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Sick and tired of pain, Kenyans fly out to procure aided suicide

Saturday February 1 2020

medically-assisted suicide

Hands of a nurse administering an injection. Medically-assisted suicide is not legal in Kenya. FILE PHOTO 

STELLA CHERONO
By STELLA CHERONO
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The epitaph on her grave reads, “To Live is Christ and to Die is Gain.” It is somewhat a representation of how she lived – and died.

TRAGIC STORY

Diana Elga Akinyi drafted the epitaph just days before she chose to die to free herself from excruciating pain and the numbing effects of medicines.

Long before she chose to die, Diana had had to bring herself to terms with her doctor’s verdict; that she had just a few days to live, because her malignant cancer had metastasized. But death was not coming, and her days were only filled with pain that only saw her use drug after drug.

In a corner of her room was a table laden with painkillers: Morphine oxycodone, fentanyl and others.

Her sister says that although these are the strongest painkillers, “at some point they seemed not to help much. She was in so much pain.”

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“She used to cry a lot,” said the sister, who prefers anonymity in order to discuss the issue freely.

And so Diana continued waiting for death. When it was not coming eight years on, she made up her mind. She would fly out and have someone assist her to end her life.

This is Diana’s tragic story.

She was involved in an accident that resulted in a spinal injury, which saw her confined to a wheelchair for six years after two years in a hospital bed.

SPINAL INJURY

“My sister had an accident in 2009,” narrated her sister sombrely. “She was driving with her boyfriend on Ngong Road in the evening when their vehicle was hit head-on by another speeding car. The boyfriend died but she was injured.”

Diana, she said, was taken to Kenyatta National Hospital and later transferred to Kijabe Hospital. For close to two months, she was in the High Dependency Unit and then transferred to the ward. She would stay in hospital for close to two years.

Doctors ruled out the possibility of her ever walking again and when she was discharged, she could only use a wheelchair.

“She could not walk. We used to bathe her and clothe her. She wore diapers. We had to employ people to take care of her. None lasted a month. Initially, the forex bureau she used to work for sent her salary to her account for some time but stopped, I guess, because they lost hope in her ever going back to work,” the sister said.

As Diana was undergoing treatment for spinal injury, she was diagnosed with liver cancer after she developed some persistent abdominal pain. Doctors said the cancer was in advanced stages and because she was already taking painkillers, it had not manifested itself.

ORGANS FAILED

“The diagnosis made her condition worse. The doctors had to change her prescription and she had to undergo chemotherapy. She could not eat, her condition was pathetic… Her skin was hideous, she lost weight, her voice disappeared, and she cried night and day. Her lips were red. When she could, she took out her frustrations on Facebook, where she shared her story, with her pictures, before and after the diagnosis. At some point, she was so weak she just wanted to die,” her sister said.

On July 27, 2017 Diana wrote: “I have lived all I could. I created friends. God gave me a family. They have done all they could. Life cannot be anymore; death nears yet so far. To live is Christ and to die is gain.”

Two days later, she called all her family members to a meeting and had a simple request: she wanted assisted suicide.

“She said she had researched about euthanasia online and she was going for it. By then her hospital bill had accumulated to Sh8.4 million and she knew that no matter how much we spent on her, she would still die. We refused and told her about the sanctity of life. We told her a miracle could happen; that euthanasia was illegal in Kenya… That no hospital could agree to that. We refused although we knew her organs had failed.

VERY FRAIL

“Later, her condition got worse and we took her to a Nairobi hospital. Sometimes she would writhe in pain and, in her very frail voice, she asked every doctor to switch off the ICU machines. She wanted death so much. One day when my elder brother was alone with her, she asked that we take her to a country where euthanasia is legal. She said she had done research online and was ready to die. She was persistent,” her sister said.

The family agreed to fly her to a European country that they prefer not to name and on October 16, 2017,  she bid farewell to her brother, mother and sister.

The sister says Diana’s last words to her were, “thank you”.

Wasn’t it expensive flying all the way to Europe to die?

“We spent less than half a million on travel, like Sh430,000 in total. The actual procedure was paid for by some activists my sister had met on social media. Apparently, she had joined some groups on Facebook and the members paid the hospital directly,” she said.

NO HOPE

They airlifted the body back to Kenya and buried it at the Lang’ata Cemetery.

Diana’s story is just one of many that illustrate the growing trend among Kenyans to seek mercy killings abroad in the face of laws banning the practice. Article 26 of the Constitution sanctifies life, making mercy killing illegal. The law states that “no one should be deprived of their life intentionally, save for the extent authorised by the Constitution or any other written law”.

However, several families have told the Saturday Nation that they have overseen assisted suicides and mercy killings of their kin who had endured a lot of pain, with no hope of being healed as the cost of medication skyrocketed with every passing hour.

Although the Kenya Medical Practitioners and Dentists Board says mercy killing is not acceptable, some Kenyans have confessed to the Saturday Nation that they subjected their kin to passive euthanasia, where they asked doctors to pull the plug or switch off the dependency machines in hospital after they realised that there was no hope of recovery.

SUFFERING

A radio presenter confessed that when their four-year-old daughter who was born with mild methemoglobinemia, a blood disorder in which an abnormal amount of methemoglobin is produced, was later diagnosed with Leukaemia which affected her organs, they agreed as a family to just end her life.

“Our baby was suffering, her hospital bill had accumulated to Sh3.6 million and that is after we sold our land to pay part of the bill. She had spent almost half of her life in hospital. She was in and out of ICU and we could feel her pain. One day, we just told her doctor to switch off the machines and let her die peacefully because her small body had endured so much pain. It was painful, because every parent wants their baby to be healthy. But ours was suffering and to deny her death meant prolonging her suffering,” she said.

