Abstract: This paper identifies common themes in the fictional literature on assisted suicide, classifying them as either major or minor. Three major themes include the absence of or, when they are present, distortion of religious values regarding assisted suicide and end-of-life decisions; the defeatist or utilitarian attitudes toward pain and suffering; and the use of the standard dehumanizing language found in euthanasia debates. At least six minor themes can be culled from the works under review: first, the diminution or eradication of the idea that life is sacred; second, the aesthetics of death; third, the definition of suicide; fourth, anti-Catholicism; fifth, a decidedly liberal bent; and sixth, the use of rhetorical erotema. Fortunately, four recent works illustrate a life-affirming response to most assisted suicide fiction: Harry Kraus’ Lethal Mercy (1997), Nicholas Sparks’ The Choice (2007), Jane St. Clair’s Walk Me to Midnight (2007), and Fiorella De Maria’s Do No Harm (2013).
This paper arose from several fears, all of which reside in the author: the fear of facing the reality that the contemporary issue called assisted suicide counters the proposition that the author is not living in the most perfect of all perfect worlds; the fear of reading literature whose narrative structures ineluctably end with a disturbingly sad denouement; the fear of what reading such disturbing literature would have on his psyche; the fear of confronting those whose arguments for assisted suicide seem unassailable; and the fear that the alternatives to assisted suicide are grand, yet pale philosophical tenets that cannot match the grander and stronger needles filled with toxic agents to end what some misguided person may think is a dreary life.
As ministers, priests, and rabbis and their secular counterparts (psychologists) suggest, the first step to overcoming such ghostly fears and replacing them with substantial reality is to seek them out, name them, look them in the face, and bid them be gone. In the world of literary criticism, these actions translate to finding works which concern assisted suicide, identifying themes in the works, countering those messages in the literature which are life-denying, and exorcising them in the name of a life-affirming literary ethic.
Thus as a starting point, titles concerning assisted suicide have been culled from research in the WorldCat database with the parameters that the work was written in or translated into English and produced since 1900. These simple parameters were chosen not only to obtain a substantial list of items concerned with this topic, but also to recognize a fact of social history: assisted suicide became a new aspect of end-of-life issues in the twentieth-century Western world. That English is the dominant language of discourse in the medical and literary fields makes the task of the literary researcher easier.
This paper first identifies common themes in the fictional literature on assisted suicide, classifying them as either major or minor. Three major themes in the literature studied here include the absence of or, when they are present, distortion of religious values regarding assisted suicide and end-of-life decisions. The distortion of religious values affecting such decisions is ecumenical; works written from the perspective of characters who are purportedly Catholic, Jewish, or Protestant illustrate their ignorance of religious values frequently. Whether such ignorance or distortion result from authorial intent to promote assisted suicide must be deferred to a vaster research project than this. The second major theme concerns the defeatist or utilitarian attitudes toward pain and suffering, intimately connected with the value placed on human life. The third major theme involves the use of the standard dehumanizing language found in euthanasia debates.
At least six minor themes can be culled from the works under review, the first being the diminution or eradication of the idea that life is sacred, predicated on the notion of “useless” life. The second minor theme involves the aesthetics of death; that is, many works studied here reference the beauty that death brings to human life. Admittedly oxymoronic, the beauty achieved in death is voiced not only by those who deny life, but also those who would most affirm its value. Third, contemporary fiction often struggles with the definition of suicide, venturing simple definitions in either the declarative or interrogative sentence functions. This inability to define suicide or assisted suicide leads to the often interesting corollary that most twentieth-century assisted suicide fiction hesitates to have characters commit the deed. Characters who tire of life are redeemed at novel’s end either with a deus ex machina love of life or by another torque in the plot that removes the stress that a character may feel when compelling someone else to assist him or her in suicide. That the hesitation frequently vanishes with twenty-first century assisted suicide fiction testifies to the abandonment of any qualms about offending readers with a topic formerly viewed as objectionable, probably because a highly secular, de-Christianized reading public itself is changing its attitude on the issue.
The remaining minor themes are infrequently found in the literature, but occur often to indicate how contemporary fiction tries to manage this controversial issue. The fourth minor theme is a staple of American bigotry, anti-Catholicism. The fifth minor theme is that many twenty-first century novels concerned with assisted suicide have a decidedly liberal bent, disparaging anything which seems rightist or conservative. Attacks against conservatives may exist in the narrative only to advance the idea that supporting assisted suicide is a liberal tenet; often, however, these attacks are as gratuitous as certain sex scenes. The sixth minor theme is the use of rhetorical erotema, which peppers some of the assisted suicide works, not only to have the reader consider a specific viewpoint, but also to stifle any opposition to the decision by a life-denying character engaged in someone’s suicide.
