Tuesday, 27 March 2012

Melanie Reid on Assisted Dying

Melanie Reid has written a clear-sighted 'view from the wheelchair' on assisted dying, prompted by yesterday's commons debate on the DPP guidelines on assisted dying (MPs supported the guidelines, though no change to law was supported). Because it's behind The Times paywall, but is very good, I make no apologies for reproducing it here, because I think it deserves a wider circulation. Reid was a Times columnist, but broke her neck and back in a horse-riding accident in 2010, and has charted her progress since then in a series of moving pieces in the magazine, called Spinal Column. Anyway, here it is, entitled I choose, fiercely, to live - but only for now:

When asked about assisted suicide, I tend to pause and take a deep breath. You really want to know what I think? From the vantage point of a severely crippled body?

Honestly? You want the voice from the coalface? You don’t just want an opinion from some able-bodied moralist who presumes to know what’s best for me?

I find it ridiculous that an educated society, facing an unaffordable explosion in dementia and age-related illness, is prevaricating over this issue. It is, for me, almost inconceivable that the law lags so many decades behind modern realities; and is so out of step with the feelings of the vast majority of the population.

Where is the democracy surrounding death? The fact is simply this. Because of a religious minority, a few antediluvian pressure groups and the might of modern medicine, we are condemning growing numbers of elderly, terminally ill or disabled people to a terrible lingering twilight rather than a good death in the circumstances of their choosing.

And we are condemning the people who want to assist them to the threat of criminal prosecution. This is a scandal.

Today, apparently for the first time in nearly 40 years, MPs are to vote on assisted suicide (in 2006 a change in the law on assisted dying was defeated in the House of Lords by 148 votes to 100). Says it all, doesn’t it? The Conservative MP Richard Ottaway has secured a debate about the guidelines by the Director of Public Prosecutions on the issue, which have been in place since February 2010. The guidelines make it clear that prosecution is unlikely in cases of compassionate amateur assistance to die.

We must hope our MPs are bold enough to represent the nation’s views and support this stance. A recent poll found that 82 per cent of people believe that the DPP’s approach to prosecution is “sensible and humane”. Every single person I know is of the same general opinion: that there is no point keeping humans alive just for the sake of it, when they don’t want to be, in circumstances which we and they regard as intolerable. And if they need help to achieve a good death, in the comfort and peace of their own home, we should be able to give it to them.

Yet we are being held back by a tiny number, not even 18 per cent I bet, who either believe the Bible rules it out or are so blinded by the doctrine of palliative care (or perhaps both), that they remove choice from the majority.

Ironic, isn’t it, that we can buy 50 different types of pasta or ice cream? We can choose a million styles of hair, or clothes, holiday destination or car. Tidal waves of consumer choice lap against us every waking minute. Yet when we need help to effect a simple, primary decision to ease out of life; when we want to avoid becoming a living shell, stuck in bed, in pain, staring at the wall for months on end, and thereby condemning our relatives to a similar suffering, we are denied that choice. Or, if we are able, we must leave the country and go to a grotty Swiss suburb to find it. In an age wedded to the gospel of human rights, in other words, we are denied the most basic human right of all.

I will be very blunt. Most mornings I contemplate suicide, briefly examining the concept in a detached, intellectual way. It’s always during the hour when I am sitting on my shower chair over the loo, leaning forward over my purple, paralysed feet, fighting nausea and light-headedness, sore bones and paralysed bowels. This, without intending to sound self-pitying, is the worst bit in the day of a life as a tetraplegic — a cruel Japanese game show, full of repeated tortures.
And every day I stare at my toes and say to myself: “Nope, got to keep going, got to keep fighting.” Because I choose, fiercely, to live for the people who love me; and will continue to do so until such point as they understand I cannot carry on. I hope that moment, if or when it comes, is many years away.

But you know sometimes, just sometimes, I get angry enough to wish that a few bishops, palliative care specialists and those dedicated campaigners from Care Not Killing — ah! what amazing arrogance lurks in a name — were in my skin, sitting in my shower chair, facing my future.

Knowing that I have a choice is a huge comfort to me; it sustains me on the days when I make the mistake of looking too far in the future. But the point is, I am blessed precisely because I have a choice. I can talk, use my hands to a limited degree. I could, if I sought to, take my own life without implicating anyone else.

There are many other people who, because of their illness or their disability, do not have this possibility of self-determination. Their right to choose is denied to them. They need help to escape from their imprisonment; and they want to know that their family or friends will not be punished for assisting them to die.

The debate today is narrow in scope and only the beginning. It covers the terminally ill, which rules out spinal injuries and a host of other forms of chronic suffering. But it is an important start.

Humanity and economics demand that, eventually — and yes, yes, yes, with all proper safeguards — assisted dying is extended to become legally available to all those who seek it, and not just cancer patients. People like me, living with the consequences of an accident, who dread growing old and lonely. People like my mother, who in the early stages of dementia expressed a clear wish to end her life and not be a burden on us.

There will be a whole generation of ageing babyboomers, in fact, who will seek to go out of life in the same way they have successfully run it: in control, not in incontinence pads in a care home. This debate is not about other people. It is about every single one of us.
(© Melanie Reid, The Times etc)

Hear, hear. It's about autonomy and resisting the tyranny of a misbegotten authoritarianism.


  • Enid Richemont says:
    11 January 2014 at 09:05

    Thanks for posting this. It is such an important issue, and religion and fantasists should be kept out of it.
    Like Melanie, I am also a writer - a children's author, much published - and my admiration for her, and her writing, is enormous. What she's said here is so important. Our lives should be our own, and we should be allowed the freedom and help to choreograph our endings with love and sensitivity and caring for those who would be affected by our death.

  • Mark Jones says:
    15 January 2014 at 02:55

    You're welcome, Enid, and I agree with everything you say.

  • researcher513 says:
    24 July 2015 at 03:02

    I hear you, Melanie.
    The economics of it alone is bonkers - and compared to how it used to be done - well, I had better not go there!
    "Being Mortal" by Atul Gawande: professor, physician writer, will give you some more ideas on this.

    I am working with a template for last wishes, which your GP/ Consultant holds, once fully discussed with members of your family.


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