I suppose I should have jumped immediately onto this particular bandwagon, since it is obviously — or was yesterday — all the rage in the British press, and this blog is, after all, called Choice in Dying. Terry Pratchett, the well-known author, has been, for some time, an active campaigner for assisted dying. Suffering from an early onset form of Alzheimer’s disease, he wants the right, when he thinks the time is right, to end his own life with assistance, and has been campaigning for the general right to do this for some time now, certainly ever since his Richard Dimbleby Lecture in February 2010. Last year he accompanied Peter Smedley and his wife Christine to Dignitas in Zürich, where Peter Smedley’s death became a part of his BBC documentary on assisted dying entitled Choosing to Die (which is, unfortunately, not available for viewing in Canada), which raises, once again, all the standard issues and accusations about assisted dying. Aside from the abusive epithets, there seems to be a determined effort not only to misrepresent, but deliberately to misunderstand, what people who are talking about the legalisation of assisted dying have in mind, and what kind of society they want to see emerge from the present almost universal will to hide the fact that, someday, each one of us will die, and that the manner of our death should be of some concern to us.
But the most vituperative response to Terry Pratchett’s documentary on choosing to die was aroused by the fact that the documentary actually shows Peter Smedley dying. This is not the first time that someone dying at Dignitas has been shown on British TV, since John Zaritsky’s documentary, The Suicide Tourist (which was, I think, given a different name for its British viewers), showed Craig Ewart, a retired university professor with motor neuron disease (or Lou Gehrig’s, or ALS, depending on where you live), dying at a Dignitas clinic in Zürich. (As an aside, the Dignitas official who helped Ewart to die was the same man, Artur Bernhard, who assisted Elizabeth to die on 8th June 2007.)
But this simple act, of a person fading peacefully away on TV was enough to arouse a chorus of disapproval from a number of British journalists and citizens, as though dying is something that should be completely isolated from life, despite the fact that each one of those who watched Peter Smedley die, will themselves die one day, and many of them may die more peaceful deaths, because people like Smedley showed the way.
Damian Thompson, of the London Telegraph, is perhaps one of the worst members of this chorus, and his voice is very ugly indeed. As a Roman Catholic, he is determined to make what Terry Pratchett did, in making a documentary about Dignitas and the the release that Dignitas provides for so many people who are suffering unduly, into something brutal and senseless. But, much more than that. He wants to paint Pratchett as a criminal:
You have to say this for Sir Terry: Alzheimer’s has not dented his self-regard. On the contrary, he seems to think it gives him the moral authority to campaign for the legalisation of a really serious criminal act – not suicide, but killing other people, some of whom may not even be ill, just old. But it doesn’t.
Thompson’s link will take you to the story of Sir Edward Downes, the well-known British conductor, whose wife was very ill, and wished a surcease to all her suffering, and the suffering that was to come, but who was, himself, not ill, just old, blind, and apparently suffering from hearing loss. Once his wife died, he apparently felt that, dependent as he would have been, there was no point in going on with life. But it was his decision, not one made for him by others — precisely the point that Damian Thompson wants us to miss.
Still, notice how Damian expresses his disapproval. He says that what Terry Pratchett wants to do is to legalise ”a really serious criminal act – not suicide, but killing other people.” It is always thus. It if were legalised, it would not be “a really serious criminal act”. Nor, if Damian Thompson would only read, learn and inwardly digest the Director of Public Prosecution’s (Keir Starmer) guidelines, is it any longer considered a serious criminal act by the Crown Prosecution service even now. If Peter Smedley had remained in the UK, and had received help from his wife, or Terry Pratchett, or any other compassionate person, to bring his life to an end, the police, after examining the evidence, would be forced, by the guidelines for prosecution now in force, not to prosecute. Certainly, they would still be subject to investigation, to make sure that no wrong-doing occurred, but it is very unlikely that any substantive charge would be brought against the person or persons concerned.