The task now is to examine these themes found in the literature.
Elizabeth Sanxay Holding’s Miasma (1929)
One of the earliest novels concerned with assisted suicide is Elizabeth Sanxay Holding’s Miasma. From the beginning, it is clear who are the good guys and who the bad; Dr. Dennison, the narrator who believes in a life-affirming ethic, mentions doctors who do “disreputable jobs” (15), and within seven pages one of the main exponents of a competing perspective regarding the value of life is the first intimation of Dr. Leatherby’s philosophy, that there is no purpose in suffering (22). Leatherby enforces the life-denying philosophy, mentioning those who live “long past the proper time” (47) and, a page later, the idea of “useless” life (48). Within another page, Dennison, who has been befriended by Leatherby, states the maxim that “while there’s life, there’s hope” (49). One could almost miss the importance of this expression, attributed to Theocritus, since there is a later reference to Dennison’s Christian faith (144). However, that Dennison manifests a continuity between the ancient pagan world and Christian values is consistent with a medical person who believes that the ancient world and the Christian are largely compatible—an idea that Leatherby later refutes.
The full import of Leatherby’s philosophy hits the reader only towards novel’s end. “Life isn’t anything sacred” (208) is asserted along with the idea that death “is painless, beautiful” (209). The explication of his ethics occupies an entire chapter (211-21) and includes the ideas that his is the “Calvinistic […] opposed to the classic” (212) view of life, which should not have “utterly futile pain” (213); “man’s life is his own” is further asserted on the same page as death viewed as “easy and beautiful” (214). Taking all these points together, Leatherby argues for “a true euthanasia” (219).
When his assisted suicide activities are discovered, fictional satisfaction occurs consistent with the moral weight of the Judeo-Christian centuries preceding the advent of this 1929 novel: to escape prosecution, Leatherby commits suicide.
Kurt Vonnegut’s Short Story “2BR02B” (1962)
Kurt Vonnegut’s short story “2BR02B” is perhaps a transition from the clear divisions of Holding’s novel to the intellectual ferment of the sixties which witnessed the destruction of the sacredness of life ethic. This is not to say that Vonnegut, known for his liberal and humanist philosophies, would have advocated the plot of this short story as a solution to overpopulation. However, that the story would have proffered the idea that one person must sacrifice him- or herself if another person (a newborn) enters the world suggests openness to the idea of balance not only in population, but also in the demands of one generation placed on another.
Vonnegut’s story concerns a father whose wife gave birth to triplets; in a futuristic society, each child becomes permitted only if someone chooses to die. Thus, the father sacrifices himself in order to have the child live. Is this short story, therefore, an explication of a euthanasia plot or the first effort of the culture to describe a person who voluntarily kills himself with the assistance of the state, the last option being a sufficient stipulative definition for “assisted suicide”? The ambiguity attending the question may be hidden by the shock value of the story. Certainly, for the 1962 audience, that a father would be forced to have himself killed so that his child would live would be unconscionable. In 2014 (after being exposed to decades of forced abortions in the People’s Republic of China, media and courtroom accounts spanning decades of mothers killing their newborns and their young children, and professors placed in the United States who openly advocate the killing of handicapped newborns), the shock value has dissipated, and so the question posed by the short story can be addressed. Since this story is as tersely written as one of Hemingway’s short stories, it is difficult to identify language which conveys the author’s position or the narrator’s tone towards assisted suicide. Such literary analysis must be relegated to future studies.
Barbara Stevens Sullivan’s The Eighth of September (1995)
Moving from a work by a humanist author to Barbara Stevens Sullivan’s The Eighth of September also moves the reader into the culture of a secular Jewish perspective on the issue of assisted suicide. The nature of the family’s religious tradition is discussed early in the novel (5), as is the general philosophical ideas of the meaning of life and death (5-6). Shirley, the main character, is described not only physically, but also in terms of her disability status: although not terminally ill, she has suffered a stroke (7). Sympathy for Shirley was probably meant to be stimulated when the narrator reports that she had aborted her third child (13), but the opposite effect may have been created by this gratuitous use of abortion as birth control. The religious and political positions of the family are eclectic; there is a mention of a visit to a Native American holy site (44), the “ridiculous war Bush” brought the United States into (45), another mention of the family’s Jewish identity if not practice (45), and further confused religious practices (50-1).
