The sticking point, of course, is what constitutes a justifiable reason to kill yourself—or have a doctor do so for you.
Today, February 20, marks the tenth anniversary of Hunter S. Thompson killing himself with a .45-caliber handgun in his home in Woody Creek, Colorado. Since his suicide, the right-to-die movement has gained a stronger foothold in American consciousness—even if the country is just as divided as ever on whether doctors should be assisting patients in ending their own lives.
“Poling has always shown a majority of people believing that someone has a moral right to commit suicide under some circumstances, but that majority has been increasing over time,” says Matthew Wynia, Director of Center for Bioethics and Humanities at the University of Colorado Anschutz Medical Campus. Wynia believes a chief factor in that change has been “more and more people say they’ve given a good deal of thought on this issue. And the more people tend to give thought to this issue, the more likely they are to say they are in favor of people having a moral right to commit suicide, under certain circumstances.”
The sticking point is what constitutes a justifiable reason to kill yourself or have a doctor do so for you. In Thompson’s case, he was suffering from intense physical discomfort due to a back injury, broken leg, hip replacement surgery, and a lung infection. But his widow, Anita, says that while the injuries were significant, they did not justify his suicide.
“His pain was unbearable at times, but was by no means terminal,” Anita tells me via email. “That is the rub. If it were a terminal illness, the horrible aftermath would have been different for me and his loved ones. None of us minded caring for him.”
A mix of popular culture and legislative initiatives have shifted the terrain since then. When Thompson made his big exit in 2005, Jack Kevorkian was still incarcerated for helping his patients shuffle off their mortal coil. He was released in 2007, and shortly before his death a few years later, HBO chronicled his struggles to change public opinion of physician-assisted suicide in the film You Don’t Know Jack, starring Al Pacino.
Last year, suicide seemed to cross a threshold of legitimacy in America. When terminally ill 29-year-old Brittany Maynard appeared on the cover of People magazine next to the headline, “My Decision to Die,” the issue was thrust into the faces of every supermarket shopper in the US. Earlier in the year, the season finale of Girls closed with one of the main characters agreeing to help her geriatric employer end her life, only to have the woman back out after swallowing a fistfull of pills, shouting, “I don’t want to die!”
After the self-inflicted death of Robin Williams last summer, those with strong moral opposition to suicide used the tragedy as an illustration of how much taking your life hurts those around you. “I simply cannot understand how any parent could kill themselves,” Henry Rollins wrote in an editorial for LA Weekly. “I don’t care how well adjusted your kid might be—choosing to kill yourself, rather than to be there for that child, is every shade of awful, traumatic and confusing. I think as soon as you have children, you waive your right to take your own life… I no longer take this person seriously. Their life wasn’t cut short—it was purposely abandoned.”
A decade earlier, Rollins’s comments might have gone unnoticed. As might have Fox News’ Shepard Smith when he referred to Williams as “such a coward” for abandoning his children. Of course, both received a good lashing in the court of public opinion for being so dismissive toward someone suffering from depression. “To the core of my being, I regret it,” Smith apologized in a statement. Rollins followed suit, saying, “I should have known better, but I obviously did not.”
A 2013 Pew Research Poll found that 38 percent of Americans believed that a person has a moral right to commit suicide if “living has become a burden.” But if the person is described as “suffering great pain and have no hope of improvement,” the number increased to 62 percent, a seven-point jump from the way Americans felt about the issue in 1990.
Still, only 47 percent of Americans in a Pew poll last October said that a doctor should be allowed to facilitate a suicide, barely different from numbers at the time of Thompson’s death. Wynia believes an enduring factor here this is the public’s fear that assisted suicide will be applied as a cost-cutting measure to an already overburdened healthcare system.
“There is worry that insurance companies will cover medication to end your life, but they won’t cover treatments that allow you to extend your life,” he says. “And then the family is stuck with either ponying up the money to extend that person’s life, or they could commit suicide. That puts a lot of pressure on both the family and the individual. Also, there is the issue of the doctor being seen as a double agent who isn’t solely looking out for their best interest.”
As with abortion before Roe v. Wade, when determined citizens are denied medical assistance and left to their own devices, the results can sometimes be disastrous. “There are people who try and fail at suicide, and sometimes they end up in much worse positions than they started,” Wynia adds. “I’ve cared for someone who tried to commit suicide by drinking Drano; that’s a good way to burn out your entire esophagus, and if you survive it, you’re in very bad shape afterward.”
A 2014 Gallup poll showed considerably more support for doctors’ involvement in ending a patient’s life. When asked if physicians should be allowed to “legally end a patient’s life by some painless means,” 69 percent of Americans said they were in favor of such a procedure. But when the question is whether physicians should be able to “assist the patient to commit suicide,” support dropped to 58 percent. This has lead many advocacy groups to adopt the term “aid in dying” as opposed to “assisted suicide.”
A statement on the Compassion and Choices website states: “It is wrong to equate ‘suicide,’ which about 30,000 Americans, suffering from mental illness, tragically resort to each year, with the death-with-dignity option utilized by only 160 terminally ill, but mentally competent, patients in Oregon and Washington last year.”
According to Oregon’s Death With Dignity Act—which permitted Brittany Maynard to be prescribed a lethal dose of drugs from her physician—a patient must be over 18 years old, of sound mind, and diagnosed with a terminal illness with less than six months to live in order to be given life-ending care. Currently, four other states have bills similar to Oregon’s, while 39 states have laws banning physician-assisted suicide. Earlier this month, legislators in Colorado attempted to pass their own version of an assisted suicide bill, but it failed in committee.
