Category Archives: Hospice & Palliative Care

Are there any religious experts? “Religion experts” on euthansia

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This post is now available in Polish translation over at Racjonalista. Thanks again go to Malgorzata.

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The Ottawa Citizen has an advice column which puts questions to so-called “religion experts,” who give answers on crucial issues facing individuals and society. There is a big problem with this, because religion experts are, almost by definition, not religion experts at all. What is there to be expert about? They might be experts in their own religion, but there is no such thing as a religion expert who is qualified to give religion’s answer to any question. A recent column in the Citizen’s “Ask the Religion Experts” column, for 31 January 2012 — thanks to Veronica Abbass for the link – asks the two questions: “Is euthanasia right? Would God want us to suffer?” And then the religion experts weigh in on the side of their favourite god. The nonsense that this makes of the questions should be clear right from the outset. We ask the experts their opinion, and all they can do is refer to the “experts” of their religion. According to Z, this is the way it is; according to Y, the truth is such-and-such, and so on. And, around the edges, a little lie or two will take you over the hump when reason fails.

The first one is perhaps the funniest. It’s by a Bahá’í scholar, Jack McLean. Seeing him described as a scholar reminds me of the day I took my M.Div. degree diploma and cut it to shreds. I no longer consider that to be a degree at all. It qualified me as an Anglican priest, but it no longer seems to me that there was anything to know, except, of course, historically, for the church does have a history (or perhaps I should say the churches have a history, for there is no point, during the whole history of Christianity, where there was an unquestioned unity within Christianity), but it is impossible to be a scholar of religion itself, for religion has no subject matter. The “theo” part of theology (the word ‘theology’ meaning, roughly, the logos of theos, or the reason, knowledge of god) is simply UA (on unauthorised absence), having departed his post, or, rather, never having been there in the first place, for all the confident pretence of religious believers, especially its officer class, to which, largely, the Ottawa Citizen has appealed for enlightenment upon a subject which has no object.

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Required Reading

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Update, 16:37, Atlantic Daylight Time, Monday, 20th August 2012: “Required Reading” is now available in Polish translation at Racjonalista. Thanks again to Malgorzata for taking an interest in my occasional thoughts.

Update, 10:40 Atlantic Daylight Time, Friday, 17th August 2012: The Tony Nicklinson judgement is now in, and is downloadable as a pdf file here. I have not read it yet, but the judgement does not rule in his favour. According to the Telegraph:

Tony Nicklinson, the “locked-in syndrome” sufferer, broke down in tears on live television as it was confirmed that he had lost his legal battle to be allowed to die.

The judgement says that it is not up to the courts to decide the issue, but is a matter for Parliament to decide. However, it is clear that, in cases where Parliament fails to act to uphold people’s rights, the courts should make it clear that Parliamentary failure will not be upheld by the courts. While it is true that a judgement in favour of Tony Nicklinson might have had implications far beyond his case, the judgement could have made those implications conditional only upon Parliament’s failure to act. There is not a necessary or logical connexion between a favourable judgement in the Nicklinson case, and an immediate extension of that judgement to other similar cases. The cruelty of the judgement is the direct outcome of years of campaigning by religious entities which will continue to oppose assistance in dying no matter what the outcome. This case however shows how wrong Tallis is in the article linked below, to confine assisted dying to the terminally ill alone. Being trapped in your body, as Nicklinson is, and may be for many years, provides a lack of quality of life which may, in individual cases, be seen to be a great harm.

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The following two articles are, for those who are concerned about assisted dying, required reading. The first is an article, published in the British Medical Journal, of the misery in dying of Ann McPherson, founder of Healthcare Professionals for Assisted Dying. Tess McPherson, Ann’s daughter, is also a physician, a specialist in dermatology, practicing in Oxford, and she writes a hair-raising account of her mother’s death which should put an end to the absurd spectacle of palliative care physicians like José Pereira claiming that palliative medicine can control all the pain, distress and indignity of dying. You can access Tess McPherson’s account as a pdf here.

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The Royal Society of Canada Expert Panel on End-of-Life Decision Making

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Panel calls for legalization of assisted suicide

Erin Anderson

Globe and Mail Update

Published Tuesday, Nov. 15, 2011 9:00AM EST | Ravaged by cancer, or stricken with pain, you want to die. You have your wits about you, and the facts in front of you. Your doctor should be allowed to help you end your life, an expert panel of researchers in Canada has recommended – and the Criminal Code should not call it murder.

