Though The Self-Made Man is only one family's story, it attempts to raise issues we all will have to face. In the developed world, aging and/or dying is often a slow process, filled with medical interventions and choices. Is it ever rational, is it ever mortally right, to choose to die? Under what circumstances? And who should make the choice and take the action?
In the United States, and around the world, government is involved in trying to answer these questions. In the United States, the case of Terri Schiavo has produced an upsurge in debate and legislation. In Canada, England, France, New Zealand, Australia and Japan, recent highly publicized cases have also prompted political debate.
Taking one's own life is legal in the United States; it is also legal for a mentally competent adult to decline life-extending medical treatment. However, Oregon is the only state which expressly allows others — and only physicians — to assist the terminally ill to die. And as we saw in the Schiavo case, when an adult has left no written record of their end-of-life wishes — and sometimes even when they have left instructions — both medical and legal rights and responsibilities remain unclear.
In its 2005-2006 session, the US Supreme Court is scheduled to hear the Bush Administration's challenge to Oregon's 1997 Death with Dignity law, which allows doctors to prescribe lethal medication to sane, terminally ill patients with less than six months to live. Similar "right-to-die" legislation is pending in California, and has recently been considered in Vermont, Arizona, Hawaii, North Carolina, Wisconsin and Wyoming. In the wake of the Schiavo case, several states are now also considering legislation to make it more difficult to remove life support if an incapacitated adult has not left written directives.
Meanwhile, elderly men, in particular, continue to take the matter into their own hands. White men over the age of 85 have a suicide rate nearly six times the national average. Suicide experts say most of these men are depressed. But whether the suicides are judged to be "rational" or the result of depression, families are always impacted. Adele, Mike, Laura and Susan Stern, and the Stern grandchildren, report that they are all well — thriving in school, work and family and community life. Susan Stern is traveling with the film, speaking and teaching. The other members of the family wish to be private. But everyone says Bob remains very much in their hearts and minds.
— Susan Stern, July 2005