“You have a very lovely, bright voice.”
These are the first words Peter Goodwin says when I answer the phone.
Goodwin is dying. He has corticobasal degeneration, a condition that resembles Parkinson’s disease, but takes a much more aggressive and lethal course. And so, in the very near future—maybe weeks, maybe months—Goodwin, a resident of Oregon, will use that state’s controversial Death With Dignity Act to end his own life.
That Goodwin should find himself in this situation is a novelistic twist, considering that he was one of the doctors responsible for getting the law passed in the first place.
The Death With Dignity Act became legal in Oregon in 1997. Since then, more than 500 terminally ill patients have used its provisions to end their lives with their doctor’s help. The number of patients who opt for this course has increased every year since the law went into effect.
Goodwin became involved in the effort to legalize physician-assisted suicide because of his own experiences as a physician.
“The medical profession was really ill-prepared to deal with the terminally ill. So the elderly patients were often just shunted aside. I was as guilty as anyone else—what can you do when someone is dying? You just look in through the door and say, ‘Hello, how’s everything going?’ and then you slip out as quickly as possible,” he says. “And I thought, this was nonsensical. We should be doing this.”
“The patient is dying, yet, believe it or not, this is the essence of being a doctor.”
Goodwin was born in London, but grew up in apartheid South Africa. He moved to the United States in the 1960s, because he’d come to feel that South Africa was too racist, too “riven with hatred and intolerance” to raise a family there.
Goodwin did stints as a doctor in South Carolina and Washington state before settling in Oregon, where he joined the faculty of Oregon Health and Science University.
It was the experience of one man in particular, Goodwin says, that spurred his involvement in the legislative effort that resulted in the Death With Dignity Act.
Goodwin recounts the story. The man had come home to find his wife suffocated with a plastic bag she’d placed over her head. She’d sent him out on an errand so that she could kill herself, ending the excruciating pain she was experiencing after two massive heart surgeries.
In the wake of this episode, Goodwin, with seven others, formed an initiative to get physician-assisted suicide legalized. Despite resistance from the Catholic Church, the law was ratified in 1997, bolstered by a Supreme Court decision signaling that this was an issue to be decided on a state-by-state basis.
“I’ve been sort of surprised and disappointed by how slowly this process has grown, mostly because, of course, it runs in the face of most religious faiths. Because death really is the territory of the religious hierarchy, and the religious hierarchy is very intolerant to this new idea,” Goodwin says. “But why it hasn’t caught on with the mass of people is surprising for me.”
And he does seem genuinely surprised. For Goodwin, this is a simple issue of personal freedom and autonomy. “And that’s what our country is based on,” he says.
Since the law went into effect, Goodwin himself has assisted in the death of many patients.
The treatment is simple, consisting of a fast-acting barbiturate given at a high dose. Often patients die within 15 minutes. Sometimes it takes longer, 12 hours, even 24. In a few cases, they wake up.
This happened to one of Goodwin’s patients and he was extremely relieved, he says, to find that the patient’s mental health remained fully intact upon waking, as patients’ full mental competence is one of the legal requirements of the Death With Dignity Act.
Because the law also requires that 17 days must elapse between the patient’s request to die and the actual administering of the medication, there can be unforeseen complications. For instance, Goodwin says, he once arrived at the home of a terminally ill patient on the appointed day. Her family was there, gathered around her, having said their goodbyes. But Goodwin discovered she was no longer completely mentally fit. Therefore, he couldn’t carry out her request. When he informed her family of this, “they were aghast,” he says. “They had no idea what I was talking about.”
However, by and large, Goodwin says, participating in assisted suicide has been “incredibly rewarding.”
“One develops intimacy with the patient and the patient’s loved ones so very, very quickly,” he says. “You know, I delivered a lot of babies during my career, and that’s a joyful experience. This is not a joyful experience, but it’s such an intimate, close process that you end up feeling that this is the essence of being a doctor. The patient is dying, yet, believe it or not, this is the essence of being a doctor.”
Now, as his own health fails, Goodwin, who is 84, talks about his own imminent death with the same unwavering clarity.
In 2008, the year he was officially diagnosed, Goodwin says, actually chuckling a bit, “I realized of course that it was a death sentence.”
The disease is one that results in an inevitable “intellectual destruction,” he says. “People die from this illness in a vegetative state. In other words, devoid of all function. In a sense, just curled up like a ball, or waiting to die from inanition. Just the ending of life because there is no other ending for this terrible body.”
And that is not the ending that Goodwin intends for himself.
He wants to be surrounded by his family, his children, his in-law children, and his doctors, with whom he is extremely close.
He says that he doesn’t know exactly what will impel him to decide it’s time. Maybe when he can no longer use his left hand, he says, or if he loses bodily function.
Comments like these might ring a bit strangely to non-Oregonian ears, or to those who haven’t spent years living with the deep, visceral conviction that we are entitled to our own kind of death.
But for Goodwin, this is simply the natural course of things.
“Like all severely controversial issues, there is no easy answer,” he says. “There is no answer that will satisfy everybody.”
One of Goodwin’s relatives, he says, is a deeply religious woman.
“She says to me, Peter, I feel what you’re doing is wrong, but I love you and I want to be with you when it happens.”
And she probably will be.