In 'The Age' on 25 March 1995 there was an article called "A Matter of Life and Death" which included the following extracts of letters written by Anna Knight (a pseudonym) to Dr Rodney Syme, a Melbourne surgeon and now President of Dying With Dignity Victoria. Mrs Knight was a member of the Voluntary Euthanasia Society of Victoria (the former name of Dying With Dignity Victoria).
Mrs Knight was married with a grown-up family and grandchildren. Within a period of ten weeks she had three operations for cancer, but then discovered that the cancer had returned and was inoperable. She was also effectively deaf as a result of tinnitus, a constant ringing in the ears. These extracts from her letters to Dr Syme cover a period of about 18 months.
"It was a huge relief to talk to someone who didn't reject my belief in voluntary euthanasia...It isn't just because I am in trouble that I have asked for help. It's my firm conviction that human beings have the right to say 'Enough'. Eventually the law will change, but too late for many people."
"The hospital experience with three operations, gastroscopy, colonoscopy, CAT scans and other X-rays, and many personal examinations, has shattered me. It was like being on a conveyor belt. The loss of dignity was worse than the pain. I felt helpless. Last night I was kept awake for four hours with quite severe abdominal pain and all the time, there is abdominal discomfort .. I am almost totally deaf - 25% hearing in one ear, none in the other, and severe tinnitus. I feel very cut off from people - no telephone, radio, group meetings, theatre, films or social occasions, and only captional TV. This all sounds very self-centred. I am telling you my story because it explains why I feel that I have had enough of life ... I am not rushing into this because I am depressed. It has been carefully thought out. If I leave it too late, there could be a situation where I couldn't change my colostomy bags, and my husband couldn't do it. It's such a repulsive job that I wouldn't want him to, even if he was able to. I want to avoid things like that happening. It is so easy to get into a situation where you lose control of your life ..... Fear, weakness and pain can rob even a brave person of their courage and dignity and knowing that their family's last memory of them will be a slowly disintegrating, dependent and probably frightened object in a bed, must often cause acute distress. Good memories can be cancelled out by a prolonged and painful death."
Anna Knight described how she had tried to explain her wish for euthanasia to one of the doctors who had treated her in hospital:
"His reply was that euthanasia and civilisation did not go hand in hand. He said that the doctors now gave their patients a good quality of life and at the end a peaceful and dignified death. I wasn't rude enough to say 'Don't talk such rot', but that is what I was thinking. If I had not felt so weak and helpless, perhaps I would have had the spirit to argue..It's when people are facing death that they most need a doctor's support and guidance. To try and to fail, that is a fear that people feel. In some cases, after the patient has been through a lot of hopeless suffering, they are allowed to die, but that is not good enough. The desperation and longing for a peaceful death that many people are forced to go through isn't humane. It's cruelty... What the doctor sees as a good quality of life can be quite different to how the patient feels. Doctors don't see the daily miseries and the struggle with weakness that many people feel every day. Our bodies belong to us, and the law should not deprive us of the assistance of our own doctors if living becomes intolerable. We have needed their help to live and now we need their help with our dying."
"When I left the hospital, I felt so afraid and desperate. It was an enormous relief for me to talk freely to you about my beliefs and fears. I left you feeling safer. Your wise counselling reassured me that it wasn't unreasonable to think about self-deliverance but that it must never be a premature act, it must be a rational decision made when my condition became intolerable, and I no longer had the will to live."
"I have thought of you a lot since we met and have said a silent prayer - 'Please don't let Mr Syme be knocked down by a bus' I would feel very much safer if you agreed to give me the information now even if I just kept it in a safe place and didn't use it. All our lives are uncertain."
"Each day is full of weakness. Every mouthful has to be pushed in. This isn't living, it's slow dying. I'm still afraid. I don't want to do this to myself. But how I long to die - quickly ... I feel very weak and shaky today and feel that I must act soon or a nursing home will get me ... You were right when you sensed that I still feel some anxiety, but I am coping with this reasonably well. Self-doubt is the main cause. I want to go through this cancer experience, and eventually death, with courage and I want to protect my family as much as possible.. I try not to look into the future but some fear and anxiety are always there."
"When I think of my lonely room and my bottle of tablets, I feel fear - to die alone, with no-one to hold my hand and give me courage. That is a very frightening thought. I don't know today whether I will take my medication on Sunday but how I want to. My only fear is of failure, not of dying. Regrets of course. I think of that last look at my family's faces. It is hard to bear that... "
(At the last moment, Mrs Knight agreed that, despite the risk of prosecution, her husband and daughter should stay with her at the end)
Before she died, Mrs Knight told Dr Syme that he could use her letters publicly after her death if he thought they would help to get the law changed, and she explained her own hope for the future:
"The present laws relating to euthanasia are not humane. They must be changed. We need some brave and compassionate politicians who will admit this and actively work towards getting the changes made. As the law stands, thousands of people are condemned to prolonged and hopeless suffering. Politicians have bodies too, and the day may come when they are caught in this inhumane dying trap, then they may well think 'Why didn't I act while I had some influence?'"
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