Damian Thompson is speaking religious speak. From the Roman Catholic point of view, as outlined in the Vatican Declaration of Euthanasia, or as developed in greater detail in John Paul II’s encyclical, Evangelium Vitae, assistance to die is considered a great crime, so great, according to the church, that there is some danger that contemporary Western society, where campaigns for the right to die are common, is becoming a death cult. Damian Thompson thinks that the death cult is already here, and is presided over by the BBC:
I would threaten to withhold my licence fee in protest, but the Beeb is utterly relentless in tracking down evaders and the last thing I want is to wake up in a Swiss clinic with a syringe staring me in the face.
The man is clearly hysterical, and has lost all sense of proportion, but it is not surprising that this kind of language has brought out, in the comments to his blog post, all the most fantastic fears that the church has managed to generate amongst the faithful about something so easily understood as compassion for the suffering of those who are in great pain, or who are diminished by degenerative diseases which will eventually not only reduce them to complete paralysis and dependence but will also force them to die miserably and in great pain.
Reading through the comments, it is easy to distinguish between the religious voices and the voices of rationality. The religious voices almost always paint a picture of chaos, where people will be killed for trivial reasons. One commenter likens it to the abortion law, which, in the opinion of the religious who supported it, thought that it would only be used by very few, and then only in extreme circumstances. Clearly, they did not know how many women were having illegal abortions, and how many suffered as a consequence. I do not have the book with me, but according to one writer, there were as many abortions — almost all of them illegal — in Canada, before 1969, when abortion was decriminalised, as there were after removing it as an offence in the criminal code. What people forget, though, is that abortion is done at the request of the women concerned. It is not something that is imposed. (Of course, since Catholicd believe that the blastocyst/embryo/foetus is already a person in full standing, they believe that abortion is imposed on these supposed persons, but this is a matter to be discussed another day.) In the same way, assisted dying will be provided for those who choose to die, and only when it is clear that the person’s decision is their own, and that it is a stable and enduring wish to bring their suffering to an end. There is simply no reason to suppose that people’s lives will be put in danger. People in wheelchairs and the old are not incompetent, and they are as capable of saying “I don’t want to die” as anyone else. Where they are genuinely incompetent, laws governing assisted dying for those who choose, will not in fact apply to them.
But the only reason for all the scare tactics, the talk about the sinister nature of Dignitas, and other rhetorical tricks used by Damian Thompson and other opponents of assisted dying, is simply to shore up the religious arguments which, as even the religious know, will be dismissed out of hand by most secular people who are concerned with this issue. It is time that the religious started to enter the discussion honestly, and, instead of trying to find more and more “secular” reasons why assisted dying should not be legalised, tell us clearly the real reasons for their opposition. Then we might find the discussion to be, not one of constant, niggling misdirection, but an open and honest discussion about the world views which inform the dispute in the first place. My guess is that, if we stack up the religious arguments against the reasonable arguments of those for whom the religious outlook is marginal or non-existent, we will find that the religious don’t have very much of real substance to stand on. Why else do they continue to use scare tactics to frighten people into compliance?
I wonder what these people think of DNR instructions in hospitals.
My dad went in for a pacemaker implant a couple of months ago, and the admission staff made a HUGE deal of making sure Dad understood what was being asked of him.
“If something goes wrong, do you want us to try to resuscitate you? Put a tube down your throat to help you breath? Perform CPR? Do everything we can to keep you alive? Or not.”
The choice in whether or not to be resuscitated is the patient’s. Are these questions not asked in Catholic hospitals? Is every patient resuscitated every single time no matter what their condition? Do they flay the dead body?
Frankly, I think one of the big problems with society today is that we have institutionalized death and hidden it behind closed doors. Time was, everyone gathered around grandma. Today, only nurses in hospice care attend to the final moments, if that. And certainly NEVER in sight of the kids. No wonder we’re so afraid of death. It’s a complete mystery.
Well, I can certainly understand that for a lot of people, dying would be a rather intimite thing, that they wouldn’t want to be televized. I certainly would consider it as such. But nobody forced anyone to watch. And although I haven’t watched the documentary yet (I plan to, if I can find a copy and time to watch it), I certainly doubt the scene where Peter Smedly died would be more inappropriate to air than your average Holleywood thriller or horror movie.
