AMSA PremedFest 
University of Florida, 
Gainesville, FL
April 11-12, 2015

Making a Date With Death

A day in the life of legal assisted suicide

The New Physician April 2007
Marianne, a volunteer “escort” who helps her clients navigate the emotion and bureaucracy of dying, listens to her answering machine: The first message is from a client who talks about his schedule for the day of his planned death. Another needs someone to talk to. The last message is from a man who has decided to set a date.

The Swiss organization EXIT helps terminal patients in that country die legally, and the documentary film “EXIT: The Right to Die” (First Run/Icarus Films, $440 on DVD, $125 rental) follows the group’s staff as they interview candidates, evaluate their judgment, and ultimately support clients through the process of making the decision to die, choosing a date and finally drinking a deadly barbiturate cocktail.

As the title implies, the documentary does not question the organization’s viewpoint. The scenes support assisted suicide and EXIT’s guidelines, and clients frame their decision to die, not as a matter of want, but of need, due to unbearable suffering.

The English-subtitled film teaches us about EXIT without formal interviews. All rules and procedures are explained in the context of phone conversations, speeches at meetings or escort-client interactions. A speech given by the group’s president, Dr. Jerome Sobel, and the cocktail-hour conversations that follow, serve to inform the viewer about EXIT’s policies and ongoing efforts in the assisted suicide movement across Europe.

Long pauses during conversations between escort and client allow the viewer to join in processing the enormity of the clients’ final acts. This technique effectively draws the viewer into the organization’s mission, but throws the spontaneity of the action and the sincerity of dialogue into question. Sometimes the camera changes angles in mid-scene, reminding us that the film is edited to provide the best portrayal of EXIT.

Leaving aside larger questions, the film simply assumes the propriety of EXIT’s work, and instead probes deeper into other issues of caregiver stress and protocol. In a team meeting, some escorts say they cannot take any more cases because they are overwhelmed with assignments as it is.

Marianne and a new escort walk through a foggy Swiss countryside, talking about the way clients affirm their humanity in the face of death. One woman insisted on repairing the shutters and clearing out the refrigerator before going. In this way, “Right to Die” argues not about morality, but about death as a part of life. The two escorts settle together on a fallen tree and discuss facing and accepting death. This acceptance is necessary for them to sit with their patients emotionally and spiritually.

Medical personnel everywhere may benefit from seeing this particular perspective of dealing with terminal patients. Unfortunately, the price of the film likely restricts purchase to organizations rather than individuals.

As Sobel makes a final drive to a client’s house, his eyes dart between the road and the rearview mirror, allowing us to imagine what he is thinking. At the house, he carefully confirms the client’s wishes, and then he helps her to sit up. As we look on from behind, he sits on the bed next to her, handing her the cocktail. For a few moments, before she starts feeling dizzy, the client, the doctor and the viewer are all looking in the same direction. Seemingly everyone is on the same page.
Jason Cheng is a third-year at the University of Michigan Medical School. Second-year William Cederquist provided editorial assistance.