Due to current events, please read May I be frank about Assisted Dying? – written by DignitySA’s Lee Last!
Both the images and the video were kindly provided by Avron’s brother Kevin.
We produced this video for Avron’s memorial service, which was held on January 17th 2015 at the Hollywood Mansion Camps Bay Venue. Avron was fighting to legalise assisted dying in South Africa and was applicant #1 in the Pretoria High Court.
Sadly missed. ☆ 1965 – † 2015
Tribute to Avron Moss’ Life and Assisted Dying in South Africa
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- Tribute to Avron Moss’ Life and Assisted Dying in South Africa:
Tribute-to-Avron-Moss-Life-and-Assisted-Dying-in-South-Africa.mp4 (80 MB)
Please read an article by DAILY MAVERICK’s Marianne Thamm on 10th March 2015
In January this year, a few days before he would feature as Applicant No 1 in a groundbreaking High Court application for the right to an assisted death, Avron Moss ended his life using medication he had smuggled into South Africa from Mexico. Diagnosed with melanoma, Moss knew when he offered to act as the applicant that it would be a race against time, the one race in life he had to lose.
When Cape Town paediatric neuropsychologist Avron Moss, 49, was told in August 2014 that he had between two and eight months to live, he began frantically researching how to end his life. Moss spent six weeks of his precious time, when he could have been peacefully preparing for death, trying to source medication that would allow him to die with dignity before the virulent melanoma – which had metastasised, doubling in size inside his brain in two weeks – rendered him incapacitated.
“He managed to smuggle in a drug from Mexico, but was petrified it might be poisonous or not the real thing. He was scared that it might not work, that he might wake up in an even worse state. So he had to source a testing kit for the drug, which he did from Australia,” Avron’s brother Kevin told the Daily Maverick.
The drug testing kit Avron had couriered from Australia to test drugs he had smuggled into South Africa from Mexico.
On the evening of 4 January, Avron, who was of sound mind and body, ingested the drug at home. He had been unable to obtain palliative care despite requesting it, said Kevin. Avron’s doctor did not do house calls and the only alternative was for him to book into a hospital, which he wanted to avoid.
In the end he died at home. Only Kevin, his younger brother, was with him. On the night he said he, too, was terrified that the drug might not work.
As he watched his brother slip away, Kevin asked Avron, “Are you in pain?”
Avron’s parting words, said Kevin, were: “This a wonderful thing. This is what every person with a terminal illness should experience.”
And then he simply closed his eyes.
It was, says Kevin, the peaceful and dignified death Avron had hoped for. The period leading up to his death, however, would have been entirely different if the laws of the country, which currently criminalise assisted death for the terminally ill, were amended in line with the country’s Constitution and the Bill of Rights.
Avron and his family and friends would have been spared the trauma of having to illicitly source drugs, as well as the anguish that these might not have been effective. A time of deep grief and mourning was taken up with vital but peripheral distractions of procuring drugs and worrying about who might be criminally implicated in his death.
Before his rapid decline, Avron had wanted to lobby for the change of law in South Africa. In order to set this in motion, he had agreed to feature as Applicant No 1 in a DignitySA High Court Challenge. He was an ideal candidate. He was a medical professional, a trained psychologist and an atheist. He also joined DignitySA as a Life Patron (the irony did not escape him) and became the first member of DignitySA’s Allied Medical Professionals for Assisted Dying initiative
His parting gift to the cause was to participate in a documentary about the last weeks of his life and, ultimately, his death. Part of the footage was screened during a moving tribute shown at Avron’s memorial service.
Before his death, and as Avron’s health deteriorated, DignitySA’s legal team worked through their recess, pro bono, on his application. Two days before he died, Avron, now in excruciating pain, managed to drag himself to a psychiatrist to obtain the psychiatric report required for the court action. But almost overnight, he became too ill to even keep down any fluids and decided that the time had come to end his life. He died a few days before the High Court application was due to be delivered.
One of his final statements to DignitySA was:
“Some terminally ill, mentally competent patients in inexorable pain and unendurable suffering consciously choose to die in dignity. That healthcare professionals cannot assist them, and that these patients are forced to buy questionable medication to end their lives from unscrupulous websites, or suffer the terror of having to shoot or hang themselves, ought to be abhorrent to any caring professional. Yet it is within the expertise of the medical profession to offer such patients assistance with the death they are asking for: a safe, pain-free, peaceful and dignified ending. The relevant law in South Africa actively perpetuates suffering, in conflict with our Constitution and with Human Rights, and is indefensibly unjust. All caring health care professionals ought to be actively involved in campaigning to change the law.”
From being consigned to the fringes of the national debate, the matter of assisted dying and changes to the law has begun to take centre stage. Professor Sean Davison first launched DignitySA in 2011 as a consequence of his arrest in New Zealand in 2010 on an attempted murder charge after admitting in his memoir that he had given his terminally ill mother, Patricia Ferguson, 85, a lethal dose of morphine.
It was President Nelson Mandela, who in 1999 tasked the South African Law Commission to explore issues of assisted dying and euthanasia. In 1999, the commission, chaired by the late Justice Ismail Mahomed, published its findings and recommendations, which included the End of Life Decisions Act 1998. The act, which was not considered a priority at the time, dropped off parliament’s radar.
In July last year the cause received a major boost when Archbishop Emeritus, Desmond Tutu, publicly stated that he was in favour of South African laws not aligned to the constitution and which do not dovetail with the human right to dignity being changed to decriminalise assisted dying.
A few months later, IFP MP Dr Mario Ambrosini ended his life, shooting himself in the bedroom of his home, as his health rapidly deteriorated after his diagnosis of lung cancer.
So far, it appears as if public sentiment towards the more controversial debates around assisted dying has become less hostile and uninformed. By far the majority (88 percent) of those responding to a poll by Carte Blanche asking, “Should the terminally ill be allowed to end their lives?” are in favour.
Davison said that DignitySA would be embarking on parallel processes. The first would be to approach the Ministers for Health, Justice and Constitutional Development, and Social Welfare and the respective Parliamentary Committees, to review the Law Commission Report in the light of recent local and international developments.
The second thrust would be to find other terminally ill South Africans who would be willing to act as applicants for another High Court Challenge in the light of Avron’s death.
In September last year Davison admitted that he had assisted medical doctor Anrich Burger, who had been left quadriplegic after an accident, to end his life in November 2013. Burger had been a close personal friend of Davison’s.
“It was an act of compassion,” Davison told the Daily Maverick, adding: “He went public a year before he died. At first he wanted to die in another country, but it would have been too much and in the end he wanted to die here.”
Asked whether he was concerned that he might be criminally implicated in Dr Burger’s death, Davison replied, “The police know about it. They’re not interested.”
Palliative care for the terminally ill is another matter that has been highlighted in the debate around assisted dying in South Africa. At present, government does not provide any palliative care facilities in public hospitals and, according to Johannesburg doctor, Wayne Korras, palliative medicine and nursing are not recognised healthcare specialties in South Africa.
Quoted in a recent Voice of America, Korras said only one university offered a postgraduate program in palliative medicine, while a few others offered only limited undergraduate courses.
As we become more comfortable with discussing death and dying, perhaps we could speed up the much-needed legal reforms that will prevent the inhumane trauma experienced by terminally ill patients such as Avron Moss and his loved ones and the many more desperate South Africans who regularly contact DignitySA begging for help.