Bella was a strong woman, with grace and fortitude. She was dignified, and wanted to make her exit with dignity. It was completely understandable.
But Hannibal was so deeply moved as he held her frail body and lowered her into the chair opposite his that he nearly had to blink back tears. She begin talking to him in her low, quiet voice, now sickly soft and cracked with the exhaustion that was overpowering her. He listened. He was staring death in the face, but it wasn't freeing, or captivating, or beautiful. It was pitiful. As he watched the life leave her body, as her eyes shut and her shoulders slumped, he was in awe: she was a beautiful woman, and death had made her ugly.
It occurred to him, then, that he had to decide what next to do. There was Crawford to consider. What would affect him more: his wife's suicide, or knowledge of her attempted one? What would matter to him more: the shared pain of someone's untimely departure, or the prevention of it? Then there was Hannibal himself. He had promised Bella the grandeur of a peaceful and dignified death. But he had been wrong before. Surely she knew better than to take his word as gospel.
He picked up the gift he had placed on the table and took it out of its satiny casing. The coin was cool to the touch and felt like velvet on his fingers. He felt his heart beating wildly, his eyes dilated, and he tossed the coin up and caught it in his palm. It was heads. Of course he knew which decision to make, but it was amusing to test fate, and to guess and be right. After all he had gone through and what he would go through before the night was over, he deserved a little amusement.