Category Archives: Assisted suicide

Why am I still here?

Friday, 15 April 2016

despair-513529_640

When other helpers fail and comforts flee,
Help of the helpless, O abide with me.

First there was the cancer diary. Nigella Lawson’s husband John Diamond wrote one, you remember. Since the advent of the self-published blog countless people have died out loud.

Next, boomers started writing about the slow and distressing decline of their parents. You’ll find an example here.

Now those boomers are old enough to write about their own dissolution and are doing so to debunk the myth that too-long life is an unmitigated good thing. In last week’s Spectator magazine Stewart Dakers (77), reflecting that the reaper has changed from terminator to tormentor, dwelt on the horrors of longevity with both dread and splendid prose. Here are just a few extracts:

The existential reality of decline is aggravated by the prospect of total physical and cognitive disintegration, the details of which are well known to us, so we live in physical discomfort and mental terror. Old age has graduated into a form of pre-traumatic stress disorder.

We are a waste of space on a seriously overcrowded planet. We are in the way and those who are most impeded are the young. We can see this and are, of course, ashamed of ourselves.

My advice to young people is simple. Eat, drink, even smoke, and be generally merry, because that way you might be spared too many days of misery for yourself and your friends and family. Live short and prosper.

Old-age rational suicide will be with us any day now, just you see.

Bring on the empty corpses

Monday, 17 November 2014

Smoke-Gets-in-Your-Eyes

 

Book review: Smoke Gets In Your Eyes by Caitlin Doughty

Caitlin Doughty, graduate in medieval history and author of a sunny thesis entitled The Suppression of Demonic Births in Late Medieval Witchcraft Theory, rejects a promising career in academia in favour of one as a corpse handler and incinerator of the dead.

Anticipating bewilderment she asks, rhetorically, “So, really, what was a nice girl like me working at a ghastly ol’ crematory like Westwind?” And she goes on to tell us what drew her to it. She describes a traumatic childhood trigger event. I won’t reveal what it was, of course; you need to read Smoke Gets In Your Eyes for yourself. Her theory is that she dispelled the consequent denial that insulated her from the traumatic event by confronting her fears and getting on down with corpses. As a result of this self-prescribed and gruelling CBT she is now at peace with the “stillness and perfection of death”.

More than that, Doughty is now the world’s leading cheerleader for death: “Death might appear to destroy the meaning in our lives,” she says, “but in fact it is the very source of our creativity.” This is just one of many debatable assertions she makes in this book. Death may inspire urgency and thereby rouse latent creativity, but it is doubtful whether it can put in what God left out.

Doughty is the leader of a clever, charismatic and acclaimed corpse cult, the Order of the Good Death, “a group of funeral industry professionals, academics, and artists exploring ways to prepare a death phobic culture for their inevitable mortality.” You’ve seen the Ask A Mortician video series — you have, haven’t you? She’s sassy, funny, outrageous and very likeable. She’s a brilliant performer. She spills and splashes behind-the-scenes secrets with a mischievous glee that appals and infuriates industry insiders, who firmly believe that there are Things It’s Best We Don’t Know. To this day, despite a great and growing following, she remains shunned by the National Funeral Directors Association. Her preparedness to bring down, in Biblical abundance, the murderous fear and loathing of old school funeral people takes guts. She’s outrageous because she’s also passionately seriousness.

Like so many progressives, Doughty is essentially retrogressive — in a positive way. Her prescription for the way things are is to get back to doing them the way we did. Nowadays, when someone dies, we call the undertaker and have them disappeared. This, reckons Doughty, is a symptom of a “vast mortality cover-up … society’s structural denial of death … There has never been a time in the history of the world when a culture has broken so completely with traditional methods of body disposition and beliefs surrounding mortality.”

The way to restore society to emotional and psychological health, Doughty believes, is to engage with the event and get hands-on with the corpse. She believes that “more families would choose to take responsibility for their own dead if they knew that it was a possibility.”

This is what working in a crematory teaches her: “Westwind Cremation & Burial changed my understanding of death. Less than a year after donning my corpse-colored glasses, I went from thinking it was strange that we don’t see dead bodies any more to believing their absence was a root cause of problems in the modern world. Corpses keep the living tethered to reality.”