Pointing to the widening gap between public opinion and the law that makes euthanasia illegal in this country, a team of researchers appointed by the Royal Society of Canada to study end-of-life care says that informed Canadians should have the right to choose death within a regulated system, even if they have not been diagnosed with a terminal illness.

Read more ……

Added Note (Choice in Dying)

The Royal Society of Canada Report is available in PDF format here. This includes the Main Messages, an Executive Summary, the Report in Brief, the Full Report, the Press Release, the Terms of Reference, and an audio of the Press Conference. All well worthwhile reading (or listening to). The report is thoughtful, methodical, and deliberately focused on the Canadian situation, and what seems to be possible, given Canadian priorities in the discussion of public issues. The recommendations are thorough, but do include the decriminalisation of assisted suicide, and the legalisation of active voluntary euthanasia. The report considers at some length the distinct between the moral right to assisted dying, which comprises a “prima facie case for the desirability of establishing a legal right.” (13, Report in Brief) The report also concludes, importantly, that

Prophesied undesirable consequences are not sufficient to negate the right to choose assisted suicide and voluntary euthanasia. Rahter, they should be taken into account in constructing the regulatory environment within which this right can be exercised.

This is a vitally important, since it is a response to the claim that legalising assisted dying will create slippery slopes that will endager vulnerable people. Despite the fact that in jurisdictions where assisted dying has been legalised such risk to the vulnerable has not been demonstrated, it is surely not up to the suffering to make sure that vulnerable persons are not targetted by laws not intended for them; this must be part of “the regulatory environment” as the report states.

Slippery Slopes should be slippery, shouldn’t they?

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In his paper in Current Oncology, and in the CTV W5 program on assisted dying, Dr. José Pereira claimed that permitting assisted dying will produce slippery slopes. He calls it “the illusion of safeguards and controls.” But slippery slopes should actually be slippery, shouldn’t they? That means, once you’re on the slope there’s no way of stopping yourself until you get to the bottom. The whole slope should be like a sheet of ice at an angle.

This is what he thinks he shows in his article, which is based on other people’s research. This is important. Pereira does no original research of his own. He takes research papers written by others and says that they provide give evidence of slippery slopes in in places where euthanasia and assisted suicide have been legalised. There are two serious problems with his approach to the issue. First, Pereira himself speaks with some regularity to Roman Catholic “pro-life” groups. His next big appearance will be at a “Priests for Life” symposium for clergy with the title, “Euthanasia — False Compassion.”

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Christians did this!

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The Guardian reported on 2 August 2011 that there is support for a change in the law regarding assisted dying. According to the report, aptly entitled “Assisted dying poll shows support for change in law“,

Three in four people said terminally ill adults who want to die should be able to ask their doctor for help, while only one in three said physically disabled adults who were not terminally ill should have the same right. [my italics]

Of course, this is old news. Polls in Britain have been almost uniformly in favour of assisted dying for the last ten or fifteen years. But, just see what Christians have wrought! Isn’t this good news, then? No, it’s not. It means that anyone who is paralysed or has locked-in syndrome — like ”Martin“, whom it would be cruelty to force to stay alive – anyone who is suffering from a degenerative disease which leaves them incapable of caring for themselves and in misery, anyone except those who are going to die — when? how long qualifies as terminal? — must put up with the pain, indignity, or what may be, to them, the sheer unrelieved boredom of being alive and in whatever condition it is that leads them to want to die, without any option.

[Thanks to Haggis for the following correction (and further below). Shows how anger can switch off your careful reading monitor. Note that it is still a disturbingly large majority who think we should make choices for others a critical points in their lives.]

Three Two out of three four people are prepared to say that they are qualified to rule about other people’s decisions about the value of their lives. Three Two out of three four are that confident!

This is important. It means that people like Sir Edward Downes, who went with his wife to Switzerland, where they both were assisted to die, would have been forced to go on living, even though, without his wife, who was terminally ill, he would have been left alone, without his life partner, in an increasingly silent, dark world, because of increasing deafness and blindness. It means that people like Daniel James, a young rugby player, who was completely paralysed and in pain, would have had to go on living, perhaps to live the full span of his life, possibly fifty years more, because he was not dying, instead of being allowed to die, as he chose to do (also at Dignitas). It might well mean that my wife Elizabeth would have been forced to live for several years in torture, paralysed, enduring constant spastic pain, unable to speak or to feed herself, until someone else decided that her condition was “terminal”.

It means that Christians, who’ve spent the last thirty years raising the anxiety level of the disabled and mentally challenged to explosive levels, have managed to force their will on the suffering, to satisfy their lust to force their will at least on some.

