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Paul Courvette and his wife Liana. "He was thrilled he could chose the time and place of his death," Liana said. Photo / supplied
Paul Couvrette awoke, like any other day. Except it wasn’t any other day – it was the day Couvrette had chosen to die.
He ate breakfast, like any other day. He walked his dogs on the beach, like any other day. Then, after a final dinner with family and a last glass of Scotch, the 72-year-old announced: “I’m ready now”.
He lay down on his bed with his wife, he thanked the doctor and the nurse who were about to administer his lethal injections, he told his wife once more how much he loved her. Then he died quietly and comfortably at home.
With aggressive cancer having spread from his lungs to his brain, and with no chance at recovery, Couvrette chose to die on his own terms – how and where he wanted.
In Canada, where Couvrette lived, he had that choice. In New Zealand, politicians are now preparing to vote on the same right for Kiwis.
“He was thrilled that he could choose the time and place of his death. He had no fear,” his wife of 11 years, Liana Brittain, told NOTED.co.nz. “He was totally at peace with his decision. He was very upbeat.”
In May last year, Couvrette became the first medically-assisted death on Prince Edward Island, Canada’s smallest province, near Nova Scotia on the Atlantic coast.
As New Zealand now tussles with the moral and legal arguments inherent in assisted dying, it’s worth examining how the practice has worked in other countries.
Around 2000 people died with medical assistance in Canada in the first 12 months following the June 2016 legalisation, according to a Canadian Government report released in October last year. In the first six months, from June-December 2016, Canada recorded 803 assisted deaths nationally. During the subsequent six months, however, the number jumped 47 per cent, with 1179 people choosing medical assistance for death. Even with the increase, the number of assisted deaths in Canada still represents less than 1 per cent of all deaths.
The most common medical condition that led people in Canada to opt for medically-assisted death was cancer, which accounted for about 63 per cent of cases.
The Canadian assisted death legislation is based on the “Oregon model”, named after the US state first to introduce legislation, which permits assisted death for mentally competent people with terminal illnesses who have a defined life expectancy. Seven US states (California, Colorado, Hawaii, Montana, Oregon, Vermont, and Washington), plus Washington DC, all follow the Oregon model, as does Victoria in Australia. New Zealand legislation, if passed, would likely also follow this model.
In other countries – such as the Netherlands, Belgium, and Switzerland – the law allows for medically assisted death for sufferers of depression, advanced requests for dementia patients, and for minors with terminal illnesses.
In Canada, advocacy and lobby group Dying With Dignity continues to fight for more relaxed assisted dying controls – including rights for people with mental illnesses, dementia, and for people under-18. Meanwhile, on the other side of the fence, Dying With Dignity chief executive Shanaaz Gokool said, opposition groups continue to fight in court for restrictions. It’s an ongoing battle.
“The opponents have not been quiet. Like us, they’re participating or trying to participate, in the legal cases challenging aspects of the federal assisted dying law. There are a number of anti-assisted dying petitions that are circulating, including in churches, schools and at universities. There are groups that are trying to keep patients from being allowed to access assisted dying in publicly funded facilities such as hospitals and long-term care facilities,” she said.
“As it happens, these groups are much, much better funded than we are, even though they represent the point of view of only a small fraction of the Canadian population.”
The procedure is obviously not to everyone’s religious or moral tastes. Many conservative opponents in Canada still – as in New Zealand – can’t stand the idea. But supporters believe strongly that it should be an option for an individual in pain.
“There are many, many ways you can choose consciously to celebrate the end of your life,” Brittain said. “You can also choose to have palliative care, palliative sedation, you can choose to die naturally, you can choose to voluntarily stop eating and drinking. [Assisted dying] is not for everyone … it’s a choice.”
Her husband chose “quality of life over quantity”, she said. He didn’t want to waste away, and he didn’t want to endure treatments that would restrict or ruin his final weeks or months, Brittain said.
His death – with or without medical assistance – was imminent and inevitable. So, instead of suffering for an extended period, he was able to go out how he wanted.
“A lot of thought went into it. But I can assure you – once Paul made that decision, it was like the weight of the world had been lifted off his shoulders.”
“We had this amazing celebratory 10 days prior to his procedure. [Paul’s death] was a blessing. It was so empowering for him to have that opportunity to not only die with dignity but to dictate all the terms of his passing,” Brittain said.
For Rob Rollins, the chance to opt out of his suffering and dictate the terms of his impending death, “brought him so much peace”.
Rollins, 56, of Ontario, had fought throat cancer for 18 months – but after 40 radiation treatments, chemotherapy, and throat surgery had left him unable to eat or drink, he decided he was ready. Like Couvrette, he chose to die at home, on a date and time that suited him.
“We talked about it and for him, it was something that was very important – he wanted to be able to die on his terms, no hospitals, no comas, none of that type of stuff,” said his husband John MacTavish.
And, like Couvrette, Rollins’s spirits lifted once he decided to set the date and time of his death. He set a date three days ahead: January 6, 2017.
“Once that decision was made, and things put into place, those three days were the best days that Rob had had in years,” MacTavish said. “He had total control, he was able to not need as many pain meds … We just had three of the most incredible days that just brought everything together, all of our 28 years together, and it brought him so much peace.”
Rollins scheduled his death for 11.30am. MacTavish bundled his husband up in their wedding quilt and hugged him as the doctor administered the series of fatal injections.
“Four minutes later, it was over. I have witnessed [many] deaths – friends, people I worked with, loved ones – and this was the most beautiful experience of my life, in a way, to see how it is and how it should be,” MacTavish said.
“I think [assisted dying] is the most humane thing we can do as human beings for each other. I think everybody deserves the right. In any country … it’s the right thing to do for individuals who suffer and who just say ‘enough’.”
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