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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.

CREDIT: CREATIVE COMMONS
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A group of men united only by sport was once my idea of hell. What changed?

It struck me, during the course of our team’s annual pre-season dinner, how much I like my team-mates. 

To the cricket team’s annual pre-season dinner. Although I’ve been playing for them for ten years or so, I’ve never been to one of these. This is because when I say “I’ve been playing for them for etc…” you’re probably not getting the right picture. What I mean is: I have played ten matches for them, and last year not at all, with a highest score of 22, and an average of 10.17. If you think that’s unimpressive, it’s a lot better than when I was a schoolboy, and I am just 26th placed out of 50 people who have played ten or more matches for them. Last year I was 25th, I see. Well, I’m going to have to do something about that.

The idea is that if I go to the dinner this time, it will inspire me to get in shape and play a game or two this season. I almost invariably enjoy it when I do, especially the time I was in a record-breaking tenth-wicket partnership of 72 while batting with a broken hand. (Well, finger. But a finger’s a part of the hand, isn’t it? Even the little finger.) I suppose there are times when I don’t enjoy it so much, such as when it’s raining hard enough for the cows in neighbouring fields to sit under a tree, but not hard enough to send us back to the pavilion or, better still, the pub, and the opposition are clouting us all over the ground despite the weather, and if we’d batted first – we never bat first, in my (limited) experience – the other lot would have polished us off about an hour ago, and we could now all be cosily inside the pavilion or, as I said earlier, even better, the pub. Then again, the team is called the Rain Men, so what did I expect?

So signing up for games involves considering a number of factors: some kind of mystic calculation about what the weather will be like, an assessment of how far away the ground is (we’re a nomadic team, so we don’t have one of our own), and how fit I think I’m going to be on the day. That’s the troublesome part. There is, of course, the melancholy of coming back, aching and knackered, at what is usually well after nine in the evening on a Sunday, lugging a cricket bag, like someone who has not been able to let go of his childhood and is out after his bedtime.

The fitness, as I said, is problematic. I got slightly out of puff going for a pee between the second and third paragraphs of this column, so I think there is going to be a lot of tedious spadework in store for me. My dumb-bells are in East Finchley, which I don’t go to, although as my cricket stuff is there too I suppose I’m going to have to bite that bullet sooner or later. If I eschew the dumb-bells then there will always be the floor, gravity, and push-ups. There will always be stairs, somewhere, I can run up and down, while I have the use of my legs. While there is an earth I can walk upon, I can walk upon it. The upper body strength, so I can pick up a cricket bat without falling over, is the thing to aim for, but right now the main goal is to be able to get out of bed and go to the loo without getting winded.

Anyway, the dinner. I decided that I’d walk to the restaurant. This was largely because the restaurant is about 200 yards from where I am holed up at the moment. There is, literally, only one restaurant closer to me. I walked a bit more than 200 yards because I had to swing by Sainsbury’s to pick up a couple of bottles of wine (the McGuigan’s Reserve Cab Sauv at £6.50 a bot, special offer, being the sedative of choice these days), as the restaurant is unlicensed. We met at the pub first, of course.

It struck me, during the course of the evening, how much I like my team-mates. I am by no means the oldest, so many of them are rich in wisdom and experience. (Amazingly, the team won more games last season than it has in its history, but that might have been because I hadn’t played for them.) Two of the people I am particularly fond of couldn’t make it, but at least I got to have A Long Rant About Life In General with Marcus Berkmann, author of two extremely amusing books about the team (Rain Men and Zimmer Men), as well as the greatest book about Star Trek ever written (Set Phasers to Stun).

Imagine: a long table sat at by a group of about 15 men, united only by a sport. It would once have been my idea of hell. So why is it not now? Is it because I actually like these guys? They’re not the typical idea of a cricket club gang, I have to say that. And we do, admittedly, talk about cricket a fair amount. But still. (I even liked I—, who gave up smoking and then had a rush of blood to the head last year and sent a round-robin email to the team saying how much he hated A—, one of our most lovable players. I— couldn’t make it to the dinner, largely on the grounds of not having been invited.) Or am I that lonely? 

Nicholas Lezard is a literary critic for the Guardian and also writes for the Independent. He writes the Down and Out in London column for the New Statesman.

This article first appeared in the 12 April 2018 issue of the New Statesman, Syria’s world war