Perhaps it is this enumeration of disparate religious data that appropriately leads into commentary from the first third of the novel about assisted suicide issues themselves. For example, having a “vegetable for a parent” (60) is obviously discouraging, and the loving devotion that a man had when he cared for his wife at home when she was in a coma is discussed in a disparaging manner (72), as if to suggest that no one should have to commit such time-consuming attention to anyone else’s care or endure such a waste of resources. “If her mother would only die!” (83) is an exclamation uttered by a daughter even though hope exists that Shirley could go home from a care facility where she temporarily resides (175-6), the image of a nursing home, of course, having been earlier depicted as suitably depressing to prevent any consideration that such a place could be life-affirming (120).
Halfway through the novel, religious elements are reduced only to casual mention of terms and bigoted statements. The exclamation “crazy Catholic mishagass [crazies]” (108) intersperses with commentary about searching for God, referring to Merton and contemplation in silence (142). Native American sweatlodges (144) appear again, and suicide is called a sin (161) even though the family members admit that they are neither Christians nor Jews (170).
A series of conditional statements can apply before the final assisted suicide occurs. Since suicide is viewed as “rescue” (149-50), since Shirley, a frequent reader of Final Exit, asserts that her life is “nothing” (157), and since life does not exist before or after this earthly life (213), the family continues to arrange plans for Shirley’s suicide, which will be anything but “beautiful”: she will take pills to put herself to sleep and, once her head is bagged, choke to death on her vomit (224-5).
Three novels intervene here, all of which briefly mention the major and minor themes. Young-Ha Kim’s I Have the Right to Destroy Myself (a 2007 translation of the 1996 Korean original) reads like any other European or American novel on assisted suicide which seems devoid of Judeo-Christian values. The narrator, a killer preoccupied by people “dragging their lives” (96), compares herself to a god “through creation or murder” (10). It is uncertain if the reader is meant to understand that Mimi’s suicide is an actual one or a literary one—a take on what Europe now calls in its dispute with Google the “right to be forgotten” (Schechner).
The situation in James McManus’ Going to the Sun (1996) is dire: David has been mauled by a grizzly (29) and wants to die. Unfortunately for David, Penny, the narrator and David’s lover, has no intellectual or spiritual resources beyond standard pat secular axioms to help her decide if she should kill David. Penny asserts that people decide if they want to die (41-). In retrospect, she questions if she is a murderer , yet cites Alaska law as an aid for her to decide her moral status (69). She speaks disrespectfully of the Sixth Commandment and confession ; refers not to any saint or moral philosopher, but to Derek Humphry and Jack Kevorkian (71); holds a view towards the Bible which shows her lack of religious values (83); and believes not in religion, but fate (281-). David was no better. He was a non-practicing Catholic (based on his sexual escapades with Penny and a former girlfriend); Penny thinks he “would not have approved of” the prayers at his funeral Mass .
John Straley’s The Angels Will Not Care (1998) concerns a “death tour industry” (62) where persons on board ship die unexpectedly. Cecil Younger, the narrator, hired to determine why people are dying, receives an ambiguous reply from the ship’s doctor when asked if he ends people’s lives, and the possibility is only hinted at throughout the novel. Another character, however, openly states, “I determine my destiny” (141). Some discussion concerns the confusion over medicines which may cause death (194), the passive vs. active distinction, and the role of the suicide doctor is eventually clarified (209); apparently, the suicides were supposed to be spaced (210). To offset any further concern about the novel focusing on assisted suicide, a deus ex machina of life-affirming joy occurs when the narrator learns that he is a father (223-5).
Aidan Chambers’ Postcards from No Man’s Land (1999)
Aidan Chambers’ Postcards from No Man’s Land is interesting for its setting and philosophical content as much as how it represents a fictional work geared for an adolescent readership. Having the Netherlands as the setting conjures up two conflicting ideas, generationally based; for an older generation, particularly Baby Boomers, this is the country which suffered greatly during World War II, a country which is the site of Anne Frank’s tragedy and affirmation of life, and the country which would most seem to affirm life after the atrocities of the war. For the younger generation, this is the country which embraced not only prostitution and drugs as liberating items necessary in contemporary culture (liberation from what is always ambiguous), but also euthanasia as the final privilege that secular persons have.
