In 1990 David Lewis, a Vancouver man living with HIV, went to a local newspaper and announced that he had assisted eight friends, all suffering from AIDS, in committing suicide--an act of murder in the eyes of Canadian law. For many people, the news simply affirmed what they had long suspected was happening in the AIDS community. But to Russel Ogden, a criminology graduate student at Simon Fraser University looking for a research project, it was an opportunity to go where no scientist had ventured before.
"I had a population in my backyard that had been living with euthanasia issues for some time," recalls Ogden, who is believed by many to be the first researcher in North America to have formally studied the practices of underground assisted suicide and euthanasia. In 1994 Ogden published his master's thesis, which documented the inner workings of this illicit network. The findings shocked the nation and branded him one of Canada's most controversial researchers.
In the decade since, Ogden has faced legal and ethical roadblocks. The authorities have repeatedly pressured him to identify his informants. Such brushes with the law have convinced him to hide his research: he now keeps his data hidden in several locations around town. And at 42, the Vancouver-based Ogden should by now be a well-established scientist. Instead he is still chasing his Ph.D. long-distance at the University of Groningen in the Netherlands--Canadian universities have shut him out. Lack of the usual academic credentials, however, has not stopped Ogden. He wants to know who asks for assisted death, who provides it and how it is done.
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Such grisly details were revealed in Ogden's first study, in which 17 individuals, including doctors, nurses, counselors, social workers and two priests, told him precisely how they had helped AIDS patients kill themselves. But the biggest surprise was that many of these deaths were not the "good deaths" often described in proeuthanasia books, which tend to romanticize the process. Of the 34 euthanasia cases, Ogden found that half were botched and ultimately resulted in increased suffering. In five situations, suffocation was unsuccessful. In one instance, the individual who assisted in the suicide had to resort to shooting the patient--in another, to slitting his wrists with a razor blade. These failed attempts often led to the acts of euthanasia taking several hours or longer to complete; in one case, it took four days for the person to die.
Unregulated euthanasia has occurred under conditions akin to back-alley abortions.
These people were first- or second-timers, "not serial death providers," Ogden remarks. "They weren't sure what they were doing." He concluded that the lack of medical knowledge, as well as the unavailability of suitable drugs and ignorance of lethal doses, contributed to the additional suffering. "This study showed that without medical supervision and formal regulations, euthanasia is happening in horrific circumstances, similar to back-alley abortions," he declares.
In February 1994 news of Ogden's study spread quickly, eventually making its way to the coroner's office. Ogden soon found himself staring at a subpoena demanding that he reveal the names of his informants, each potentially facing prosecution. Ogden refused, never wavering on his promise to his participants, and chose to risk jail time.
Amid the battle, Simon Fraser University abandoned him, leaving Ogden to conduct his own defense. He successfully argued that his research passed Canada's Wigmore criteria, a set of common law privileges that excused him from disclosing his confidential sources. The coroner eventually dropped the charges.
With a tarnished reputation in Canada, Ogden went to the University of Exeter in England in 1995, where he resumed his studies of assisted death in AIDS patients--with assurances that the university would stand behind him and his research subjects. So for three years he interviewed nearly 100 physicians and nonmedical death providers in the U.K., the U.S., Canada and the Netherlands--the last is one of only three countries where national law allows doctors to assist in dying. (Oregon has a state law permitting physician-assisted death.) [break]
Ogden discovered that although the methods used for dying are similar (most involve drug overdose), attitudes toward assisted death are quite different. In Europe, people have a more passive and deferential approach, allowing a dear one to make the decision, usually after the person has lapsed into unconsciousness or has severe dementia, Ogden explains. "In the U.S. and Canada, there is a big push for assisted suicide where patients make the decision of when to die and take the drugs themselves; it's more individualistic and autonomous."
Ogden's study, however, abruptly ended: In 1998 Exeter reneged on its promise, citing concern over institutional liability. Fearing legal intervention, Ogden did not chance publishing his data without protection and thus left the university and his work behind. Ogden returned, sans Ph.D., to Vancouver, where he began teaching criminology as well as shifting his studies to the NuTech movement, a loose coalition of right-to-die activists from several nations. Since 1999 he has collected hundreds of interviews and reports from NuTech and may be the only outsider to have been invited to its secret meetings.
NuTech's approach is to take medicine out of assisted death, with methods that are simple, painless, inexpensive and impossible to trace. Suffocation devices, such as the "debreather," a modified piece of scuba diving equipment, and the "exit bag," a plastic bag equipped with Velcro straps, are commonly used. Most popular, Ogden has found, is the plastic bag in conjunction with helium gas. "This is the quickest way to go; used properly, you're unconscious after the second breath and dead in about 10 minutes," he reveals. Such methods are more efficient and reliable than lethal drugs, but suffocation devices remain unappealing and undignified to people. Most still want something they can drink. In that case, death providers recommend black-market Nembutal, a liquid barbiturate used by veterinarians to put down animals.
NuTech is at the forefront of what Ogden calls the "deathing counterculture," in which nonmedical death practitioners offer referrals, consultations and house calls. "They are taking the place of physicians to deliver virtually undetectable death assistance," says Ogden, who notes that the most famous death provider, Jack Kevorkian, began his career as a pathologist, not a personal physician, and did not see patients. What is more, he has found that this counterculture is growing in direct response to the lack of supporting legislation. But Ogden sees problems with NuTech: no medical or counseling personnel to ensure mental competence, no informed consent and no exploration of treatment alternatives. Hence, the NuTech practice will be difficult to regulate and protect from abuse.
Opponents do not see how Ogden's research can be of any benefit, especially because there is no way to verify if participants' responses are truthful. "Most people who study this want to show that assisted suicide is occurring quite commonly, therefore we should just bite the bullet and legalize it," says Margaret Somerville, director of the Center for Medicine, Ethics and Law at McGill University, who argues that assisted death and euthanasia reduce the respect for life. Still, Ogden's work has informed public and political debates. For example, in Ottawa, Senate committees in Parliament have repeatedly relied on his data for their reports and recommendations.
Ogden expects to receive his doctorate for his NuTech work soon, but beyond that, his future is uncertain. Without a university position, he will have a hard time securing government funding. Thus far he has covered the cost of his research partly with settlement money he received after filing grievances against both Simon Fraser and Exeter.
Despite his years of research, Ogden has not experienced one thing he feels is critical: witnessing covert assisted death. "It's one thing to be told what's happening and it's another to actually see it. To my knowledge, I would be the first researcher to do this," he says. More controversy would surely follow.