Assisted Dying is a Kindness - not Cruelty

Alf Thomson was never the physically strongest of men. No Alpha Male he. He was however a brilliant man. He had a mind which worked differently from most, and a hidden intelligence which had he been given the opportunity, he could have done so much more with. He was my dad, and while we did not always get along, I respected him enormously, and loved him completely.

He did believe in a god of sorts, but he was not a Christian. He had in his life voiced that if the worst came to the worst, he would not want to linger in pain, or when his mind started to go.

That was robbed from him.

As he got older, my father was first diagnosed with Age-related Macular Degradation, which was sending him slowly blind. Then he was diagnosed with the terrible respiratory illness, COPD, and then he was diagnosed with cancer of the bladder. As he was so old and given his poor health, oncologists were unwilling to remove the tumour, as he almost certainly would have died on the operating table.

I struggled to help my dad over the next six years, as I watched this brilliant, vibrant man waste away. He wanted to stay at home to die, but this was not to be, and he eventually was hospitalised, which was probably for the best, as the care he needed was beyond my capabilities. The medication he was given caused his mind to wander, creating hallucinations and strange imaginings.

Towards the end he was more helpless than a newborn baby. Hooked up to a permanent catheter and a colostomy bag, and with his morphine maxed out, he was still in pain, and nothing could be done about that. The doctors could not give him any more morphine, as that would cause an overdose, killing him, which would have been illegal, so instead they had to leave him for nature to take it’s course. That is the perverse current situation in Scotland.

My sister and I were called into the hospital on 29 March 2009, and were told that this was his last day. Absolutely drugged out of his mind, he was breathing shallowly as he slowly drowned in the fluid from his own lungs; a noise I can only describe as like a child blowing into a bowl of soapy bubbles. We were told that he could not hear or see us, and didn’t know we were there. Yet as I held his hand and spoke softly to him, he feebly tried to grip his fingers on my hand. Oh, he knew, he knew. “Let it go, Dad,” I whispered, “Please just let go.”

When he did breathe out his last, in a long, drawn-out death rattle, his fingers eased, and I knew he was gone. And before the grief even had time to hit me, my first, overriding feeling was one of relief. At last, he was away from all that pain and suffering, and nothing and no-one could hurt him any more.

I said to my sister, “Whatever happens to me, I can promise you this now, I will never die like that.” To this day, I stand by those words, and if anything, my resolve today is greater than it has ever been.

Many people say that we treat animals better than we do human beings where end of life care is concerned. This is true, but few realise just how true it is. An animal which is suffering knows only the pain of that moment. They cannot understand it, and just want it to end. That is why it truly is kinder to end their life. Yet we, being sapient creatures, are capable of informing ourselves about whichever illness we may have. We can learn what may lie ahead for us, and the prognosis of what further pain and suffering we may face. This can and does cause the mind to dream up all sorts of dark thoughts of what may come. To subject any human being to that sort of horror, and pretend that we are being kind to them, is not merely terrorising them, it is utter hypocrisy, and the most abject, masochistic cruelty.

Some who object to Assisted Dying claim that the terminally ill can be treated with palliative care. This is true, and I would never try to take anything away the extremely kind medical professionals who administer palliative care, or the science behind it. But those same professionals, and the scientists concerned would be first to inform them that palliative care has it’s limits. It is not some great panacea which sees every patient comfortably and painlessly through the end of their life, as my own father is testimony to. There comes a time with some patients that no more palliative care can be administered, and the doctors hands are effectively tied by the law. If they don’t relieve suffering, they are condemning the patient to a painful, lingering death. If they do relieve suffering, they risk being charged with and tried for homicide. And of course, should that happen, no matter how professional they may be, how many patients they may have comforted at end of life, even if they are acquitted due to the circumstances, that is the end of their medical career. A ban on AD is not just unethical towards patients, it is unethical towards medical staff.

