Assisted suicide – God forbids it, but isn’t it the greater moral act?

It's hard to reconcile a merciful God with the religious prohibitions against euthanasia

What would any of us reply, if we were asked by an elderly relative facing a terrible, increasing infirmity whether we would agree to assist them to die rather than endure a terminal illness in pain and indignity? Such a question would be very difficult to deal with, but surely one's instinct - indeed, one's conscience - would direct us to put the wishes of the sufferer first. A YouGov poll in today's Telegraph suggests that most people in the UK agree. Three quarters of respondents said the law should be changed to allow the act of assisted suicide, which at present carries a prison sentence of up to 14 years. Four fifths said that even if the law was not amended, the prosecution should stay its hand in such circumstances.

The issue is very much of the moment after the recent cases of Kay Gilderdale and Frances Inglis. Given the lack of real clarity over the courts' opposite verdicts on these two women, the proposal by Sir Terry Pratchett for "euthanasia tribunals" to be set up appears a humane and sensible one. The author, who has Alzheimer's, is due to give a lecture to the Royal College of Physicians tonight in which he will say: "If I knew that I could die at any time I wanted, then suddenly every day would be as precious as a million pounds. If I knew that I could die, I would live. My life, my death, my choice."

I found the subject vivid in my mind last summer, when the distinguished conductor Sir Edward Downes and his wife chose to die at the Dignitas clinic in Switzerland. Sir Edward was 85 and Lady Downes was 74, and both had very serious health problems. I not only had happy memories of going to concerts conducted by Sir Edward, but was in the same house at school as his son, Caractacus. A much-liked boy, and a talented musician himself, I remember "Crac", as we all called him, as a kindly individual who always had time for a word with junior pupils. Who could blame him and his sister for witnessing the deaths their parents chose rather than trying to insist they continue lives they no longer wished to lead.

It's worth noting, however, that neither the Downes nor Pratchett had or have any formal religious beliefs. While the promise of the afterlife means
that death is not something members of the Abrahamic faiths should fear, Judaism, Christianity and Islam all have strong prohibitions against suicide or euthanasia, and the current pope has been especially forceful on this, calling euthanasia "a false solution" and "evil". One might be able to find scriptures and verses that could be interpreted so liberally as to make this a grey area; but opponents would be armed with many more that make it clear that such acts were not permissible.

The only plea left, perhaps, is that at the time those holy books were written, no one - apart from the likes of Methuselah - was expected to reach the ages that are commonplace now. It's hard to reconcile a merciful God with a deity who demands humans endure years, even decades, of lives they don't consider worth living. Doesn't easing a painless exit seem to be the greater moral act?

 

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Sholto Byrnes is a Contributing Editor to the New Statesman
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A swimming pool and a bleeding toe put my medical competency in doubt

Doctors are used to contending with Google. Sometimes the search engine wins. 

The brutal heatwave affecting southern Europe this summer has become known among locals as “Lucifer”. Having just returned from Italy, I fully understand the nickname. An early excursion caused the beginnings of sunstroke, so we abandoned plans to explore the cultural heritage of the Amalfi region and strayed no further than five metres from the hotel pool for the rest of the week.

The children were delighted, particularly my 12-year-old stepdaughter, Gracie, who proceeded to spend hours at a time playing in the water. Towelling herself after one long session, she noticed something odd.

“What’s happened there?” she asked, holding her foot aloft in front of my face.

I inspected the proffered appendage: on the underside of her big toe was an oblong area of glistening red flesh that looked like a chunk of raw steak.

“Did you injure it?”

She shook her head. “It doesn’t hurt at all.”

I shrugged and said she must have grazed it. She wasn’t convinced, pointing out that she would remember if she had done that. She has great faith in plasters, though, and once it was dressed she forgot all about it. I dismissed it, too, assuming it was one of those things.

By the end of the next day, the pulp on the underside of all of her toes looked the same. As the doctor in the family, I felt under some pressure to come up with an explanation. I made up something about burns from the hot paving slabs around the pool. Gracie didn’t say as much, but her look suggested a dawning scepticism over my claims to hold a medical degree.

The next day, Gracie and her new-found holiday playmate, Eve, abruptly terminated a marathon piggy-in-the-middle session in the pool with Eve’s dad. “Our feet are bleeding,” they announced, somewhat incredulously. Sure enough, bright-red blood was flowing, apparently painlessly, from the bottoms of their big toes.

Doctors are used to contending with Google. Often, what patients discover on the internet causes them undue alarm, and our role is to provide context and reassurance. But not infrequently, people come across information that outstrips our knowledge. On my return from our room with fresh supplies of plasters, my wife looked up from her sun lounger with an air of quiet amusement.

“It’s called ‘pool toe’,” she said, handing me her iPhone. The page she had tracked down described the girls’ situation exactly: friction burns, most commonly seen in children, caused by repetitive hopping about on the abrasive floors of swimming pools. Doctors practising in hot countries must see it all the time. I doubt it presents often to British GPs.

I remained puzzled about the lack of pain. The injuries looked bad, but neither Gracie nor Eve was particularly bothered. Here the internet drew a blank, but I suspect it has to do with the “pruning” of our skin that we’re all familiar with after a soak in the bath. This only occurs over the pulps of our fingers and toes. It was once thought to be caused by water diffusing into skin cells, making them swell, but the truth is far more fascinating.

The wrinkling is an active process, triggered by immersion, in which the blood supply to the pulp regions is switched off, causing the skin there to shrink and pucker. This creates the biological equivalent of tyre treads on our fingers and toes and markedly improves our grip – of great evolutionary advantage when grasping slippery fish in a river, or if trying to maintain balance on slick wet rocks.

The flip side of this is much greater friction, leading to abrasion of the skin through repeated micro-trauma. And the lack of blood flow causes nerves to shut down, depriving us of the pain that would otherwise alert us to the ongoing tissue damage. An adaptation that helped our ancestors hunt in rivers proves considerably less use on a modern summer holiday.

I may not have seen much of the local heritage, but the trip to Italy taught me something new all the same. 

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear