Oregon resident Ann Jackson was all of 12 when she first dipped her toe in the debate over doctor-assisted death – a debate rekindled across the Canadian border last week when the British Columbia Supreme Court declared the federal ban on the right to end life this way unconstitutional.
She and her classmates were asked to write essays on controversial topics. Her assignment? To argue in favour of physician-assisted suicide.
It is the viewpoint that Ms. Jackson, now 71 and for two decades executive director of the Portland-based Oregon Hospice Association, holds today – and expressed in an affadavit tote B.C. court. – but only after taking a long hiatus.
She opposed the state's famed Death With Dignity Act when it passed in 1994, and three years later voted with those trying to have it repealed.
But over the years, her perspective began to change, she says in a telephone inteview. She came to believe that necessary safeguards had been put in place and even the terminally ill who chose not to end their lives benefited from knowing they had the option.
"People were being steered to information to help them make good decisions," she says. " I think that's overwhelmingly a good thing because we struggle so hard to talk about death.
"If it were to be on the ballot again today, I would vote for it."
The ruling in B.C. sparked a circus-like atmosphere outside the court after the ruling came down. Proponents held a news conference to celebrate victory; opponents waved signs predicting an increase in elder abuse.
The verdict was suspended for a year to give Parliament time to draft new legislation, and the federal government has not said whether it will appeal.
In her affidavit, Ms. Jackson outlined her concerns when the Oregon legislation first appeared, For example, would be the bar be high enough to stop a patient with questionable judgment?
The answer, she said, was yes. Those who seek physician-assisted death must go through a series of requests, examinations, consultations, and counselling, if appropriate.
Ms. Jackson told the court she'd been "cavalier" when she believed the need to control one's own death was somehow "unworthy" – and flatly rejects the notion that it creates a slippery slope. "What some people call a slippery slope other people would call progress."
How did her own viewpoint change? There was no one defining moment, she says. Rather, her perspective evolved, suggesting that of Canadian opponents may do the same over time.
However, she adds, it started to become clear after the first year – when 16 patients chose to end their lives – that the system could work, that it could exist without major flaws and allow people to die with dignity.
Since leaving her post with the hospice association in 2008, Ms. Jackson has worked as a consultant, helping private clients decide how, and whether, to end their lives.
However, "one of the things I don't often get is the outcome of the story," she says. "I talk with people, but I don't know whether they go ahead and use it, except in a very few cases.
"What is most gratifying to me, and what is most important to me, is the fact that people are so grateful for having the knowledge and for having someone that they can talk to openly."
Ms. Jackson has found that, for every 25 people who qualify for physician-assisted suicide, only one goes through with it. The others benefit from knowing that, in the worst-case scenario, they have an option.
As for Canada, she says that if and when its guidelines for physician-assisted death are drawn up, she'd be happy to offer her expertise – on both sides of the issue.