Michele Causse: 1936-2010 Maryan Street recently withdrew her End of Life Choices Bill from the private members bill ballot box. What stake do LGBT individuals have within the euthanasia debate? There are conflicting questions about this contentious social issue. As I've noted beforehand, HIV/AIDS is now better managed through medication and access to new pharmaceutical advances in microbiology such as protease inhibitors. Consequently, much the same is true about new forms of cancer prevention and management drugs in the context of breast and cervical cancer, although not ovarian cancer. Institutional racism, colonialism, poverty and transphobia continue to insure the uneven nature of the HIV epidemic and outcomes of breast cancer diagnoses. As my GayNZ.com fellow blogger Michael Stevens told me when I asked him several years ago, most New Zealand PLWAs and HIV+ individuals were concerned at the subversion of Pharmac's regulatory procedures and medication subsidies by pharmaceutical multinationals in the event of New Zealand ascent to the Transpacific Trade Partnership free trade agreement. From time to time, concerns arise over backlogs in the regulatory process, or subsidy refusal for some drugs- such as Herceptin for breast cancer survivors, and lesbians were involved in lobbying for New Zealand access within Herceptin Heroes. For these reasons, decriminalisation of voluntary euthanasia or assisted suicide isn't seen as an LGBT priority. This isn't to say that our interests don't coincide with those of the euthanasia debate, but not as much as one might think. In this article, I'll examine the lives and deaths of three LGBT individuals who made the 'choice' of 'death with dignity' (?) for themselves. Alan Cutkelvin Rees (56) revealed details of his visit to Zurich's Dignitas clinic for assisted suicide by his partner Kevin Cutkelvin (58) in 2009. Kevin was suffering from metastasised pancreatic cancer, for which nothing further could be done within the British medical system. Given that voluntary euthanasia/physician assisted suicide is illegal within the United Kingdom, but not Switzerland in the context of assisted suicide, Alan might have faced charges by the UK Director of Public Prosecutions, but it seems to be the case that the United Kingdom now recognises that its ambit does not extend to overseas jurisdictions in this context. Moreover, Swiss voters have been disinclined to prevent travel by those seeking assisted suicide as an end of life choice or option. Note that Kevin was suffering from pancreatic cancer in this context, not HIV/AIDS or anal cancer, which one would have thought might have been a greater drawcard. Note also that the issue wasn't discussed in UK gay male magazines like Attitude or Gay Times. My second example is lesbian feminist Michele Causse (1936-2010), who made a similar choice to end her life at Zurich's Dignitas. She had a rich career as a translator and French lesbian feminist author before she decided to end her own life in 2010, due to inoperable metastasised cancer. Her own website doesn't clarify this, but as a lesbian feminist, she may have felt that male dominated institutions like the Catholic Church should not dictate her mode of death as a lesbian feminist and so ended her life that way as a political act. Judging from the extended documentary about her death aired on Swiss television in 2010, in her own words, Causse explained that her bones had become fragile, that she was suffering from compressed vertebrae, osteoporosis, kidney loss, and asthma, perhaps as a result of bone cancer. She was frustrated at her fatigue, dependency on others and perhaps also the onset of Alzheimers and related disorders as she noted loss of memory and vocabulary. There may have been a more intimate reason too, as I noticed an affadavit from Causse in the context of a Quebecois lover's suicide (?), which supported that ex-lover's decision before a Court of Appeal. Did this lover's liver cancer and protracted dying affect Causse's decision? Causse didn't die alone. She had a friend, Martine, her lover Nikki and a Dignitas medical practitioner, Erika Lully, with whom she flirted as she took the medication necessary for her choice as well as post-delivery chocolate. It is difficult not to feel some sympathy with Michele and Nikki in this context. To balance things out, however, I have felt it necessary to provide a third example. Unlike Alan and Kevin, or Michele and Nikki's experiences, Nathan Verhelst's case is far more disturbing. Nathan was an FTM transsexual who was disappointed at the outcome of his reassignment surgery, particularly the condition of his breasts and his newly crafted penis. It should be noted that in this context, he seems to have been interviewed by a Belgian tabloid, as he used Belgium's decriminalised voluntary euthanasia service to end his life. Unlike