Those who use the palliative care line are obviously pitifully uninformed about the limits to it, and the circumstances of those patients who have reached the limit of it’s effectiveness. I used to say that I wish they too could witness a loved one drowning in the fluid from their own lungs, but in retrospect I never meant that, and would not wish that upon them. No-one should have to witness anyone suffer such a horrifying death, far less someone they love dearly. But as with so many other aspects of science, the detractors desperately need to inform themselves upon the science, because they patently do not know what they are talking about. I do not mean that to come across in any way unkind; I am merely stating a fact. Whenever I am faced with a topic I am uninformed upon, I prefer not to give any opinion until I am informed upon it. I only wish more would do likewise.

Some detractors will point to the dangers of the terminally ill, or even just the elderly, being killed through collusion from relatives who consider them a burden, or from those who would gain financially. In fact, there have been very, very few instances of this ever happening in places where AD is already in law. And in the instances where it has happened, the detractors miss a point; when they point to actual cases of this happening, the only reason they are able to do so is because the perpetrators have been caught, and are facing the full penalty of law for their actions. Murder is murder, and legalised AD does not change that. In fact, the rate of offences where AD is abused where it is legal is not higher than other homicides by doctors or in medical facilities. English doctor Harold Shipman sweet-talked 15 old ladies into changing their wills in his favour, and then killed them. He did not need legalised AD to do so.

Some may try to claim that legalised AD could exacerbate this. The first response I would give to this would be to provide proof for that claim. The second thing I would say is that this underlines why AD should only ever pertain to someone who is in the fullness of their mental capabilities, and have made it clear that they and they alone wish to end their life before they lose full capability. My third point would be that most terminally ill people do not die at home, but rather usually in hospitals, where with many witnesses, the chances of any collusion or wrongdoing is minimal.

Some will point to cases where children have been euthanised with parental consent. Where this has indeed happened, the quality of life of the children concerned was completely gone, and to leave them to continue to live would have been to subject them to unnecessary pain and suffering. Parents do hold the responsibility of consent for medical procedures upon children, and in the few cases concerned where they have had to take the terrible decision to end their child’s life, it has always been the right thing to do. I would ask those detractors to think less on a child whose life was not viable, and a lot more upon the parents who were faced with having to take that decision. To listen to some of these detractors, you’d think that the parents were callous murderers who thought nothing for the lives of their children, when in fact it must have been an utterly heartbreaking thing to do, which no doubt destroyed them, but they did nonetheless, because they loved their children, and wanted nothing more than to take them away from pain and suffering.

I actually once took issue with someone who proposed that the elderly and terminally ill should consider euthanasia, to prevent being a “burden upon their families and upon the state”. The person in question was Baroness Warnock, a Conservative Party Peer, who proposed this stating “If you are demented, you are wasting people's lives, your family's lives, and you are wasting the resources of the National Health Service.” Of course, what Baroness Warnock failed to realise is that the elderly with dementia would not be offered AD, on the grounds that they are not in full possession of their mental capabilities. Warnock’s words led to one of the very few instances where those pro-AD and anti-AD were united; both sides were equally horrified by her words. She was 82 years old at the time, and as a member of the House of Lords, drew her salary from the public purse. Given such, I sent her a message pointing out that as she was elderly, and effectively a burden upon the taxpayer, that she lead by example. Given that she lived on another 8 years, I am assuming she did not.

Some will say that AD is “playing God”. I could not agree more. Medical science does play God. It does so all the time, and has done ever since our early ancestors discovered that a particular herb settled the stomach, that a kind of tree bark alleviated headaches, and that rubbing mouldy bread on a wound prevented infection (ancient Greek horse riders used to do this – Fleming actually rediscovered the properties of penicillin). The greatest irony of course is that we nowadays enjoy relatively long and healthy lives precisely because medical science does play God, and the vast majority would not have it any day. It is utter hypocrisy that the opponents to AD complain about medical science “playing God”, yet they are the exact same people who try to stop people being taken off life support, or indeed, being administered palliative care, which is in itself, “playing God”.

