like all the nuance in this issue has been stripped away by too much group therapy. Yes, this is a conversation we in america desperately need to have.
posted by Biblio at 1:29 PM on June 13, 2011 [1 favorite]

I just hope that Sir Terry knows, when he goes, how much joy he afforded people who have read and enjoyed his books over the years. And I wish him gods-speed and no suffering.
posted by Lynsey at 1:29 PM on June 13, 2011 [1 favorite]

Poet_Lariat: I'll probably start on the Discworld books at some point even though I usually don't read that genre.

The Discworld books are a genre unto themselves.

And, as a note both for you, and for the person upthread who said that he/she started the Discworld series, but found they got boring and repetitive, Pterry is one of the only authors I've ever read whose books got better and better as they went on, to the point where reading one of his more current novels--and by "current" I mean, say, the last 10-15 years--as compared to his earlier works, is almost like reading two entirely different series. I suggest starting with Small Gods.
posted by tzikeh at 1:37 PM on June 13, 2011 [1 favorite]

Hugo Claus, one of Belgium's foremost writers, died by euthanasia in 2008. He found the loss of his command of language due to Alzheimer's to be unbearable.
posted by LVdB at 1:40 PM on June 13, 2011

I suggest starting with Small Gods.

This is an excellent recommendation, writing-wise, it sits a bit later in the series, after he really found his voice, and story-wise, it exists a couple of decades earlier in the world than the rest of the books, so there are no characters that you are reading out of order, (excepting Death, who is timeless.)

It also has some wonderfully poignant messages about religion, treating each other with kindness, and the importance of being nice to tortoises.

It's a perfect introduction to the series, and the one I typically give to people who I want to addict to Pratchett.
posted by quin at 1:50 PM on June 13, 2011 [3 favorites]

My last comment was a joke, and is now the most favorited thing that I've written on this site. I feel rather bad about this, so a serious comment:

We need to stop labeling these cases as "assisted suicide."

These are cases where the disease has no known treatment, and absolutely zero chance of recovery. Their deaths will be slow, and painful by almost every objective definition of the word.

Choosing to die once the disease has made your life literally unbearable should always be an option. It lifts the burden on families, and also reduces strain on our hospitals, so that resources can be devoted to treating patients who have better odds of recovery.

DNRs have been around for quite some time, and I don't see them referred to as "suicide." This should be no different.

The world will be a lesser place without Terry. However, this is most assuredly his decision to make.
posted by schmod at 2:01 PM on June 13, 2011 [5 favorites]

Mort is rather fun and the first novel where Pratchett really comes into his own. The first two are fun and inventive, but pastiche-y fantasy romps, Equal Rites is good, but Mort is ... well. It's a great story about growing up, death, Death, finding yourself, fighting the inevitable, accepting the inevitable, and it has a flying horse called Binky.

Small Gods is excellent, but slightly less comedic and more thoughtful. Nonetheless, it's still one of the standouts of the series, as it's superbly comedic and superbly thoughtful.
posted by NoiselessPenguin at 2:03 PM on June 13, 2011 [1 favorite]

I started Terry Pratchett with Equal Rites - which as a somewhat feminist 14-year-old was the perfect introduction book. That said, the other nerdy kid in my class - who was a huge fan of Colour of Magic and other Rincewind books - hated it. I never did read Mort because I couldn't get into it, but had Small Gods as my absolute favorite for years, only to be solely displaced by the books starring either the Witches or Vimes; Jingo didn't hit my heart, but blew my head as to how prescient it was. (Now if I had to pick one favorite, I would just chicken out and say it's Where's My Cow?).