That quote from Damian Thompson about the BBC coming after him with needles is really something, though. Wow.
The programme, I felt, was balanced, despite the cries of the Bishops (watch the Newsnight debate for a nauseating performance from the Bishop of Exeter). In fact, if anything it neglected to investigate the very real chance that some can suffer long periods of indignity at the end of their life. The chap that Pratchett spoke to who had chosen the hospice was a very chipper cabbie; well, good luck to him, but not everyone feels the same. And what the religiously minded want to do is to deny choice to those people, based on their misguided world view. It’s the very definition of authoritarianism.
I did get the impression that Peter Smedley and Andrew Colgan might not have chosen *that moment* to do the deed, but this was not through coercion, which was operating against their choice, I felt. Instead, they were clearly worried that delaying would risk them never returning to Switzerland. It was heartbreaking that they couldn’t make this choice in the UK.
The DPP is called Keir Starmer, incidentally, not Keith.
Which shows that blocking assisted dying legalization may actually shorten some people’s lives.
Yes, thank you Mark, I knew that, but wrote Keith anyway. However, it’s corrected now.
As for hospice or palliative care. A lot of people think that assisted dying and palliative care are alternatives. They’re not. In fact, hospice patients, according to Clive Seale’s evidence before the Falconer Commission, are more likely to ask for assisted dying than those who are dying in other places, like hospital wards. Assistance in dying should be provided for anyone who feels that suffering has become intolerable. Sometimes this has to do with pain, but very often because of other aspects of sickness — incontinence, air hunger, the smell of decaying flesh, itchiness, existential angst — and yes, even being a burden. Why should the fact that people feel they are burdensome not be an aspect of people’s wish no longer to be alive? Being a burden includes feelings of dependence, lack of dignity, a sense of personal responsibility (e.g., not wanting to be a burden), and many other factors. It is simply ridiculous to say that the fact that people might feel burdensome is sufficient reason not to decriminalise assisted dying.
“Time was, everyone gathered around grandma.”
Thank you Kevin for reminding me. I was one of the people who gathered around my grandmother when she was dying in her own home with her family and her doctor around her.
I also remember my four year old sister in a pink coffin waked in our home.
Every time I receive a pamphlet from a funeral home or a graveyard that asks the recipient to make his or her death easier for his or her loved ones I realize that “we have institutionalized death and hidden it behind closed doors.”
Eric, I’m sorry the documentary isn’t immediately available in Canada; I hope this means the rights are held by a Canadian broadcaster who will soon show it there.
One thing I realised only after it was over: during the studio discussion after, the opponents of assisted dying never spoke to the point. The Bishop of Exeter was especially guilty: his first point wasn’t, for instance, to disagree with the individual choices made in the film, it was to say how the film had manipulated Mr Smedley into participating in its pro-suicide “narrative”. When pressed on the principle later on, he then said how it was all very well for those in studio to accept assisted dying (he was face to face with a woman who went to the High Court for this right)… but what about his daughter? She’d just lost her house – suppose she was tempted?
It’s difficult to even prepare for a rational discussion on the issue when the opponents immediately start extruding their own inner weirdness. I guess that’s what happens when the real reason and ground for opposition – religion – dare not speak its name directly in any discussion. All manner of equally appalling rubbish rushes in instead.
Eric, as usual *I wish I could have said it like that*. I found the documentary moving precisely because it didn’t seem to be making a point or dressing anything up in a particular way. Pratchett was and is pro-choice, but obviously felt non-plussed by the experience of watching Peter Smedley die, which I imagine anyone would be. It wasn’t portrayed as a great thing, it was portrayed as “er….well…what the fuck do I think about this after all?” This seems like an appropriate response regardless of what position anyone might previously have held and I applaud the documentary for this.
The message seemed to be that people don’t get to die how they’d like because of rules imposed by other people’s *ick*, mostly religiously inspired. So they have to die how they *don’t* like, either in pain and misery or in a place and time they wouldn’t otherwise have chosen. This is desperately sad.