The religious perspective of the characters is evident from the first pages when “god” is used as an interjection instead of a vocative for the Supreme Being. A litany of contemporary social problems does not list any of the life issues, an indication of the traditionally myopic view of the liberal mindset (41). Geertrui, the main character, “has an incurable illness” (64) and wants assisted suicide (93-4). A long section of the novel engages in the in medias res technique, allowing the reader to see how a character such as Geertrui reached her current religious position. She “still prayed in those days” (during the war) (97); her criticism of “ideology” (103) is a necessary precursor to the claim that the Bible is a “novel” (112). After the death of Jacob, Geertrui’s British lover during the war, “the human instinct to keep life going at any cost” (228) controlled her life. Unfortunately, the general horrors of the war and the specific horror of the death of her lover marked Geertrui considerably; she talks disparagingly about mothers who had illegitimate children and who were assisted by nuns (251). Why such negativity should be uttered may not be clear at first, except to show not only her disgust of those who chose life even under dire circumstances, but also, possibly, to attack any Catholic entity as a suitable target for religious bigotry. The antagonism for all things religious even affects non-human entities; the attitude regarding religious hymns is distinctly negative (239-40).
The disregard for religious values is evident in other characters as well. Daan, the friend of the ostensible protagonist of the novel (Jacob), is irreligious and bisexual (113 and 278); Jacob’s girlfriend Hille supports assisted suicide in a lengthy philosophical passage (215-8); and Jacob masturbates, treating the sexual activity merely as a “call of nature” and not as a sexually immoral act (233).
Geertrui’s ambivalence about her assisted suicide is deflected so that, instead of focusing on the act itself, she demonstrates her mental confusion by writing that she does not want Jacob at her assisted suicide (301-2). After the killing, since this is a novel written for young adults who are irreligious and live a carpe diem life, the only way to end the plot is to focus not on how someone’s suicide comports with the divine will or how that suicide affects others. For the secular and entirely earthbound adolescent characters of this fictional world who do not live by the standard of sexual fidelity within marriage, the novel ends with an appropriately salacious teen sex scene (311-2).
A quick survey will highlight the major and minor themes evident in five novels which intervene in the decade following Chambers’ work.
Jonathan Kellerman’s detective novel Dr. Death (2000) concerns the murder of an assisted suicide doctor, Eldon H. Mate, who is modeled after Jack Kevorkian. One of the investigators calls Mate “just a homicidal nut with a medical degree” (15). The novel contains pro-assisted suicide statements from a character who asserts that Mate was concerned with death, not “quality of life” (63). This character also blames Catholics for Mate’s murder (70) with no justification beyond her having worked for a Catholic hospital.
Louis Bayard’s The Pale Blue Eye (2006) is a historical novel set in 1831 which attempts to draw on the mysterious character of Edgar Allan Poe when he was a West Point cadet. Gus, the narrator, views an epileptic boy as “a shell where a human being had once lived” . He asks Poe to shoot him so that he will not be convicted and hanged of the murder of his sickly wife (406); Gus calls it a “mercy” (407). He eventually commits suicide , saving Poe from having to decide the moral issue—as well as maintaining the status quo of literary history.
Edward St. Aubyn’s Mother’s Milk (2006) contains much religious discussion for a novel concerned with Eleanor’s desire to have Patrick, her son, assist her suicide. Although characters do not believe in Original Sin (70-1), they recognize the futility of a New Age foundation (103-4), acknowledge the “gravitational field of confession” (121), and consider the philosophy behind “love thy neighbour” as a former “meaning of life” (126). A Garden of Eden reference occurs (129) as does a commentary about Purgatory (190), yet any suggestion that the novel will suddenly turn life-affirming because of these religious references is halted by the claim that “an awful Christian stench” (191-2) is occupying the discussion. Patrick treats his mother with compassion (220) yet considers assisting with her death as “a filial role” (221); this last assertion is supported by Patrick’s comparison of himself and his family with the Holy Family (227). However, in a deus ex machina, Eleanor decides to “do nothing”; Patrick acquiesces (278-9).
The unnamed narrator in Stephen White’s Kill Me (2006) contracts with an organization called the Death Angels to kill him should he become incapacitated. When Adam, a son from a casual sexual encounter, appears on the scene, the narrator realizes that he cannot allow himself to be killed until he resolves whatever issues he has with his son. However, when the narrator develops an aneurism, the Death Angels activate his contract and intend to kill him. At novel’s end, his son needs a liver transplant, and the only person who can provide a perfect match is the narrator. The narrator allows Lizzie, a former employee of the Death Angels, to kill him, allowing his liver to be donated to his son. Just as an ignorant reading public may think that obtaining embryonic stem cells may seem morally justified if they are put to “good use”, since obtaining the cells requires the killing of a human being, the moral ambiguity of such a utilitarian and pathos-inspired approach toward assisted suicide in this novel may obscure the fact that a murder is being committed.
