A Response to Miriam Toews All My Puny Sorrows

I having been reading a lot about assisted suicide recently as I completed a study guide on All My Puny Sorrows by Miriam Toews for work. The novel is about a young pianist, Elfrieda von Reison, who is suicidal. According to the author, she is overwhelmed by sorrow. The book starts with her second failed suicide attempt. Throughout most of the novel Elf is in the hospital, though she is released twice. The first time, she starts taking her medication and is allowed to go home. She slits her wrists the moment she is left alone and drinks bleach. She is rushed back to the hospital and remains there until she is allowed a pass for her birthday. Released from the hospital a second time, she slips away from her husband Nic and throws herself in front of a train. The novel uses Elf’s repeated attempts to and eventual success at killing herself as a backdrop for a discussion about the morality of euthanasia.

When is it morally right to help another person kill themselves? Toews makes the argument that the mentally ill should have access to euthanasia as a “treatment” for their problems. She asks how we can differentiate between physical and mental suffering. What is the difference between someone overwhelmed by sorrow and someone dying of breast cancer? Do we not have a moral obligation to relieve suffering? Toews presents no real answer to these questions. Her suicidal character is not euthanized but, instead, kills herself. Yet Yoli, Elf’s sister whom Elf had begged to take her to Switzerland for euthanasia, feels overwhelming guilt that she did not help Elf die. The novel ends with Yoli’s dream of taking Elf to Switzerland and providing her a peaceful death surrounded by her family.

If someone is dying, do they not deserve to die with dignity at a time and place of their choosing? When one of my mother’s friends was diagnosed with cancer and told it was incurable he gathered his family together and said goodbye. He told them all he loved them and would miss them when he was gone. He then went out to his hunting cabin and shot himself. We all admire his bravery and ability to make a tough decision when faced with a slow and agonizing death. Once someone has made that decision what if they are not that brave?

Right now, suicidal tendencies automatically equal insanity. Social norms tell us that those who are suicidal need our help and support to find meaning in life once more. In general, that is not a wrong approach. Overwrought teens who down pills because of bullies need help to see that life goes on after high school. That the pain they are feeling is not all there is to life and that one day, if they hang in, things will get better.

On the other hand, are those living in situations where it will not get better, and they have no quality of life. If they want a way out should we not give it to they. No one can really know what is in another’s head. If someone is living with chronic pain and wants to fight like hell they should be given every resource to do so. Yet, if they don’t want to fight anymore those voices should be listened to as well. The tricky part is that it has to come from the individual.

There is a fear that if euthanasia is an option it will become a prescription for those living with chronic pain conditions or the mentally ill to ease the burden on society.  I’m not sure how much this is a flawed slippery slope argument, rampant paranoia or a legitimate concern. Euthanasia, as practiced today, places the decision in the hands of the patient. Doctors and family are consulted, but the ultimate decision is the patient’s. In fact, Switzerland’s current law says that no one who gains by the person’s death can assist in that death. Rarely is it the worries that we most talk about that come to pass since once discussed a solution can usually be found. Problems that are left in the dark are much more worrisome than those problems that see the light of day. Euthanasia, at this point, is too closely supervised to be abused. It makes sense to offer it as a personal choice for those in need. Like death itself, euthanasia is a question each person must ultimately face alone.

Please feel free to add your own comments, stories, or concerns. As a personal choice, I don’t know what I would choose. I don’t think many of us do until confronted with our own mortality, but I think as a free society each of us should have as many options open to us as possible.


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