Pratchet is someone for whom I would customise recommendations. He is so eclectic in his themes and stories that he really offers very different books for different people. What I would recommend to one person would depend on who they are, what age, what they are interested in (politics, literature, etc) - and their mood at that moment.
posted by jb at 2:59 PM on June 13, 2011

Regarding Where's My Cow, the members of the North American Discworld Convention will attempt the largest ever public reading of the book. Come one, come all.
posted by Captain Ligntning at 3:11 PM on June 13, 2011 [2 favorites]

I am not among those who believe we treat our pets "humanely". Killing someone who has no rights and no language fits poorly with my understanding of the word humane.

You've never actually had a terminally-ill-and-suffering pet, have you? I've had to have a few pets euthanized over the years (kidney failure, cancer, and so on), always as a last resort, and I've wept hot, bitter tears over every single one. I'm tearing up now as I write this.

When the alternative to euthanasia, though, is letting them linger on in whatever short time they might have left in agonizing pain and not being able to understand what's happening to them, you bet your ass that having the vet give them a shot and letting them painlessly drift off is the humane thing to do.
posted by Mr. Bad Example at 3:26 PM on June 13, 2011 [11 favorites]

Suicide is everyone's right.

Making the most of every last second is everyone's duty.

Gee, glib one-liners don't really capture the complexity of this awful dilemma at all, do they?
posted by obiwanwasabi at 4:14 PM on June 13, 2011

obiwanwasabi, you clearly have no idea what is going on here. The "duty" you cite is horse crap. My statement is concise, accurate, and understood by everyone who has been where Mr. Pratchett and his family are now. Have you?
posted by Captain Ligntning at 4:21 PM on June 13, 2011

I've just finished watching the documentary by Sir Terry, where he investigates what it's like for two men who go to dignitas with the intent to kill themselves.

Both did.

Andrew, a MS sufferer, told us of his life, like a narrowing corridor he had to crawl down with no exit, and why he had booked his trip, a few days away at the time. We got to see a few minutes of his last night alive, calmly sitting in a near empty restaurant with his mother, Sir Terry and the BBC crew and talk about his decision - and his mother's decision to support him in it.

We also got to meet Peter, who had Motor Neurone disease. A man I've just seen sitting calmly at a table, knowing he's going to die in a few minutes in a little blue corrugated sided house on an industrial estate in Switzerland just before christmas, as that's the only country in Europe that lets foreign citizens come there to end their lives - as long as they don't do it in a residential area. He sat there, having drank the first drink that would numb his stomach, knowing he had to wait 25 minutes before taking the second, fatal draft. And he sits there, completely calm, deciding what chocolate to have while his wife unwraps it for him, both of them with upper lips so stiff you could bounce rocks off them.

I saw him intentionally pick up a glass of poison, afirm repeatedly that he knew what he was about to do, and drink it. A few minutes later, we saw him die, as his breathing stopped, having fallen unconscious.

His wife was afraid to sit beside him in his last few moments, because she didn't want to be seen to be assisting him at all - because that is a crime, and it carries a long prison term.

I have no shame in admitting that I had tears in my eyes as I watched it. Sir Terry was there too, as he watched Peter calmly drink something he knew would kill him in minutes, and in some pain before it knocked him out. And you could *see* Terry watching him, you could *see* he was imagining what it would be like to sat in that same chair, and drink that same drink that would kill him.

I've met Sir Terry. A few years ago, I was a book signing in London. Hogfather had just come out, and i went there to pick up a couple of copies for myself and my sister. I also took along a number of my other books, because I had no idea how busy it would be. I queued for hours, but it was great fun to be with other people who were also fans. Sir Terry was signing for what must have been at least 6 hours before I finally got to the front, having just bought my two new hardbacks. And yet, he was smiling, and joking with people in the queue. He politely asked who he should sign the books for, and he did that. Then he saw the bag of other books I had with me, and asked if I wanted them signing too. I hadn't intended to ask - he'd been there so long, and no doubt he must have been exhausted. But he insisted, and signed every damn single one of them. We'd exchanged a few comments on alt.fan.pratchett a few days before, back when that was the place for Pratchett fans, and he even remembered them. He's a good, good man, and I'll be incredibly sad when he's gone - and I hope he gets to enjoy every last minute of it.

