Burial is no longer the default option. Photo: Matt Cardy/Getty Images
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In small communities beyond our cities, the undertaker is always a jack of all trades

Cremation is our most popular mode of dealing with mortal remains: around three-quarters of British funerals are now held at crematoriums, a sea change from sixty years ago, when burial was the default option.

Midway through surgery I get a call from Peter, a GP at a nearby practice. “Hi, Phil. Can you do a Part Two for me?”

It’s on an 80-year-old patient of his, Brenda Roy, who has passed away at ten to one that morning. Peter gives me a summary: she went through the chemotherapy mill after lymphoma was diagnosed last year; when the disease recurred, she decided she’d had enough and declined further active treatment.

“She’s at Francis Kennearly’s. I’ll leave the paperwork there.”

Cremation is our most popular mode of dealing with mortal remains: around three-quarters of British funerals are now held at crematoriums, a sea change from sixty years ago, when burial was the default option. Worldwide, cremation rates vary markedly, reflecting cultural and religious traditions. Burial is virtually unheard of in Japan, whereas in strongly Catholic countries such as Ireland and Italy cremation follows fewer than two in every ten deaths. Practical considerations play their part, too: cremation in the west is most frequent in cities, where cemetery plots are often in short supply.

From a UK jurisprudence perspective, cremation entails the permanent loss of potential forensic evidence. To guard against miscarriages of justice, two medical practitioners must complete a form that is scrutinised by an independent referee. The first part is filled in by the doctor who cared for the deceased. “Part Two” must be given to a practitioner with no prior involvement in the case.

Peter practises in a large village set among rolling hills, a long way from any A-roads. It is not especially picturesque; it’s a working community with few holiday and weekend cottages, and the local businesses and shops are still thriving. Francis Kennearly has been the undertaker here for twenty-odd years. The door of his funeral parlour is locked when I arrive. I ring him on his mobile, and it’s a somewhat dusty Frank who gets out of his van a few minutes later. Although he conducts virtually all the funerals in the village, there aren’t enough to keep his own body and soul together, so he undertakes various other jobs on the side. Today, I’ve interrupted him plastering someone’s living room.

He takes me inside and I perform a brief examination of the deceased, confirming her identity and excluding neglect or foul play in the absence of any obvious signs. In truth, it’s a redundant exercise. Frank gives me a swift run-down of Brenda’s life story, family connections and notable contributions to the village. He’s always known his deceased personally, often for many years, and nothing untoward would make it past his eye. His trusted place in his community has more than a little to do with the affection and respect he always shows towards the recently departed.

Following the Harold Shipman affair – in which the GP serial killer repeatedly evaded the checks in previous cremation certification procedures – the Part Two doctor is now obliged to make additional inquiries of someone who nursed the deceased during his or her final illness. This can be delicate when it is a family member: something about asking whether there was anything untoward about the way their loved one died generates an undercurrent of suspicion no matter how carefully the question is phrased. Again, Frank proves invaluable, not only tracking down Brenda’s daughter (she wasn’t on the number Peter had given me) but putting her at ease before handing the phone across. The only thing she has to tell me is how fantastically well Peter and his district nursing colleagues cared for her mother.

Part Two completed, I pop next door to the village shop to get some lunch. The assistant and the customer in front are ruefully discussing Brenda’s demise. The news has spread quickly; they even know the time of death. Living and dying in such a close-knit place might be too claustrophobic for some, but there is a connectedness and belonging here that seems the very essence of community, something increasingly rare in this country of ours.

This article first appeared in the 19 June 2015 issue of the New Statesman, Mini Mao

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Morning after pill: It's time to say no to the "ultimate sexist surcharge"

A new campaign aims to put pressure on the government to reduce the cost of emergency contraception.

The British Pregnancy Advisory Service recently launched its Just Say Non! campaign to highlight the fact that British women pay up to five times more for emergency contraception than women on the continent. The justification for the UK price of up to £30 – and the mandatory consultation with a pharmacist – is that otherwise British women might use the morning-after pill as a regular method of contraception. After all, you know what us ladies are like. Give us any form of meaningful control over our reproductive lives and before you know it we’re knocking back those emergency pills just for the nausea and irregular bleeding highs.