John Barth’s The Development: Nine Stories (2008) presents a variety of characters who express life-denying views based on the absence of religious principles. One character ponders “the prospect of his merely ceasing to exist” (28). His wish is to “simply disappear—poof!” (29; italics in original), and the italicized interjection is probably intended as a comical approach to a serious end-of-life matter. However, that people “only get one go-round” (42) and the expression of doubt concerning what exists after death (49) illustrate that eternal life asserted by religious belief is absent in these characters’ lives.
Greg Ames’ Buffalo Lockjaw (2009)
If Barbara Stevens Sullivan’s The Eighth of September (1995) is the contemporary Jewish take on the assisted suicide issue, then Greg Ames’ Buffalo Lockjaw provides a view of a purportedly Catholic family struggling with the issue—“purportedly” being the operative term, since none of the characters lives up to the standards of Catholicism on the issue of assisted suicide or other tenets of Catholic belief. For example, two main characters’ sexual behavior testifies against their adherence to Catholicism: Jimmy, the narrator, fornicates (43), and his lesbian sister is pregnant by a sperm donor (154).
Jimmy’s perspective on assisted suicide is immediately apparent when he mentions that he is reading, not a compendium of moral theology or the latest pronouncements from Church authorities on the topic, but Assisted Suicide for Dummies (4). He thinks he has the right to kill his mother (13) because suicide is not a sin (14); since his life is not founded on religious principles, he may have been persuaded more by his mother’s support for assisted suicide (104) as well as her debilitated state. His hostility against his faith is obvious in several statements. “Buffalo is a hard-core Catholic city” (172) could be a statement of praise, but it is not meant as epideictic. Obvious hate statements against pro-lifers further distance the narrator from his religion’s activism on behalf of life; he cites the “antiabortion group Christians in Action” (200) and calls pro-lifers “sadists” (201) with no just cause.
Instead of focusing on the religious or moral aspects of end-of-life issues, Jimmy seems most concerned with the beauty of death. He often mentions his concern with “finding beauty” (23) and that he should “find the beauty” (106 and 136). However, the concern over beauty cannot obscure several passages which read as logical argumentation and syllogisms used to comment on or support assisted suicide. For example, the erotema “They shoot horses, don’t they?” (15) is a rhetorical ploy designed to elicit an affirmative response, the unstated enthymeme of the logical fallacy being that, if horses which are decrepit are shot, then humans who are similarly decrepit should be shot. Jimmy’s friend may have come closest to arguing an analogy appropriate for resemblance arguments in the Aristotelian system when he equates assisted suicide with hiring a hit man (80-1). Furthermore, the several instances of logical elements (such as a series of “if…then” propositions in two locations, pages 117 and 252) suggest that the lines mentioning finding beauty in death may deflect the more important task of making the case for euthanasia.
The final bit of evidence that the novel shows ostensible Catholics not living up to their faith’s position on care for the infirm is revealed after Jimmy’s mother’s death. The police suggest that Jimmy’s father, purported to be a faithful Catholic, was involved with his mother’s death (280-1), and Jimmy suspects his father may have killed his mother with the cooperation of a nurse who seemed so caring and compassionate toward his mother in her nursing home (287). Apparently, it is a secret that they will uncomfortably share for the rest of their lives.
This paper began with a statement of several fears. Fortunately, while the fiction discussed above may parallel the excruciating decisions that some people have to make regarding end-of-life decisions, the depictions of persons in dire straits, devoid of religious principles to guide them into their final days, do not constitute the comprehensive perspective on the issue that it may seem. There are novels which display characters who are ordinary people, engaged with end-of-life issues from a different worldview, one which the vast majority of the world’s population experiences and which über-leftist writers may have renounced. Four recent works may illustrate the response of that different worldview which counters the dismal, Cormac McCarthy post-apocalyptic road that some would have the reading public travel, and they include Harry Kraus’ Lethal Mercy (1997), Nicholas Sparks’ The Choice (2007), Jane St. Clair’s Walk Me to Midnight (2007), and Fiorella De Maria’s Do No Harm (2013).
