If having a vivacious, photogenic young woman on the cover of People magazine is what it takes to advance the discussion about death with dignity, so be it.
On Saturday night, Brittany Maynard, swallowed a handful of pills – barbiturates and muscle relaxants she was prescribed by a doctor – and died at the age of 29. Her death, like the last months of her life, was catalogued in breathless detail by People magazine and numerous other media outlets.
In January, Ms. Maynard was diagnosed with glioblastoma multiforme, an aggressive form of brain cancer. After testing, she was given six months to live.
Ms. Maynard moved from California to Oregon in order to access that state's Death With Dignity Act. On Oct. 6, she announced on YouTube that she planned to die at the end of the month. The video went viral with more than 10 million hits, making her the new face of the right-to-die movement.
Unlike many people faced with terminal illness, Ms. Maynard was in relatively good physical health. She spent her final weeks travelling to destinations including Alaska, British Columbia, Yellowstone National Park and the Grand Canyon.
Hers was a Hollywood-esque bucket-list journey, undertaken without visible signs of pain and suffering, which is a bit misleading. Nevertheless, Ms. Maynard made some important contributions to the public discourse, most notably reminding people that suicide and dying with dignity are not at all the same thing.
"I am not suicidal," she wrote in a blog post for CNN. "I do not want to die. But I am dying. And I want to die on my own terms."
Ms. Maynard's decision to move to Oregon also brought that state's Death With Dignity Act into the spotlight. The scrutiny was informative.
Oregon introduced right-to-die legislation in 1997. Despite built-in safeguards, there were dire warnings that it would open the door to abuse and carnage. But between 1997 and 2013, there were 1,173 prescriptions issued for "aid in dying" medication, and 752 people who hastened their death (not including Ms. Maynard). In 2013, just 0.2 per cent of Oregon's deaths required the help of such prescriptions.
Most people who choose a hastened death are college-educated and affluent, and have terminal cancer. In addition, 85 per cent received hospice palliative care before their deaths. In fact, palliative care has improved markedly in Oregon since the law was passed, in large part because the end-of-life discussion is much more open and consumers have become more demanding about pain control and dignity in their final days.
Ms. Maynard, who aligned herself with the group Compassion & Choices, said her purpose in going public was to push for death with dignity legislation in all 50 states (and, one would presume, in countries such as Canada as well).
So far, though, only Oregon, Vermont and the state of Washington have right-to-die laws. (Court rulings in two other states, Montana and New Mexico, have struck down laws banning the practice.)
The most significant difference between Quebec and Oregon is that in the latter, patients are prescribed a lethal dose of pills that they take on their own. In Quebec, the drugs have to be administered by a physician. But both jurisdictions require wait periods and restrict use of the law to competent adults with terminal illness. In Oregon, only one in six requests for aid-in-dying medication is actually granted.
Earlier this month, the Supreme Court of Canada heard legal arguments in a case arguing that the Criminal Code restrictions on assisted death should be struck down as unconstitutional. A ruling is expected in 2015.
In a similar case in the United States this year, a state court struck down New Mexico's law. In the judge's ruling, she wrote: "This court cannot envisage a right more fundamental … than the right of a competent, terminally ill patient to choose aid in dying."
That was essentially the message Ms. Maynard was trying to deliver, in different terms.
"For people to argue against this choice for sick people really seems evil to me," she told People. "There's not a single part of me that wants to die. But I am dying."