I very much doubt he remembers that day now. Even if it wasn't for his disease, it was just another day, signing books for a huge crowd. But now, so many of his memories have been taken from him, along with his ability to type, tie a tie, pour a cup of tea or even read very well. Yet to talk to him, or see him on camera, you'd not even know he was ill.

But you know what I feel most of all? I feel fucking ANGRY. I feel so furious that Peter and Andrew and the many thousands of others that have ended their lives early because of our brain-dead, inhuman laws in the UK.

They had to spend thousands of pounds, and fly to Switzerland, and go sit in a little blue house on an industrial estate to kill themselves too early, while they still had the ability to pick up a glass and drink it. While they were still strong enough to do what they had decided to do in a clear, rational decision by themselves. That they didn't want to spend months, or even years buried in a hospital bed, possibly invaded by tubes, as their bodies and/or minds were eaten away by their illness and finally die, quite possibly in great pain and fear as their shell of a body finally was allowed to give up and finally die.

They had to do it now, early, *while they still could* because they couldn't do it at home, in their own beds without their friends or family being prosecuted for murder.

I'm angry for those people who wanted to wait, but had to decide to go while they still could. I'm angry for those people who didn't go for whatever reason, and tried to kill themselves in a messy and painful way with pills, or jumping in front of a train or whatever horrible way to die they choose. I'm angry for those people who were too sick to go, and asked their family to finally give them relief, knowing that they risked prosecution - and many of them have been.

I'm really, really angry for those people who chose to carry on, and eke out every day as best they could, but instead of ending up in a comfortable hospice with nurses who looked after them well in their final days, ended up in some shitty care home where they sat in their own filth while the minimum wage staff abused them or just left them to die afraid in the dark.

I don't want Sir Terry to go. I have serious depression myself, and have toyed with the idea of suicide, years ago. In my case I decided I couldn't do that to my family - to those left behind, no matter how bad the self-loathing got. I would carry on living, even if it was the last thing I wanted to do. I *fingers crossed* won't have to make that choice again, for many years. Given my family history, it's going to be brain cancer, heart disease or dementia that gets me, if I'm lucky enough to get that far. If it's the alzheimers, I may make a decision to checkout early. I don't know. I get to live through my parents - both are starting to show early signs, and I'm really not looking forward to that, at all - not least for their sake. I saw it happen to my grandfather when I was young, even though my parents shielded me from it as best they could, and it's not something I'd wish on anyone on earth.

Sir Terry doesn't get my choice. He's going to die. He's going to die in a few more short years, whether he likes it or not. He has to decide whether it's in a clinical little house in Switzerland, or in a hospice with his mind having long since left the meat shell he leaves behind. He doesn't get the choice of sitting on his lawn in the sunshine, with a good drink of whiskey and his favourite music on his ipod, because it is illegal, and quite possibly someone will end up going to jail for it if he does.

Many more who don't make that choice will face a hard, hard death in far from the best circumstances, because that is all they can afford.

A right to a dignified end is something we should all have. Whether you choose to end it early is entirely your own choice, and you should have good quality care no matter what you decide.

That both options suck so much is the real crime here.
posted by ArkhanJG at 4:25 PM on June 13, 2011 [56 favorites]

Well said, ArkhanJG.

Best wishes to you on your journey, Mr. Pratchett.
posted by FeralHat at 6:13 PM on June 13, 2011

Hey, I just bought The Colour of Magic! I hope this series doesn't suck, or you nerds will owe me $7.99 + tax.
posted by Eideteker at 7:31 PM on June 13, 2011

My husband's grandmother has Alzheimers, and my great-aunt died in late stage Alzheimers. For those of you who have never been touched by this disease, count your lucky stars. It is deeply terrifying, both for the patient and for the survivors. You have no idea the toll it takes. I'm a fairly expressive writer, and I cannot make myself conjur up the horror that it is to watch someone's mind disappear, and know that some spark of them is conscious that they've lost their mind. It is a living kafkaesque nightmare where death is the only escape. This disease strikes me with such visceral fear; I've seen what it does, and I would never, never make the decision to let Alzheimers take it's course, if I had an option like Switzerland available.

