By Margaret Cheatham Williams
Photograph by Christaan Felber for The New York Times. Video by Margaret Cheatham Williams.
A Right to Die, a Will to Live: As a bioethicist, Peggy Battin fought for the right of people to end their own lives. After her husband's cycling accident, her field of study turned unbearably personal.
If Margaret Pabst Battin hadn't had a cold that day, she would have joined her husband, Brooke Hopkins, on his bike ride. Instead Peggy (as just about everyone calls her) went to two lectures at the University of Utah, where she teaches philosophy and writes about end-of-life bioethics. Which is why she wasn't with Brooke the moment everything changed.
Christaan Felber for The New York Times
Brooke Hopkins in his modified bedroom. "You can get used to anything," he says.
Brooke was cycling down a hill in City Creek Canyon in Salt Lake City when he collided with an oncoming bicycle around a blind curve, catapulting him onto the mountain path. His helmet cracked just above the left temple, meaning Brooke fell directly on his head, and his body followed in a grotesque somersault that broke his neck at the top of the spine. He stopped breathing, turned purple and might have died if a flight-rescue nurse didn't happen to jog by. The jogger resuscitated and stabilized him, and someone raced to the bottom of the canyon to call 911.
If Peggy had been there and known the extent of Brooke's injury, she might have urged the rescuers not to revive him. Brooke updated a living will the previous year, specifying that should he suffer a grievous illness or injury leading to a terminal condition or vegetative state, he wanted no procedures done that "would serve only to unnaturally prolong the moment of my death and to unnaturally postpone or prolong the dying process." But Peggy wasn't there, and Brooke, who had recently retired as an English professor at the University of Utah, was kept breathing with a hand-pumped air bag during the ambulance ride to University Hospital, three miles away. As soon as he got there, he was attached to a ventilator.
By the time Peggy arrived and saw her husband ensnared in the life-sustaining machinery he hoped to avoid, decisions about intervention already had been made. It was Nov. 14, 2008, late afternoon. She didn't know yet that Brooke would end up a quadriplegic, paralyzed from the shoulders down.
Suffering, suicide, euthanasia, a dignified death — these were subjects she had thought and written about for years, and now, suddenly, they turned unbearably personal. Alongside her physically ravaged husband, she would watch lofty ideas be trumped by reality — and would discover just how messy, raw and muddled the end of life can be.
In the weeks after the accident, Peggy found herself thinking about the title character in Tolstoy's "Death of Ivan Ilyich," who wondered, "What if my whole life has been wrong?" Her whole life had involved writing "wheelbarrows full" of books and articles championing self-determination in dying. And now here was her husband, a plugged-in mannequin in the I.C.U., the very embodiment of a right-to-die case study.
An international leader in bioethics, Peggy explored the right to a good and easeful death by their own hand, if need be, for people who were terminally ill, as well as for those whose lives had become intolerable because of chronic illness, serious injury or extreme old age. She didn't shy away from contentious words like "euthanasia." Nor did she run from fringe groups like NuTech, which is devoted to finding more-efficient methods of what it calls self-deliverance, or Soars (Society for Old Age Rational Suicide), which defends the right of the "very elderly" to choose death as a way to pre-empt old-age catastrophes. She also found common purpose with more-mainstream groups, like Compassion and Choices, that push for legislation or ballot initiatives to allow doctors to help "hasten death" in the terminally ill (which is now permitted, with restrictions, in Oregon, Washington, Montana and Vermont). And she testified in trials on behalf of individuals seeking permission to end their lives legally with the help of a doctor or a loved one.
At the heart of her argument was her belief in autonomy. "The competent patient can, and ought to be accorded the right to, determine what is to be done to him or her, even if . . . it means he or she will die," she wrote in 1994 in "The Least Worst Death," the third of her seven books about how we die.
Robin Marantz Henig is a contributing writer for the magazine and co-author, with her daughter Samantha Henig, of ''Twentysomething: Why Do Young Adults Seem Stuck?''
Editor: Ilena Silverman
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