I’m not so sure. I have in mind David Clark’s 1982 paper, Death in Staithes. The older inhabitants of Staithes, a fishing village on the east coast of Yorkshire, could easily recall the way things used to be: “When a person passed away the first thing they did was go for the board – the lying-out board,” which was kept by the village joiner. The lying-out itself was supervised by women qualified by skill and experience. These same villagers had lived through the commodification of death and the arrival of the Co-operative. To them the hands-on past is no paradise lost and they display no desire to return to it.

I question Doughty’s assertion that we suffer from “structural denial of death.” If we were to think about death some more, would it really do us any good? Yes, she says: “I don’t just pretend to love death. I really do love death. I bet you would too if you got to know him.” Elsewhere, she writes: “Accepting death doesn’t mean that you won’t be devastated when someone you love dies. It means you will be able to focus on your grief, unburdened by the bigger existential questions like ‘Why do people die?'”

Philip Larkin felt sort of the same until he hit 50. In Julian Barnes’ words, “our national connoisseur of mortal terror … died in a hospital in Hull. A friend, visiting him the day before, said, ‘If Philip hadn’t been drugged, he would have been raving. He was that frightened.’” Pretty much the same can be said about the death of another connoisseur, Sherwin Nuland, the man who wrote with spooky prescience “I have not seen much dignity in the process by which we die.” He was that frightened, too.

“Let us … reclaim our mortality,” exhorts Doughty headily. But does the dearth of corpses in our lives really distance us from death? Death was big in the lives of everyone in the past because people died at any age. They don’t do that so much now, they mostly die old, and that’s less tragic, less sensational. But death is arguably bigger in our lives than ever before because the dying spend so bloody long about it. There can be very few children who are not acquainted with a tottering, muttering relative, and very few adults who do not spend years despairingly caring for dementing, degenerating parents. They are in no doubt about what their parents are doing: they are dying a modern death, a slow and beastly death. That’s why there’s such an intense national conversation in so many countries about assisted suicide — come on, how mortality aware is that? Far from being a time of death denial, the present age has focussed our attention on mortality at least as urgently as any other because the distressing dilapidation of legions of almost-corpses starkly and terrifyingly prefigures our own end times, leaving us in no doubt that the home straight is going to be unutterably horrible. If we don’t feel we have much to learn from corpses, we learn as much as we feel we need from the living dead (ever seen a stroke ward?) and from self-deliverers like Brittany Maynard. They teach us the allure of Nembutal. We talk about this. A lot.

What people believe also plays its part in modern attitudes. Religious and spiritual-but-not-religious people are, pretty much all of them, dualists. There’s a soul and there’s a body. It’s a belief reinforced by the appearance of any corpse they have ever seen. Gape-jawed and evacuated of all vitality, a corpse speaks of the absence of self. Whoever it once embodied has gone. The corpse is not the person, so what value is there to be gained from cosseting it? This isn’t a new thing. Radical Protestantism has always taught it. Calvinist settlers in America became very careless of the ‘dignity’ of their soul-less dead and drifted into just hauling them into the forest or pushing them into rivers. In some places it got so bad that neighbours were appointed to oversee next door’s disposal arrangements and held responsible for making sure things were done properly. For these settlers, direct cremation would have been a godsend.

If I take issue with Doughty’s thesis, it is because someone’s got to. For Doughty, the contemplation of the corpse is “the beginning of wisdom.” If you are inclined to believe that, she says, “Don’t let anyone ever tell you you are ‘sick’ or ‘morbid’ or ‘deviant.’”

What does morbid mean, exactly? It is Doughty herself who has pointed out that it has no antonym. Yes, what is the word for a healthy interest in death and dying? How does it express itself? Doughty and her fellow members of the Order of the Good Death express their wisdom exotically, sharing delight in much that others would regard as macabre — transi tombs, taxidermy, mortabilia and of all sorts. All a bit goth for my taste; I think there’s more than a dash of innate morbidity here. It would be idiotic to question the charisma of the cause, because it has attracted a huge worldwide following. How does it play to Mr and Mrs Everyday-Person? It remains to be seen. All I can say is that, speaking as a detached and jaded dullwit, after 6 years of hanging out with funeral people and their charges I remain unconvinced of the value of the corpse in death rituals, and while I acknowledge matter-of-factly the inevitability of death, I hate it as much as I ever did.

