Michael E. Holtby, LCSW, BCD
Assisted Suicide -- Gone Wrong
Originally published in Colorado's AIDS Newsletter, Resolute! , April 1995
Do not reproduce without the permission of the author
When Greg first asked Bill to help him die they had been together for twelve years, and it was the day after Christmas. Greg had been so weak that he couldn't lift a present. It was even too much for him to pull wrapping paper off of a box. He had such bad diarrhea that he needed a diaper change as much as seven times a day. Greg had lost so much weight his knees would knock together and cause sores. Because he had only wasting syndrome and no major opportunistic infections, they were told he could live several more months in this condition.
They first tried hospice care, but what was available at the time was offered
nursing homes. The first place Bill looked at was so dirty he reported it to the
Health Department. The second looked nice enough, but after Greg was left in his
own excrement for three hours Bill took him home.
Greg had been asking for help for three months, but not specifically enough
for Bill to respond. When Greg finally made it clear the day after Christmas, "I
want you to help me die," Bill initially said he didn't think he could. Greg
withdrew in anger until Bill relented. Then as Bill tells it, 'It was like he'd
won die lottery, knowing he wasn't going to be suffering anymore."
This is becoming an increasingly common story that health professionals are
hearing as PWA's opt for what is called rational
suicide or self deliverance. Where just a few years ago
mental health professionals felt an obligation to hospitalize someone under
these circumstances to prevent such actions, the National Association of Social
Workers came out with a policy statement in 1993 which was supportive of an
individual's right to die. NASW stated: "If a social worker is unable to help
with decisions about assisted suicide or other end-of-life choices, he or she
has a professional obligation to refer patients and their families to competent
professionals who are available to address end-of-life issues." There is a
definite shift in our culture in its attitudes on the subject, and Oregon has
passed a law (now challenged in court) condoning and regulating
In a study of physicians in San Francisco (1992), one in four said they would
prescribe a lethal dose of medication for a PWA who requested it, and two in
five would refer their patient to die Hemlock Society. In Amsterdam it is legal,
and Prime Time Live recently documented in a very sympathetic manner a doctor
helping a patient die. Sixty minutes and National Public Radio have aired
similar accounts on the same subject. Clearly the mood of society is changing.
Unfortunately, Colorado's felony statutes specifically refer to assisted
suicide as a form of manslaughter, along with recklessly causing the death of
another, or killing someone in the heat of passion. Rep. Peggy Lamb recently
introduced a bill in our state legislature to legalize physician-assisted
suicide, but it died in committee There has been some talk of a petition drive
to get the issue on the ballot, but I couldn't get her office to return phone
calls for this piece.
Because of the legal restraints in this state, more unnecessary pain and
violence is wrought upon the HIV/AIDS community. Without the help of a mental
health professional the couple may lack support at the very time they need it
most. I have had clients try and protect me, by not seeing me or not telling me
what is going on until the deed has been done. In one instance, I didn't know
until my client's lover came into my office and put his ashes on the coffee
table between us.
Even worse, their actions may be ill considered and unnecessary. A member of
one of my HIV groups considered a morphine overdose because he was afraid of
death by choking -- which is the end he foresaw. The group's combined experience
with dying was enough to reassure him that his dying process was not going to be
with difficulty. He died peacefully a few weeks later.
And yet as Julian Rush, the Director of the Colorado AIDS Project, has said,
"We can't guarantee PWA's a death that is pain free and with dignity." However,
without the help of a physician the chance of a botched job is quite high.
According to a study done at Simon Fraser University in Vancouver, close to half
of the assisted suicides left permanent injuries or loved ones resorting to
suffocation or slashing wrists. But if partners or family members don't assist,
even more violence is a possibility; most typically the use of guns and hanging.