Where the themes of most of the earlier assisted suicide fiction novels either plead ignorance or utter hostility against religious principles, these four works openly profess a reverence for life based on religious themes without being didactic for a contemporary audience. While the novels considered earlier suffer from defeatist or utilitarian attitudes toward pain and suffering, these life-affirming novels in contrast view suffering only as a means to an end, the end being a perfected state of existence with one’s family and, ultimately, the Divine Being. Similarly, although the earlier works use standard dehumanizing language found in euthanasia debates, the four life-affirming novels contain characters who show respect for those suffering or near death.
Moreover, the four life-affirming novels address or counter the five minor themes identified earlier. There is no diminution or eradication of the sacredness of life. While life-denying novels suggest that death brings beauty to life, these life-affirming novels argue the opposite: that the respectful treatment of human life in its precarious or final stages could give beauty to the period surrounding death. In these four novels, the definitions of suicide and assisted suicide are not difficult to grasp, and there is no bigotry against Catholicism or other denominations of Christianity or other religions. Finally, the labels “conservative” and “liberal” tend to merge when characters are concerned with the care of the dying, and thus become moot; the important element in the plot is not advocating a leftist view, making the characters’ situations the mere background for didactic passages in support of assisted suicide, but depictions of care for fellow humans who are suffering or near death. If this last proposition is accepted, then rhetorical erotema to stifle opposition to a life-denying decision is a useless literary tool.
Perhaps the fears that some have about end-of-life decisions would be alleviated if the steady stream of life-denying fictional works is balanced by fiction which does not focus on what seem to be insurmountable tragedies surrounding the end of life. Writing serious fiction on a serious topic need not be morose, but this is the final characteristic of life-denying fiction. In virtually all of the assisted suicide novels which end with the death of the person requesting suicide, the denouement is necessarily (and obviously) somber. Just like abortion novels, there is no way to rejoice over the death of fellow human beings.
The life-affirming novels, however, have one saving grace: their plots are resolved, if not happily (for a human being has died), then at least satisfactorily. That is, no life-affirming character suffers the final personal anguish of Dr. Leatherby (who, remember, commits suicide at novel’s end), or the father in Vonnegut’s short story (who goes grudgingly to his death when he would rather live and celebrate life with his newborn), or the assisted suicide victim in Sullivan’s novel (choking ever so beautifully on her vomit), or the young man in Chambers’ work (incognizant of the facts that, first, he was tangentially involved with a family acceding to a matriarch’s assisted suicide and, second, he has been reduced to a sexual toy by his assisted suicide supporting girlfriend), or the chronologically adult yet adolescent-minded lost boy Jimmy in Ames’ novel (who will live the rest of his life, virtually but not absolutely certain that his father killed his mother). Although fiction is often merely an escape from the dreariness of cubicle life at work or a frustrating day with the kids instead of a didactic enterprise, with such necessarily dreary denouements that assisted suicide novels bring, readers may prefer to engage with life-affirming fictional worlds that enlighten their own.
Ames, Greg. Buffalo Lockjaw. New York: Hyperion, 2009. Print.
Baddock, James. Piccolo. New York: Walker, 1992. Print.
Barth, John. The Development: Nine Stories. Boston: Houghton Mifflin, 2008. Print.
Bayard, Louis. The Pale Blue Eye. New York: HarperCollins, 2006. Print.
Chambers, Aidan. Postcards from No Man’s Land. New York: Speak, 1999.
Crombie, Deborah. All Shall Be Well. New York: Avon, 1994. Print.
De Maria, Fiorella. Do No Harm. San Francisco: Ignatius P, 2013. Print.
Goldsborough, Robert. Death on Deadline. Toronto: Bantam, 1987. Print.
Holding, Elizabeth Sanxay. Miasma. New York: E. P. Dutton, 1929. Print.
Kellerman, Jonathan. Dr. Death. New York: Random House, 2000. Print.
Kim, Young-Ha. I Have the Right to Destroy Myself. Trans. Chi-Young Kim.
Orlando: Harcourt, 2007. Trans. of Na nun na rul p’agoehal kwolli ka itta. Munhakdongne, 1996. Print.
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 Since most of the published popular fiction studied here illustrates a negative view of human life, these themes could more properly be restricted by the hyphenated phrase “life-denying” in contrast with those works which convey life-affirming messages. The classification of the themes as major or minor results from a cursory tally as the items under Works Cited were read and annotated.
