A Slip of the Keyboard (37 page)

Observation, conversation, and some careful deduction lead me to believe that the majority of doctors who support the right to die are those who are most closely involved day to day with patients, while support appears to tail off as you reach those heights where politics and medicine merge. It would be interesting to speculate how many doctors would “come out” were it not for the baleful glare of the BMA. Anyone who has any long-term friendships, acquaintances, or professional dealings within the medical profession, let alone knows anything about the social history of medicine, knows that down the ages doctors and nurses have seen it as part of their duty to allow those beyond hope and skill to depart in peace.
I can recall the metaphors that have been used: “helping them over the step,” “showing them the way,” “helping them find the door,” “pointing them to heaven.” But never, ever “killing them,” because in their minds they were not killing and in their minds they were right.

In fact, I have not found any reputable information from those places where assisted death is allowed that shows any deleterious effect on the community. I certainly do not expect or assume that every GP or hospital practitioner would be prepared to assist death by arrangement, even in the face of overwhelming medical evidence. That is their choice. Choice is very important in this matter. But there will be some, probably older, probably wiser, who will understand. It seems sensible to me that we should look to the medical profession, that over the centuries has helped us to live longer and healthier lives, to help us die peacefully among our loved ones in our own home without a long stay in God’s waiting room.

And finally there is the God argument, which I think these days appears to have been subsumed into concern for the innocent that may suffer if assisted dying were allowed. The problem with the God argument is that it only works if you believe in God, more specifically, Jehovah, which I do not. Spinoza, Darwin, and Carl Sagan have found in my imagination places which God has never found. Therefore I am a humanist and would rather believe that we are a rising ape, not a falling angel. Nevertheless, I have a sneaking regard for the Church of England and those I disagree with. We should always debate ideas that appear to strike at the centre of our humanity. Ideas and proposals should be tested. I believe that consensual “assisted death” for those that ask for it is quite hard to oppose, especially by those that have some compassion. But we do need in this world people to remind us that we are all human, and that humanity is precious.

It’s that much heralded thing the quality of life that is important.
How you live your life, what you get out of it, what you put into it, and what you leave behind after it. We should aim for a good and rich life well lived, and at the end of it, in the comfort of our own home, in the company of those who love us, have a death worth dying for.

The DPP’s new guidelines are good. People, not the diseases, need to be in control

The Times
,
26 February 2010

It’s a scene right out of
Trading Places
. We’re all waiting for the crop reports, although this turns out to be my fevered imagination, as I didn’t sleep much last night.

We are watching the clock, waiting for Keir Starmer, director of Public Prosecutions, to formally present the new guidelines on assisted suicide. And then suddenly it’s eleven o’clock and we’re all in Millbank, where you can’t shake a stick without hitting two reporters, or three if you’re lucky.

For Debbie Purdy and me, the race is on. We pass each other endlessly in lifts and in corridors. It’s like a high-tech slave auction.
You stagger around from one TV interview to another and end up not remembering anything about it.

We’re talking about assisted dying. I find out what I think by listening to what I say. And it seems to me that the guidelines presented are about as good as we can expect without a change in the law. I hated the provisional guidelines released in September last year. They seemed to be about ticking boxes. They seemed to be about bureaucracy.

But the word
compassion
catches my eye. And as I read on, it seems to me that this streamlined policy is more about what goes through the hearts and minds of people than exactly which hoops to jump through. I might dare to believe that someone who, out of compassion and love, helps another human who is not physically able to do it themselves to leave behind an unbearable life, would have little to fear from the authorities.

Nevertheless, I believe that a tribunal, proposed by me and others, should definitely come into existence through a change in the law. It would establish the facts of a case well before the assisted death takes place. But it is also vitally important that the limited freedoms suggested by these guidelines are not used to mask abuse. I believe it is essential that, for the safety of all concerned, the proposed actions and the reasons behind them are discussed in the nonaggressive atmosphere of the tribunal, which may advise, warn, or, should it be suspicious, refuse.

The enlightened U.S. state of Oregon is one of three that at the moment allow assisted suicide. In Oregon, after consultation with two doctors, the terminally ill patient is given a prescription that will end their life.

