Whatever our circumstances, how our life ends is not a consumer choice
Today marks the feast day of St Francis of Assisi, and coincides with the final day of the Catholic Church’s Season of Creation, the period of the year in which we are called to reflect especially on our relationship with God, our neighbour and the earth we all share.
So it seems deeply ironic that today is the day that the government has chosen to pull the trigger on a parliamentary debate on what’s become known colloquially as ‘assisted dying’. Labour MP Kim Leadbeater will be putting forward a bill this month intended to give terminally ill people the right to end their life. The MP believes that “now is the time” to hold a fresh debate after MPs rejected a bill on the same issue in 2015.
It is expected that the new bill will be introduced on 16th October, with a debate and then an initial vote later this year. Details of the proposal have yet to be finalised but it is thought that the bill would allow terminally ill adults with less than six months to live to opt for taking their own lives rather than seeking palliative care.
The issue has been the subject of a media narrative for some months after TV presenter Dame Esther Rantzen took to the tabloid press to campaign for a euthanasia bill. Dame Esther is terminally ill with lung cancer and has been calling for a bill to be introduced as her ‘dying wish’. Before the General Election her plea was supported by Keir Starmer, who yesterday confirmed that he was committed to granting Rantzen’s wish.
“All I’m asking for is that we be given the dignity of choice,” the Childline founder told Radio 4’s Today programme this morning (4th October).
“If I decide that my own life is not worth living, please may I ask for help to die. It’s a choice,” Dame Esther said.
The idea that deciding to end your life is some kind of consumer decision may sound like anathema but it’s an outlook that is gaining dangerous traction in a world that is becoming increasingly dehumanised and impersonal. From a secular, fiscal point of view there’s a dreadfully coherent logic in encouraging unwell citizens to terminate their own lives rather than absorb precious and expensive social care, but is this the kind of world we would ever want to live in?
As anyone who has ever accompanied a person they loved dearly on that final, desperate journey through a terminal illness will know, the arguments for a dignified and controlled death are powerful. I helped nurse my own father through four months of deterioration and decline from lymphatic cancer, and it was no easy thing to watch him decline from a vibrant, powerful and physically-fit personality to a broken shell of his former self in a hospital ward. The strange and confusing conflict of loss yet joy when he finally succumbed to his illness is something only those who have made this journey will understand – the gaping sense of loss juxtaposed with the sense of release for everyone, and the relief that there will be no more pain and suffering.
To replace this with a neatly planned and carefully choreographed departure from this world, saying goodbye to loved ones while you’re still coherent and recognisable may seem like a no-brainer to some, as it respects both autonomy and freedom of choice. Perhaps it does, but choosing to end one’s life intentionally in the face of physical decline and likely suffering is to create a dangerous and profound paradigm shift in the human narrative, and in particular in the relationship between the individual, the state and society in general.
Whilst we can do much to alter the course and purpose of our lives, the two events at either end of our mortal span are defining moments of certainty that have been with us since the start of human existence, and to alter either of these is to play profoundly with the fundamental purpose of the human journey – whatever we may believe about subsequent consciousness.
Contrary to popular belief, the dispute between assisted dying and palliative care is not an issue of religious belief or morals, but of profound differences of opinion about how we should live out our lives. These antagonisms have been around a very long time – and for Christians in particular the notion that the manner of your death is as important as the manner of your life harks right back to the example of Christ himself. Whatever the agonies of a terminal illness, nothing can compare to the agony of the Cross.
It was inevitable that, in a society where science and commerce seeks a remedy to every ailment and discomfort that besets the flawed human condition, we would eventually arrive at a point where we are seeking a remedy to a painful death. How that is achieved is the great controversy, and it is this that will lie at the heart of any parliamentary debate.
More particularly we will need to think very carefully about passing our end-of-life journey over to the state, which is effectively what an assisted dying bill could do. Of course many will argue this is a dystopian nonsense, but presently all that the state can do in a case of terminal decline is to mitigate the process – but the human journey remains inviolable. moving to a position of legalised assisted dying is a profound shift, which opens up the final days narrative to all kinds of unforeseen pressures and persuasions, which incidentally is why the British medical Association has always been opposed to the legislation of assisted dying in any form.
