What do we mean by self-deliverance?

In Britain, even if you have exhausted all other options and despite sincerely requesting it, the humane assistance of a doctor to bring your death a little closer is neither something you can count on nor something tolerated by law. Hopefully you would never want someone to do that anyway - most terminal suffering can be relieved these days - but if you were one of the unlucky ones whose suffering couldn't be relieved, what consolation is it to know that the law might be changed long after you're dead? Probably not a lot. But a doctor or friend helping you (or even being in the same room with you) when you decide to end your life could result in a criminal prosecution for the survivor.

In a country where voluntary euthanasia and assisted suicide are unregulated and illegal, the only real option for some people can be, sadly, to commit suicide. The English language is short on words to distinguish between different types of suicide. The word "suicide" can be used to cover the irrational self-killing of a lonely teenager who is suffering temporary emotional depression. But take the death of a 93 year old man suffering unrelievable indignities from a terminal illness who calmly decides to go out on his own terms, at his own time and choosing: suicide hardly seems to describe it, and so the term "self-deliverance" has gradually come into popular usage.

SO IF PEOPLE CAN CHOOSE SELF-DELIVERANCE, SURELY THERE'S NO NEED FOR VOLUNTARY EUTHANASIA? Unfortunately it isn't quite that simple. There are many ways that people die, but very few completely reliable ways. In the case of a suicidally-depressed teenager, it is perhaps a good thing that a lot of attempts fail; but failure in the case of a rational attempt - to leave an existence of unbearable suffering - only adds trauma and a sense of inability to the unrelievable problems which motivated the attempt. The horrors of failed rational suicides have been well documented by writers such as Russel Ogden and Lonny Shavelson - many of these failures have followed good "advice".

BUT IF YOU MAKE THE INFORMATION AVAILABLE TO THE PEOPLE WHO NEED IT, WHAT IF IT GETS INTO THE WRONG HANDS? Someone who is determined to find ways to end his or her own life will probably unearth all the known information from newspapers, crime stories and medical libraries. Depressed people may not even bother researching the ways - they may choose violent methods such as crashing a motor-car or jumping off a cliff (though even these methods are not completely foolproof). But for rational self-deliverance, such means are abhorrent - a life of dignity and self-control reflects consideration for other people and the memories one leaves behind. Drugs or car exhausts are more often the method of choice. There has been for a time books on methods of self-deliverance, such as "Final Exit", "Suicide Mode d'Emploi" and "Gentle Death." These books have been available from almost any bookstore. Although their success has drawn valuable public attention to the desperate need for such information, the Scottish Voluntary Euthanasia Society does not believe that such open dissemination of this type of literature is desirable. We seek to discourage irrational suicide that is a result of transient emotional depression; but, especially since physician-assisted suicide is not an option in this country, we believe that competent adults should still have some say in timing their death if they so wish. For the vast majority, knowing that one can choose the door marked "Exit" if things get too bad is an immense comfort and reassurance. That reassurance, however, is nothing but false hope if the information is faulty.

In July 1979, Exit - then the Voluntary Euthanasia Society (Great Britain) decided that a book on how to end one's own life would be a good idea. After announcing their intention, membership rose at a rate of 1,000 a month from an initial 2,000. The following year however, concerned over conflicting legal opinions, they decided not to publish. The Scottish Branch voted to become independent in order to publish and so, in 1980, the Scottish Voluntary Euthanasia Society (Scottish Exit) became the first right to die society in the world to publish such a booklet for its members. It was called "How to Die With Dignity." The booklet was based on the opinions of a single doctor and contained many errors, as have subsequent books, and so eventually in 1993 an International Drugs Consensus Working Party met at the Society's headquarters to finalise a scientifically researched volume called "Departing Drugs." The academic foundations were published in a later work called "Beyond Final Exit", and the legality of publication examined by the Scottish Regius Professor of Law, Joseph Thomson. Please note that self-deliverance books often give varying information and, that of the various drugs books available, we can only vouch for the information in these two volumes, which is based on published scientific research.

The booklet was compiled and distributed as a non-profit venture and, unlike other manuals, available not from bookshops but only by formal application to the Society. Before the book was issued, one of the rules was that any purchaser must have been a member of a right to die society for at least three months, so discouraging irresponsible or ill-considered use of its contents. The Society also reserves the right to refuse to sell it - something an assistant in a bookshop is unable to do with the "popular" guides. We take our responsibilities very seriously. Most members who purchase the booklet are in excellent health and are simply wanting a sort of insurance for their dying years, months or days. But if an individual seems suicidal we always offer counselling or referral to a support group.

DO PEOPLE USE SELF-DELIVERANCE IN THE NETHERLANDS? When a person has made a successful request for voluntary euthanasia, doctors often favour allowing the patient to take the final, lethal medicine him or herself, as a final act of will. Departing Drugs was translated into Dutch (as it has been translated into Spanish, German and French). However, only a few patients are physically able to do so by the time they want their final release. For those that are, there is the added assurance that the doctor will take over if anything goes wrong. Equally important, there is always the presence of a reassuring hand, whether of the doctor, friends or relatives - all of whom may be present. The recommendations in Departing Drugs were tampered with by the Dutch publishers, resulting in a number of distressing deaths. This breached Exit's copyright and the contractual arrangements made with Exit for the translated version, and Exit had no choice but withdraw permission to distribute the Dutch version.

It is a sad reflection on the society in which we live that people sometimes need to die alone and in secret. A humane law for voluntary euthanasia or physician-assisted suicide would reduce the pressure on "self-deliverance." Until then, people are dying, often badly, and they deserve what help and support we can give them.

WHAT'S THE BEST SOURCE OF INFORMATION ON THIS NOW?
Departing Drugs was produced due to the poor quality of information elsewhere. Unreliable books or websites expressing an 'opinion' but without solid evidence to back it up. Such sources often result in botched suicide attempts. Exit has continued the tradition of extensively analyzing every method, comparing different sources, and recommending only safest, painless means of rational suicide.

Existing knowledge is collected in two books: Five Last Acts II and Five Last Acts - The Exit Path. These are available on Amazon and better value than anything else you can buy.

At the end of your life, you need knowledge you can count on. Don't leave it until then!

exploring the options for dying with dignity...