 The erotema by the narrator in Peter Robinson’s Before the Poison (2012) further suggests a perspective that could cover all of the themes in the literature found thus far: self-centeredness. Granted that Chris Lowndes, the narrator, has no faith (7) and that the seasonal trappings, if not the religious meanings, of Christmas in York, England make him feel alive (271-2), the heavy use of first-person pronouns stand out when he discusses his killing of his wife, who had suffered from cancer, by morphine overdoses. In at least two locations, before the novel ends on page 358, the narrator says, “I told myself that I had done Laura a favor, and I knew in my heart that it was true, but I had still killed her. Did that make me a murderer?” (337) and “I didn’t know whether that technically made me a murderer or not, but that didn’t matter. I had killed” (354). Even the tortured denouement includes too obvious first-person language; Chris’ discovery that the woman whose hanging he had been investigating was justified (she had killed her husband so that he would not pursue chemical weapons research) led to “the first tentative move toward forgiving myself” (356). Placing such introspection at the end of the novel changes it from one which is a mystery involving the execution of another person who had killed. Such psychological transference may therefore justify the nearly 20% overuse of the words quoted here (eleven of the fifty-eight) being first-person subject, object, and reflexive pronouns.
 Louis Trimble’s Give up the Body (1946) contains evidence that the question may have been asked earlier. More a murder mystery than a discourse on assisted suicide, one character asks a rhetorical question which could be an attempt to redefine suicide: “Is suicide extreme cowardice or extreme bravery?” (192).
 Three novels are omitted from the larger discussion here, but two common threads connect them: first, a hesitation to have characters engage in assisted suicide; second, its opposite, an affirmation of life. Robert Goldsborough’s Death on Deadline (1987) has one character identifying suicide as the “ultimate admission of failure” (67) and the deus ex machina reveals that Harriet’s death was an accident, not a suspected suicide, assisted or otherwise (159-60). Although James Baddock’s Piccolo (1992) is not concerned with assisted suicide (it is a detective novel, involving scientists whose suicides were actually murders), there is a brief and quasi-assisted suicide scene; Redmond kills a criminal engulfed in flames (215), ostensibly to put him out of the misery of the situation. Finally, Deborah Crombie’s All Shall Be Well (1994) may involve Meg in the assisted suicide of Jasmine Dent who is under her care; however, towards the denouement it is learned that Jasmine was killed by her visiting nurse (264); furthermore, Jasmine’s last journal entry praises life and affirms that she wanted to live (267-8).
 While it seems that the main plot of Jodi Picoult’s Mercy (1996) concerns the adultery of a husband more than an assisted suicide courtroom drama (most of the 400 pages constitute a tedious development of the adultery theme instead of the intricacies of assisted suicide), the novel contains some choice rhetorical uses of inaccurate language to denote mercy killers and their victims, “vegetable” being a key element. Maggie, a cancer patient who was killed by her husband, discusses vegetable imagery (30); the husband’s defense attorney “didn’t know how he felt about euthanasia” and asks, “Was it the same as wanting someone to pull the plug if you ever became a vegetable?” (90).
 Chambers’ novel is only one of many fictional works for young adults which discuss assisted suicide. Two such novels deserve attention here. Terry Trueman’s Stuck in Neutral (2000) concerns fourteen-year-old Shawn, who has cerebral palsy, and his father, who won a Pulitzer Prize for a poem about him. Shawn says that his father “divorced me” (4; emphasis in original) since he is a “total retardate” (4). Shawn defines euthanasia as “the killing of sick people” (11) and affirms that “there’s an actual person hidden inside my useless body; I am in here, I’m just sort of stuck in neutral” (11; emphasis in original); he even comments on the use of “vegetable” to describe a handicapped person (25). Unlike authors who are concerned with the beauty that euthanasia brings to one’s death, Shawn describes the beginning of his seizures (“crackling”) as beautiful (32). Shawn suspects that his father will kill him (12), and his speculation is justified. His father thinks out loud that “maybe you’d be better off if I ended your pain”, the act of euthanasia which he contemplates changed both euphemistically and metonymically (21). Shawn’s father makes a documentary at Shawn’s school which questions the utility of funding education for “the uneducable” (44-7). The murder that his father wants to commit is foreshadowed when it is suggested that he will write a book about a convicted man who suffocated his brain-damaged two-year-old son (66).
The family’s religious practices are ambiguous. Shawn’s mother does not finish the idea that “a lot of people believe in life after—”, and the presumption is that she does not (16). The father is an atheist (50) who “almost started believing in God” when Shawn was born; he had prayed for a cure for his son (112). Despite the parents’ lack of faith, Shawn argues, since “we are more than just our bodies and our brains, I should believe that we have souls” (59). At novel’s end, it is presumed that the father will suffocate Shawn (113-4). The fictional nature of this work is tempered by the novel being based on the author’s experiences with his son, who has cerebral palsy (115-6).
