11.02.2010

Right to a dignified life - right to a dignified death

The comfort and self-respect of the incurably ill and the dying must be ensured, writes Eddie Ford

Terry Pratchett’s February 1 TV Dimbleby lecture calling for “euthanasia tribunals” attracted 2.1 million viewers - some 15% of the total share - and drew more viewers than any other programme shown in the same BBC 1 time slot, not to mention pulling the biggest ever TV audience for that august annual event.

His 45-minute talk, entitled ‘Shaking hands with death’ - brilliantly read by the actor, Tony Robinson - sparked off a nationwide debate on ‘assisted suicide’ and such like. This topic has already featured heavily in the media following recent high-profile cases involving the ‘mercy killing’ of individuals with incurable, terminal or helplessly debilitating illnesses.

So we had the tragic incidences of Bridget Gilderdale and Frances Inglis. The latter injected her brain-damaged son - who could only communicate (possibly) by blinking and had to be fed through a tube in his stomach - with a lethal dose of heroin to release him from the “living hell” of his vegetative state: she was given a minimum of nine years in jail provoking cries of “Shame!” from her supportive relatives and friends in the public gallery. Gilderdale, on the other hand, was acquitted of attempted murder and given a 12-month conditional discharge after helping her daughter, Lynn, to end her life with a morphine overdose. In her online diary, Lynn wrote that she no longer wanted to “keep hanging on for that ever diminishing, non-existent hope that one day I will be well again” - and even though “[anti-depressant] drugs have stopped me from crying all the time”, this “hasn’t stopped me from my desire not be on this planet any more”.[1]

Pratchett is, of course, the phenomenally successful author of comic fantasy novels, particularly the Discworld series - set in a flat world (or slightly convex disc, to be more accurate) balanced on the backs of four elephants which, in turn, stand on the back of a giant turtle named Great A’Tuin, which swims slowly through space. So far 37 Discworld novels have been published and in total his books have sold more than 65 million copies, having being translated into 37 languages - making him into some sort of cultural icon. Pratchett also became the first ever novelist to deliver a Dimbleby lecture, normally reserved for the great and the good - bastions of the establishment - like prince Charles, dame Stella Rimington, Dr Rowan Williams, Bill Clinton, and so on.

Perhaps more to the point, Pratchett suffers from Alzheimer’s disease - so in December 2007 he was diagnosed to have a very rare form of this so far incurable condition, called posterior cortical atrophy, in which areas at the back of the brain begin to shrivel. Not long after, in an article published in mid-2009, Pratchett expressed a desire to commit ‘assisted suicide’ - or “assisted death”, as he prefers to call it - before his disease progresses to a critical point. In February 2009 Pratchett made a two-part programme for the BBC entitled, Living with Alzheimer’s - which attracted 4.3 million viewers.

In his BBC lecture from the Royal College of Physicians in London, Pratchett said his proposed tribunal would be acting for the “good of society”, as well as that of the applicant - allowing people to end their lives “at a time of their choosing”. Of course, continued Pratchett, the tribunal would “ensure” that anyone before them was of “sound and informed mind”, “firm of purpose”, suffered from a “life-threatening and incurable disease” and not “under the influence of a third party. Furthermore, and crucially, the tribunal would also offer “protection to the medical profession” and he suggested that many GPs would come out in support of the “right to die” if they knew they were legally protected.

For Pratchett, “we should aim for a good and rich life” - one that is “well lived” - and at the end of it, to pass away in the “comfort of our own home” and in the “company of those who love us”: to have a “death worth dying for”. At the end of his lecture, in summary, the author hoped that he would “die peacefully with Thomas Tallis on my iPod before the disease takes me over” and declared: “If I knew that I could die at any time I wanted, then suddenly every day would be as precious as a million pounds. If I knew that I could die, I would live. My life, my death, my choice.”[2]

As part of his campaign to legalise euthanasia, the author has championed the case of Debbie Purdy - who suffers from multiple sclerosis and publicly mounted a challenge to the current law in England and Wales as regards assisted suicide, which is a contradictory muddle (like many other laws). Hence in the UK, the 1961 Suicide Act decriminalised the act of suicide - or “self-murder” - so that anyone who failed to kill themselves would no longer be prosecuted. Prior to then, it was a criminal offence to attempt suicide, for which you could be imprisoned, and the families of those who succeeded faced potential prosecution as well.

Of course, this inhuman attitude towards deeply unhappy individuals reflected the baleful influence of Christianity - with thinkers and propagandists like Augustine and Thomas Aquinas adhering to the dogma that whoever deliberately took away the life given to them by their supposed creator was displaying the utmost disregard for “the will and authority of god” and hence jeopardising their path to salvation. Consequently, they strongly encouraged the church to treat suicide as a “sin”, a position essentially retained by today’s catholic church.