Currently physician-assisted suicide (PAS) is legal in some countries, under certain circumstances, including Austria, Belgium, Canada, Germany, Luxembourg, the Netherlands, New Zealand, Portugal, Spain, Switzerland, parts of the United States and all six states of Australia. By definition this is a method of killing that requires the participation of a doctor, though more recent developments in this field have led to the creation of ‘non-medical’ equipment such as the Dutch-designed Sarco Pod, a 3D-printed detachable capsule mounted on a stand that contains a canister of liquid nitrogen to die by suicide through inert gas asphyxiation. Not surprising, many have condemned this dreadful device as a ‘glorified gas chamber’. However the device is now in active use – just last week in the Swiss canton of Schaffhausen police arrested several people after a 64 year-old woman from the United States had used the machine to end her life; criminal proceedings for the inducement, aiding and abetting of suicide have been commenced in what will be the first test case of the legality of the Sacro pod. Despite this, the inventor and designer has already committed to making the 3D-printing blueprints available globally online whatever the outcome of the case.
Of course what makes any discussion about end-of-life-care difficult is that we simply can never know what the final stages of a human life can bring, and the grave danger about bringing assisted dying legislation into force is how you define futility. Some medical conditions may be statistically unsurvivable, though even for an atheist miracles are perfectly possible – so how are we going to measure exactly when a life becomes unviable, other than to take a person’s word? More disturbingly, some countries are even extending the boundaries of futility to include mental depression and other debilitating ailments in assisted dying legislation. In Canada and Holland in particular dangerously vague and ambiguous protocols around assisted dying legislation could be extended quite easily to include the termination of any life considered to be undignified and purposeless to society, which could include disabilities, old age and even perfectly treatable mental disorders.
The present preoccupation with granting premature death wishes is a dark manifestation of a society that has become obsessed with self-control, and that clearly views dependency as a fate worse than death. It has even been argued that assisted dying is a mechanism to restore a person’s free will, autonomy and self-determination and eliminate the shame of being a burden to family and to society.
This may suit the circumstances of the wealthy and empowered, but it could have devastating consequences for the most vulnerable and impressionable in society, at a time when declining health and increased dependency are placing them at their weakest.
As we celebrate the feast of St Francis of Assisi today, it’s worth remembering that he was just 44 years old when he died – a death that was dreadful and undignified in an age when there was no such thing as palliative care. Suffering from trachoma, a painful infectious disease that causes roughening of the inner surface of the eyelids and eventual blindness, all attempts at curing the condition failed. Eventually the Bishop of Ostia ordered that his eyes be operated on – by cauterizing them with hot irons! Such was the state of his decline that Francis claimed to have felt nothing during the operation. He died shortly after, on the evening of Saturday, 3rd October 1226, singing Psalm 141, “Voce mea ad Dominum”.
Thankfully, none of us will have to suffer those terrors today, due to the incredible advances in palliative care, which offer a humane and dignified alternative to assisted killing. As Pope Francis pointed out earlier this year at the International Interfaith Symposium on Palliative Care in Rome:
Authentic palliative care is radically different from euthanasia, which is never a source of hope or genuine concern for the sick and dying. Instead, it is a failure of love, a reflection of a “throwaway culture” in which “persons are no longer seen as a paramount value to be cared for and respected” (Fratelli Tutti, 18). Indeed, euthanasia is often presented falsely as a form of compassion. Yet “compassion”, a word that means “suffering with”, does not involve the intentional ending of a life, but rather the willingness to share the burdens of those facing the end stages of our earthly pilgrimage. Palliative care, then, is a genuine form of compassion, for it responds to suffering, whether physical, emotional, psychological or spiritual, by affirming the fundamental and inviolable dignity of every person, especially the dying, and helping them to accept the inevitable moment of passage from this life to eternal life.
We can only hope that legislators consider this viewpoint seriously when they come to debate this profound issue later this year, and they give due consideration not to the wishes of celebrities and the media, but to the potential consequences that such legislation might have on the most vulnerable, and potentially on the whole future and purpose of human society.
Joseph Kelly is a Catholic writer and theologian
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