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"It was easy, folks. It was easy."—Roger Sagner, just after taking a legally prescribed fatal dose of drugs
Roger Sagner's recorded death that begins this documentary may have been easy—as he assures those present and those watching, using up some of his last breaths to do so. However, the rights that allowed him to legally choose the time and manner of his death were not easily obtained. Director Peter Richardson's How to Die in Oregon examines the human implications of that state's controversial law allowing physician-assisted suicide, primarily through the story of one woman with terminal cancer. It's a documentary about a crucially important issue that a lot of people don't want to think about. Like the death it depicts, the film is emotionally harrowing and unexpectedly, heart-wrenchingly beautiful.
Facts of the Case
How to Die in Oregon gives us snippets of several people's dying processes and the work of volunteers who shepherd them through the personal decisions and legal hurdles involved in pursuing an assisted suicide. The bulk of the film, though, tracks that journey as undertaken by one woman, Cody Curtis, who is dying of colon cancer in her mid-fifties. Chronicling her family's feelings about Cody's choice of assisted suicide, her relationship with her physician, and her evolving attitudes toward death during a long dying process, the documentary provides a comprehensive and intimate look at a single death.
"It's a very human thing to die," Cody says, as she contemplates her own impending death. She's right, in the sense that death unites all humanity, representing a truly universal experience. And yet, humans—at least American humans—haven't been very good at dying for some time now. Cody's statement gives death connotations of ease and naturalness, but it rarely seems to feel that way in our hyper-medicalized culture. Treatments and technologies that can extend life also tend to extend the suffering associated with our top causes of death, the vast majority of which are withering diseases like cancer or heart failure. Though How to Die in Oregon's title may seem flippant, the challenges these long and painful modern deaths create really do raise the need for "how to" manuals—and, in the opinion of right-to-die advocates, for better alternatives. As Cody puts it, "If I had an option, I would prefer not to die, thank you very much. But given that I know I'm going to die, does an extra three months of fluid leaking through my pores sound that great? No. I'd rather go when I'm still feeling okay and when I can still communicate with my family."
While the film is certainly an advocacy documentary—endeavoring not only to educate viewers about right-to-die issues, but also to suggest a favorable outlook upon them—the political aspect of Cody's death is only one section of a much larger portrait. Even for the audience member who doesn't care much about the political aspect or positions herself on the other side of this debate, How to Die in Oregon offers profound lessons about dying that are too little acknowledged in our culture. One that Cody learns is that death's timing is hard to predict, and that its unpredictability can be psychologically difficult. After outliving a prognosis of six more months and still feeling good, Cody isn't quite sure how to process her continuing vitality, what (if anything) to plan for the future, or how to time the rituals of farewell she's been planning. Another difficult lesson is that successfully navigating the psychology of dying doesn't make the physical aspects of dying easier or more moldable. When Cody feels like she has accepted her death and is ready to go, her body won't cooperate with her mind: "I thought I would just drift away, but my body's so strong. It was clear that I wasn't going to drift away, that it was going to be excruciating and long." Difficult as it is to accept, the fact is that very few of us will be lucky enough to "drift away" quickly and peacefully when our lives end. For Cody and the hundreds of other Oregonians who have exercised their right to physician-assisted suicide, what mattered was the ability to have that quick, peaceful exit when pain makes life no longer worth living.
In addition to its demystification of the death, How to Die in Oregon makes another all-too-rare offering to its audience: one model of dying well. Cody is conscious of wanting to make that offering, not to the film's audience but to her family: "I feel like I want to model for my children a kind of grace and acceptance." Indeed it is difficult to conceive of a someone dying much more gracefully than Cody, who retains so much of her warmth, humor, and joyfulness throughout her struggle. Cody's story illustrates how one can continue to live meaningfully even under the shadow of a terminal diagnosis. In that time, we see Cody hiking with her family, visiting old friends, tending her garden, and teaching her son family recipes that only she knows. Cody keeps living even as she is dying, she retains what control she reasonably can in her medical decisions and in her choice of physician-assisted suicide, and she accepts what she cannot control or predict in this tumultuous process. Hearing her reflections on this journey throughout the film and getting a little glimpse of her death when it does come felt like great privileges.
While Cody's story forms the core of the film, the others in How to Die in Oregon can be equally moving, if brief. One dying man who prided himself on his singing and speaking voice goes to a recording studio to do a eulogy for himself to play at his funeral. Another describes finally understanding why his parents "wanted out" when they were dying. He says with the lethal drugs he is prescribed, he'll lay down and go to sleep: "That's the decent thing to do. For once in my life, I'll be decent." The film devotes a bit more attention to the widow of a man who died an extremely painful death in Washington and made a last request of his wife: to fight for a Death with Dignity law in Washington, so that others can avoid the suffering he endured. This story works very well in the film, both emotionally and practically, because it provides a spokesperson for the right to die movement whose personal experience illuminates a lot of what's at stake in the debate.
Having read about How to Die in Oregon back when it played at Sundance, I was thrilled to hear that it would be distributed on DVD by Docurama. As usual, they offer a great documentary and present it well. The image quality is quite good for this scale of production, especially the rich color that crops up here and there (though some compression artifacts are visible). Speech is clear throughout. The main extra is a generous helping of deleted scenes, totaling 43 minutes. About half of these follow one man with cancer who collects signatures for getting Washington's Death with Dignity law on the ballot. There are also three that follow up with Nancy, the woman who fought for that law after her husband's painful death.
The Rebuttal Witnesses
The documentary at one point makes a what appears to be a gesture toward showing the other point of view in the right-to-die debate by interviewing a man who could get an assisted suicide financially covered but not life-extending treatments. While there are certainly important points to be made about the social inequalities that persist in the "universal" experience of death—and about how these affect right-to-die issues—it feels like How to Die in Oregon should either have devoted more attention to this matter or omitted it. What we do get in the film feels so brief and superficially covered that it's a bit disorienting.
When you take a step back from the right to die debate, it becomes clear that part of the problem with figuring out what's moral and what should be legal in dying is that no one trying to sort through those issues has ever gone through the experience in question. None of us can truly know what dying is like until we do it, but that doesn't change our need to make decisions—as individuals and as a society—about end-of-life care. Documentaries such as How to Die in Oregon (or Silverlake Life: The View from Here, The End, or The Suicide Tourist) can be such a help here, allowing us to grasp some understanding—however partial, however distant—of one of life's most important and enigmatic events.
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