If by now you need some remission from my grinding and joyless pessimism, you need to buy this book. It it touches all the right bases — funny, shocking, sad, wise. Above all, it is full of hope and purpose. It is also highly readable. It was only when I re-read it that I became aware just how beautifully constructed it is. This is the work of a highly intelligent person who has got the inspiration-perspiration balance right (1:99). What she has to say is the product of experience, a lot of it penitential. She has captured the zeitgeist. This is a manifesto for today.

ECSTASY OF DECAY №1: Your Mortician from Angeline Gragasin on Vimeo.

So it goes

Thursday, 17 July 2014

Lucius-Annaeus-Seneca

 

Posted by Vale

Have you ever thought what it is to be a King or a Queen?

You are, usually, born to it: it is your life and your duty. Our own Queen clearly feels this keenly. As far as a commoner can tell, for her, the coronation oath confirmed what birth had bestowed: she became Queen for life, a vow as absolute as a nun’s.

Others, apparently, see it differently: Queen Beatrice and King Carlos have just unthroned themselves and nobody seemed to mind.

Who’s has the right of it? Our queen or the continentals?  Who cares? It’s strange now to remember that, once upon a time people fought and died over just this question. Did kings rule by divine right? Could you dispose of a bad one without sin or was it really the worst of crimes – worse than murder or treason, an affront to the very order of the universe?

Suicide used to carry a similar stigma. It was both self-murder – a broken commandment – and a direct affront to god. Our lives aren’t our own. Choosing to end them is to fling the gift of life back in god’s face.

In this week of debate about assisted dying, I do wonder how much its opponents arguments are rooted in these old beliefs. The feeling in our bones that suicide, however rational the argument, is still taboo.

Of course assisted dying is more complicated. It raises different, difficult questions. At its simplest, it’s about the way that others become implicated in a personal choice, blurring the line between suicide and murder.

But we need to work these issues through because attitudes are already changing – starting with suicide itself.

I need to be careful here. I am not praising or promoting suicide. If you are a celebrant or funeral director you know only too well what suicide means – the agony of families ruptured by the loss; the disbelief; the unanswerable questions; the terrible feelings of failure regret; the anger.

But there are occasions when it is not like that.

I took a service recently for someone who had lived a very full life. She was clever, accomplished and active.

She had known hardships and grief – her husband was dead and, many years before, her daughter had died. She had faced both losses with courage and great resource.

Without family now, she was connected to a wide network of good, loving, friends. She was involved, loved to to learn new things, enjoyed writing and painting.

Then Parkinsons was diagnosed and, as it progressed, she realised that her life was dwindling. It was becoming more about staying alive than about living so, well before she needed to, she made her arrangements and killed herself.

The service we planned was full of the thoughts and poems she had left us. The crematorium was filled to overflowing with all her friends. There was sadness and a deep sense of loss but there was respect too for her decision and her determination. We sympathised with her. I suspect that many of us were thinking about our own old age, wondering if we would be as brave as she had been.

Is helplessness and incapacity a universal fear these days? Is it feared now more than death itself?

There was no horror, though, or despair; just reflection and a determination to honour and celebrate our friend’s life. We wanted to do justice to her courage.

Too many things have changed now for lawmakers to avoid the hard questions. As we age we know what awaits us. We know that medicine now has powers to both save and destroy us.

People are already making their own choices, beginning to join that old stoic Seneca saying:

The ship that I sail in, I choose; the house that I live in, I choose; so will I choose the death by which I leave life.

We need to support people in their choice. We will need support ourselves when the choice comes to us.

How To Die In Britain

Monday, 14 July 2014

 
In just over a week Lord Falconer’s bill on assisted dying will have its second reading in the House of Lords. Opinion seems to be moving in its favour. The British Medical Journal has published an editorial in favour, recognising that increasing numbers of medical people support it.

A powerful voice was added at the end of June when the Supreme Court turned down the appeals of three people demanding the right to die but, in a judgement that revealed increasing exasperation with timorous politicians, 5 of the 9 judges concluded that they had the right to declare that the present law breaches the right to a private life. Were they to do so, Parliament would be forced to act.

