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One day, Ellen Wiebe will be seen as a courageous pioneer. And likely so will John Hofsess.

Dr. Wiebe is the Vancouver physician who this week oversaw the first court-sanctioned physician-assisted death in the country. Since that historic event, she has spoken out about the need for clear federal guidelines governing the procedure and a national directory of physicians willing to assist. The woman whose life the doctor helped end this week came to her after she was unable to find any physicians in Calgary, where she lived, who were willing to assist.

Right now, Dr. Wiebe is fairly alone as she tries to champion policy measures that will make physician-assisted deaths a more regulated and less unnerving process. In a fascinating irony, the momentous milestone reached this week in the right-to-die area coincided with the publication of a remarkable confessional in Toronto Life magazine by Mr. Hofsess, a prominent advocate of an individual's authority to end her life upon her choosing.

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In the piece, Mr. Hofsess admits to assisting in the deaths of eight people who wanted to end their lives, including celebrated Canadian poet Al Purdy. Until now, it had been assumed Mr. Purdy had died at his Vancouver Island home from lung cancer on April 20, 2000. He did have cancer and he did die in his home, but after downing some Chilean wine laced with the powerful sedative Rohypnol and afterward having an "exit bag" filled with helium pulled down over his head by Mr. Hofsess and an assistant.

Why would Mr. Hofsess admit to actions that could attract the interest of police? Because he is no longer alive. He wrote the piece knowing that he would soon be seeking the help of others to terminate his own life, one that did indeed end in Switzerland on Monday. He had two forms of terminal cancer and his medical condition was deteriorating rapidly. He wanted to leave the Earth on his terms, much like Mr. Purdy and the others whose lives he helped end.

I support the proposition that people who find themselves in unbearable circumstances – being trapped and paralyzed in one's own body by Lou Gehrig's disease comes to mind – should have the right to end their life in a dignified way. Still, I confess to finding parts of Mr. Hofsess's account of his actions disturbing. And I'm certain it will provide fodder to those adamantly opposed to assisted death of any description.

For instance, his description of the procedure used to kill some of those who sought out his assistance is chilling. In one part, he talks about the role of the "exit bag" and details how a Velcro strip is used to seal the bag filled with helium snugly around the person's neck. The story describes the evolution of his technique, leading to a new method called a "debreather," which involves a person inhaling the inert gas nitrogen and declining levels of oxygen.

It all sounds rather crude and unseemly. Still, what is inescapable is that for those whose lives Mr. Hofsess helped end, his system, as rudimentary as it was, remained a better option than the miserable existence they were enduring. And it is unquestionably a better route than jumping from a tall building, something a couple of people Mr. Hofsess knew did to end their pain.

It was those two experiences that largely persuaded Mr. Hofsess to found the Right to Die Society, and eventually hasten the demise of eight people who did not want to go on living under the terms of their present existence. Some people will brand Mr. Hofsess a coward and a murderer. I take a different view; I think he was a man of immense compassion who had a deep understanding of the human condition.

I think Dr. Wiebe would fall under the same category.

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Physician-assisted deaths will be conducted using procedures far more sophisticated and humane than anything Mr. Hofsess ever employed. And eventually they will be seen as an important public service and not the nefarious actions of a few.

"I imagine a time when the progressive features of Al Purdy's death will become end-of-life options for all Canadians," Mr. Hofsess writes in the ending of his piece. "My actions will be considered unremarkable."

Unremarkable? I doubt that will ever be the case.

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