Asked whether she sometimes feels guilty for ending her daughter’s life, she said, “No, she was suffering and there were no hopes at all. Her organs had failed and there was never going to be a miracle about that.”

Assisted death and euthanasia in Kenya are classified as murder but, just like abortion, they are happening in secret. Nakuru-based criminal lawyer David Mong’eri asserts that assisted suicide is simply murder.

NOT PERMITED

“Even when someone has requested you or consented to it, it is simply a crime,” he told the Saturday Nation.

Article 43(2) also provides that a person shall not be denied emergency medical treatment. Similar provisions are also contained in international and regional human rights instruments, such as the International Covenant on Economic, Social and Cultural Rights and the African Charter on Human and People’s Rights, both of which Kenya has ratified.

Kenya Medical Practitioners and Dentists Board chief executive officer, Dr Daniel Yumbya, says that the Code of Professional Conduct and Discipline that guides medical practitioners does not permit assisted suicide in whatever form.

“Euthanasia in Kenya is illegal and doctors found conducting it should be prosecuted. It is criminal and unethical,” he said, adding that there have been no formal complaints against any doctor in Kenya.

In April last year, the High Court in Narok sentenced a couple, Emmanuel Kiprotich Sigei, 25, and Irene Nalomuta Sigei, 23, to 15 years in jail for killing their one-and-half-year-old baby because she was sickly. The couple, residents of Nasitori in Narok South Sub-county, on February 6, 2014 bought a chemical used to spray livestock from an agrovet shop and gave it to baby Brenda Chepkorir.

TABOO TAG

Justice Justus Bwonwong’a, while sentencing them, said: “The duty of the accused as parents was to take care and protect the deceased. Instead, they murdered her. Even if the accused thought this type of killing was a form of euthanasia, since the child was crawling and sickly due to flu, it is still an offence.”

Kenyans, and Africans in general, would traditionally rather have a person die naturally, even when there was no chance of survival, yet, since time immemorial, euthanasia has been practised, albeit under the tag of taboo.

Among the Nandi, for instance, the elderly who got “tired of living” would travel to Nandi and take their own lives by plunging down 150-metre cliffs overlooking Lelmokwo at Koigaro Falls into Chepteon River.

A resident of the area, Jeremiah Kosibon, said that in the olden days, those who courted death would hold hands, stand in line and then hunker backwards down the cliff.

“This was a sure way of dying. There was the alternative of drowning in a river, but no one wanted to conduct this. It was easier this way,” Mr Kosibon said.

FOUND GUILTY

The closest Africa has gone towards legalising euthanasia is when a South African court recently ruled that a terminally ill man, Robin Stransham-Ford, could have a doctor assist his death by lethal injection or lethal medication. But still, South Africa has not legalised euthanasia and, in fact, last year, it sentenced leading pro-euthanasia activist Sean Davison to three years in prison after he was found guilty of premeditated murder for helping three people to kill themselves.

In some countries such as Netherlands, euthanasia is permitted, but the law only allows it to be done on persons who are experiencing unbearable physical or mental suffering without possibility of cure.

A lot of paper work is done prior to euthanasia, which must be done under the supervision of a medical practitioner.

Other countries where euthanasia is legal are Belgium, Colombia, Luxembourg and Canada. Assisted suicide is also permitted in Switzerland, Germany and the Netherlands.

In America, states like Washington, Oregon, Colorado, Hawaii, Vermont, Montana, Maine, New Jersey and California have legalised euthanasia.

QUALITY OF LIFE

Renowned Australian ecologist and botanist David Goodall was 104 when he travelled to Switzerland to commit assisted suicide after trying to kill himself in vain. He was not sick, but he chose death simply because “the quality of his life had deteriorated”.

“My abilities have been in decline over the past year or two, my eyesight over the past six years… I feel I have lost my dignity and self-respect… I no longer want to continue living. I’m happy to have the chance tomorrow to end it,” Dr Goodall told the media in Switzerland before his death. He remains one of the most cited examples in global discourses on euthanasia.

There has been a push in Kenya for its legalisation but it has not really gained momentum. Ann Ngigi, an advocate of the High Court of Kenya once wrote: “Kenya should legalise euthanasia and/or physician-assisted suicide for deserving cases. Without legal guidance, it is difficult to know when to cease life support if a patient’s condition will not improve.”

There have been several debates in Parliament, at medical practitioners’ conferences, among lawyers and other fields. But religious leaders have been categorical that euthanasia should not be allowed.

LETHAL INJECTIONS

Reverend Canon Peter Karanja, the former secretary of the National Council of Churches of Kenya, says that the Bible forbids killing.

“Life is therefore of God. He gives, and he takes. We have no right whatsoever to take life, as the Fifth Commandment orders,” he said.

He, however, separates the killing of someone who is sick from turning off machines in hospital, saying the latter is not killing.

“There are instances when the family and the doctors are well aware that without the machines assisting life, a person will die. In this case, I think there is no need to hold on just because technology is available. I am however against instances where someone is subjected to a lethal injection, suffocation and the likes, simply because they are suffering from ill-health,” he said.

LIFE SACRED

Human rights crusader Abdimajid Mohamed Ali says that even though euthanasia happens, it is wrong.

“It is bad. I will never advocate it. It is God who gives life and he is the one who takes it, why do you want to terminate it?

He says that according to the Koran, life is sacred.

“In the Koran 17:33, Allah says in the Koran ‘You shall not kill any person - for God has made life sacred,’” he said.

Sociologist Salmona Oketch observes that many people opt for mercy killing or assisted suicide after they lose hope in good health.

DIGNITY FADE

“There are people who would rather die than subject their families to a lot of problems. Some of them would rather not see their dignity fade way so they go for what I would call premature death. I see nothing wrong with that, only that it is illegal here,” she said.