An enormous new study on attitudes toward death recently appeared in the American Journal of Geriatric Psychiatry. Researchers at the University of California discovered that there's no such thing as a single death: Every death divides so that it's felt separately, and differently, by family members, by caretakers, by lawmakers, in addition to the person who is in fact dying. What matters, as a person dies, is radically altered by perspective and historical context. It is this division of attitudes that gets taken up in Sandra Martin's excellent new book on the intractable but fascinating problem of euthanasia.
The timeliness of Martin's book, A Good Death, is hard to overstate. As the baby boom slouches into its final stage and becomes the grey boom, death seems to be on everyone's mind. Certainly it's on the minds of the largest voting block in Canada. In another decade, 20 per cent of us will be senior citizens. Canadian life expectancy was 76 in 1981, but it rose to 81 by 2006; by 2036, 40 per cent of us are expected to live to 90.
But, as Martin makes painfully clear, this does not just mean an uptick in birthday cake sales. It means more dementia; it means more caretakers; it means more failing organs and incurable pains and decimated bank accounts. "The concept of life everlasting," she writes, "is in danger of becoming a fearful secular nightmare rather than a religious solace, as most people in an aging demographic spend the last ten years of their lives coping with chronic and complicated diseases that force them into long-term care."
All this has led to a massive shift in thinking as we view the problem of how to die well in a harsh new light. We rarely die simply any more, or suddenly; instead, we die protracted and hospitalized deaths – deaths that many now hope to avoid.
Martin focuses on the recent history of death, detailing legal battles in Belgium, Luxembourg, Switzerland, the Netherlands and parts of the United States that have drawn new boundaries in the battle for legalized euthanasia. Still, it is Canada's struggle that dominates this book. In 2015, the Supreme Court of Canada decided that Canadians have a constitutional right to, under very particular circumstances, ask our doctors for help in ending our lives. But the procedures for "rational suicide" are far from clear-cut. Reams of stakeholders have a say while the federal government struggles toward new legislation.
Martin has listened to them all. More than two years of reporting (some for this newspaper) have included interviews with doctors, patients, ethicists, activists and underground suicide aides. The opposition to decriminalizing certain suicides (and suicide assistance) is hefty and sometimes moralistic – with religious groups, pundits and palliative-care doctors sometimes raising a true panic. Martin parses through the arguments on both sides of the debate, but does little to hide the fact she's firmly in the right-to-die camp.
Many on-the-fencers will join her by the time they finish this deeply researched read. Martin has a special talent for bringing federal-scale political problems down to the painfully intimate. She forces her readers to visit the deathbeds of patients suffering from advanced Alzheimer's before considering whether they should be forced to live in a vegetative state; she forces us to reckon with the pain of someone like Sue Rodriguez, who famously asked the media's cameras (shortly before her own suicide): "If I cannot give consent to my own death, whose body is this? Who owns my life?"
This is the power of Martin's book: With cool yet compassionate prose, she lays out all the legal and political ramifications on the table and then spins your chair around, makes you sit beside an actual, tortuous death. Then another. And another.
It's a sound history even if it is partisan. Martin plays both the polemicist and the journalist, to equally powerful effect. Her convincing argument boils down to this: Death must be allowed to evolve in tandem with our medical realities. Perhaps there was a time when assisted suicides did not reflect the moral or spiritual realities faced by most people. But that time is past. Martin argues that lengthening lifespans and crippling medical bills – exacerbated by the baby boom's en masse decline – necessitate a new branch of civil liberty, one where we choose our own death and those choices are respected. In this sympathetic and sombre book, Martin outlines the battle for "our final human right."
Michael Harris is the author of The End of Absence . He is currently working on a book about solitude.