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Dignity in life, dignity in death: Laurie Penny on euthanasia

Theological dogma should not dictate policy when it comes to assisted suicide.

It's not easy watching a man commit suicide on camera. The public uproar over the BBC documentary Choosing To Die, in which the author and Alzheimer's sufferer Sir Terry Pratchett visits the Dignitas euthanasia clinic in Switzerland, has reopened the debate over whether or not sufferers from terminal and chronic illness should be allowed to end their own lives. In the film, we watch Peter Smedley, a British sufferer from motor neurone disease, as he swallows the killing draught; he coughs as he begins to fall asleep, and asks for water. The prim Dignitas "escort" refuses. His wife, the picture of pseudo-aristocratic dignity, holds his hand as his head begins to drop to his chest. Sir Terry sits opposite the Smedleys as they say goodbye, swallowing obvious tears. It is terribly hard to watch.

It is no harder, however, than it would be to watch a man die slowly and in pain, longing for release. Sir Terry, whose own encroaching mortality is a constant, ominous presence in the programme, concludes with wobbling lip that this was a good death -- "When we think of all the ways people can die, that would count as a result" -- and that the creepy little blue house on the Swiss industrial estate where so many come to die exists for a good reason. It is difficult not to take his point, especially when one sees how rigorous and exhausting are the checks for fitness of mind and non-coercion run by the clinic. With an ageing population suffering increasingly from protracted, agonising end-of-life conditions, now would seem precisely the time for an adult debate about assisted dying. It seems likely, however, that the debate will be messy, drawn-out and painful.

Talking about suicide has always been taboo, even in journalism, a profession not generally known for tact and discretion. It is only 50 years since the practice was decriminalised in this country, and parts of the 1961 suicide act provide that, while you can no longer be sent to jail for surviving a suicide attempt, your friends and family can be imprisoned for up to 14 years if they are suspected of assisting a suicide -- even just for offering, like brave Mrs Smedley, a loving hand to hold at the end. There is something about this subject that repels rational debate. It sticks in the craw, disgorging reason. You can't help but feel that the reason nobody wants to ask the important questions about chosen death is that nobody really wants to hear the answers.

There is a very real fear that if we talk about this properly, we might reach a conclusion that we might not want to face: that, in some cases, taking one's own life is a sane and sensible thing to do. The term that commenters keep returning to is "slippery slope": if we acknowledge that self-murder might be acceptable for the terminally ill, what about the chronically ill? What about the mentally ill? What about those who are in perfect physical health but, like a small minority of Dignitas clients, are simply "weary of life"? If everyone could die in a time and place of their choosing, might we not see the numbers of suicides rise from current averages of just over 5,000 a year to tens or hundreds of thousands, many of them young people with everything to live for?

This is a legitimate fear. At 24, I have lost several friends to suicide. I have seen many more young people with big lives ahead of them attempt to end those lives. I have intervened personally in three suicide attempts, all of them involving young adults under 22. Those incidents were frightening, painful and heartbreaking for everyone involved. Hundreds of children and young people commit suicide every year in Britain and, according to the Samaritans and Barnados, that number is rising. I believe, like the Dignitas director, Ludwig Minelli, that the "right to self-determination" includes the right to control the manner of your death as far as possible, but the thought that it might somehow become acceptable for anyone simply to give up on life genuinely chills me.

That is not, however, what a service like Dignitas is offering. Dignitas, in fact, appears to offer a civilised solution to a problem which has dogged society, not to mention the medical profession, for centuries -- injecting a merciful dose of procedural oversight into a shadowy world of unspoken pain and moral dilemma, providing one has the £10,000 to cover the clinic's costs.

The key statistic is that 70 per cent of those who make enquiries with Dignitas never call back. The knowledge that the option of a quick and painless end is there seems, in fact, to give many people the strength to carry on. There is cause to believe that oversight and legitimacy in the field of euthanasia might, in fact, reduce the number of tragic suicides, by giving desperate people back a sense of control over the end of their lives. As Nietzsche observed, the thought of suicide, considered rationally, may well be "a powerful solace: by means of it one gets through many a bad night."

We live, for now, in a society where theological dogma does not dictate policy, but the notion of suicide as a "sin" persists. The reasons behind religious proselytising against suicide -- which comes with the not insignificant metaphysical threat of hell -- are benign enough for anyone who believes that God and law can and should dictate the lives of human beings. There is, however, also a powerful argument that the "sanctity" of life is worth less if the individual living that life cannot determine its boundaries. There is an argument that a measure of formality, choice and control in death is no bad thing for a person living out their last days in pain and terror. These are arguments that, if we wish to live in a truly civilised society, we will soon collectively be obliged to consider.

Rather than consider them, however, much of the response to this documentary and the difficult issues it raises, particularly on the Christian right, has focused on the possibility of a second "slippery slope". The fear seems to be that if euthanasia were not taboo, the elderly and infirm might be encouraged to end their lives against their will, to spare their families and the state the burden of caring for them, despite the enormous bureaucracy already in place to prevent this from happening. The hypocrisy of this moral panic is unbelievable, when hospices and end-of-life care centres are facing funding cuts of 30 per cent, according to a report released in January.

The brutal truth is that we do not need to fear a world where the sick, disabled and terminally ill are denied support and treated as disposable. We are living in that world, right now.