It looks as if the tide is unstoppable. Sooner rather than later we’ll have an assisted dying law in England and Wales. The Scots seem to be headed the same way.

If this is how the majority sees it, it’s not surprising that they’re not in campaigning mode. Most of the noise is being made by those campaigning against, who have no such complacency to comfort them.

Under the alarming headline Oregon – steady annual increase in assisted suicide cases sounds warning to UK, Dr Peter Saunders, writing for the Christian Medical Comment blog, predicts that we can expect just that in the UK. The inference is that things have got out of hand in Oregon – a predictable unintended consequence.

Why does he quote Oregon? Because our law will be based on theirs, passed in 1998.

And he’s right. The numbers are climbing steadily as you can see from the chart below [Source].

Oregon stats

Why are the numbers climbing? And does it matter? In other words, are things getting out of control in Oregon? Are disabled and vulnerable people being despatched as people said they would be?

The answer would seem to be no. If you draft a law carefully, you get what you legislate for. It cannot be denied that Dr Saunders and his ilk serve a useful purpose at the drafting stage.

What we are seeing, though, is the substitution of the Hippocratic Oath (‘First, do no harm’) with the overriding concept of respect for patient autonomy. It’s a big shift.

Back to the rising numbers in Oregon, the explanation would seem to be that it’s all down, not to unintended consequences, but to rising awareness of the availability of physician-assisted suicide brought about by those in favour of it. A powerfully persuasive factor has been the award-winning film, How To Die In Oregon (trailer at the top of the page). All in all, probably nothing to get too worried about. Dr Saunders, basing his figures on Oregon’s, reckons around 1232 Brits will kill themselves annually.

The social profile of those who choose to do themselves in is interesting. More men than women do it, more whites than other ethnic groups, and most because they have lost autonomy and all joy in life. The education profile is interesting, too – below.

Ed profile

 

In Britain the debate is possibly best exemplified by the opposing views of Archbishop Welby and his predecessor, Lord Carey. Welby argues from principle: “Compassion literally means ‘to suffer with'”. The greater the suffering, the greater the compassion required. Carey, on the other hand, argues from experience. It was the Nicklinson business that changed his mind: “The old philosophical certainties have collapsed in the face of the reality of needless suffering.”

British funeral celebrants are beginning to report funerals they have conducted for people who deliberately ended their suffering. They were beautiful and respectful of the choice. It would be good to hear from you if you have had any experience of this.

Just checking

Friday, 25 April 2014

Man writing on the paper in the office

 

In the good old days, death happened before we were ready for it. It struck untimely. Now, it creeps up, perhaps getting to us long after we have timed out.

Which raises the question: when is a timely death?

Journalist Matthew Parris is not alone in contemplating old age with trepidation. In a recent article he asked “How long do you want to live?”

It is a question my generation are the first in modern history to be asking ourselves in very large numbers. We ask it because we are among the first to expect — again in very large numbers — that our lives may be prolonged past a point when we may want or think we ought to live.

We will ask it, too, because we are the first generation among whom a majority no longer believes that suicide is a mortal sin.

I’ve decided to write myself a letter to be opened at the age of 75 and thereafter revisited annually. It sets out my criteria for carrying on. These are the criteria for me alone and I don’t apply them to others, who must frame their own.

Dear Matthew,

To the following eight questions a box is to be ticked, “yes” or “no”. The answer to some may obviate the need to ask some others. If the answer to either of the first two questions is “yes” then brush this letter aside and live on. If the answer to both is “no” then read no further, and reach for the razor blade.

1 Do you still, on balance and taking good times with bad, enjoy being alive?
2 Is there anyone else whose life would be devastated by your death?

The final six questions are not critical, but they may help you to decide in case of doubt:

3 Are you still of any practical use?
Are you more or less of sound mind? — in which case who is the prime minister, and multiply two by nine then subtract seven.
5 Are you more or less in possession of your physical faculties?
6 Are you still curious about the world? Can you get on a plane?
7 Behind your back, do people pity you?
8 Can you justify the cost to others, to the NHS and to your country of staying alive?

Full article here.