But here is the interesting bit: 40 percent of those who have the prescription to hand die without using it. They’ve known that they can, and every day they have decided not to. They know that, if they choose, it is they who are in control, not the disease. That is power. That is triumph. That is how a human being should die.

New Humanist
,
July/August 2011

A short time ago I had to insist to a not very youthful journalist that during my early lifetime anyone who attempted to commit suicide and failed would face a criminal charge and be locked up, presumably to show them life was wonderful and thoroughly worth living.

It would be nice to think that in the not too distant future someone will be incredulous when told that a British citizen stricken with a debilitating and ultimately fatal disease, and yet nevertheless still quite compos mentis, would have to go all the way to another country to die. They would ask for an explanation, and I’d be damned if I could think of one. Three decent, sedate, and civilized European countries already allow physician-assisted suicide and yet, despite the fact that every indication is that British
people understand and are in favour of assisted dying, if properly conducted, the government consistently turns its back on it. A year ago I was told by a cabinet minister that it would never happen in Britain and I suggested that this was a strange thing to say in a democracy and got a black look for my pains.

Initially, I thought the opposition was largely due to a certain amount of curdled Christianity; despite the fact that there is no scriptural objection, the prohibition came about in the fourteenth century when, because of religious wars and the Black Death, people were committing suicide on the basis that, well, since this world was now so dreadfully unpleasant then maybe it would be a good idea to make an attempt on heaven. Authority thought otherwise and objected. Who would milk the cows? Who would fight the wars? People couldn’t be allowed to slope off like that. They had to stay and face their just punishment for being born.

Even now I detect some echoes of that frame of mind: that affliction is somehow a penance for an unknown transgression. To hell with that! Every time the question of assisted dying is broached in this country there is a choreographed outcry, at suggested overtones of Nazism and, of course, the murder of grandmothers for their money. And the perpetrators get away with it because the British have a certain tradition of bullying from the top down. “The common people are stupid and we who know better must make the decisions for them.”

Well, the common people are not stupid. They might watch godawfully stupid reality TV and make a lot of noise in football grounds and they don’t understand, perhaps, the politics of Trident, but they are very clever about the politics of blood and bone and pain and suffering. They understand about compassion and, like my father, they are nothing if not practical about these things. He was incurably ill and saw no reason, given the absence of the hope of any
cure, that he shouldn’t forgo any more suffering and head straight for the door.

And people also understand that, especially if you don’t have much money, long-term care in the U.K. can be somewhat problematical at best. And yet the government sits there like an ancient Pope, hoping that it will all go away.

Sunday Times
,
12 June 2011

Just before Christmas I saw a man die; Peter Smedley and his wife, Christine, had travelled to the Dignitas clinic in Switzerland, because Peter felt that only there could he find what he wanted, which was a neat, tidy, and timely death. And I went with him to watch. The mind does indeed boggle. I once read that you should judge the length of the journey by the things you learn along the way. If that is true, then my road to Switzerland, and back home again, was a marathon.

Late last year the BBC, who had transmitted my Dimbleby Lecture on assisted dying much earlier in the year, asked me to learn something about assisted dying as practised elsewhere in Europe, and also to speak to Britons who had signed up with Dignitas, the Swiss organization which is your last resort if you live in
Europe and your country does not allow you an assisted death. Of course, I said yes.

Three years ago I was diagnosed with Alzheimer’s disease. I will not go into the reasons here why I may wish to be able to choose to end my life before the disease takes hold—I have spoken about and investigated dementia at length. As a writer I am blessed and cursed with an overactive imagination.

But would I still think this was such a good idea if I went to witness it firsthand?

In the U.K. assisted dying is illegal and anyone who dares assist a stricken friend or relative at their request is liable to end up in court, possibly on a charge of murder. There is some fine detail around this and it appears that some leniency could be afforded in the case of those who help out of compassion or love, which is why, so far, the judges have been extremely understanding; in short, here in Britain, amateurs are allowed to help other amateurs to die. It is a nonsense but it is the only nonsense we have got.