Lurlene McDaniel’s Breathless (2009) concerns the situation of Travis, a young man with osteocarcinoma, who asks his girlfriend Emily to kill him. The idea of God that Emily, the narrator, holds is of one who fixes things (44). Her religious affiliation is confusing; she prays “Kyrie eleison” (45) even though she is a “minister’s daughter” and thus some category of Protestant (89). Travis asks for a do-not-resuscitate order and offers, not complete rational thoughts, but two phrases as his justification for doing so: “My body. My choice” (96) and proceeds to plan his suicide with Emily’s help. His attitude about seeing God after his death is clearly aggressive: “We’ll deal with each other when we meet” (137). Once his decision is made, Emily abandons the trappings of her religious belief: she stops going to church (114) and hides her bible far in a closet corner (150), yet she ironically at novel’s end goes to Mexico to build a church (162). The most important feature of the novel is the last sentence, an erotema. After Emily kills Travis (163-5), her rhetorical question is just as taunting as Travis’: “Who’s my judge?” (165).
 Two other novels following Ames’ work deserve some attention. Serena Nanda and Joan Gregg, coauthors of Assisted Dying: An Ethnographic Murder Mystery on Florida’s Gold Coast (2011) offer brief mentions of terms and ideas associated with assisted suicide and euthanasia. The American attitude toward aging and independence (12) is discussed along with the Muslim attitude toward caring for the elderly (16). Euthanasia is mentioned (68) as is the idea of “useless, selfish creatures” (79). One character thinks death leading to something better is not a matter of religious certainty, but “a great point for consideration” (87). The characters’ antipathy to anything but leftist beliefs is evident when one says that she has “never been to a Wal-Mart” (159) and when the Tea Party and President George W. Bush are disparaged (162). It is interesting that discussion question ten asks, “Can death be made beautiful?” (195).
The second novel is Jodi Picoult’s The Storyteller (2013), which involves Sage, the narrator, an atheist who comes from a Jewish family (15), who is asked by Josef, a former SS officer, to assist him in his suicide. After a long and tedious retrospective narrative, Sage agrees to kill Josef (410), baking a roll containing the poison monkshood. However, only in the denouement is it learned that a case of mistaken identity had occurred. Josef was not the SS man that Sage thought (457), but his brother. Thus, Sage did not assist in a suicide as much as she committed murder by killing the “wrong” person (458).
 Although De Maria’s and Sparks’ novels concern problems attending a living will law in (respectively) Britain and the United States and not assisted suicide per se, the timeliness of these works which illustrate several ideas discussed above justify their inclusion in this study. De Maria’s work concerns efforts to deny life-saving treatment for a young woman affected by a pro-life physician’s abrogation of her living will. That the young woman’s friends seem to collaborate in “assisting” (or promoting) her death when ordinary medical care could save her life is implicit in this novel. The degree to which anti-life forces can agitate for denial of medical care when such care would save someone’s life, to the point of prosecuting physicians who live by the Hippocratic Oath, is a frightening consequence of their autocratic demand for social acceptance of their views.
Sparks’ novel is philosophically milder. Although four-fifths of the novel is concerned with the romance of the main characters, the last section of The Choice offers a different take on the frighteningly life-denying role that living wills play in end-of-life decisions. Gabby, the wife of Dr. Travis Parker, has been in a coma for eight-four days. Since her living will specified that feeding tubes should be removed after twelve weeks, Travis must decide whether to follow the living will or ignore his wife’s wishes. Although he is depicted as an upstanding man (despite the fact that his and Gabby’s ideas about premarital sex follow typical American norms and not the chaste religious view that sex should be reserved for marriage), Travis’ religious sense is ambiguous throughout the novel. The closest he comes to considering religious beliefs occurs when the narrator says that
he’d been searching for answers in the Bible and in the writings of Aquinas and Augustine. Occasionally he would find a striking passage, but nothing more than that; he would close the cover of the book and find himself staring out the window, his thoughts blank, as if hoping to find the solution somewhere in the sky. (240)
Although this passage indicates neither his religious affiliation nor the degree to which religious ideas affect his decision-making, Travis is aware of key ideas in end-of-matters. He ponders if he would become a killer by withdrawing feeding tubes (291) and thinks that “where there was life, there was always hope” (294). Fortunately, Travis chose not to remove Gabby’s feeding tubes (300), and she awakes from her coma.