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Terry Pratchett ready to be test case for suicide law
February 1, 2010 12:10 AM   Subscribe

Sir Terry Pratchett, the popular comical fantasy author who in 2007 revealed that he had been diagnosed with early-onset Alzheimer's, will present today his ideas about having a tribunal set up to help those with incurable diseases end their lives with help from doctors.
posted by Jeremy Banks (39 comments total) 13 users marked this as a favorite

 
We once discussed a sci-fi/fantasy author here (I want to say it was Orson Scott Card) and the unfortunate reality that many such authors have at times deeply unpleasant ideas, beliefs, and ideologies. This demonstrates once again that being a Terry Pratchett fan carries with it the immense pleasure of being a fan of what seems to be a thoroughly decent human being.
posted by Pope Guilty at 12:17 AM on February 1, 2010 [20 favorites]


In the US, both Oregon and Washington now have laws to allow assisted suicide in some circumstances, and Montana apparently doesn't forbid it (and of course there's Dr Kevorkian).
posted by hattifattener at 12:23 AM on February 1, 2010


This depresses me mostly because Terry Pratchett is awesome and I would prefer he not be dead. However, I can also see how Sir Pratchett may prefer to not have to live in the world of an advanced Alzheimer's sufferer.
posted by that girl at 12:32 AM on February 1, 2010 [2 favorites]


I would greatly appreciate it if doctors and nurses in the US could talk directly about assisted death for terminal patients rather than having to tiptoe around the topic. The entire nudge and wink practice currently leaves a patient very much in doubt about whether their wishes will be carried out if they do become permanently demented or vegetative.
posted by zippy at 12:40 AM on February 1, 2010 [5 favorites]


Responding to the Panorama poll, Director of Care Not Killing, Dr Peter Saunders, said: "To argue that if you are terminally ill you deserve less protection from the law than do the rest of us is highly discriminatory as well as dangerous.

"Many cases of abuse involving elderly, sick and disabled people occur in the context of so-called 'loving families' and the blanket prohibition of intentional killing or assisting suicide is there to ensure that vulnerable people are not put at risk."


Isn't the law against assisted suicide highly discriminatory? Able-bodied people are free to attempt suicide time and again, but disabled people risk criminalizing their family and friends by asking them for assistance. The blanket prohibition on assisted suicide destroys the human right to integrity of the body by removing the individual's choice on its disposal. Assisted suicide is not a license to kill others, but to protect the rights of the disabled - those who are, or have become, incapable of putting their will into practice. You cannot pretend to care for the physical and mental well-being of a person by appropriating their body and will, and only a system that allows them to express their will and have it respected is truly caring.
posted by Sova at 12:50 AM on February 1, 2010 [21 favorites]


This depresses me mostly because Terry Pratchett is awesome and I would prefer he not be dead.

I think Terry would remind you that everything dies, and there is nothing wrong with that.
posted by mek at 1:12 AM on February 1, 2010 [3 favorites]


From the article, it seems like the statements from palliative care doctors aren't really responding to the idea of the tribunals. I'm guessing that's because they were asked for a comment before Pratchett's speech was given. I'd be interested to see what they say after they've heard the proposal.
posted by harriet vane at 1:37 AM on February 1, 2010


I think a tribunal would be too bureaucratic; we need clear rules, not case-by-case enquiry.

The Gilderdale case in the UK is interesting because it seems to establish that in practice (a) you can safely assist the suicide of someone who does not have a fatal illness, so long as they are seriously ill and have expressed a wish to die, and (b) that you can take the initiative in such cases and use additional means which have not been previously discussed; all without being guilty of murder.

The case has evoked some controversy because the illness in question has been seen as merely 'yuppie flu', though in fact it appears to have been very much worse than that.

Nevertheless, to paint it at its blackest it could be argued that the case (or the way the case has been reported) has sent the message that if your daughter has got ME and feels suicidal, it's basically OK to poison her, even if you haven't discussed the details.

In the light of all this, it doesn't seem completely clear to me that the judge's view - that the murder case should never even have come to court - was really correct.
posted by Phanx at 1:40 AM on February 1, 2010


I think Terry would remind you that everything dies, and there is nothing wrong with that.

I BELIEVE YOU MAY BE RIGHT, MR. MEK.