Never say die

Wednesday, 13 November 2013

2008bu5954_julianis_time_and_death_tableau

Time and Death, wax relief, Italy, probably before 1727 [Source]

 

The Falconer Bill on assisted dying is making its way through the Lords before going on to the Commons, and the familiar debate rages once more. The usual suspects oppose it. They include senior doctors and lawyers and, you probably think, a lot of religious people, yes? And disabled people?

Actually, the stats show support for assisted dying as follows: 

  • * General population: 80%
  • * Religious people: anywhere between 60% and 80% depending on how you ask the question.
  • * Disabled people: 75% 

The principal players in the battle are, on one side, those who argue for personal autonomy and the right of anyone to die when they damn well please (terms and conditions apply), versus, on the other, those who seek to safeguard the interests of the vulnerable, whether elderly or disabled  — those who might come under pressure to do away with themselves. Should the Bill become law, there is the customary fear of slippery slopes and thin ends of wedges. It’s certainly true to say that the original Abortion Act never envisaged or intended that there should be so many abortions — but for all that, abortion rides high in the public’s favour.

The argument about assisted dying is one that needs to be heard; the law, when it comes, needs to be a good one. The eventual outcome is a forgone conclusion, of course. If it be not now, yet it will come. 

It’s perhaps regrettable that the Bill uses the euphemism ‘assisted dying’. What it means is assisted suicide – a doctor enables vetted people to kill themselves by handing them a fatal cocktail. One thing it is not is euthanasia, where it’s the doctor who does the killing. If the Bill becomes law, euthanasia will still be murder. 

Falconer’s Bill is pretty much a carbon copy of Oregon’s Death with Dignity Act of 2007. If you want to see how things are likely to pan out here in Britain, see how they have panned out over there

And if you want to find out precisely when you are going to die, click here. If you want to watch a US tv series showing people dying in real life, click here

The interesting thing about the debate about assisted dying is that it is taking place in the context of new science which is continuously calling for a reappraisal of the definition of death. At what point can we say that someone is dead? 

Take Ariel Sharon. Remember him? Prime minister of Israel. Had a huge stroke in 2006. Yes, that one. 

He’s still alive, lingering on in a permanent vegetative state (pic below). 

Areil Sharon replica

Once upon a time death was cardio-pulmonary death. Still is. But when technology made it possible sometimes to restore cardio-pulmonary function, but not consciousness, a redefinition was required. It’s called brain stem death. In nautical terms, the bridge has been wiped out, but the engine room is still humming. 

Brain stem death describes not loss of consciousness but the end of consciousness. Brain stem death is the point at which living organs can legally be harvested — and give a new lease of life to dying people. How dead is that? How dead are you when your heart literally goes, in the words of the song, on? A brain-dead pregnant mother nourished a foetus for 107 days and gave birth to a healthy child.

Which is why some people deny that brain stem death is death. 

Twenty years ago an MRI scan of a stroke patient might have shown them to be utterly dead.  Today, tissue plasminogen activator can restore them to unimpaired health. 

What price, then, the irreversibility of death? 

How would we define death in the as-yet hypothetical case of someone’s brain being transplanted from their dead — in a cardio-pulmonary sense — body into a de-brained but otherwise healthy body? 

Take it a stage further: if death is the cessation of life, what is life? 

Some people propose that death should be defined as the irreversible loss of personhood — the point at which you can declare that Elvis has left the building and ain’t coming back. Okay then, if so, when do you call time of death on a demented person? How do you address the matter of the still-beating heart? 

And yes, what constitutes “a person”? 

Over in America, Dr Sam Parnia is now reviving people who have died of a heart attack several hours after they have died, and he reckons that in 10-20 years’ time it’ll be possible to resurrect dead people after 24 hours. Parnia even proposes allowing a person who has died of, say, pneumonia, to remain dead while an antibiotic goes on working to kill the disease, and then, when they’re ‘well’ again, bringing them back to life. 

Understand this: brain death is nowhere near an event. It’s a process that takes longer than anyone thought. The brain goes on dying for hours after the heart has stopped beating. So: what levels of awareness do we retain after our death, and for how long? 

