At the center of Me Before You is an intensely emotional and ethical debate about assisted suicide; and in particular, of the assisted-death organization, Dignitas, which plays a primary role in the story. Dignitas, founded near Zurich, Switzerland in 1998, has as its motto "to live with dignity to die with dignity." The organization's assisted suicide programs are very carefully regulated and require that prospective patients undergo a series of psychological and medical assessments. Patients must also certify that they are making the decision to die of their own free will; Swiss law mandates that assisted suicide be done without coercion or self-interest on the part of the person or organization assisting with the process. Suicide is accomplished humanely through ingestion of a powerful overdose of pentobarbital, which first numbs pain, then induces a coma, and finally results in respiratory arrest and death. It's estimated that more than a thousand people have been assisted to die by Dignitas.
Dignitas is not the only organization providing these services, and Swtizerland is not the only place in the world where assisted suicide is legal (three U.S. states have legalized physician-assisted suicide, although under stricter regulation than in Switzerland). Digitas's relatively liberal policies and their willingness to work with so-called "suicide tourists" who travel to Switzerland from elsewhere in Europe or around the world has resulted in significant attention and publicity, as well as criticism and controversy. A former nurse employed by the organization has accused it of being overly concerned with profits and not enough with the mental and physical well-being of its patients. According to the Journal of Medical Ethics, more than 20 percent of Dignitas's patients have no physical or mental illnesses, but simply cite "weariness with life" as their rationale for suicide, raising numerous questions about what constitutes reasonable and ethical grounds for suicide assistance. A recent article in the Daily Mail relates the agonizing story of a man who took ninety minutes to die, nearly three times as long as what Dignitas's physicians promise.
No matter what, the issue of assisted suicide, and Dignitas's services in particular, will continue to be debated in literary circles; British superstar writer Terry Pratchett, who was diagnosed with Alzheimer's disease in 2008, has declared his intention to seek death with Dignitas when the time comes, saying "it should be possible for someone stricken with a serious and ultimately fatal illness to choose to die peacefully with medical help, rather than suffer."
Photo by Steffan Hill
This article was originally published in January 2013, and has been updated for the
July 2013 paperback release.
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