SQUEAK
posted by Skeptic at 2:00 AM on February 1, 2010 [17 favorites]


However, as Phanx points out, the Gilderdale case is rather complicated, because not only did it not involve a fatal disease, but also one whose very existence has been disputed.
posted by Skeptic at 2:03 AM on February 1, 2010


I skipped a beat there, initially, thinking I'd be reading an obit. Phew.
posted by ersatz at 3:07 AM on February 1, 2010 [5 favorites]


Man, there is just about nothing that scares me like the thought of Alzheimer's. Kudos to Sir Terry for making it this far; the mere notion of going out that way makes me look around for the nearest high thing I could jump off of.
posted by bokane at 4:35 AM on February 1, 2010 [1 favorite]


I'm not sure about this.

Much as I appreciate Pratchett's desire to choose when he dies, there is this issue of murder. A percentage (not sure what it is, but I've been led to believe it's quite high) of people change their minds when it comes to being suicided, and I'd hate to think that somebody did change their mind, but was killed anyway.

Then there are the awful cases where a family member just can't take being a carer any more and does the wrong thing. These are desperate, sad cases, but a murder has been committed.

Having a tribunal seems like an OK idea, but we have something that (sort of) works now. In the Gilderdale case, it appears that the law did the right thing. A woman who shouldn't have been locked up for a murder wasn't locked up for that murder. In cases where there is enough evidence to prove that the killing was unwarranted, maybe a different verdict would be reached. In those extremely rare complex cases where there is a possibility of either verdict being correct, the courts will take a much longer time to come to a verdict.

This is not to say that in the current situation, some innocent people will be locked up and some guilty people will be let free, but I don't see how a tribunal would change this.

Of course, if it were me in this situation, I'd probably feel very, very differently. I think that any enquires need to strongly take this into account.
posted by seanyboy at 4:35 AM on February 1, 2010


This is a well-meaning proposal and I shall be interested to read the full text of the Dimbleby Lecture when it's available, but from the few details mentioned here I'm not sure that Pratchett has thought this through very carefully:

"If granny walks up to the tribunal and bangs her walking stick on the table and says 'look, I've really had enough, I hate this bloody disease, and I'd like to die thank you very much young man' I don't see why anyone should stand in her way.

"The tribunal would be acting for the good of society as well as that of the applicant – and ensure they are of sound and informed mind, firm in their purpose, suffering from a life threatening and incurable disease and not under the influence of a third party."


Pratchett's example implies that Granny's own wishes are paramount -- if she wants to end her life, why should anyone stand in her way? But he also implies that the tribunals would have the power to overrule people's own wishes -- to say, in certain cases, "sorry Granny, but we don't think your illness is serious enough". He seems reluctant to confront the possibility that the wishes of the individual might not always go hand-in-hand with 'the good of society'.

This is very much of a piece with his earlier remarks on assisted suicide, which struck me as well-meant but naive. In his world, doctors and nurses have the best interests of their patients at heart; coroners are wise and compassionate men; elderly people can't be coerced into doing things they don't wish to do; euthanasia could never become part of national health policy because 'we are a democracy'; and all difficult ethical problems can be solved by 'the wisdom of ordinary people'. Sir Terry is a living national treasure and we all love and cherish him, but not all of us share his faith in the goodness of human nature.
posted by verstegan at 4:46 AM on February 1, 2010 [5 favorites]


Brilliant. I recommend we call them "death panels."
posted by Frankieist at 5:05 AM on February 1, 2010 [13 favorites]


This would be a little easier to swallow if Unseen Academicals hadn't been so awesome. Also, there's another Tiffany Aching book on the way.
posted by Halloween Jack at 5:34 AM on February 1, 2010


Can someone more knowledgeable explain to how the BBC article says that Ms. Gilderdale was both acquitted ("cleared of attempted murder"), and got a "12 month conditional discharge"?

Oh wait, I see now. She was charged with both attempted murder and with aiding and abetting, acquitted of the former and conditional discharge of the second. Poorly-worded, at least.
posted by Lemurrhea at 5:42 AM on February 1, 2010


ersatz: My heart skipped a beat too.
posted by Jilder at 5:53 AM on February 1, 2010


I would greatly appreciate it if doctors and nurses in the US could talk directly about assisted death for terminal patients rather than having to tiptoe around the topic.

On the other hand, I greatly appreciate that health insurance companies and HMOs in the US don't have "cheaply kill patient" as one of their treatment regimens.
posted by ROU_Xenophobe at 6:11 AM on February 1, 2010


I don't like the whole tribunal idea at all I'm afraid.

Obviously we need protection from murder disguised as assisted suicide, I get that part.

But why complicate things with tribunals which get to decide if your own wish to die should be respected? And why complicate things with illness? Ideally shouldn't anybody, regardless of their health, be able to go through a process to verity that they aren't being coerced, aren't mentally incompetent, etc, and then get an assisted suicide?

