When I was twenty years old, I thought that a person the age I am now (I’ll be seventy this month) was a fossil, but then in 1962 the life expectancy of a Canadian male was only sixty-eight. In the years since, advances in health care, nutrition, and quality of life have improved the odds. According to Statistics Canada, my eight-month-old grandson can expect to live to eighty-one. Someone my age has a good chance now of reaching ninety, which means that with a little luck and good genes (my mother is still going strong at ninety-six), I have twenty-plus years ahead of me. When I think about how much life I crammed into my first twenty years, the prospect of twenty more seems encouraging—although as I grow older, I find myself worrying less about how many years I have left and more about whether the last years of my life may be the worst of my life.
This is the reality for more and more elderly Canadians. We have replaced their disintegrating hips, mended their damaged hearts, removed their cataracts, and treated their cancers, prolonging their lives and inflating the populations of the country’s 2,136 senior homes—although most elder care in Canada is still provided by families and friends, often at great financial, physical, and emotional cost. As for the seniors being cared for, we have kept them alive, but are they really living? A million Canadians are now over seventy-five, and according to the Alzheimer Society of Canada almost 200,000 of them suffer from some form of dementia. Medical science has yet to find cures for this and any number of other chronic diseases, so too many lives wind down in a dispiriting, ultimately futile struggle to “manage” them. One seldom hears laughter amid the congestion of four-wheeled walkers in nursing homes.
A friend told me recently how she and her husband plan to avoid this grim outcome. They have agreed that if declining health causes either of them to despair of living, the other will help facilitate his or her death. “Isn’t that illegal? ” I asked, at which point she told me about Dignitas, an organization founded by a Swiss lawyer that helps people who want to die do so. Assisted suicide is legal in Switzerland, unless it’s motivated by self-interest; Dignitas charges fees but operates as a not-for-profit. Clients submit to consultations with independent doctors and sign affidavits confirming their wish to end their lives. At an agreed-upon time, a lethal dose of powdered pentobarbital dissolved in water brings on sleep in ten minutes and death within thirty. Many hundreds have availed themselves of this service since it was first offered in 1988, and some of them, including a friend of my friend, did not have a terminal illness; they simply wanted out of what had become a miserable life.
Soon after I learned about Dignitas, the Royal Society of Canada issued a report proposing that in the absence of legislation to legalize assisted suicide (it now carries a prison sentence of up to fourteen years), the provinces and territories should instruct their prosecutors not to pursue charges. To date, only British Columbia has issued such an order, although none of the provinces or territories appears anxious to enforce the law. Nor do politicians of any persuasion show much appetite for a national debate, even though polls show that the public would support decriminalization, ever since right-to-die advocate Sue Rodriguez took the case for legalization to the Supreme Court in 1993 (the judges ruled 5–4 against her, but she went on to fulfill her wish with the help of an anonymous doctor). The matter may yet be decided judicially: the British Columbia Supreme Court will soon rule on the case of Gloria Taylor, like Rodriguez terminally ill with ALS (amyotrophic lateral sclerosis, or Lou Gehrig’s disease), who is also fighting for the right to an assisted suicide.
Whatever the courts decide, the issue won’t go away. The number of seniors in Canada has more than doubled in the past twenty-five years, and it will double again in the decades to come, as the baby boomers reach retirement age. Economist David Foot observed in his 1996 book, Boom, Bust and Echo, that the boomers constitute the country’s largest demographic cohort, and consequently they are accustomed to getting what they want. For the moment, they are the healthiest middle-aged Canadians ever, having expended unprecedented time and energy in gyms “managing” the aging process. But that will change. Inevitably, their bodies will let them down, and when that happens they won’t settle for the unnecessarily prolonged and undignified fate that befell many of their parents. They will want what is already available in Switzerland, the Netherlands, Belgium, and a handful of American states, and one way or another they will get it. Within the next twenty years—dare I say, during my lifetime?—assisted suicide will become a legal option in Canada.
This appeared in the March 2012 issue.