You know, I find myself increasingly uneasy with the way that assisted suicide legal cases are being reported in the press. The tone of some of the reporting of Debbie Purdy’s legal case this week was triumphalist and as though she was some kind of freedom fighter. Whilst I do think that she has the right to know whether actions that she encourages her husband to take will lead to prosecution, I don’t think that making it easier for him to help her will necessarily lead to a greater moral good for society.
Ah, people say, but wouldn’t you want to make choices of your own if your life was so terrible, so desperate, so intolerable?
Well, that question does not trump the law and it does not trump the need to build a society in which those who are most vulnerable are most protected from harmful actions and harmful influence. Whilst I might be able to understand anyone making choices in dire circumstances, the thing I don’t want to do is live in a society which says that some lives are not worth living.
There are huge human rights issues here which are not getting picked up in the press much these days. Whenever a new legal “victory” is won by those seeking to extend the law, campaigners ask for more. The recent joint suicide of Joan Downes and Sir Edward Downes was portrayed almost as a love story in the media yet the ballyhoo did not give us much chance to reflect on the fact that one of them was not terminally ill at all. The deaths (killings?) of a composer and his wife represent a much more complex moral question than a simple love story and it is in moral complexity of that sort that all kinds of injustices for those who are most vulnerable are waiting to take us unawares.
Now, how do we get such positive coverage for those doing research into pain relief and those who need yet to campaign for better end of life care within the society we have? Diminishing pain seems to me to be unquestionably a moral good. Assisted suicide seems to me much more difficult to affirm. It is a far from satisfactory answer to what is often not right at the end of people’s lives
There was a case last year where a man in his early 20’s who had been left paralysed after a rugby accident went to Switzerland to end his own life. Someone was quoted saying something along the lines of; ‘His life had become of such poor quality that we had to support him.’
I remember at the time being incredibly saddened, not only that this young man and his family felt it was the right thing to do but also at the message that such a quote sent to other people in the same situation. Many folk are paralysed in accidents – sporting and other – and go on to achieve great things despite their injuries. How did they feel reading that because of his injuries (which they share) life has become worthless?
I think that this highlights one of the major problems with assisted suicide, namely that different people respond differently in the face of similar circumstances.
Fr. Kelvin, I must tell you that I felt the same way with that press reporting. However, my prayer is and has always been that God, by the power His Holy Spirit will continue to guide the process of making ang changing laws in this land.
Well said, Kelvin. The trouble with such ‘victories’ is that they shift the perspective from which society views everything else.
I wonder how much the joint suicide was driven by the fear that a survivor would be prosecuted.
I wonder how many are driven to earlier suicide for fear that if they wait until they need assistance the assistant will be prosecuted.
Certainly better end of life aid is needed including but not solely pain relief (in the US doctors have been prosecuted for ‘over-prescribing’ pain killers). Support for families is needed. Better and more facilities for caring (and varied types depending on the needs of those being cared for) are needed.
It cannot be the case that the joint suicide was driven by fear that a survivor would be prosecuted. There are reports that the couple’s daughter and son (Boudicca and Caractacus) were with them in the room when they died. Caractacus apparently travelled with his parents to Switzerland.
Kelvin – The last paragraph of you blog strikes a chord with me.
As society progresses do we have the moral maturity to cope with the improvements in pain relief or that matter other improvements in medical science.
For that matter the other advances in medical science. 100 years ago many people who had chronic ailments would have died. They can no be cured or have their condition managed be it diabetes, cancer, etc. Technology can be used to keep seriously ill people alive. Transplant surgery means that those with terminal organ damge can receive replacement organs.
I find it difficult when I see a loved one being kept alive with machines. Is this the right thing to do. Maybe it is the fear of being in this situation that has resulted in the demand for clinics such as those in Switzerland.
I do not know the answer, however we must remember the fraility of the human body and mind.
I am in two minds about this whole issue -I have one part of me saying that if people find their lives involve such suffering caused by terminal illness that they should have the right to say “no more”. Having seen and loved people in that situation, I can empathise with them.
On the other hand, I wouldn’t want the culture to shift so that people who didn’t want to take their own lives were seen as somehow indulgent.
It’s a hard one. I might write some more about this at some point because there are so many intertwined issues to explore.
One of the hardest moments of my life was when someone in awful, terminal pain asked for that sort of help and I said no. I felt it was the right thing to do, for that person as much as me. It’s not an easy position to be in, though.
A haunting thought was voiced by Matthew Parris in the Times yesterday when he described suicide as “the greatest of human freedoms, underwriting all the the others” He also said “The possibility of suicide is what makes life voluntary and each new day an act of will”. Much of the commentary at present reflects on the individual’s right to choose their own destiny and fate. I have no quarrel with that but it is protecting the vulnerable individual from pressure from either the family or the state to end a life that is no longer perceived and being useful or fufilling. What starts as an arguably desirable libertarian step (the right to choose to die, the right to choose to use dangerous drugs) may end up with the authorities granted powers of life and death with which the most extreme totalitarian regeime would be delighted.