However, while the Suicide Act graciously declared under section 1 that suicide as a crime is henceforth “abrogated”, section 2(1) also states: “A person who aids, abets, counsels or procures the suicide of another, or attempt by another to commit suicide shall be liable on conviction on indictment to imprisonment for a term not exceeding 14 years.”[3] Which is to say, it created a new offence of ‘complicity in suicide’ - so if an individual actually incapable of committing suicide for him or herself enlists the aid of an outside party in performing such an act, that party may be charged with conspiracy. This necessarily creates an illogical situation, where the act itself is not illegal, but assisting it most certainly is - which effectively means that in practice the 1961 act changed nothing for those incapable of ending their own lives unaided.

In the case of Debbie Purdy, she ‘officially’ asked the courts whether her husband would face prosecution and hence a possible 14-year jail sentence if he helped her travel to the now famous Dignitas clinic in Zurich. This is a fully legal institution that helps people with severe physical and terminal illness to die in relative peace and comfort, so long as they are deemed to be of “sound judgement” and fulfil the specifications and strictures required by the federal supreme court of Switzerland. As yet, no family member of the 92 Britons who have gone abroad for an assisted suicide has been prosecuted - but some have been charged and have had to wait for months before hearing the prosecution has been withdrawn.

Naturally, Purdy does not want her husband to go through such gruelling psychological and emotional torture. Indeed, her counsel argued the director of public prosecutions was “infringing on her human rights” by failing to clarify how the 1961 Suicide Act might or might not be enforced in this example. And in September 2009 the law lords finally ruled that the director of public prosecutions must issue Purdy with “guidance” - that is, she had the “right to know” if her husband would be prosecuted if he helped her to travel to Zurich to commit suicide. Accordingly, the UK government is due this spring to publish these guidelines on the law surrounding assisted suicide.

Immediately prior to Pratchett’s Dimbleby lecture, in a “pure coincidence” according to the BBC, there was an edition of its ‘flagship’ current affairs programme, Panorama, which also debated the issue of ‘assisted suicide’. The show featured a poll conducted by ComRes, which surveyed 1,010 adults by telephone between January 8-10 - with the data being “weighted” so as to be “representative demographically” of all the UK’s adults. It was discovered that 73% said yes to the question - “Should a family member or close friend be allowed by law to help them end their life without fear of prosecution?”.

Similarly, when asked if they thought a “medical professional” should be legally allowed to help patients end their lives, 74% of people replied in the affirmative. But when questioned about helping a person to die who is suffering from an “incurable and painful illness or condition from which they will not die”, then 49% opposed such an intervention.[4] Furthermore, a recent Daily Telegraph poll revealed that four out of five people believe relatives should be allowed to help terminally ill loved ones end their own lives - while three quarters of those polled by YouGov said the law should be amended to allow assisted suicide.

Clearly then, majority public opinion is firmly against the current suicide laws in this country. In fact, you can say with reasonable confidence that most people are positively for ‘assisted suicide’ - that is, support the ‘right to die’. We in the CPGB fully share this healthy, pro-human sentiment, having absolutely no moral objections or problems with suicide: with someone wanting to end their life, especially if they have been subjected to a long and cruel process of humiliating - maybe even dehumanising - physical and mental suffering.

Obviously, this is not “Nazism” - as often stupidly, and hysterically, claimed by many ‘pro-lifers’ and religious fanatics, Rather, it is a recognition that the quality of life - dignity - is just as important as its quantity, or duration. Everyone should have the greatest possible degree of conscious choice when it comes to the manner of their dying, as Terry Pratchett correctly says, just as they should have control over their own life process. Unavoidably, in some highly stressful circumstances this might mean allowing spouses and/or doctors to make that choice on their behalf - like with Terri Schiavo in Florida who was diagnosed as being in a persistent vegetative state for several years and who became a grotesque cause célèbre for the parasitical Christian right, eventually dying in 2005 after the local court ordered her to be disconnected her from the life support system.[5]

Unlike moralists like George Galloway and the catholic church, we support voluntary euthanasia, or the ‘right to die’. As our draft programme insists, “The comfort and dignity of the dying must be ensured at all times. Euthanasia and disposal of the body after death should be carried out according to the wishes of the individual” - though it should be noted that this ‘immediate demand’ appears under the ‘Pensioners and the elderly’ heading, when obviously it is a general demand, applicable to all, old or otherwise.

Communists therefore concur with the demands of Dignity in Dying, formerly the Voluntary Euthanasia Society, which are: “Our vision is for everyone to be guaranteed choice and dignity at the end of their life, to help take away the fear of the process of dying. Palliative care and medical treatment should be patient-led and include a legal right to maximum pain control, to help ease suffering. We want end-of-life decision-making to be open and honest, and firmly under the control of the patient. We want people with terminal illnesses to be able to ask for medical help to die within proper legal safeguards, to remove the conditions which give rise to unchecked euthanasia and ‘mercy killings’.”[6]

In short, communists support the right to choose when and how one’s life ends.

Notes

1. The Mirror January 27.
2. The Guardian February 2.
3. www.statutelaw.gov.uk/content.aspx?activeTextDocId=1132509
4. news.bbc.co.uk/panorama/hi/front_page/newsid_8487000/8487768.stm
5. See Weekly Worker March 31 2005.
6. www.dignityindying.org.uk