It’s science that’s altering the definition of death in the modern age. Many religions have, for centuries, thought of death, not as a full and final event, but as a time of transition. Science has not ruled out continuing consciousness. Sam Parnia, who has for years collected the recollections of the out-of-body experiences of those of his patients who have died for a short time, offers this caveat to those who think that the seat of selfhood is the brain:

“We always assume that all scientists believe the brain produces the mind, but in fact there are plenty who are not certain of that. Even prominent neuroscientists, such as Sir John Eccles, a Nobel prizewinner, believe that we are never going to understand mind through neuronal activity. All I can say is what I have observed from my work. It seems that when consciousness shuts down in death, psyche, or soul – by which I don’t mean ghosts, I mean your individual self – persists for a least those hours before you are resuscitated. From which we might justifiably begin to conclude that the brain is acting as an intermediary to manifest your idea of soul or self but it may not be the source or originator of it… I think that the evidence is beginning to suggest that we should keep open our minds to the possibility that memory, while obviously a scientific entity of some kind – I’m not saying it is magic or anything like that – is not neuronal.”

If you’ve got an hour and a quarter, this is well worth watching:

 

 

Lord, now lettest thou thy servant depart in peace…

Tuesday, 22 October 2013

one-day-later

 

An average 68 per cent of Canadians favour the legalisation of assisted suicide, but the Court of Appeal in British Columbia has just rejected it. Read more here

The arguments for and against assisted dying, assisted suicide, dying with dignity, call it want you will, will be with us for some time to come, but the outcome is already perfectly evident: in the end we’ll buy it. The debate we’re in now is very close in kind to the debate older readers remember from their youth about abortion. The big difference is that, aesthetically, letting old and very ill people depart in peace is much more ‘acceptable’ than aborting foetuses. 

In response to the recent setback, the Canadian National Post published letters for, against and don’t know. They illuminate the arguments well. Here’s a selection:

FOR

* There is no difference between refusing to give pain-killing drugs to patients dying in agony and refusing to assist them in ending their lives when these drugs are no longer effective. Both are unconscionable acts of prolonging torture. Our fellow citizens have no authority to decide when we give birth, nor when we die. Our lives are our own, and when or how we decide to die is up to us.

* Sane citizens must be given the right to die controlled and dignified deaths. If religious people wish to prolong the suffering of their loved ones in some perverted acknowledgement of the “gift of life,” fine, but do not impose that tenet on the rest of us. 

* The average life expectancy in 1908 was 48 years old. So the idea of living beyond our best-before date is a relatively new dilemma for the human race. I use the word “dilemma” because except for the fortunate few who will one day fall asleep and never wake up, most of us will experience a long, painful, debilitating, demoralizing, humiliating drawn-out demise. It’s time to rethink the end of one’s life.

AGAINST

* From legally assisted suicide, there is one short step to legal murder demanded by survivors who are not up to caring or even tolerating having to deal emotionally with death and dying.

* Yes, we all die, and the wages of sin is death. We do not want to suffer much while we are dying. But are not our doctors efficiently trained to control pain? God teaches us what dying with dignity means and it does not mean to kill oneself. It means to trust His promises and to lean on His Son for the forgiveness of our sins and in Him die in peace. That’s dying with dignity.

* We cannot just accept someone’s death wish and agree that their lives are no longer worth living. Instead, we must ease their suffering, provide comfort, and restore their sense of dignity and value.

* I am wary of any law that makes it easier for somebody to kill another person.

* It is time for the dying or suffering to accept the final burden of their own demise and not open the Pandora’s Box of state-assisted suicide. How long would the choice be theirs and not someone else’s?

DON’T KNOW

* I can imagine that if I were in excruciating pain from illness and the prognosis was dire, I’d want the right to be able to end my life — and quickly. However, that is not my situation and so it’s disingenuous of me to presume that I’d actually know what I’d want. This debate should only take place between people who are facing an imminent end to their lives, as well as their loved ones who are watching them suffer. Armchair philosophers should take their wise thoughts elsewhere.

When death is no longer the worst thing that can happen to you

Monday, 27 May 2013

76478-501-50_full

 

Phonobarbital — what they do you in with

 

It’s not the worthy efforts of the members of the Dying Matters coalition that have raised awareness of the need to talk about death and dying. What’s actually got more and more of us talking is our personal experiences of the difficult and protracted end-of-life suffering of members of our families. Alongside twenty-first century death agony, extinction is the least we have to fear. Bring it on, goes up the cry, as, just this week, the Falconer Assisted Dying Bill passed its first reading in the House of Lords, Vermont became the fourth state in the USA to legislate for assisted suicide (let’s call it what it is, shall we, Charlie?) and in liberal (if that’s the right word) Switzerland an 80 year old woman in perfectly good health appealed to the European Court of Human Rights to be allowed to go now rather than get any older. She’s had enough, thanks. 

