Some novels are designed merely to entertain. Others shed light on the human con-dition and, particularly, how we face challenges, such as disability and death. JoJo Moyes’ novel1 artfully presents the narrowing choices faced by a once vibrant “king of the world” (born to wealth and all the privileges that accords, gifted in other ways, and thoroughly enchanting to men and women alike) brought to a pitiful crisis. The book has travelled extremely well across the Atlantic, having reached best-seller status first in Britain and now in the United States.
A mere outline of Me Before You does not suggest a bestselling novel: Will Traynor, an athletic, wealthy, successful 35-year-old suffers a horrendous motorcycle accident, severing his spine at C5-6, which leaves him quadriplegic with only limited movement in one arm and needing 24-hour care. Lou (Louisa) Clark, only slightly younger, works in a bakeshop in the same town that Will returns to for care that he will require the rest of his life. Lou, clever but uncredentialed, loses her job, applies desperately to become Will’s companion, stirring up class consciousness in her own family as well as Will’s.
Despite their differences, Lou and Will bond. Although Will is condemned to live the rest of his life in a wheelchair propelled by others, Lou persuades Will to continue to explore challenges despite his fears and limitations. The couple falls into a spiritual love that, given the way Moyes has developed her characters, is convincing despite their dif-ferent needs and backgrounds.3 Will’s condition worsens. Despite all that Lou has done to raise his spirits, she begins to understand Will’s desire to end his life. Will she help him achieve his last goal? If so, will they succeed? And, will there be legal repercussions?
In the hands of a lesser writer, this would be melodrama at best. Jojo Moyers, how-ever, adds to the story convincing detail about class distinctions in a provincial corner of England and the physical challenges — to caretaker and patient — of paralyzed limbs. Moyes traces the occasional joys4 and agonies of disability in a way that should both in-struct and engage nearly all Elder Law attorneys and many of our clients.
The function of a novel, ultimately, is to tell a story whose characters incarnate our greatest fantasies or fears, shed light on the choices we make, and how, ultimately, we pass or fail the tests of life in the company of others. Is Lou’s dedication to Will romantic, altruistic, exploitive, or doomed? Is Will’s resolve to hasten his death inevitable given his condition? And, with a plot that could have been torn from today’s newspapers, Ms. Moyes poses a fairly stark picture of “assisted suicide” as some call it or as its proponents prefer, compassion and choices. Should society punish those (companions or profession-als) who assist in suicide?
Until recent decades, death and the dying process were largely the matter of private decisions made within specific religious and cultural frameworks. Increasingly, however, questions of how we make decisions at the end of life have become a matter of public policy and of ethical debate. Advances in medicine have the capacity to extend life indefi-nitely, but often with poor quality and escalating dependence on medical technologies. Demographically, the aging population in most developed countries and the increasing incidence of AIDS and other chronic diseases promise to complicate end-of-life decision making. As a greater proportion of societal resources are expended at the end of life, the ethical and policy issues are bound to intensify.
In the United States, Oregon and Washington enacted statutes almost a decade ago that allow competent adults to choose to die and those who help them avoid prosecution, but only if it can be ascertained that the patient is likely to die, naturally, within the next six months.7 Other specific conditions require that the patient a) reside in the state, b) be capable of making a health care decision and communicate it to medical professionals, and c) follow a mandated process, that sometimes requires reiteration of the intent. A similar rule applies in Montana following its Supreme Court decision in Baxter v. State.
