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New York Times
4 days ago
- General
- New York Times
A Merciful Death
I grew up in the '80s and '90s and remember being fascinated by the controversy around Jack Kevorkian. He was a Michigan doctor who argued that sick people should be allowed to die on their own terms rather than suffer through a grueling illness. Was he a traitor to his oath to 'do no harm'? Or was he an angel of mercy, letting victims of disease exercise one last bit of agency over their failing bodies? Kevorkian, who went to prison for helping dozens of people with 'physician-assisted suicides,' seemed so radical at the time. Now his ideas are commonplace. Ten states and lots of Western nations have assisted-dying laws. But they're mostly built for people with a life-ending diagnosis. Canada is trying something more. There, a patient can have a state-sanctioned death if she is suffering — but not necessarily dying — from an illness. For the cover story of yesterday's New York Times Magazine, Katie Engelhart followed one woman's journey to die. It's a nuanced portrait of a person racked with pain and a tour of some controversial bioethics. I spoke with Katie about the difficulty in knowing what's right and what's wrong when people suffer. Your story has so much intimate detail about the struggles of the main character, Paula Ritchie. How did you get her to confide in you? Paula was, in her own words, 'an open book.' The first time I called her, we talked for nearly three hours. She had applied for medical assistance in dying, or MAID, after suffering a concussion, which led to dizziness and insomnia and pain that never went away. I knew that Paula would be an interesting case study, in large part because of the complexity — the messiness, really — of her life. She was the kind of patient whom opponents of MAID worry about. Paula had a mix of physical and psychiatric conditions: chronic pain, chronic fatigue, bipolar disorder, depression. She had a history of childhood trauma. She lived below the poverty line. She was very lonely. You watched Paula die. I was moved, reading about her last moments. What was it like to see that? I was trying to be as small a presence as possible in the room. I sat in a folding chair at the foot of her bed. As a reporter, the experience was doubly intense: I was there to do a job — to gather information — but I was also experiencing the moment as a human being, sitting in a room full of suffering. I said very little to Paula and she said very little to me, although she did briefly reach for my hand as she was getting ready for her injections. Want all of The Times? Subscribe.
New York Times
5 days ago
- General
- New York Times
Do Patients Without a Terminal Illness Have the Right to Die?
One of the doctors wanted to know why, despite everything, Paula Ritchie was still alive. 'I'm just curious,' she said. 'What has kept you from attempting suicide since August of 2023?' 'I'm not very good at it,' Paula said. 'Obviously.' Then she started to cry. She said that everything was getting worse. She said she didn't want to suffer anymore. 'This is a more dignified way to go than suicide.' Paula was lying in the big bed that she had pulled into the center of the living room, facing an old TV and a window that looked out on a row of garbage bins. The room's brown linoleum floors were stained, and its walls were mostly unadorned. On a bookshelf, there was a small figurine of an angel, her arm raised in offering. At 52, Paula had a pale, unblemished face and a tangle of dark hair that fell around her waist. The day before the appointment, in January this year, she washed her hair for the first time in weeks, but then she was not able to lift herself out of the bathtub. When, after hours, she managed to get out, her pain and dizziness was so bad that she had to crawl across the floor. Dr. Matt Wonnacott sat in a folding chair at the foot of the bed. He was there as Paula's 'primary assessor': one of two independent physicians, along with Dr. Elspeth MacEwan, a psychiatrist, who drove through the snow to Smiths Falls, Ontario, to evaluate Paula's eligibility for Canada's Medical Assistance in Dying (MAID) program — what critics call physician-assisted suicide. 'You're a difficult case,' Wonnacott admitted. Another clinician had already assessed Paula and determined that she was ineligible — but there was no limit to how many assessments a patient could undergo, and Paula had called the region's MAID coordination service every day, sometimes every hour, demanding to be assessed again, until the nurse on the other line had practically begged Wonnacott and his colleagues to take Paula off her roster. Want all of The Times? Subscribe.