Coxy – sorry that your comment got caught in a filter – I’ve just found and restored it.
By the mercy of God I have never been asked to give that kind of help. The only deaths I have lived beside were of those dear to me. There seems a clear distinction though, between demanding treatments designed to lengthen lives by a few months (which I would feel it was fine to refuse) and undertaking to end life.
I was talking to junior doctor the other day who said she longed to be able to say to patients at a certain stage of lung cancer – look you can have this treatment which is pretty horrid, and it will make you miserable for six months, and then you will probably have six nice months, and then you will get pretty ill. Or you can refuse it, and have six pretty good months and then die.
Where she worked, such openness was discouraged.
But the press tells stories. Really, it tells clichés. If anybody wants to challenge the clichés they need to find another more compelling story.
So to challenge the noble and romantic choice of death story, you need another better story.
This is a tricky one, right enough. And I think if the pain and dignity thing was managed better by the NHS then things would be so different.
My mum was diagnosed with pancreatic cancer and given 3 months to live. No point in chemo because it had already spread elsewhere and was too far gone. (And don’t get me started on the amount of times she went to the doc and hospital while being told she was fine.) She signed a living will saying she didn’t want to be resuscitated.
What we didn’t know was that she would be in dreadful pain which nothing seemed to help for about the last month. But worse than that was losing control of her bowels and having her family clean up. That was the worse thing for her – losing any dignity. She begged to be allowed to die. She begged to be taken off heart medication that was probably helping to keep her alive but was told they couldn’t do that. She pleaded for extra morphine but was told no.
Eventually she was forced to go into the Hospice against her will. As a result she got depression and turned her face to the wall literally. We visited and she couldn’t speak for depression – real depression. She was given anti-depressants and we were told they’d take a few weeks to work – she had about 7 days to live.
So our last memories of mum are of a woman lying facing a wall not able to speak because of depression. I can cope with that but her grandchildren struggled.
Of course, only the wealthy can afford to go to Switzerland – assisted suicide only works for the upper middle classes. But I just wish our own hospices really had the pain thing sorted and when it was okay to withdraw medication that is keeping people alive.
Hmmm. Reading this, and the comments, brings a couple of thoughts to mind.
First is the classic argument the crops up elsewhere in the fields of CoE women bishops, the legalization of cannibis, et al – “it’s not as though we’re mandating assisted death in *all* of a particular set of circumstances, but they would help in *some* cases and if the legal door isn’t open, people will either do it illegally or suffer more”.
Second, doctors do have some tools for palliative care – analysis in terms of QALYs (http://en.wikipedia.org/wiki/Quality-adjusted_life_year) etc, whether that system/approach helps make wiser decisions or not. We should not knock too hard the system that works for most people most of the time.
The media only know how to report a story as though it were drama. We should not take anything therein at face-value; rather I hope we could get on with the changes required to afford maximum quality of life and dignity to all, using all means available.
The truth is that you cannot always deliver both pain relief and consciousness (my daughter works in a pain clinic) – but it strikes me as absurd that somebody with only days to live is kept conscious and in agony.
I see Terry Pratchett has written on this.
Of all the heart rending positions to be in, Pratchet’s must be about the worst. He has my heartfelt sympathy.
None of us are in a position to tell another story, are we? Or I don’t think we are. I certainly cannot say: ‘I have a progressive disease, which will leave me helpless and incontinent, and I am prepared to suffer that because I trust in God that I will somehow make that journey with him and it has some meaning. I only ask you do not use medicine or force feeding to prolong my suffering beyond what is reasonable.’ It is in that category of things which can only be said with meaning by those in the situation (however much others my offer support).
One think however we can do, and do now, is to learn to be helped and to be helped graciously. It is a hard thing, I find. I am currently being helped with this renovation project of a house by neighbours who I cannot thank adequately. It does not come easily to me to allow this – and I doubt I am alone. If we seriously want to undertake this fight, we have to tackle the ‘I am a burden’ mentality by replacing it with ‘I allow others to grow by allowing them to help me.’
The other thing I want to add is that if we undertake this, we also have to say, and loudly, that it is equally unnecessary to cling to life at all costs – grabbing a few extra weeks or months at huge expense (emotional and financial). On the one hand, we don’t need to refuse all treatment that will give us longer lives ( we are all dying after all) and on the other, we need to make kindly judgements on what is really enough for us and individuals. In arguing against assisted suicide, we don’t need to argue for all treatments whatever.