The suicide last week of South African musician and entertainer Ian von Memerty (61) could affect an upcoming Constitutional Court motion on end-of-life decisions for the terminally ill, reports Daily Maverick.
It has taken DignitySA more than four years to prepare the founding papers for an important Constitutional Court motion taking place on 9 April, challenging the current blanket prohibition on assisted dying for the terminally ill in South Africa.
Previous challenges to the law by the lobby group have been ruled on an ad-hoc basis, but this is the final showdown, where a team of 16 foreign experts and two donor-funded senior advocates will argue for a change to the law.
Showman Von Memerty was not terminally ill when he ended his life: he was just tired of it all and feared old age, poverty and sickness.
These same fears no doubt resonated with other people, which is why Von Memerty’s public posts on Facebook justifying his decision drew widespread support.
Thousands followed his “series” in which he argued that “suicide and self-deliverance are not the same thing”.
“Self-deliverance” is a term that became popular in the 1990s as discussions about voluntary euthanasia raged globally, as the “right to die” movement peaked. This was after the 1991 publication of Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying by Derek Humphry.
Von Memerty co-opted the term to describe his decision to end his life, and by “self-deliverance,” he said he meant “a peaceful and non-violent death (I cannot describe methods; doing so would result in possible censorship and removal). It is deliberate and prepared”.
His series was not about assisted dying, said Von Memerty. “Assisted dying requires conditions and access that many people simply do not have.” He was referring to the lack of social and medical services and support for people in mental distress.
The law and suicide
South African health legislation requires that anyone with knowledge of a threatened suicide must intervene and seek mental health for that individual.
Technically, those who supported Von Memerty on Facebook have violated the law. The Mental Health Care Act of 2002 states that “if a person is threatening suicide, they may be subject to involuntary care, treatment and rehabilitation”.
The person threatening suicide can also be “involuntarily” admitted to “a designated health facility for a 72-hour assessment to determine their mental state and immediate risk”. The law also makes provision for South African Police Service intervention.
The Protection from Harassment Act (2011) classifies the threat of suicide in certain contexts (within a relationship or to manipulate or coerce a partner) as “a form of emotional abuse or harassment”.
The law also states that while suicide is not a crime, “assisting or inciting someone to commit suicide is unlawful in South Africa and can be treated as murder or culpable homicide”.
The right to die
DignitySA, which lobbies for the right to die for the terminally ill, has provided 11 case studies – including that of Craig Schonegevel, who suffered from a punishing variant of neurofibromatosis and took his own life at 28 on 1 September 2009 – in support of the motion.
Von Memerty, in selecting the terminology, the words, used in the right to die debate, may have set the battle back by proving the “slippery slope” argument that has been proffered by those against end-of-life decision-making.
Chris Jones, chief researcher with the Department of Systematic Theology and Ecclesiology and head of the Unit for Moral Leadership at Stellenbosch University, has written that people make decisions throughout their lives about their health.
“But when they are terminally ill, often in unbearable pain and suffering – and sometimes even losing their dignity – they are not allowed to decide when they want to die,” he writes.
He asks whether, when someone is terminally ill and suffering, a strong moral case could be made “that such a person – within prescribed medical-ethical parameters, evaluating the patient’s suffering, prognosis, mental competence, informed decision-making and clear communication – could be assisted with the dying process?”
He noted that three arguments had been put forward in support of “active euthanasia”: that personal autonomy should be respected, unbearable suffering should be prevented, and that no one should be forced to endure suffering, often at high medical cost.
This implied that a “competent person” had a moral right to make his or her own choice.
Von Memerty left us to continue to lobby for the legal right to die for the terminally ill to be promulgated.
His death is an example of why we need new laws as medical science alters the way we live and die. We also need many more spaces and places where people who are desperate, jobless and hopeless can find some support and help when it all becomes too much.
See more from MedicalBrief archives:
Why SA needs both palliative care and assisted dying
Euthanasia activist says SA doctors support legalising assisted dying
Euthanasia activist Sean Davison calls for law change after house arrest ends