On 10 June last year, Paul Reekie, a 48-year-old poet from Edinburgh, took his own life. Spread out on the table beside him, in place of a suicide note, were two letters: one informing him that his Incapacity Benefit had been stopped, and another informing him that his Housing Benefit had also been stopped. This government, expanding on the policies of the last, is currently forcing over a million sick and disabled people to undergo a work capability assessment performed by a private company, Atos Origin, with a £300m mandate to deny benefits to hundreds of thousands of claimants. As a result of these tests, patients in the final stages of cancer have been refused the pittance of state support that was supposed to make the end of their lives bearable.

This month, top mental health charities warned the government that the tests were already causing desperate claimants to take their own lives, and that more suicides can be expected if the scheme continues. Someone in government appears already to have accepted and made provisions for this eventuality, distributing handy suicide guidelines to staff at call-centres dealing with benefit claims. The callousness with which this is being done should shock us; it should shock us far more than as-yet-abstract idea of state-sanctioned euthanasia. Instead, we nod along as ministers and tabloid headlines inform us that these people are not worth the good money we could be pumping into tax relief for the banking system.

We need no longer fear a world where society and the state cannot be bothered to expend time and money looking after the sick, the dying and the unprofitable. We are already living in that world. We are halfway down the slippery slope, clutching for handholds of humanity. If we truly believe that all human life is precious, if we truly believe in dignity in life and in death, we should start by taking an honest look at the slow, unmerciful slaughter of a welfare state which, while ailing, has so much more to give - and considering what that says about all of us.

Laurie Penny is a contributing editor to the New Statesman. She is the author of five books, most recently Unspeakable Things.

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Hilary Benn has been sacked. What happens now?

Jeremy Corbyn has sacked Hilary Benn, effectively challenging his critics to put up or shut up.

Hilary Benn been sacked from the shadow cabinet, following an article in the Observer reporting that the former shadow foreign secretary had told Labour MPs he would challenge Jeremy Corbyn should Corbyn lose the vote of confidence in his leadership that the PLP are due to discuss on Monday.

Anti-Corbyn plotters are convinced that they have the numbers to pass the no confidence motion in Corbyn’s leadership. Passing that motion, however, would not formally trigger either Corbyn’s resignation or a leadership challenge.

The word from Corbyn’s inner circle is that he would remain in post even if he were to lose the confidence vote, and dare his opponents to collect the 50 names they would need to trigger a leadership challenge.

Should that come about, Corbyn’s allies are certain that they would triumph over whoever ran against him. As one senior source said “they lost really badly in September and that’s not gonna change”.

Labour’s rebels are convinced that they have the numbers necessary to trigger a formal challenge to Corbyn’s leadership.

What happens next is fraught as the relevant clause in Labour’s rulebook is unhelpfully vague: 

“ii. Where there is no vacancy, nominations may be sought by potential challengers each year prior to the annual session of party conference. In this case any nomination must be supported by 20 per cent of the PLP. Nominations not attaining this threshold shall be null and void.”

The question that no-one is certain of the answer to: whether the challenged leader would have to seek nominations as well or if they would be on the ballot as by right. My understanding is that the legal advice that Corbyn’s critics have is that Corbyn would not automatically have a place on the ballot. But Jolyon Maugham, a lawyer who writes regularly for the New Statesman, looked over the clause for us and believes that he would.

More important than the legal basis, though, is what the party’s ruling National Executive Committee, which would rule on whether Corbyn had to seek nominations to stand, believes.

Although Corbyn has received the backing of 12 of Labour’s affiliated general secretaries, a well-placed source tells me that they are confident the NEC would rule that Corbyn will need to seek nominations if he is to stand again.

But control over the NEC is finely balanced, and could shift decisively towards Corbyn following this year’s elections to the NEC; one reason why Corbyn’s opponents are keen to strike now.

In that situation, Corbyn’s allies believe they can secure the 50 nominations he would need – the threshold has been raised due to a rule change giving Labour members of the European Parliament the same nominating powers as their cousins in Westminster – thanks to a combination of ideological support for Corbyn and pressure from the party’s grassroots. Senior sources believe that once Corbyn reached shouting distance of 50 nominations, the bulk of the shadow cabinet would quickly fall in line. Another estimates that the “vast majority” of the PLP accept Corbyn requires more time and that the plotting is the result of “a rump” of MPs.

But Corbyn’s critics believe that the European result, which saw Labour voters reject the party line in large numbers, has left Labour MPs with large majorities in the party’s ex-industrial seats more spooked by their voters than by their activists, putting them in the same group as those MPs with small majorities. (The two groups who currently pose the biggest danger to Corbyn are MPs who are old enough to be eligible to collect their pension at or before the next election, and MPs with majorities of under 2,000.) 

Who's right? Much depends on the disposition of Labour's 20 MEPs. Prior to Britain's Brexit vote, they were believed to be the most sensitive to the concerns of the party's activists, as Labour members vote on the order of the party's list, making anti-Corbynites vulnerable. Now all 20 MEPs are out of a job at, or before, the next European election regardless, the question is whether they decide to keep Corbyn off the ballot, or try to curry favour with Corbyn's supporters in the membership prior to making a bid for seats at Westminster. 

Stephen Bush is special correspondent at the New Statesman. He usually writes about politics.