I adore Terry Pratchett. I love his books, I love his talks, I love his tone. I love how wonderful he is to fans; I love that he flew out to do a teeny little rinky dink fantasy convention in Nowhere, Texas because we asked. I love that he adores his wife and children, and they in turn adore him right back.

I love that he's written ideas that seem plucked from the cultural unconscious and presented in such a way that they seem both new and comfortably familiar at the same time. His idea of "small gods", for example, is just brilliant.

I am glad that he has an option to chose when meet Death, and I wish him a safe and pleasant journey whenever he chooses to take it. The world will be a smaller, darker, and less funny place without him, but because of him, there will always be joy, and pleasure, and happiness.
posted by dejah420 at 8:37 PM on June 13, 2011 [3 favorites]

<sub>Hey, I just bought The Colour of Magic! I hope this series doesn't suck, or you nerds will owe me $7.99 + tax.

With all respect to Pratchett, The Colour of Magic is pretty widely accepted to be one of his worst books. His work got better over time. A lot better. The reading guide's all well and good, but don't start with the Rinsewind stories. I started with The Truth (by accident), and thought it was a great place to dive in.

And, damn... ArkhanJG... now that's a comment. Now, for some reason, all I can think about is the "Quietus" scene from Children of Men.....</sub>
posted by schmod at 9:43 PM on June 13, 2011

Something to consider, for those opposed to the idea of a personal, legal choice to die - for many at the end, it's genuinely not living anymore, in any sense more than 'still breathing'.

For the last two weeks of my mother's life (terminal cancer, in her case) she was so heavily dosed with morphine to block out the pain that she was unconscious the entire time.

For at least the month and a half prior to that, she was..i don't quite know how to describe it. Hazy? Woozy? Not really present, is the closest I can come. She was aware of the pain and could converse with some effort, but she wasn't able to do anything. She couldn't read, watch TV, anything like that - though that had been the case for the prior 5 months or so. Something about the medications she was taking, she said it made everything too difficult, that she couldn't concentrate and so trying to read/watch anything became frustrating and upsetting. (This was particularly upsetting to her, she'd been a voracious reader her whole life.)

Sorry, i've gotten a little off-track - my point here is yes, she was still breathing that whole time. But there was no living. Little joy. She was unconscious the entire last few weeks because to wake up was to be in agony. In the end, since no-one was allowed to legally do anything else she simply choked to death on the fluid in her lungs. For 8 hours.

So simply breathing through every second possible may not be as desirable as all that. At least, not for everyone.

(For what it's worth, she told me a few months before the end that she wished she had a choice about what happened to her. And after sitting by her bed for those 8 hours, i'm pretty fiercely in favour of giving people that choice, and control of their own bodies.)
posted by pseudonymph at 11:12 PM on June 13, 2011 [9 favorites]

Preparing for death is maybe not so much about grand plans and Swiss clinics, as it is making sure you have lived in a way that someone can be there for you when you need them.

My grandmother lived surrounded by a village that massively supported her, similarly a church that massively supported her (to the point that she was still living alone and independently when she had significant dementia); and she still wanted to die rather than continuing to live with dementia. And in relation to the nun studies linked to, she was massively articulate and multi-lingual - and that just made losing her mental abilities even more horrific to her.
posted by Coobeastie at 1:28 AM on June 14, 2011

People that seek out assisted suicide are by definition insane.