Kevin and Michele, he was not in an active relationship and there is no mention whether his surgery was accompanied by psychotherapy or counselling in this context, or informed consent, or whether he had unrealistic expectations of surgical outcome. Understandably, transgender rights groups are angered at the distorted emphasis on Nathan's transitioning in some transphobic tabloid media accounts, as well as the implication that his case is representative of transsexual reassignment surgery and consequent transitioning. They are also uneasy about the fact that Nathan chose euthanasia in this context, as he was not terminally ill. The implication is that Nathan's life as an FTM transsexual man was not worth living, which they reject. Disability rights groups have shared this condemnation, given that Nathan's death has reinforced criticisms that euthanasia or physician assisted suicide reinforces disability discrimination and is a form of disability discrimination. Did Nathan have bipolar disorder? If so, that could have been managed through antipsychotic medication and counselling. However, he appears to have experienced neglect and emotional abuse at the hands of his negligent parents and I was so disgusted at his mother's blasé and callous response to his death that I refuse to describe such transphobic garbage here. While he had no lover, Nathan died with a friend at his side- I also find distasteful that some anti-euthanasia pressure groups have tried to co-opt Nathan's euthanasia for their own cause and refuse to describe him by appropriate male gender pronouns purely because of conservative Catholicism's newly minted opposition to gender reassignment surgery and transsexuality, which only dates from 2003. As other news items have noted, Nathan qualified for Belgium's voluntary euthanasia programme because of his mental health condition. Most users of Belgium's voluntary euthanasia programme are people experiencing endstage cancer after Belgium became the second nation to decriminalise the practise in 2002. Meanwhile, the New Zealand Christian Right is busily reorienting itself from their defeat against marriage equality to opposing euthanasia law reform. Predictably, Family First's Bob McCoskrie has materialised in this context. Appearing on TVNZ's Breakfast, McCoskrie publicised the recent work of a Canadian Christian Right organisation, the Institute of Marriage and Family Canada. McCoskrie claimed that thirty three percent of Oregonian and Washington State assisted suicide cases were "non-consensual" and that elder abuse and "disability cleansing" resulted from such instances. He also argued that palliative care and hospices should receive more government funding and drew attention to New Zealand Medical Association opposition. Against him, euthanasia reform advocate and Labour List MP Maryan Street questioned his use of Washington and Oregon statistics, noted that assisted suicide only accounted for 0.5 percent of total deaths in either state, and noted that her proposed bill had strong safeguards against abuse. Canada, though? Yes, for while Section 241(b) of the Canadian Criminal Code outlaws assisted suicide, nevertheless the British Columbian Supreme Court struck that provision down on June 15, 2012, although the federal Minister of Justice and Attorney-General have appealed that decision and it is going to head off to the Canadian Supreme Court in Ottawa as a result. The Canadian Medical Association has declared neutrality, while the Quebec College of Physicians is actively supporting passage of the legislation. Given that either neutrality or support from national, provincial or US state medical associations usually results in passage of euthanasia law reform, Canada may be about to make history as the first British Commonwealth nation to decriminalise voluntary euthanasia/physician assisted suicide. It will be interesting to see whether Maryan Street and other euthanasia law reform advocates recognise this and accordingly adapt their own strategies to fit this context. Recommended: "Man who helped partner die calls for assisted suicide law change" Guardian: 15.06.2009: http://www.guardian.co.uk/society/2009/jun/15/assisted-suicide-dignitas-cutkelvin-laws "Court of Appeal: October 1996: Michele Causse": http://www.michele-causse.com/docs/Court_of_Appeal-MicheleCausse.pdf Michele Causse: Assisted Suicide on Swiss TV: http://www.youtube.com/watch?v=l_uEmdmSsY Assisted Suicide: Death By Prescription (Documentary): http://www.youtube.com/watch?v=52fJRnhDjmo Joe Morgan: "Transman chooses death after "botched" surgical transition" Gay Star News: 02.10.2013: http://www.gaystarnews.com/article/trans-man-chooses-death-after-botched-surgical-transition021013 Not Recommended: "Debating Euthanasia and Abuse": McBlog: 24.10.2013: http://www.bobmccoskrie.com/?p=9861 Craig Young - 14th November 2013