I don't really see how illness, terminal or not, has much to do with anything. If Random Person wants to die I say that's their right. If I know Random Person I'd probably try to discourage them from that course of action (except in illness and whatnot), but I don't see how the state should be able to forbid Random Person from dying, or seeking help in dying. No tribunal should be empowered to decide that, assuming Random Person is sane and non-coerced, Random Person doesn't have the right to die.
posted by sotonohito at 6:57 AM on February 1, 2010 [3 favorites]



I would greatly appreciate it if doctors and nurses in the US could talk directly about assisted death for terminal patients rather than having to tiptoe around the topic.


Yeah that would be the just thing to do, but to them the problem is: When you're dead you stop paying them. So that's not an option.
posted by Liquidwolf at 7:28 AM on February 1, 2010


ersatz: So did I. My morning MeFi FPP skim tripped over that name and for a moment I just froze. Then I read the rest of the sentence and felt better. Not a lot better, because almost everything I read about Mr. Pratchett reminds me that we'll be losing him too soon.
posted by ChrisR at 7:41 AM on February 1, 2010 [1 favorite]


Killing someone and making it look like suicide is older than Agatha Christie. I don't see how assisted suicide would change anything. It would still be a crime to murder someone who didn't want to die. All this talk about governments or companies killing patients is just scare talk. Maybe assuming the best of people means your plans will go astray but assuming the worst of people makes you paranoid and nothing ever gets better. I'd prefer to try to be humane and fail than to try to be paranoid and fail.

I'll really miss him when he goes.
posted by irisclara at 8:35 AM on February 1, 2010


I would kill any of you if you asked me to. That's how much I like you, Mefites.
posted by greekphilosophy at 9:05 AM on February 1, 2010 [4 favorites]


I got a chance to interview him for the magazine I was editing right before he got the knighthood last year, and I can confirm that he is not only a brilliant writer, but a spectacularly interesting human being instead. Bravo, Sir Terry. Bravo.

(We got off on so many tangents about interesting subtopics that we ended up talking for an hour...he is so delightful, and just plain fascinating. I wish him ALL the best).
posted by bitter-girl.com at 9:37 AM on February 1, 2010


Let's just get on installing suicide booths and we'll be well on our way. Only 25 cents and three easy to understand settings!
posted by Askiba at 10:05 AM on February 1, 2010


Damn it. Every time I see Pratchett's name show up in a front page post, my heart literally starts racing and I have to calm myself down and make sure that it isn't an obit thread. I freaking hate that.

I think that the author needs to have a word with his most famous anthropomorphic personification and get this sorted out. I need at least another twenty to one hundred years of Discworld books.
posted by quin at 10:11 AM on February 1, 2010 [2 favorites]


Ah, on non-preview, I see I'm not the only one...
posted by quin at 10:12 AM on February 1, 2010


Yeah that would be the just thing to do, but to them the problem is: When you're dead you stop paying them. So that's not an option.

In my (limited, but gut-wrenching) experience with this, that's not the problem. The problem is that people don't become doctors and nurses because they like to let people die. It's the ultimate in selection bias; medical professionals like to see people survive.

My father-in-law overrode HIS father's DNR documents no less than four times during his slide towards death. Grandpa had advanced senile dementia, though it wasn't clear if it was Alzheimer's or the result of microstrokes from years of severe alcoholism. He was bedridden, incontinent, unable to play the violin anymore (he was a 40-year professional symphonic violinist), and a double amputee. He refused to eat or drink anything, and my FIL had a feeding tube placed. He suffered progressively more severe strokes, and my FIL had him maintained on life support every time until he came out of his coma. And when he finally suffered a severe, catastrophic brainstem stroke from which there could be no recovery, my FIL kept him alive on a ventilator for two and a half weeks until my husband called a chaplain, a social worker, a neurologist, and Grandpa's personal physician and spent seven hours convincing his father to let Grandpa finally die. This is, beyond a doubt, the hardest thing my husband has ever had to do in his life.

When the decision was made to pull the life support, my husband found the attending physician and said "I want everything possible done to make sure my grandfather is in no pain. None at all. Even if those measures hasten his death." The attending agreed, and wrote orders for truly massive doses of Fentanyl. My husband had to stay at his grandfather's side for the next four hours to defend him from doctors and nurses who wanted to lower the dose to "protect his respirations." This is the second hardest thing my husband has ever had to do.