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Myths about Assisted Dying

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I’ve been involved during the last couple of days in going from link to link, reminding me of my early days at university walking through the stacks and feeling overcome by all the learning that was “out there”, and how small a portion of it I could ever comprehend, and hold, as it were, in a single glance. It seemed, as I went from link to link — a kind of arguing by exponents. And it seemed, as I did so, that it would be impossible ever to come to any kind of sane conclusion which could be securely based on the evidence, on good reasons, on some kind of unquestionable data.

Of course, we do it all the time, day in and day out. We have to make decisions, come to conclusions, express our opinions, argue for our point of view, and we know that some of those conclusions, opinions and points of view are more likely to be correct than others. Otherwise, like Buridan’s ass, we would remain stuck, and life would become a dramatic still life of indecision.

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Death should not be as easy as going to the dentist

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That is the headline of an opinion piece by Allison Pearson in The Telegraph yesterday (15th June). I was going to ignore it, because it’s a bit of the same old same old, but it has a spin which makes it worthwhile mentioning, I think. You know that you’ve just fallen down the rabbit hole when it becomes clear that you need to read the article backwards, starting with the last paragraph:

I’m sure he’s right, and all my humane instincts recoil from the cold indignity of Dignitas. And yet, at the back of my mind, a small voice keeps   saying: “If I had Alzheimer’s and knew that my self was about to vanish,   like sand through a sieve, would I want the rest of me to go on?”

Death itself, it is perhaps helpful to remember, is not dignified, and indeed seems itself very cold, so speaking of the “cold indignity of Dignitas” is not only hopelessly biased, it fails to mention what death is like for many people in other situations. Since most people in Western nations now die in hospitals or hospices, we must  ask whether the coldness and indignity that Allison Pearson discerned in the way Peter Smedley died is in any significant way different to the cold indignity of dying in hospital or hospice, and whether those who died with the help of Dignitas would have described their deaths as lacking in humanity or dignity.

I do not know how my wife Elizabeth felt as she lay dying in my arms — I sometimes wish, even now, that I could have been privy to her last thoughts – but I suspect that she felt a sense of peace that she did not feel the day she tried to take her own life all alone slightly less than a year before. In both cases it was by her own choice, and I daresay, since she would have fairly soon been completely paralysed — that is certainly the course the disease was taking — that there was more dignity in her dying that way, than perhaps dying after years of pain and indignity that her MS would have accorded her, had she not had the opportunity to die as she did. And it seems particularly cruel for someone who hears a small voice in the back of her mind wondering whether she, too, might someday be in a situation where she would want help in dying, to condemn so harshly the decision of someone whose small voice had grown into an insistent and unignorable appeal for relief before it was too late to escape the worst and most diminishing aspects of dying.

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Look at Japan. It’s a direct answer to all our prayers!

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Religion at work

[Thanks to James Sweet for the correction. The video is a parody. See here on Slate. The point made by the Slate piece -- "Without a winking smiley or other blatant display of humor, it is impossible to create a parody of fundamentalism that someone won't mistake for the real thing." -- is the reason why I will let this stand. People are complaining about TamTamPamela's lack of taste, but in what sense is this a lack of taste and Pat Robertson and Jerry Falwell's remarks about the 9/11 disaster acceptably religious? But the following is an edited version of the original text, taking the parodic nature of the piece into account.]

And — just for comparison – this one is not a parody:



[And now you know why Christopher Hitchens, speaking of Falwell after the latter's death, said that, if he had been given an enema, he could have been buried in a matchbox.]

This almost made me physically sick. Sad but true: This is the religious mind at work. And even if, as James Sweet points out in a comment, this is a parody, it is a very good one, and it still says what so many religious people say. I can still remember the posters that used to be found in many church halls and offices. It showed a picture of a beautiful natural scene with the words under it: OUR GOD IS AN AWESOME GOD! And if you listen carefully, you will hear what faith in sky fathers and other imaginary friends must lead you to believe. I am relieved to hear that it is a parody, but I do not think I will change my mind that this is an apt expression of religious faith. For, if religious faith really does hold that there is a god who cares for us, and is interested in our welfare, then everything that happens must happen for a purpose. This, by the way, is one reason that my wife Elizabeth refused to believe in gods or life after death, because that would mean that the pointlessness of her suffering had a point, and was purposed from the start, and she was not prepared to accept that. Everything that happens must be for the best, and, as religious people say about answered prayers: Sometimes the answer is no.

