How to Die in Oregon

Physician-assisted Suicide or Death with Dignity.  It's legal in Oregon. 

In the most thought-provoking movie I saw at Hot Docs,  How to Die in Oregon takes a hard look at the practice of physician-assisted suicide in Oregon.  And I mean a hard look.  The film opens with a man drinking the physician-prescribed deadly dose and the camera zooms in as he slips into a coma with his family around him.  A physician has prescribed the lethal dose; a volunteer mixes the Seconal into a glass of water; the patient drinks it himself.  The volunteer asks two confirming questions before handing over the drink.   "Are you sure you want to do this?  You know, you can change your mind." "Can you tell me what will be the result of drinking this mixture?"  Physician-assisted suicide is different from euthanasia in that the doctor does not administer a lethal dose; the patient has to be physically able to drink the liquid dose.

In the movie, we come to know Cody Curtis, an active, attractive, elegant, woman with a positive attitude, a caring husband and two children, who is suffering from terminal liver cancer.  She wanted to choose to die with dignity when the pain became intolerable.  Is it a sign of great moral courage to endure such pain in a hopeless situation when there is an alternative?  Clearly Cody didn't think so.  As Cody says near the end, "I don't ever want to have a night like that again".  

Doctors also face a tough dilemma when asked to prescribe a lethal dose for their patients.  Is this prescription at variance with their Hippocratic Oath or is it the ultimate good they can do their patients?  Cody's doctor was conflicted about this, but concluded that she owed it to her patient to give her freedom of choice.  

One of the reasons director Peter Richardson chose to focus the movie on Cody was because the doctor was willing to be included.  But he also included a statement by another doctor arguing vehemently that prescribing a lethal dose just couldn't qualify for doing no harm to a patient.  Opinions are fervently held on both sides of this question.  Richardson told us at the Q and A that he filmed 16 patients who had filled the lethal-dose prescription, but most did not use it.  Clearly just having the prescription in the drawer is comforting to many.

Cody postponed her original date when she was still feeling quite well;  she laughed about having to replace the the jewellery she had given away.  However, she knew the time had come in December.  Cody doesn't quite make Christmas as she'd hoped, but she does teach her son how to prepare the traditional Christmas squares.  When her husband asks where the cheque book is, she exclaims "I've been trying to tell him about that for 35 years!"  We watch through a lighted window as we hear the quiet conversation of Cody, her family, and her doctor as Cody achieves her peaceful end.

The movie followed the citizen-led push for a physician-assisted suicide law in Washington, led by a woman who has lost her husband in an ugly and painful death by brain cancer.  He did not have time after his diagnosis to establish residency in Oregon so he could not opt for physician-assisted suicide.  His wife pledged to him that she would fight for the law in Washington, and it ultimately passed by a significant majority.  Other states are considering adopting this law.  Laws for assisted suicide have been proposed more than once in Canada.

How To Die In Oregon won the Sundance Grand Jury Prize and was third in the People's Choice Awards at HotDocs (How good must those first two be!).  The movie was funded by HBO and will thus be available widely.  

What a strong movie.  Besides developing great affection and respect for Cody Curtis, and shedding some tears, I got thinking about end-of-life choices.  With the coming aging of our society, and the ability for medicine to keep us alive longer, this is a question that will be challenging many of us. 

 Would I want a 'get out of pain free' card, when faced with prolonged, futile suffering?  I would.  What do you think?

Family Portrait in Black and White

Family Portrait in Black and White opens in the Ukraine with scenes of laughing children playing together under the care of the saintly Olga Nenya, a foster mother taking care of 23 such orphaned children. Sixteen of them  are biracial,  and Olga's dedication is even more impressive when set against the malevolent, open racism in the town and the active skinheads who beat up and kill black people, seemingly with little intervention from the police.  

The children's lives are highly structured: strict rules and plenty of household tasks.  Life is modest - the council thinks the house should be condemned - but we see lots of caring and hugs between the children and their foster mother, whom they consider to be their real mother.  Through a charity organized to help Ukrainian children after Chernobyl, several children spend summers and Christmas with generous families in Italy and France, which adds enrichment to the spartan life they experience in the Ukraine.

But the movie slowly unveils problems within this unusual family.  Older children, especially the brightest ones, face difficulties following the educational paths they want.  When some of the European families want to adopt the children, they are blocked by Olga who holds their guardianship.  One girl 'escapes' from the family.  It's clear she's grateful to Olga and still holds her in considerable affection, but feels she needs to pursue the better life in Italy.

The movie ends with the reflections of Kiril, a bright and sensitive boy who makes it to university, resulting in estrangement from Olga.  Kiril characterizes the home as a totalitarian state with Olga in the role of Stalin, and Kiril a dissident.  

This film might have Black and White in the title, but there's nothing black and white about this situation.  It's a complex, nuanced film and not the one the filmmaker originally set out to make.  At first, she was going to make a film about racism in the Ukraine.  Then she thought it would be about the saintly foster mother Olga.  As time went on, the focus veered to the autocratic style of Olga.  The movie ended up containing elements of all these themes.

I wasn't the only one who loved this film.  It won the Best Canadian Feature at Hot Docs.