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The Suicide Tourist
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My husband, a palliative care doctor, and I watched a documentary last week that had us yelling at the TV. It was a beautifully well-done movie called “The Suicide Tourist” on public television’s Frontline series. This was a movie (now several years old) about a middle aged man with amyotrophic lateral sclerosis (ALS) for 5 months who had decided he wanted to end his own life.
To accomplish this, he traveled to Switzerland where physician-assisted suicide is legal. He was clearly an intelligent and thoughtful man, and his wife was nothing if not supportive of him. None of this is what led to the yelling. Where it gets outrageous is the simple fact that this man was on a vent. Ending his life could have been accomplished by withdrawing the vent and treating his breathlessness with opiates and benzodiazepines — with no need to travel to Europe! More outrageous was that only once in the whole movie did they show him talking to a physician — and that was a pro-assisted suicide surgeon, who as far as I could tell did very little meaningful counseling.
Where was the palliative care team? Or an internist or a neurologist who would know something about this man’s options to permit death as his disease progressed? His decision to kill himself seemed mostly driven by an intense fear of suffering — the possibility of more suffering as he died naturally was too much to bear. But even the patient admitted that he was perhaps ending his life too soon. But he couldn’t possibly wait until he could no longer swallow on his own. I shuttered when I watched him take the fatal cocktail — clearly nauseous and gagging down the barbiturates.
Where were the supportive medications that we would have had at our disposal were he dying in a medical or hospice setting — the antiemetics, the medicines for dyspnea, pain, fear or anxiety? All he had was an advocate, a camera man and his wife. It all seemed so senseless and unnecessary. I can’t help but think that if he had better counseling prior to making this decision, a different choice would have been made.