Since BPAS announced the campaign on Tuesday, there has been much hand-wringing over whether or not it is a good idea. The Daily Mail quotes family policy researcher Patricia Morgan, who claims that “it will just encourage casual sex and a general lack of responsibility,” while Norman Wells, director of the Family Education Trust, which promotes what it calls "traditional values", fears that “there is a very real danger that [emergency contraception] could be misused or overused.”  

The Department of Health has indicated that it has no intention of changing current policy: “We are clear it is only for use in emergencies and we have no plans to change the system.” But why not? What is the worst that could happen? Wells argues that: “The health risks to women who use the morning-after pill repeatedly over a period of time are not known.” This may be true. But do you know what is known? The health risks to women who get pregnant. Pregnancy kills hundreds of women every single day. There are no hypotheticals here.  

The current understanding of risk in relation to contraception and abortion is distorted by a complete failure to factor in the physical, psychological and financial risk posed by pregnancy itself. It is as though choosing not to be pregnant is an act of self-indulgence, akin to refusing to do the washing up or blowing one’s first pay packet on a pair of ridiculous shoes. It’s something a woman does to “feel liberated” without truly understanding the negative consequences, hence she must be protected from herself. Casually downing pills in order to get out of something as trivial as a pregnancy? What next?

Being pregnant – gestating a new life – is not some neutral alternative to risking life and limb by taking the morning-after pill. On the contrary, while the UK maternal mortality rate of 9 per 100,000 live births is low compared to the global rate of 216, pregnant women are at increased risk of male violence and conditions such as depression, preeclampsia, gestational diabetes and hyperemesis. And even if one dismisses the possible risks, one has to account for the inevitabilities. Taking a pregnancy to term will have a significant impact on a woman’s mind and body for the rest of her life. There is no way around this. Refusing to support easy access to emergency contraception because it strikes you as an imperfect solution to the problem of accidental pregnancy seems to me rather like refusing to vote for the less evil candidate in a US presidential election because you’d rather not have either of them. When it comes to relative damage, pregnancy is Donald Trump.

There is only a short window in a woman’s menstrual cycle when she is at her most fertile, hence a contraceptive failure will not always lead to a pregnancy. Knowing this, many women will feel that paying £30 to avoid something which, in all probability, is not going to happen is simply unjustifiable. I’ve bought emergency contraception while conscious that, either because I was breastfeeding or very close to my period, I’d have been highly unlikely to conceive. If that money had been earmarked to spend on the gas bill or food for my children, I might have risked an unwanted pregnancy instead. This would not have been an irrational choice, but it is one that no woman should have to make.

Because it is always women who have to make these decisions. Male bodies do not suffer the consequences of contraceptive failure, yet we are not supposed to say this is unfair. After all, human reproduction is natural and nature is meant to be objective. One group of people is at risk of unwanted pregnancy, another group isn’t. That’s life, right? Might as well argue that it is unfair for the sky to be blue and not pink. But it is not human reproduction itself that is unfair; it is our chosen response to it. Just because one class of people can perform a type of labour which another class cannot, it does not follow that the latter has no option but to exploit the former. And let’s be clear: the gatekeeping that surrounds access to abortion and emergency contraception is a form of exploitation. It removes ownership of reproductive labour from the people who perform it.

No man’s sperm is so precious and sacred that a woman should have to pay £30 to reduce the chances of it leaving her with an unwanted pregnancy. On the contrary, the male sex owes an immeasurable debt to the female sex for the fact that we continue with any pregnancies at all. I don’t expect this debt to be paid off any time soon, but cheap emergency contraception would be a start. Instead we are going backwards.

This year’s NHS report on Sexual and Reproductive Health Services in England states both that the number of emergency contraception items provided for free by SRH services has “fallen steadily over the last ten years” and that the likelihood of a woman being provided with emergency contraception “will be influenced by the availability of such services in their area of residence.” With significant cuts being made to spending on contraception and sexual health services, it is unjustifiable for the Department of Health to continue using the excuse that the morning-after pill can, theoretically, be obtained for free. One cannot simultaneously argue in favour of a pricing policy specifically aimed at being a deterrent then claim there is no real deterrent at all.

BPAS chief executive Anne Furedi is right to call the price of Levonelle “the ultimate sexist surcharge.” It not only tells women our reproductive work has no value, but it insists that we pay for the privilege of not having to perform it. It’s time we started saying no

 

 

Glosswitch is a feminist mother of three who works in publishing.