I'm not sure what the right way to handle end-of-life care is, but I know that this isn't it.
posted by KathrynT at 10:52 AM on February 1, 2010 [14 favorites]


My grandfather died in a hospital he helped found, which likely helped get the DNR order followed. I can at least be pretty sure that, as a physician, and a man who'd lived well with disability for my entire lifetime, he understood quite well where he wanted the line drawn.

For myself, I am deeply grateful that most of my genetic pitfalls may kill me in painful ways, but at least they're not going to steal my brain by inches in the process. (If I clear 60 without dying of cancer, I'll be breaking a pattern, but the few relatives who have made it to 90+ made it with their mental faculties fairly intact.)
posted by Karmakaze at 1:10 PM on February 1, 2010


Hi Jilder, ChrisR, quin.
posted by ersatz at 1:56 PM on February 1, 2010


Well, brain-stealing, body-rotting diseases of long duration run in my family. I hope to effing god that there's some way for me to legally commit suicide while ill by the time I come down with any of them. I've watched too many of my relatives rot away for a decade apiece to want to go through the same thing myself.

I have also been in a situation similar to KathrynT's husband.
posted by jenfullmoon at 2:51 PM on February 1, 2010 [1 favorite]


I just saw the lecture, and it was wonderful. Tony Robinson did such a great job delivering Pratchett's words, and I found Pratchett's points considered and practical, which isn't surprising. I'm so glad that he is speaking about these issues, it gives me hope that if I were to suffer the same fate as Terry, I'd be able to die the way he'd like to -- in my garden with my favourite artist on my iPod and a glass of brandy. I hope he gets to die as he wishes, and I hope it happens a long, long time from now.
posted by ukdanae at 3:37 PM on February 1, 2010


we have something that (sort of) works now. In the Gilderdale case, it appears that the law did the right thing. A woman who shouldn't have been locked up for a murder wasn't locked up for that murder.

yea, but being on trial for murder was probably a hell that, after everything else, she shouldn't have had to go through
posted by 5_13_23_42_69_666 at 9:38 PM on February 1, 2010


KathrynT, I'm sorry you (and your husband) had to go through that. So much extra pain for all concerned.

I am more fortunate, I hope, in that my father's clear wishes are equally shared by our family. No extraordinary measures; DNR. Now that he has worsening dementia, and has had two non-trivial medical crises in the last month, we know that if he reaches a severe point we will choose hospice and try to make it as compassionate as possible. I don't know how soon that may be, but after this month my prior guesstimate of "around two years" seems on the high side.
posted by dhartung at 11:16 PM on February 1, 2010


In the Gilderdale case, it appears that the law did the right thing[...]but I don't see how a tribunal would change this.

The whole bit where you don't have to go through a high-profile criminal trial as murderer?

Perhaps we could use the criminal courts to determine whether doctors should be locked up for manslaughter whenever a paient dies under care, too.

I'm not sure what the right way to handle end-of-life care is, but I know that this isn't it.

Absolutely.

Numerous people of my parents' generation (I'm 36) have watched their parents go to their graves as the first generation where it has become easy, to the point of being commonplace, for us to be able to keep people alive long, long after a complete loss of any quality of life; dementia, Alzheimers, you name it. It's very, very common for conversations along the lines of, "If I ever get like that, shoot me."

Something must, sooner or later, change. If only for my own interest: I never want to have to choose between jail and following my parents' desire to go with a modicum of dignity.

(Although it is not, I guess, a new dilemma; it is interesting to note that generally conservative Catholic Tolkien's elves could pass from the world when they grew too weary of it, and that the Numenoreans could simply will themselves to death when they began to lose their faculties.)
posted by rodgerd at 11:48 PM on February 1, 2010


Edited transcript of the lecture

Full lecture on BBC iPlayer

If you have the time, the latter is well worth watching. Tony Robinson gives an excellent reading of the lecture, with a noticeably moved Terry Pratchett sat alongside him.

Beforehand, I was probably a softliner on assisted death, agreeing in principle but with enough doubts to feel uneasy. Seeing this has thrust aside, or rendered irrelevant, most of those doubts, and put me pretty firmly on his side.

If I knew that I could die, I would live. My life, my death, my choice.
posted by Hartster at 2:09 AM on February 2, 2010 [1 favorite]


everything dies, and there is nothing wrong with that.

Yes, there is. It's horrible. Not a day goes by that I don't miss my father.
posted by Joe in Australia at 8:40 PM on February 2, 2010


For those unable to watch the lecture on BBC's iPlayer here it is on youtube(first part).
posted by aldurtregi at 6:17 PM on February 3, 2010


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