But if you listen very carefully, you can still see why religious people will kill you to make their point, you can see why they think suffering is a god’s way of speaking to you, and you will realise that you have to be an airhead in order to believe in god. Anyone who doesn’t sound like this is hiding something, because, given the evidence that is missing, belief in god can only amount to this. Forget the sophisticated theology, forget all the scientific bible or qu’ran criticism (if there’s any of the latter), forget the figurative interpretation of biblical or religious stories, forget the ridiculous attempt to accommodate religion to science: Parody or not, THIS is what religion is all about! And it should make you sick.

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Like Vultures

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There is a sad little drama playing itself out in the children’s hospital in London, Ontario. A 13th month old baby, with a fatal degenerative neurological condition, is dying. There is no way to prevent that. The doctors at the hospital want to remove his breathing tube, and an Ontario Superior Court judge has ruled in favour of this course of action. The baby would then die. The family, who, we are told, are praying for a miracle, want the doctors to perform a tracheotomy so that he can be transferred home to die. This the doctors have refused to do. The hospital is now rejecting charges that the hosptial might “kill” Baby Joseph as “outrageous and defamatory.”

When I was growing up in India, school holidays were in the winter, when the mountains where the school was situated were covered with snow. In my teen years my father worked in a small city in Madhya Pradesh (Central India) named Ratlam, on the main railway line from Bombay to Delhi. Just over the fence from the “Mission Compound” was a tree under which the leather workers used to skin the cows that died of natural causes. Since they were sacred to the Hindus, they could not be simply killed, but once they were dead, their skin could be used for leather. On the tree the vultures used to gather, waiting for the carcass that would be left. It was a gory business, watching animals being skinned, and then watching the vultures devouring them, fighting with each other for tastier bits, yet fascinating too.

And now the religious vultures are gathering around the Baby Joseph, just like the vultures used to gather at that charnel house beneath the vulture tree. Christians, like vultures, scrap over the little bits of publicity they can gain for their fanatical drive to hold all life sacred, stirred up by their exorbitant claims about the value of human life, and how it should be honoured, no matter what its quality, no matter how much suffering. The Terry Schiavo Life and Hope Network and Priests for Life are at the centre of the media circus. Alex Schadenburg, of the Euthanasia Prevention Coalition, a Roman Catholic group in London Ontario that interferes with people’s decisions across Canada, and occasionally elsewhere in the world, has joined in the fracas, trumpeting his usual take on issues of life and death, that this concerns us all. There will even be protests and prayer vigils at the hospital this weekend.

I want to write more comprehensively about this in a later post, and this post is only to bring it to your attention. Perhaps what is most notable about this case is that (i) a jet is standing by waiting to take Baby Joseph to the US for treatment; (ii) there is a “Save Baby Joseph” campaign to raise money for … well, what, exactly?; and (iii) a prominent Christian lawyer from the US has taken over Baby Joseph’s case.

Baby Joseph is not going to survive. Prolonging his life will only cause more suffering to a sensitive being who is not able to understand what is happening to him, but who can, nevertheless, suffer. People like Alex Schadenburg, who are still fulminating about pulling the plug on Terry Schiavo, and consider it an act of murder, are playing up this story for all it is worth. Stories like this are like gold to them. They can bring their concerns to millions, while so many die in misery alone. “A warning to us all. Who will be next?” they cry in frenzied tones. Somewhere along the line someone has forgotten that this is supposed to be about compassion, not a bitter struggle for life regardless of the cost in human suffering. Every breath that Baby Joseph takes, we are told, is of infinite value. Is it really so important to keep this baby alive just so that he can suffer more? Hasn’t someone lost the thread of the human story? I’ll come back to this in a later post.

Religion and the Right to Life

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As the subtitle of this Blog points out, my purpose is mainly to argue for the right to die, and to oppose the religious obstruction of this right. Christians argue, however, that had it not been for the Christian belief that God is love, we would not be speaking about rights at all. In his book, Atheist Delusions, the Orthodox theologian David Bentley Hart argues that “‘memes’ like ‘human rights’ and ‘human dignity’ may not indefinitely continue replicating themselves once the Christian ‘infinite value of every life’ meme has died out.” (Kindle ed., Loc. 3311)

Is this true? Does the meme for human rights have a religious origin? And, were religion to disappear, would human rights disappear along with it? Do human rights depend upon the idea of the infinite value of every life? What, if it comes to that, does it mean to speak of every life as infinitely valuable? What practical consequences follow from the idea that every life has infinite value?

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