Live issues in this debate are: 1) what constitutes suffering; 2) the right of the state to limit personal autonomy and an individual’s right to self-determination; 3) the duty of doctors to write a prescription for those who ask for a chemical exit; and 4) the protection of those going through a depressive patch or who are susceptible to duress from predatory relatives, etc.

Over time, of course, this is going to reconfigure attitudes to funerals. 

In the context of all this, I was struck by the following letter in last Sunday’s Sunday Times:  

It isn’t just dementia that thwarts our plans. I also dread the disease that robbed me of my mother, and the thought of my daughter changing my nappies and enduring tyrannical rages  and repeated conversations fills me with dismay.

So strong are my feelings that five years ago I wrote a detailed advance directive,  had it witnessed, shared it with my family and lodged a copy with my GP. I take little comfort from this as it  appears that some people — who do not know me but  have some religious or ethical opinion — are insisting they have more rights over my  body than me.

Why should the limited resources of this tiny planet be used on my dribbling, deranged shell when I’ve requested otherwise?

Sue Parkes, Halesowen, West Midlands

How do you define ‘dying’?

Monday, 22 April 2013

Dignitas-room-Zurich-Nove-001

Where you die when you go to Dignitas

 

Sarah Wootton, chief exec of Dignity in Dying, wrote in Friday’s Times about the case of Paul Lamb, who wants to be allowed to die:  

Dignity in Dying is not fighting for an unfettered right to die, but for the right of dying people to die well. We believe that right must be based on two core criteria: terminal illness and mental competence. Mr Lamb is mentally competent, but not terminally ill. Our proposed law would not help him. 

Any law must balance the rights of the individual against the needs of society. A small but significant minority of dying Britons are suffering unbearably, against their wishes, at the end of life. I am certain that we can implement a law that would give them the freedom to reduce their suffering without compromising the safety of potentially vulnerable people. 

Restricting the law to those with a terminal illness would protect those who have recently become disabled and have yet to come to terms with their situation, or those facing new and difficult, but ultimately controllable, symptoms of a chronic condition. It is also important that patients take the final action themselves. This ensures that they are in complete control of the decision about how and when they die. 

“I am not without a heart,” Wootton says, “but still I cannot fully support [Lamb’s] case.” 

Wootton is taking into consideration here the acceptability of right-to-die legislation to the public. What she wants, 80 per cent of the population wants. Extend the right to people who are simply fed up with living and acceptability plunges to just 40 per cent. 

She may also have been thinking about Belgium, where euthanasia has increased by 4,620 per cent in just ten years. 

In Belgium, there lived two identical twins, Marc and Eddy Verbessem. Both were born deaf. They never married, but lived together and worked as cobblers.

When they were 45 they were diagnosed with a form of glaucoma which meant that they would shortly go blind. When they learned this they were very sad and felt they had nothing to live for any more. They went to their local hospital and asked for euthanasia. The hospital said no.

So they went to another hospital. The doctors listened to their story kindly and empathically. They agreed with Marc and Eddy that their outlook was very bleak indeed and, yes, their lives had lost all value.  So they killed them with a lethal injection.

This happened a fortnight before last Christmas, 2012. It was entirely legal. 

Responses to Wootton’s article are interesting.

Simon Roue says: “Having the debate about whether people have the right to take their own life seems hopelessly outmoded in a society that de-criminalised suicide in the 1960s.” 

Robin Thomas says: “Sarah Wootton is right to draw our attention to the distinction between her campaign (for the ‘dying’) and Mr Lamb’s (for those living in hell). But ultimately I wonder if this is a distinction without difference? Are we not all dying, just some faster than others?” 

Mike Gratton says: “Frankly madam I could not care less whether or not you are with or without a heart. I have a terminal illness and my life is my concern . Keep your “conscience” to yourself. We sufferers feel the pain, not your conscience.”

 

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