In 1995, Australia’s Northern Territory briefly legalized euthanasia through the Rights of the Terminally Ill Act. Dr. Philip Nitschke was the first doctor to administer a voluntary lethal injection to a patient, followed by three more before the law was overturned by the Australian Parliament in 1997. Nitschke retired from medicine that year and began working to educate the public on how to administer their own life-ending procedure without medical supervision or assistance. Last summer, the Australian Medical Board suspended his medical registration, a decision which he is appealing.
Nitschke says two states in Australia currently offer life in prison as a penalty for anyone assisting in another’s suicide, and that he’s been contacted by the British police, who say he may be in violation of the United Kingdom’s assisted suicide laws for hosting workshops educating Brits on how to kill themselves. Unlike more moderate groups like Compassion and Choices, Nitschke’s Exit International doesn’t shy away from words like “suicide,” and feels that the right to die should be expanded dramatically.
Laws in most countries that allow physician-assisted suicide under specific circumstances do not consider psychological ailments like depression a justifiable reason for ending your life. Nitschke sees a circular hypocrisy in this, arguing that everyone should be granted the right to end their own life regardless of health, and that those suffering a mental illness are still able to give informed consent.
“Psychic suffering is as important as physical suffering when determining if a person should have help to die,” Nitschke tells me. “The prevailing medical board [in Australia] views almost any psychiatric illness as a reason why one cannot give consent—but the catch-22 is that anyone contemplating suicide, for whatever reason, must be suffering psychiatric illness.”
These days, Nitschke is avoiding criminal prosecution by merely providing information on effective suicide techniques. So long as he doesn’t physically administer a death agent to anyone—the crime that resulted in Kevorkian being hit with a second-degree murder conviction and eight years in prison—he’ll most likely steer clear of jail time.
“I think our society is very confused about liberty,” Andrew Solomon, author of The Noonday Demon: An Atlas of Depression, wrote in 2012. “I don’t think it makes sense to force women to carry children they don’t want, and I don’t think it makes sense to prevent people who wish to die from doing so. Just as my marrying my husband doesn’t damage the marriages of straight people, so people who end their lives with assistance do not threaten the lives or decisions of other people.”
While support for laws banning physician-assisted suicide typically come from conservative religious groups and those mistrustful of government-run healthcare, the idea that the government has a role in deciding your end of life care is rooted in a left-leaning philosophy.
“The theory used to be that the state has an interest in the health and wellbeing of its citizens,” acccording to Wynia, “and therefore you as a citizen do not have a right to kill yourself, because you are, in essence, a property of the state.”
This conflicted greatly with the philosophy of Hunter S. Thompson. A proponent of both left-wing social justice and right-wing rhetoric about personal freedoms, Thompson had very strong feelings about the role of government in our daily lives, particularly when it came to what we were allowed to do with our own bodies.
“He once said to me, ‘I’d feel real trapped in this life, Ralph, if I didn’t know I could commit suicide at any moment,'” remembered friend and longtime collaborator Ralph Steadman in a recent interview with Esquire.
Sitting in a New York hotel room while writing the introduction to The Great Shark Hunt, a collection of his essays and journalism published in 1979, Thompson described feeling an existential angst when reflecting on the body of work. “I feel like I might as well be sitting up here carving the words for my own tombstone… and when I finish, the only fitting exit will be right straight off this fucking terrace and into The Fountain, 28 stories below and at least 200 yards out into the air and across Fifth Avenue… The only way I can deal with this eerie situation at all is to make conscious decision that I have already lived and finished the life I planned to live—(13 years longer, in fact).”
Thompson’s widow, Anita, was on the phone with her husband when he took his life. To this day, she feels that the situation was far from hopeless, that his injuries weren’t beyond repair, and that he still had plenty of years left in him.
“He was about to have back surgery again, which meant that the problem would soon be fixed and he could commence his recovery,” she tells me. “My belief is that supporting somebody’s ‘freedom’ to commit suicide because he or she is in some pain or depressed is much different than a chronic or terminal illness. Although I’ve healed from the tragedy, the fact that his personal decision was actually hurried by a series of events and people that later admitted they supported his decision, still haunts me today.”
In September 2005, Rolling Stone published what has come to be known as Hunter Thompson’s suicide note. Despite being written four days beforehand, the brief message does contain the weighty despair of a man unable to inspire in himself the will to go on:
No More Games. No More Bombs. No More Walking. No More Fun. No More Swimming. 67. That is 17 years past 50. 17 more than I needed or wanted. Boring. I am always bitchy. No Fun — for anybody. 67. You are getting Greedy. Act your old age. Relax—This won’t hurt.
Seeing as he lived his life as an undefinable political anomaly—he was an icon of the the hedonism of the 60s and 70s, and also a card-carrying member of the NRA—it’s only fitting that Thompson’s exit from this earth was through the most divisive and controversial doorway possible.
“The fundamental beliefs that underlie our nation are sometimes in conflict with each other—and these issues get at some of the basic tensions in what we value as Americans,” says Wynia. “We value our individual liberties, we value our right to make decisions for ourselves, but we also are a religious community, and we are mistrustful of authority. When you talk about giving the power to doctors or anyone else to help you commit suicide, it makes a lot of people nervous. Even though we also have a libertarian streak that believes, ‘I should be allowed to do this, and I should be allowed to ask my doctor to help me.’ I think this is bound to be a contentious issue for some time to come.”
If you are feeling hopeless of suicidal, there are people you can talk to. Please call the Suicide Prevention Lifeline at 1-800-273-8255.