Ethicist, physician, and writer Eric Cassell has remarked that it is troubling that patients and laypersons consider the relief of suffering to be one of the primary ends of medicine, yet the medical profession neglects it. It is even more disturbing given that we are on a daily basis confronted with images of war, pain, and displacement. Rodney Syme’s book about ending life brings issues relating to suffering close to home. It reminds us about this facet of the human condition, even for those who have, for the most part, led tranquil lives. Increased longevity often entails a difficult expiration. Many of us will die slowly – perhaps of cancer or organ failure – or without dignity, as dementia robs us of what makes us human.

In Time to Die, the suffering and indignity of chronic illness, or a protracted death, are described, and the standard arguments against assistance in ending life, such as the efficacy of palliative care, are examined in great detail. True to the biblical title, Syme returns us to a more holistic view of the life cycle. He challenges the medical and legal imperative to extend life at all costs. In so doing, he asks us to consider what makes for a fully human life, even in the midst of suffering.

Unlike countries such as Canada, Switzerland, and the Netherlands, assisting death – that is, prescribing or administering drugs to end life – is illegal in all parts of Australia. It was not always thus. Between 1995 and 1996, The Rights of the Terminally Ill Act in the Northern Territory ensured that one could receive assistance to die. The Howard government’s reversal of this act in 1997 once again left many with few choices other than painful and often grotesquely ineffective ways of suicide.