It’s a funny business. There’s hardly a time in our lives when we don’t think of ourselves as “I”. We interpret everything we sense through that filter. It’s probably safe to say that we’re pretty much wired to feel that if we own anything at all, it’s our own life.
And yet Bishops would have us believe differently. We can’t do what we like with our lives while we live and we can’t dispose of them when we want to. Because religion is fundamentally about *other people’s* suffering.
I’m 38. I’ve been in pain for about 20 years. Every moment of my life is conducted in recognition of this pain. I dream about pain. I love life and I don’t want to die yet, but it’s getting worse and I know there’ll be a point where every moment – awake or otherwise – is a burden on me and everyone who knows me. I sometimes catch myself being shit to other people because of it and I’m horrified to think that’s what I might become.
My illness isn’t terminal, but it will increasingly piss people off as it progresses. I want to choose when to stop inflicting it on others.
I have only just discovered your blog, thanks to Stephen Turner, who posted a link on Jesus & Mo (http://www.jesusandmo.net/2011/06/14/death2/). I shall have to go back and read all your articles, but in the meantime thank you for sharing your story of Elizabeth with us – I was deeply moved. My wife has stage 4 breast cancer, now spread to her spine, meninges, and possibly lungs and stomach. She is like Elizabeth in many ways, not least in the close relationship we share. She has sent a detailed submission to the Commission on Assisted Dying here in the UK (you can read some of these on http://www.commissiononassisteddying.co.uk/read-evidence, but hers has not yet been posted). I should like to share this with your readers, and to that end would like you to email me with a contact address. This way I can send you the full text, for you to decide whether or not to post it here.
In any case, please keep up the good work. I have tabbed your site to follow regularly, and hope to contribute our thoughts from time to time.
In fact, it seems to me that the only secular argument anyone can come up with is the slippery slope one, for abortion and assisted dying both: “if we start down this road, we’ll be Nazis within a year, gassing the mentally and physically disabled, and black people, and political dissenters, and etc.”
But then, I live in the US, where any social change is fought with claims that, if the change is permitted, civilization will collapse right after, and do we want our children to live in a collapsed civilization?
I can’t remember if I’ve mentioned this already, but Peter Suber wrote a pretty thorough philosophical debunking of the “sanctity of life” position a lot of people think they have. It’s here, if I get the tags right. His main point is that medical technology requires us to examine our thinking about the beginnings and the endings of life, because our knee-jerk feelings on the matter are no longer sufficient to the purpose. Here’s a sample from the introduction:
There is nothing there which will help you in a conversation with a religious person, but it did help me systematize my thinking on the matter.
Interesting, enlightening, and spot on (as usual) Eric!
The thing I found most disturbing was the concept of moral authority he throws in there – totally unselfconscious to how he is claiming the moral authority to deny people the right to die.
It appears that clips of the programme have been taken down from YouTube, though it may be available elsewhere.
When I blogged last week about the programme the BBC linked to my post. As a result I’ve had many comments from people who’ve seen it, and every one of them is in favour of legalisation.
Personally I thought it was a very well made film, but watching those three minutes was difficult — and not something I’m likely to forget. One thing the opponents of legalisation do seem to forget, however, is that it’s all about choice. The (mostly religious) stance against choice is to my mind indefensible.
Eric, there’s a good, and thoughtful, review of Pratchett’s programme in today’s Observer, by Euan Ferguson. He sums up my feelings about the programme pretty much exactly. See:
http://www.guardian.co.uk/tv-and-radio/2011/jun/19/pratchett-choosing-to-die
Eric,
I finally got around to watching the Terry Pratchett documentary over the weekend. It had everyone in the room in tears, and we were pretty stunned at the end – I think because of the sheer intensity with which the program makes you feel and think about what you’re seeing. The only way it could be accused of not being balanced is that it didn’t include anyone who’s opinion was that people should be forced to suffer no matter what their wish.
I have thinking more about assisted suicide recently, mainly due to your thoughtful posts. So I thought this was as good a post as any under which to thank you for your wonderful work helping me and others think through the issues.
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