In the case of Greg and Bill, they used a lethal dose of pills. However,
Greg's digestive tract wasn't absorbing properly, so although he was unconscious
he didn't die. Bill recounts his story from this point:
"I think we probably started about one o'clock in the morning or so. So I
just sat there, and I listened to music, and I don't think he ever really woke
up after that. But I think when it got to be about 3 or 3:30 in the morning, I
started freaking out thinking he was still alive. He was very much alive, and
breathing just fine and so I tried to wake him up, and I guess I started
panicking, and I guess I kind of said to him, you know, do you still want to do
this? And I swear in my mind he said yes, mumbled the word yes. So I waited
about another hour, and then I thought I have to do something soon, because once
it becomes morning, and then his mother comes down and he's not gone, and it
could be -- well, who knows what would happen. I was afraid that the amount of
medication if it didn't kill him, would put him in a coma or would, you know,
make him a vegetable, and then he would die naturally anyway, after how many
days, but, I didn't want them to know. I didn't want anyone to know. Because I
really thought I was getting away with murder. And I was terrified, and I
remember at the beginning the blinds weren't closed, out to the backyard, and
there really isn't any way anybody could see in because we had a big tree, and
you know the garage was back there and stuff, and then I remember when finally
did decide to use the plastic bag that was probably about 4, 4:30 in the
morning, then I closed the blinds completely, but I kept looking around the
whole time, because...
The first time I did the plastic bag, I put it on top of his head, and I
made sure there were no air holes, and I laid on top of him over a pillow. I
don't know how long -- it seemed like it was forever -- and I swear, I put my
ear to his chest and I felt his nose and stuff and there was no movement. So I
took the plastic bag and I hid it -- I don't even know where. Not that that
would've done anything. And I went back in, and all of a sudden he goes like
(gasps) and it's like he was just holding it in and stuff, and I thought he was
gone, but he wasn't, and so he was taking this big deep breath, so at that
point, I really freaked out, and I got two plastic bags, and I really made sure
that they were tight, and I put a pillow, and I just lay on top of him.
It was really strange, but there was no going back at that point, you
know. So it probably took more than five minutes. I really wanted to make sure
the second time, because I wasn't going to do it again.
I'm sure he was drugged enough to where there probably wasn't
any pain or any consciousness on his part. He was making a move, at the
very end he made a movement and a sound of gasping for breath,
because the whole plastic bag was really molded to his face because
there was no air. His legs might have, you
know, tensed up a little bit, moved up a little bit, his arms might
have moved just a little bit, but no... no
struggling. Definitely, no.
And then I still couldn't' tell because my
heart was beating so fast, and I kept hearing something, and I thought,
is that his heart or is that my heart? I had to call a friend with a
stethoscope, and he confirmed Greg was gone because I really
I picture that person laying on top of Greg with two plastic bags and a pillow, and it just doesn't seem like it was me."
Greg was unconscious, and he had said specifically with
regard to suffocation, "Do whatever it takes. I just don't want to be here
anymore.' Yet this is such a great sacrifice on Bill's part, one of the greatest
acts of love one could do for another. Needless to say, it has left Bill with
powerful grief, guilt and fear that could have been avoided with more support
both psychological and medical at the time this was going on.
Susan Dunshee, President of the Compassion in Dying organization in Seattle
sums it up best: "It is startling how many times assisted suicides fail, leaving
both the victim and loved ones in terrible despair. Legalizing
assisted suicide would help standardize the practice by allowing physicians to
prescribe the right combination of drugs and to advise the patients properly."
A postscript: Bill now has AIDS himself and when asked if he would consider self deliverance he didn't hesitate to say, 'Yes, definitely if the quality of my life is severely compromised and I'm disabled to the point Greg was. But I wouldn't ask my present lover to help me.'
RELATED ARTICLES ON THIS SUBJECT BY THIS AUTHOR:
OTHER SIGHTS ON THE RIGHT TO DIE & ASSISTED SUICIDE:
Compassion & Choices (Formerly the Hemlock Society)
Last messed with March 11th, 2010
Copyright(c) 2001 Michael E. Holtby, LCSW. All rights reserved.