But actually, little of all this matters because, at the end of his judgment, the judge says that even if everything the Bentleys argued were correct, he would still have ruled against them. In his own words: “Even if Mrs. Bentley was found incapable of making the decision to accept oral nutrition and hydration, I am not satisfied that the British Columbia legislature intended to allow reference to previously expressed wishes or substitute decision makers to be relied on to refuse basic personal care that is necessary to preserve life.” Translation? If Margot really meant she didn’t want to be spoon-fed if she was ravaged by dementia, she was actually, electively, asking for help in dying, and that was assisted suicide, which is illegal in B.C. and in the rest of Canada. All the rest of the arguments, it would appear, were but a smokescreen. Why spend so much time on them if they are irrelevant? Why take up every one of the plaintiff’s claims so systematically if a broader law rendered them moot in the first place? Was the justice trying to cover every base in the event of an appeal? Or was he just trying to convince himself? It’s hard to believe that Justice Greyell was not aware that Margot did not want to live a life where she signalled consent by opening and closing her mouth. Yet he refused to grant her the death she wanted. By way of explanation, I thought (I guess I hoped) he’d say that he was sorry but hamstrung by the law and felt for her plight. But he didn’t!
If this fate can befall Margot, is any of us safe? The awful irony, of course, is that it should have been Margot. Who knew the real face of dementia better than she? Who tried harder to avoid what she dreaded might come? Who has more standing in the struggle to rest in peace?
This decision is important to all those who have thought through their own demise and created Advance Directives. Certainly, I’ll be phoning my lawyer to go over my Living Will and, if you have one, perhaps you should, too. What we all thought was clear may no longer be clear enough. Kieran Bridge, the Bentley family’s lawyer, suggests that Justice Greyell has set a standard of clarity so high that the greatest jurists in the world would have trouble satisfying it. Still, we must try.
Clearly, the issue of feeding needs more definition. Can the Directive show that at signing the patient understood that he or she might at some point not be able to feed themselves without assistance? On the other hand, when does assistance become too much? Does opening of the mouth constitute “consent”?
Another issue, perhaps the scariest of them all, concerns the person whose mind is still fully alive but whose body is not. They may be trapped within, without movement, voice or even vision. That was Sue Rodriguez. That is my greatest fear.
And, from the caregiver’s side, the executor’s side, how does a person develop the knowledge, the strength and the confidence to carry out the Directive for their loved one when pressured on all sides by the medical system, the legal system and other members of the family?
While Dying with Dignity focuses its efforts on those who are grievously and irremediably ill and suffering unbearably, that Margot is neither terminal nor in any apparent physical discomfort brings into high relief the fact that our rapidly aging world will soon need to also confront the advisability of allowing mentally competent older individuals suffering from various chronic and excruciating non-terminal problems to receive professional assistance in dying if that is their persistent wish and demand.
As Bing Sherrill, a reader from Buffalo, N.Y., put in a letter to me: “This is not an easy or happy subject. But the more discussion ahead of the challenge, the better prepared we will be for the inevitable.”
