Laura’s Choice
Any discussion around the issue of Physician Assisted Dying is sensitive, controversial - and urgently needed.
Laura’s Choice is the story of one woman’s brave effort to take control of her destiny - and the obstacles she encountered in achieving that goal.
As their Grief Counselor, I feel privileged to have participated in that long, challenging, and emotionally testing journey with her and her family
- albeit from the other side of the planet.
The small blue plastic wheel valve cradled in the palm of Laura’s left hand was now the only thing standing between the reservoir of lethal barbiturates in her intravenous drip line …… and permanent oblivion. Ninety year old Laura had traveled over ten thousand miles from her home in Australia to the Pegasos Clinic in Basel, Switzerland, accompanied by her daughter Cathy and her granddaughter Sam, with one single objective …. to die peacefully.
“OK. Here we go” she said, as she thumbed the little wheel. As she gently slipped out of consciousness, her last words to them both were “You’re going to make a good, good film. You’re going to cause a tsunami”. Thirty seconds later she was gone. The time was 2.49 pm on the afternoon of December 19th 2019.
For Laura, it was the end of a long and arduous journey that had begun three years previously. For Cathy and Sam - both distinguished documentary film makers - their journey was still far from over. They knew that for the next six months or more, they would be watching Laura’s last moments again and again in the impersonal confines of a video editing suite, as they assembled the film that would become “Laura’s Choice”. Already it has won widespread acclaim – and prestigious international awards – even before its scheduled broadcast across Australia and around the world throughout 2021.
But that’s not how it all began. In 2016, Laura had decided to book a river cruise from Amsterdam to Vienna – a city that she had always longed to visit. She invited her granddaughter, Sam, to accompany her on this ‘great adventure’. And Sam, an increasingly celebrated young film maker, did what all film makers do – she took her professional camera gear along to record every moment of the trip. The early footage is a predictable mix of the sights and sounds of a once-in-a-lifetime experience, being thoroughly enjoyed by the intrepid duo.
Until the accident.
After taking a tumble beside one of Holland’s most picturesque windmill landmarks – a tumble which required a brief visit to the local hospital to dress the cuts and scrapes to her forehead – she began to develop that scourge of the elderly – pneumonia. By the time they reached Vienna, her condition had become so grave that Laura needed to be hospitalized again – and any thought of making their scheduled homebound flight the next day was dismissed until she was strong enough to travel. It was not until four weeks later that Laura and Sam were finally able to return to Australia, but by then something fundamental had changed in Laura’s demeanor. She had, in her own words, “had the stuffing knocked out of her” and as she settled back into her routine as an elderly lady living on her own in her modest Ballina bungalow, that close encounter with her own mortality began to dominate her thoughts.
Always fiercely independent, the prospect of encroaching infirmity and incapacity haunted her. Any thought of institutionalized life in an old folk’s home terrified her and she slowly became aware of the discussions that were occurring in certain corners of the media on the subject of planning a death by suicide. Previously, she had been unaware of the various ‘death with dignity’ organizations that existed around the world, or the ‘physician assisted dying’ initiatives that were taking place within her own country. But in 2018, the issue received renewed attention in the world’s media when 104 year old David Goodall, a celebrated scientist from Western Australia, announced that he was planning to travel to Switzerland to avail himself of their physician assisted dying services. Like Laura, he too had suffered a serious fall, but unlike Laura he had been alone in his one room apartment when it happened and was only discovered by his cleaner two days later. Until that fall, he had maintained an active and engaged personal and professional lifestyle, but now the doctors were calling for around the clock care or that he be moved to a nursing home. He would have none of it, famously stating “I’m not ill. I just want to die.” And so he did, by his own hand, on May 10th, 2018 at a clinic in Liesthal, Switzerland, officially registered for that specific purpose.
Gradually, Laura came to the conclusion that Dr Goodall’s course of action was the one that she also wanted to pursue. At the age of 89, she had lived a full life and now wanted to exit on her own terms peacefully, painlessly and with dignity.
