Brittany Maynard and Lauren Hill will leave very different legacies

Brittany Maynard, who had a terminal form of brain cancer, has received enormous support for her decision to die at a time of her own choice, surrounded by her family and friends.

She found meaning in actively promoting the “right to die”, supported by Compassion and Choice, formerly the Hemlock society.

By coincidence, at the time she was planning to die, I was at an Anscombe Bioethics Centre conference in London: Euthanasia and Assisted Suicide: Lessons from Belgium.

The programme included both pro- and anti- euthanasia advocates. Interestingly, they agreed on a number of issues, such as that the law is being “stretched” to accommodate cases never intended to fall within its scope.

They also all believed it is completely untenable, due to conflict of interests, that Dr Wim Distelmans, one of Belgium’s foremost practitioners of euthanasia, also heads up the government regulatory body for euthanasia.

Prof Distelmans euthanised Marc and Eddy Verbessem, twin brothers who were already deaf and but also facing blindness.

He ended Nathan (born Nancy) Verhelst’s life. Verhelst could not cope with the fact that a sex change operation did not solve his problems. He had been constantly told by his mother that it was a pity that he was not a boy. After his death, his mother expressed no regret, saying that they had never had a bond.

It all seems very far from the vibrant, beautiful, articulate and determined Brittany Maynard and her tragic illness.

Unthinkable

But is it so different? Twelve years ago when euthanasia was introduced, the cases outlined above would have been unthinkable in Belgium.

Nor would it have been foreseen that the law would have been extended to children, without any age limits, as has just happened.

Another speaker, a respected researcher and oncologist, Prof Benoit Beuselinck, described a surreal realisation he’d had when a woman requested euthanasia, but also wanted her little dog put down. He realised ending her life would be uncontroversial, but that animal rights activists would probably prevent him putting the dog down.

He does not euthanise patients, because he believes passionately that it is possible to provide a high standard of care and relief of pain, without having to violate the ideals for which he entered medicine – to heal, not to kill.

He sees more and more patients who request euthanasia because they are fearful of being a burden, as the “right to die” gradually becomes the “duty to die”. He showed a slide of a euthanasia information seminar held in a senior citizens’ home. The sponsor? A health insurance company.

Death is cheap

Euthanasia is far cheaper than treatment. In Oregon, where Maynard died, there have been several cases where health insurance policies do not cover cancer treatment that will relieve suffering, but will not cure. However, the policies will cover assisted suicide.

Brittany Maynard wanted death with dignity, at a time of her choosing, although, heartbreakingly, her mother had told her that it would be “her honour” to care for her in any way necessary.

Death with dignity is not a synonym for assisted suicide.

The modern hospice movement started in 1967, when Dame Cicely Saunders opened the first purpose-built hospice in London. Modern hospices operate according to three principles to ease the process of dying: relief of physical pain, preservation of dignity, and respect for the psychological and spiritual aspects of death.

Brittany could have still died surrounded by her family, in peace and comfort, but perhaps much later, because patients receiving palliative care tend to live a little longer.

It was shocking to learn that in palliative care units in Belgium, euthanasia is also carried out, because it seems to violate everything that palliative care should be.

As Maynard was planning her death, another young American with incurable brain cancer was fulfilling a dream – playing in her first college basketball game.

Lauren Hill, aged 19, is just as vibrant, articulate and determined as Maynard, but unsurprisingly, has received a fraction of the publicity (http://tinyurl.com/kpfyy5n). Hill is channelling her energy into fund-raising for The Cure Starts Now. This foundation researches a cure for her rare form of cancer, which normally affects children aged five to 10. Sadly, any cure will be too late for Lauren.

Both women’s circumstances are desperately tragic. Both will be dearly missed by people who adore them. Both will leave a legacy, but their long-term impact will be radically different.