Neal Auch— Vanitas for Sophie

“The government sees me as expendable trash, a complainer, useless and a pain in the ass.”

This is how a 51-year-old woman known pseudonymously as Sophie described her situation just 8 days before she was scheduled to die.

Sophie suffered from a severe sensitivity to chemicals that made living with the omnipresent cigarette smoke in her Scarborough apartment complex intolerable. During the pandemic, Sophie had become increasingly confined to her bedroom—the “dungeon” as she called it. Although she sealed off the doors and ventilation ducts, cannabis and cigarette smoke were inescapable, and Sophie’s conditioned deteriorated.

For two years, Sophie struggled to find affordable housing where she could be free from exposure to smoke and harsh chemical cleansers. For two years, she appealed desperately for assistance from her landlord, friends, family, the public, and government officials at both the federal and provincial level. And, at every turn, Sophie was met with failure.

In the end, seeing no other option to alleviate her suffering, Sophie decided to end her life.

On Feb 22, 2022, Sophie became the first person in the world to successfully obtain a medically induced death for a diagnosis of multiple chemical sensitivities (MCS).

Much of the media coverage surrounding Sophie’s story focused on the ethical debate surrounding medical assistance in dying (MAID). Speaking personally, I do think MAID should be accessible to those who need it; however, I also think that this framing largely misses the point.

What makes Sophie’s story complex is this: the root cause of her suffering wasn’t a medical condition—it was poverty.

Research shows that many symptoms of MCS disappear when chemicals are removed from a person’s environment; while we don’t know much about Sophie’s personal medical history, there is good reason to believe that she could have lived a long and happy life if only she could have afforded a nicer apartment. “It’s not that she didn’t want to live,” said Rohini Peris, President of the Environmental Health Association of Québec. “She couldn’t live that way.”

Even though she lived in one of the most prosperous countries in the world, it was easier for Sophie to obtain government assistance in dying than it was for her to access affordable housing. The details of how this sad story unfolds intersect with a host of systemic barriers and complex questions in ethics, medicine, and politics. But, at its core, Sophie’s story is disturbing because it lays bare an uncomfortable truth: we live under a system that places less value on the lives of our most vulnerable citizens than it does on the economic cost of housing and caring for those people.

A recurrent motif of classical Vanitas paintings is the juxtaposition of superficial markers of material wealth (coins, luxury items, etc) against reminders of mortality, such as skulls and bones. These works were a call to piety and a critique of greed—a death-haunted reminder that the accumulation of wealth is meaningless vanity in the face of certain death. At the heart of the Vanitas’ moralizing is the very same question of cultural values Sophie’s story raises. Do we want to live in a society where the worth of a human life is expressible in economic terms?

This series of compositions revisits the themes of 17th-century Dutch Vanitas paintings through the lens of Sophie’s sad story. As in classical works, coins are placed alongside reminders of mortality (animal bones, in this case) as a reminder that our time on this earth is limited and there are matters more worthy of our concern than the accumulation of wealth in the hands of a few (already wealthy) landlords. Extinguished candles were a common motif in classical Vanitas paintings. Here, I have replaced those with smouldering cigarettes, offering a reminder of both the fragility of human life and, at the same time, the catalyst of Sophie’s torment.

A Clarification…

It is an unfortunate reality of the media landscape that we currently inhabit that the majority of people who interact with this work will do so on a platform like Facebook or Twitter—places where nuance goes to die. Given the ethical complexity of Sophie’s story, it seems very likely that I will end up being accused of holding a position that I don’t actually endorse. For the sake of clarity, let me be as blunt as I can about what I do (and do not) believe. Bear in mind that I am neither an ethicist nor a lawmaker nor a political influencer; my position on this issue is basically irrelevant to any practical real world matter and if you disagree with me that’s fine because, again, I don’t have any power to sway policy in any way whatsoever.

With that out of the way…

As I stated above, I do personally think MAID should be available to those who need it. And I think the complex medical/ethical question of who does (and does not) qualify for MAID should be made by someone other than me. I’m not a doctor and I could not possibly adjudicate such matters. This question is, frankly, well above my pay grade and I believe that it should be left in the hands of ethicists and doctors and—crucially—the patients who are actually seeking out the service. I also think that this is one of those problems where, no matter how you draw the line between who does and does not qualify, there will be disturbing cases that sit on the boundary of that line. It’s just too complex to have a clean answer that everyone agree upon.

But, as I said above, I think that Sophie’s story actually has very little to do with the ethics of MAID. Fundamentally, her story is about right to housing. We live in a world where there would be more than enough to go around were it not for the fact that a tiny handful of people are hoarding a disproportionate share of wealth and resources. In that context, I think it’s inhumane to deny people access to the basics that are needed for life. In a more equitable world, I think that access to suitable housing, food, water, medical care, etc, would be treated as basic human rights. If you disagree with me that’s fine—remember that I have no sway over our political system. And, in any case, you can rest assured that the world I’m describing here as “ideal“ will probably never materialize. I realize this view is idealistic; I’m simply stating what kind of world I’d chose, given the choice.

So, again, to be as blunt as possible: I think the tragedy of Sophie’s story isn’t that she chose MAID. I think the tragedy is that she lived under a system where something as simple and potentially life-saving as a smoke-free apartment was impossible to access.

Finally, I suspect there will be some people who will argue that Sophie’s chemical sensitivity condition was “fake“ in some way or another. Again: I’m not a doctor and the diagnosis of MCS is way above my pay grade. I’m happy to take Sophie and the actual doctors who treated her at their word, and I have no interest in belittling those suffering from chronic conditions that I’m not qualified to understand by claiming they’re “crazy“ or “just making it up“ or whatever.

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Vanitas for Sophie

A Clarification…