What arrant tosh. And what a profoundly insolent statement.
posted by Decani at 4:12 AM on June 14, 2011 [2 favorites]

Galadriel: Someone with advanced enough Alzheimer's isn't *in* there anymore; the person they were is effectively dead already. Before they quite reach that point, they are continually frightened with no ability to understand the fear.

This is a hopeful guess, but being around my partner's mother as she moves into the "severe" stage of Alzheimer's disease has really brought home the point that one of the horrors of the illness is the inability to effectively communicate. As horrible as the conventional wisdom is, wouldn't it be even more terrifying if they were still in there? What if the idea that "the person you knew is gone" is just something we say to comfort ourselves?

Legomancer: Let me add this: If you are around an advanced Alzheimer's patient for a few minutes, you will *hope* the person is not in there anymore.

Quoted for truth.
posted by infinitywaltz at 9:03 AM on June 14, 2011

"With all respect to Pratchett, The Colour of Magic is pretty widely accepted to be one of his worst books."

NOW you tell me. *holds hand out for refund*
posted by Eideteker at 10:03 AM on June 14, 2011

The Color of Magic certainly isn't bad, it's just that the first six or so book in the series aren't quite as good as what comes later. For my money, Pyramids is the first of the really great Discworld books, but that isn't to say that the first six aren't also good (if fact, they keep getting better and better); and compared to a lot of the other, non-Pratchett stuff, out there, it's nothing short of genius. But it isn't as good as what's to come.

I'd definitely recommended reading it, just be fully aware that you haven't seen the brilliant stuff yet.
posted by quin at 10:13 AM on June 14, 2011

This kind of makes me want to cry. But then Schmod's comment made it all better.
posted by shesaysgo at 2:31 PM on June 14, 2011

Hey, I just bought The Colour of Magic! I hope this series doesn't suck, or you nerds will owe me $7.99 + tax.

I would have suggested Guards! Guards! or perhaps Reaper Man.
posted by Fleebnork at 2:53 PM on June 14, 2011 [1 favorite]

And I would suggest all the Tiffany Aching books (The Wee Free Men, etc), but that's me...
posted by bitter-girl.com at 8:11 AM on June 15, 2011 [2 favorites]

N-thing Small Gods. It's truly brilliant. It was the very first Pratchett book I ever read, and this one simple exchange between two characters turned me into a devoted fan:

"Slave is an Ephebian word. In Om we have no word for slave."

"So I understand. I imagine that fish have no word for water."

posted by zarq at 10:59 AM on June 15, 2011 [1 favorite]

Depending on who I'm introducing to the universe, I go with Small Gods (people who are interested in religion), Soul Music (people who are interested in music), Pyramids (people who like weird history), Men at Arms (people who like procedurals and detective stories), or Mort (people who like Bill and Ted's Excellent Adventure, which is everyone).

I think this list says a lot more about the kinds of friends I have than anything else, but there you are.
posted by Errant at 12:16 PM on June 15, 2011

I agree that it is his choice, and that the real shame is that the choices are so bad.

Worked in a nursing home in my younger days, one that had several Altzheimer's patients. They were difficult to deal with, physically and emotionally. One broke another aide's arm when she was trying to feed her. If I were the praying type, I'd pray that none of them were still in there.

Especially R. She was terrified at night. If I sat with her and held her, she'd calm down, but I had lots of other people to take care of, too. From talking with her family (who came frequently to visit and who were more supportive of R. than nearly all the other families), I found out that R. had been raped by a stranger who broke in to her apartment one night when she was young.

From the way R. acted, what her family told me and the few things R. was able to say, I suspect she was trapped in that night.

If I find out I have Altzheimer's, I probably won't be able to afford Dignitas. I will be able to afford a shotgun, though.
posted by QIbHom at 12:46 PM on June 15, 2011 [1 favorite]

Dammit! Soul Music was the only one at The Strand, but I passed it up because, well, you begin at the beginning. It's probably gone now. =(
posted by Eideteker at 1:31 PM on June 15, 2011