At Liberty to Die

A Review of Howard Ball's At Liberty to Die: The Battle for Death With Dignity in America.

Published by New York University Press (2012)

Price: $24.20 (Paper)

Reviewed by Mike Jones 

On February 6th of this year (2015) the Supreme Court of Canada ruled that competent adults living with a terminal disease can ask a physician to help them die.  This decision has triggered an extremely intense conversation about end of life issues here in Canada.  There's nothing wrong with a conversation like this but those of us who participate need to be informed as we "dive in" with our own thoughts and beliefs.  It cannot be repeated often enough that informed decision making is how democracy works best. 

As I was preparing for an internet conversation on the subject of Physician Assisted Suicide I ran across Howard Ball's book on the subject.  Entitled At Liberty to Die: The Battle for Death with Dignity in America Ball's book surveys the legal decision making that addresses the subject of Physician Assisted Suicide and euthanasia.  He explains many of the constitutional issues and how different key sections and amendments of the American constitution have been used and interpreted.  Ball raises several important questions, and issues, about how we die. He also asks us to consider under which circumstances we end our lives.

In At Liberty to Die Ball introduces us to the different courts that have heard and rendered decisions on a variety of cases and appeals.  We read how politicians and religious leaders have contributed to the debate.  It is both interesting and troubling to read how the different ideologies clash without regard for the lives of the people directly affected by their terminal condition. Ball navigates this conflict in a clear, accessible and informative way.  He defines key terms and explorers what it means to be a competent adult and a physician committing to "doing no harm".  He informs the reader about how competent adults would be screened as they proceed along the way to their respects ends. 

Many lawmakers and lobbyists are correct in suggesting that this process is open to abuse on a variety of fronts and Ball offers suggestions on how this risk of abuse can be reduced.  Many of the court decisions mentioned in At Liberty to Die address the series of events that would be necessary for a patient to have their requests granted.  Courts often base these decisions on such concepts as the patient's right to privacy and freedom over their body.  They confront demands that we uphold the notion of the sanctity of life. 

Regardless of our religious, political or philosophical leanings Ball gives us some sense of the complexity faced by leaders and decision makers.  This, alone, should serve us on our collective journey towards some sort of resolution and legal work that helps competent patients address their future.    

This is a debate and conversation that has it all.  There is something for the philosopher, politician, lawyer, theologian, physician, families, patients and many others.  In At Liberty to Die Ball offers a resource that can help us understand the issues and figure out what the content of this conversation means for each and every situation.  

With this in mind I would commend At Liberty to Die to readers participating in the ongoing discussion on Doctor Assisted Suicide and Euthanasia.  This would include church leaders and lay people.  I would also include civic leaders in this group as well.  Even though the content of At Liberty to Die is drawn from the American context it can still be a helpful resource for those of us struggling with the issue here in Canada.  Once again, democratic decisions need to be informed and this is especially true of how we end our days when living with a terminal illness.