Heartbreaking Story of Assisted Death
On August 3rd, the NY Times published an expose on a fiercely brave Colombian woman, Tatiana Andia, who had to undergo tremendous administrative hurdles and institutional roadblocks before finally being able to pass on peacefully through physician assisted death. Tears streamed from my eyes as I finished the article.
Colombia’s rules for assisted death are among the most expansive in the world; the procedure is allowed for patients — even children — with unbearable suffering, whether their illness is terminal or not. That said, only a tiny percentage of Colombians have completed the process. As stated in Stephanie Nolen’s article, because physician assisted dying rights in Columbia came about by court order, and not legislation, it wasn’t the subject of broad public debate. Doctors, uncomfortable with ending lives and reluctant to give patients so much control, hadn’t encouraged it, and by 2023 only one in three hospitals had established the required review committees. Health insurance companies, which nominally have the job of organizing assisted deaths, are so bureaucratic that people die of their illness or give up before they get access.
As a result, assisted deaths remain rare. Between 2015 and 2023, the last year for which data has been released, there were a total of 692 medically assisted deaths in a country of 53 million people.
My father looked at Columbia when he was researching assisted death options but ended up choosing Switzerland, as he found the process less cumbersome there.
The situation in Columbia is far from unique. In most jurisdictions that have legalized physician or medically assisted death, there remain substantial cultural, administrative, and logistical barriers. In Canada, for instance, there is a significant shortage of physicians willing to conduct the necessary patient evaluations. The same is true in Columbia, and several other countries where the procedure is allowed. Many palliative care physicians actively lobby against the practice, believing resources and medication must be exhausted completely before death should be allowed to occur via the patient’s informed consent.
As chronicled by the Times’ article, Ms. Andia, a former official in Colombia’s health ministry, had to rely on well established industry relationships to navigate insurance and treatment hurdles; or as she put it, “the deep bureaucracy of dying.”
Ms. Andia’s plight is but one example of the need for greater education and awareness surrounding physician assisted death. Such knowledge will break barriers and allow more people like Ms. Andia and my father, who both experienced extreme physical, mental, and emotional suffering, to choose to die on their terms—lovingly, gracefully, and peacefully—with dignity.