Terry Pratchett investigates assisted suicide in Choosing To Die

Death is a central figure in Terry Pratchett‘s Discworld novels, but that’s no help to him when it comes to assisted suicide. In BBC Two’s Choosing To Die, Pratchett looks at the options for people with degenerative diseases to end their lives before the disease progresses to the advanced stages.

Pratchett himself has a vested interest in this subject: diagnosed with Alzheimers’ disease in 2008, he feels that he would like an assisted death and preferably at the point where he’s no longer able to produce books. He’s already lost the ability to use a keyboard, and his books are now written by him dictating to his assistant. He also has problems with his short term memory that affect him.

The author meets up with a number of people suffering various degenerative diseases: Peter Smedley, an affable 61 year old suffering from motor neurone disease; and multiple sclerosis sufferer Andrew Colgan, 42.

Peter charmingly describes his illness as “a beastly, undignified business”. He doesn’t want to suffer the advanced effects of the disease, and he wants to protect his wife from having to watch his condition become worse and worse. The problem is, assisted suicide (as we know from the recent Emmerdale storyline) is illegal in the UK. The well-known loophole is for patients to fly to Switzerland’s Dignitas to die, but if they’re accompanied by a relative, then that relative is in a legally precarious position when they return to the country.

Terry’s particularly upset when meeting Andrew Colgan – who he describes as a “boy” because he’s so young and considering suicide. Andrew has attempted to take his own life twice in the past, but like Peter Smedley, he’s decided to fly to Dignitas to check out his options.

I like to think that in the course of his investigation, Terry Pratchett had to face up to his steely assumptions that assisted dying was the best course of action. For instance, he visits the Dignitas organisation to look at their facilities and talk to their director. He discovers that it’s a square blue prefab building located on an industrial estate – quite at odds to the peaceful notion of nodding off to the soothing sight of the Swiss Alps. And during his chat with Ludwig Minelli, he discovers that many people who sign up with Dignitas don’t follow through on their suicide because just having the choice empowers them to continue living. It’s an interesting notion that maybe bears more discussion.

While in Zurich, Terry meets up with Andrew Colgan, who has travelled there to die. Peter Smedley and his wife have also come along to meet with Dignitas and assess their options. Both men opt for the assisted suicide. Terry meets up with Andrew on the evening before his death and they share a touching time together. Andrew’s mother has accompanied him on the journey and she’s extremely stoic and supportive. Terry and his assistant later share a drink and reflect on Andrew’s decision.

Unexpectedly, Peter Smedley invites Terry and the camera crew to film his assisted suicide. The process involves a lot of paperwork, and two drinks of a poison that will end his life. Dignitas provides two escorts to help with the death, and the whole process is very civilised and dignified. The Smedleys handled the whole procedure with amazing stoicism, but even so, watching the last few moments of Peter’s life was uncomfortable viewing. There’s a moment when the medicine is kicking in, where he briefly panics and asks for water. The escort denies his request, but holds him until the sedatives kick in and he falls asleep.

Pratchett is obviously incredibly moved by what he’s seen. Again, briefly you think that it may have changed his mind about assisted suicide. But it appears to have reinforced his belief that it’s the right decision for him: he compares the relatively calm death at Dignitas with a gradual, undignified decline and death.

There’s a sour note for Terry’s personal situation – a Dignitas doctor tells him that as his Alzheimers’ progresses, he may not be lucid enough to prove his intention to die. And the procedure in the Dignitas facility actually requires the patient to take the drugs that will kill them.

Some discussion questions about assisted suicide

  1. Should assisted suicide be made legal in the UK? Should religious attitudes to suicide be taken into account, or should this be kept strictly secular?
  2. Do we agree that people have the right to choose the circumstances of their death? As Ludwig Minelli pointed out, it’s enshrined in Human Rights law that people have the right to self-determinate.
  3. How do you ensure that vulnerable patients are not forced into assisted suicide against their will? I assume this is one of the biggest arguments against assisted suicide. Persumably it’s best dealt with with living wills made at a time when the patient is provably lucid.
  4. If it were to become legal in the UK, would you anticipate assisted suicide being available on the NHS or as a private service like Dignitas? 

For my part, I believe everyone has the right to choose their death. I don’t believe it’s fair to consign a seriously ill person to years of suffering if it’s their preference to end their life and avoid that pain. There are probably a bunch of different factors at play here, but I personally wouldn’t want to put my family through the distress of watching me deteriorate and having to care for me round the clock.

What are your thoughts on Terry Pratchett: Choosing To Die, and on euthanisa in general?

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