Easier said than done.
And this is where Laura’s story – like Dr Goodall’s - departs from the growing number of others in which a terminally ill patient, often in great pain, has been able to take advantage of local law – where it exists – to request a physician’s assistance in hastening their imminent and inevitable death. Laura was not terminally ill, nor was she suffering from any long-term condition, such as dementia, that might have rendered her incapable of determining her own fate. Nor was the legislation yet in place in her own Australian state to indemnify a doctor, or anyone else, to assist her in death by suicide. It’s still an almost universal requirement, wherever in the world physician assisted dying has been legalized, that the patient must be a resident in the state where the procedure is to be undertaken. And even then the process is lengthy and involves the professional opinions of a number of specifically qualified doctors – which is as it should be. Greedy relatives should never be able to decide that rich Uncle Alfred’s time is up, just because they fancy his inheritance.
Currently, there are only a very few places where last stage terminal illness and residency are not a necessary requirement. And Switzerland is one of them. Although they are strongly resistant to being labelled as a destination for “suicide tourism”, their laws do permit healthy non-residents over the age of 18 to access the services of a small number of strictly controlled clinics where physician assisted dying is available. The bureaucracy is still lengthy, as Laura was to discover, and the medical oversight is still diligently applied, but eventually those who are prepared to undergo the process of submissions and reviews can travel to Switzerland to die.
Getting ‘the greenlight’ from the clinic, with a firm date and time for her ‘appointment’, proved to be a turning point for Laura, Cathy and Sam. Now, Laura’s long life journey had a clear, definite and known end. Cathy and Sam were determined to fill Laura’s last days and weeks with her favourite activities – theater visits, ballet and musical performances, and a grand farewell party. Initially, not all of Laura’s friends and relatives were comfortable with her decision, but eventually they all came to the conclusion that she would not be dissuaded – and perhaps they shouldn’t try.
In the months preceding that final journey to Switzerland, Laura wrote what she called her ‘manifesto’. It runs to ten closely typed pages of passionately argued opinion, and begins:
“So you think you’re free. You are part of a democratic society, so you have the freedom of choice in how you live – and die. Well, you don’t. You don’t have the freedom to die in a dignified manner, which means you don’t have the most basic of human rights. Animals are treated better than humans in this regard”
In the same assertive vein, she goes on to observe that:
“Life has been called a game. If it is, then like any other game, we should have the right and ability to retire: not to wait until we are beaten by any incompetent player, but to retire while we are still ahead, so that we leave the game with dignity, not shame.“
In her view, the ‘incompetent player’ was old age itself – and the infirmity that can accompany it:
"When old age has sapped the energy out of you and left you a poor shell of what you were, you begin to find life more of a burden than a pleasure. Then you should be able to take control of your own life and end it if you wish. You should not have to be in excruciating pain or terminally ill to be able to make this choice.”
One of Laura’s most frequent descriptions of herself was that she was “no shrinking violet”. From the film that her daughter and her granddaughter have made, that is abundantly clear. She was forthright and clear sighted until her dying breath, and seemed unafraid of what might happen next. As she stated in her manifesto:
“If I choose to face my maker having taken my own life, it is nobody’s business except mine. If there is to be a punishment for it, that is my affair and nobody else’s. If I am fully aware of the situation, as I am, I should not be thwarted. I am of the opinion that no such punishment awaits me, but if I am wrong, that is my affair.”
Laura’s situation, and her decision to end her own life on her own terms, raises profound questions about the extent to which society should be able to intervene in what has to be the most personal moment of any individual’s life.
Namely their death.
As the ‘silver tsunami’ of baby boomers builds around the world, an increasing number of vested interests, from medical professionals to legal theorists to insurance policymakers, will have to consider how to address what is already a growing community of individuals who may want to exercise the ultimate right to choose how and when they will die.
To emulate ‘Laura’s Choice’.