Friday 17 August 2012

killing me softly....

I know that, at this time of the week, I usually write about the songs that have been floating around the inside of my head.  Well, no earworms this week.  Instead I'm going to talk about something far more important: Facebook.  Well, indirectly.

I'm sure you noticed the news this week that two victims of "Locked-In Syndrome" have been denied in court the right to die with medical assistance.  As the Guardian reported:

"Tony Nicklinson, 58, who had sought to end his "dull, miserable, demeaning, undignified and intolerable" life after he was left paralysed below the neck following a stroke seven years ago, wept uncontrollably after the judgment and said it meant his anguish would continue.....judges said that while the cases were deeply moving and deserved the most careful and sympathetic consideration, the questions they raised were too significant to be decided upon in a court, and could only be answered by parliament.  Lord Justice Toulson said that allowing the two men to be helped to end their lives would have implications far beyond their cases, and a ruling in Nicklinson's case in particular would have amounted to a major change in murder laws which exceeded the powers of the courts."

You would surely need to have a heart of stone not to be moved by the plight of these men.  Just watch the video on that link above of Nicklinson reacting to the judgement with uncontrollable sobs.  Heart-breaking.

Mind you, they may have been bitterly disappointed by the ruling, but neither man could have been surprised by the decision.  You remember Debbie Purdy?   Purdy has Primary Progressive MS and has fought a long battle to seek assurances from the law that her partner will not be prosecuted as an accessory to suicide simply for helping her travel to Dignitas in Switzerland.  It is still not clear whether even helping someone to travel to a clinic to end their life is a crime, even if ultimately that person dies entirely by their own hand.

Yesterday's cases are significantly different: once at Dignitas, Purdy - or indeed any other potential customer of the clinic - must be well enough to administer the lethal medication for themselves.  They cannot be helped by anyone else; they are choosing to die and are ending their lives in as dignified a fashion as they can.  Nicklinson and 'Martin', the other man presenting a case yesterday, are unable to kill themselves and would require assistance.

That's a clear difference, and one that I think is easily missed.

So where does Facebook come in?  Well, this appeared in a friend's timeline yesterday evening, alongside a link to the news story (and apologies if he's reading this here):

"If you haven't got the freedom to walk away from your own life on your own terms, you've got no freedom at all."

Now, this I agree with... broadly.  What riled me slightly were some of the comments.  Here are a couple of them:

"if those pious bastards are so concerned with his welfare let them dedicate the rest of their lives to wiping his arse, feeding and trying to make his hellish existence a little more tolerable rather than lecturing him on what he should or shouldn't be able to do with his own existence."

"Thinking about this man's predicament, I cant begin to imagine the emotional horror of it. Please put him out of his undoubted and literal misery....."

"YOU MUST LIVE.. LIVE ON.. YOU MUST.. Life at the pinnacle of medicine.. Miserable state of affairs".

"ERROR: We cannot let a single tax payer escape the system!
ERROR: We cannot let a single tax payer escape the system!
ERROR: We cannot let a single tax payer escape the system!"

Look.  I get where they are coming from, I really do (well, apart from the tax guy)... but I think they're missing the point.  I know that pro-life campaigners will be celebrating these decisions, but I think they're missing the point too.  This isn't about the sanctity of life or protecting the vulnerable who may feel pressured into killing themselves.  Neither is it simply the refusal of the state to allow someone to kill themselves.  It's a much more complicated ethical, moral and legal dilemma: if someone wants to kill themselves but they can't do it themselves, then what can we do?  How do you go about ending someone's life?  Who pushes the button?  What qualifies them to do so?  What gives them the right? What guidelines would need to be in place to make such a thing 'safe'?

The court decision may leave Nicklinson, and people like him, facing up to the unpleasant choice of either continuing to live or attempting to starve themselves to a long, drawn-out and ultimately undignified end.  But what other decision could the court make?  Yes, we may routinely choose to euthanise animals to prevent suffering, but surely we can all agree that it's not quite the same for human beings?  You can't just sit down with the doctor and agree that your mother has had a good innings and it's just her time, before quietly putting her to sleep.....

I've quoted this before, but Matthew Parris wrote about the distinction between the right to die and assisted suicide in The Times back in 2009, talking about the Purdy case:

"I can’t tell you how simple I find these arguments: so simple that I’ve hardly bothered to write about the issue. Suicide is the greatest of human freedoms, underwriting all the others, for it gives us the possibility of defying every thing and every one there is. The possibility of suicide is what makes life voluntary and each new day an act of will. No wonder the faith community gnash their teeth at suicide. God Himself, if He existed, would gnash His teeth at suicide: the supreme act of defiance, the final raspberry. The knowledge that I’m here by choice, that every breath I take I take by choice, injects into my soul a transcendent joy. That we can let go whenever we want is for me the deepest sort of thrill. People should be able to choose. Obviously. And if they choose the end but seek help with the means, they should be able to. Obviously. End of argument."

However, Parris goes on to say that he is opposed to legalising assisted suicide - on the grounds that this means that someone has to officially decide who can, and who cannot, die:

"It is one thing for the State to decline, at its discretion, to prosecute someone who has killed without authority. It is quite another thing for the State to issue an authority to kill. We do best, I think, to stay on that first, more limited, ground."

I don't have any answers, and my heart goes out to anyone facing this situation, but this is not a trivial issue with an obvious solution, and anyone who thinks it is clearly hasn't thought it through.


  1. Another thought-provoking post.

    From my own point of view, while he has my sympathy, there is one clear reason why Tony Nicklinson was not granted his right to die: he can still communicate, however crudely. He still has the ability to think for himself. True, he uses a board and electronics that operate by eyesight, but he can still communicate.

    It sounds to me that he has the ability to think. And that is that he has in common with someone else: Stephen Hawking. Both have the same ability to think, but obviously at different ends of the scale.

    Just my thoughts, that's all. But I do say again, he has my sympathy.

  2. This subject is something which is very close to home for me. My Mum has had MS for 40 years and for the last five years she has been largely confined to a chair, doubly incontinent and for the most part utterly miserable. She was a beautiful, vibrant funny person who has been robbed of her dignity in the cruellest possible way. Her quality of life is crap - some of it is down to MS, some of it is down to a vicious circle of lifestyle choices (diet etc) but depression has also robbed her of her fight and motivation to do everything she can to help herself. She almost died from pneumonia last year and spent seven months in hospital recovering. Modern medicine saved her but for what purpose. The first night she came out of hospital she was inconsolable and as she grabbed my hand she said she wished she hadn't survived. This was hard for me to hear but I "got" it. I know there are times where she has thought about taking her own life but she has now reached a stage where she probably wouldn't be able to do it on her own but I also know that she would never ask her family to help her because she would worry about what would happen to us.

    Advances in modern medicine mean that chronically ill people are now surviving longer and whilst this is great for those people who do want to live, it is a double-edged sword for those people who are ready to die. Their only other option is to take their own life or ask a family member to help them to do it.

    I don't have any answers but I do think society in general needs to start debating these issues and think about where modern medicine is taking us.