Written by Rev. Dr John Mcclean, Christ College
In the last month (October 2014) Brittany Maynard became the youthful face of the campaign for Physician Assisted Suicide (PAS). Newly married and only 29 she was diagnosed with a brain tumour on New Years Day this year. She had surgery, but by April the tumour had returned and her prognosis was bleak. In an article on the CNN website she mentions an estimate of six months of life left. She was told that whole brain radio-therapy, which may have limited the progress of the cancer, would probably also give her severe side-effects. So she decided to have minimal treatment while she did some of the things on her ‘bucket-list’. And she moved from her home state of California to Oregon where she could access legalised Physician Assisted Suicide.
Brittany’s story hit the headlines and captivated social media. She gave several TV interviews, wrote an op-ed piece for CNN, kept a blog and had a series of you-tube clips with her and her family. She announced her plan to end her life a few weeks ago and did so on 1st November.
Her situation grabs attention because it is so heart-breaking. She began this year trying to start a family, by the end of the year she has taken her own life. She was young and good looking and articulate. There were beautiful wedding portraits, shots of adventure travel before she was sick and lovely informal pictures. Social media allowed us to follow her story and created a connection with her. Some commentators have suggested that her public advocacy might change the politics of PAS in the US, bringing the millennial generation into a campaign.
Some of the rhetoric about Brittany’s case is revealing. A CNN report introduced her story as all about her choice: she chose to get married, she chose to travel and explore the world and now she has chosen to die. Many of the quotes from Brittany focus on her “choice”. The argument for PAS often assumes that ‘death with dignity’ requires a patient to choose their death. This assumption needs to be challenged. We can’t build a coherent ethic simply on the right to decide. Personal autonomy is not enough for a good society, we also need some idea of what it means to live well. Suicide is not part of that. What’s more good palliative care can allow a great deal of dignity for a dying patient without them taking their own life. It is fallacious to equate dignity in death with a choice to die.
There is also the hint of further tragedy in Brittany’s case. While we don’t know her clinical details and so can’t be at all definitive, it seems there would have been other possible treatments. In some similar cases chemotherapy has been effective in slowing the tumours and allowing the patient significant extra time. Her concern that there would not be sufficient pain control was probably ill-founded. While the US does not always offer the same quality of palliative care as Australia, her pain would have almost certainly have been controllable. She mentions the fear of developing morphine resistant pain, when there are a range of effective pain treatments available now. Even the initial suggestion that she had only six months to live after the recurrence in April turned out to be wrong, since she was still able to visit the Grand Canyon in the weeks before she ended her life. All this makes me wonder if she had received medical advice which was skewed in favour of PAS. Was she given the worst case scenario? And that would be a further tragedy at two levels. For Brittany and her family, it means that they may have lost quite a long period of time in which they could have still enjoyed life together. More widely, it means that the medical profession is losing a commitment to life and starting to advocate death.
Brittany Maynard’s sickness was terrible, and her death, however it came about, was always going to be grievous. I suspect that Physician Assisted Suicide has made it even more tragic.
I would like to thank Associate Professor, David Bell, Senior Medical Oncologist at Northern Cancer Institute, St Leonards for his advice on clinical aspects of this article.