Some detractors will try to point to the infamous “Hippocratic Oath”, and will quote, “First, do no harm”. Except for one little fact; “First, do no harm” does not appear in the Hippocratic Oath. It is in fact in another work by Hippocrates, “Of the Epidemics”. But even then, if the Hippocratic Oath were taken literally, then all medicine would come to a standstill. The Hippocratic Oath states, “Neither will I administer a poison to anybody when asked to do so”, so there goes the administration of most modern medicines out right away. The Hippocratic Oath also states, “I will not cut, even for the stone”. This in fact means not to cut for the kidney or liver. So there goes a great deal of surgery out as well. The Hippocratic Oath is in fact not sworn by most medical professionals, because it is unworkable with modern medical science. Most in fact swear modern oaths written up by whichever university they graduate from. Given such, there is nothing to prevent those oaths being rewritten to take account for AD.

However, if we were to take, “First, do not harm” literally, then we have to ask ourselves just what we mean by “harm”. Is not leaving someone in pain harming them? Is not prolonging suffering inflicting harm? Even if we consider the mental effects of a terminal illness, as I pointed out above, to subject anyone to that terror is indeed harmful. Many detractors merely think of physical aspects alone, but never the psychological ones. But they are nonetheless harming the individual. I know that many of those who oppose AD do so for religious grounds, and there are many of those who are Roman Catholics. I would point them to the doctrine of the “Sin of Omission”; if you are in a position to do something for someone, but fail to do so with the result they are harmed, that is still sinning against them. I would venture that likewise to leave someone to die a needlessly painful death is indeed inflicting harm upon them. It is effectively a “Sin of Omission”.

And I believe there is an important point here. The Bill about to be submitted to the Scottish Parliament covers the terminally ill, with full mental capacity, alongside palliative care. I am more than happy to support that, but it could be strongly argued that does not go far enough, and that when someone is suffering psychological terror, with no hope of alleviating that, then they too should have the right to a painless and dignified death. I will point to the case of Nathan Verhelst.

Belgian Nathan Verhelst was assigned female at birth, and given the name Nancy. However, he always identified as male, and once adult, came out as transgender and took the name Nathan. Having lived as a man for many years, Nathan decided to undergo transition surgery. Firstly, his double mastectomy was botched, leaving his chest horribly scarred. Then his body rejected the penis which had been formed, and it had to be removed. Suffering terrible depression, Nathan was told that nothing more could be done. Being faced with a life of being biologically neither male nor female, Nathan decided that death held less terrors, and in 2013 opted for Assisted Suicide. He was 44 years old.

Many have said that Nathan Verhelst should have been offered better psychological care and counselling. My reply to that is just what psychoanalyst could sympathise, or even empathise, with his plight? How many biologically ‘androgynous’ psychiatrists are there in Belgium, or even the world, who could have helped him? There are none. In the end, it was Nathan’s body, and Nathan’s life, and whatever he did with them was his decision to take, no-one else’s, and that is something we should all respect.

Which neatly brings me on to my next, extremely important point over AD. By refusing us a dignified and painless death, just what is the state saying? They are saying that they effectively own our lives. If this were any other medical procedure, where the government intervened to say that you cannot have it, because their laws say no, there would be a bloody uproar – and quite rightly so. Yet when it comes to a dignified, painless death, suddenly we are the property of the state. And worse still, the laws which prevent AD are based on rules laid down by the Christian religion. I am an atheist. I don’t believe in the Judeo/Christian/Muslim God, I don’t believe in any gods. Yet if I were unfortunate to develop or contract a terminal illness, suddenly the state would be telling me what I can and cannot do with my life, based on their Bible. Well, sorry (not sorry), my life is just that; mine. It is not the property of the state, and far, far less of any church.

The refusal to legalise AD is effectively enforcing religion upon those who may not adhere to those beliefs. That alone is just crying out for wholly secular laws and government.

All life is not sacred. Certainly it is better to live, and we should always do our utmost to uphold the right to life, and to strive to make life better for every individual. However, when quality of life is gone, when there is nothing left but pain and suffering, then that life itself has already gone, and to prolong it is not a kindness, it is cruelty. I do not seek to legalise AD because I am some sadistic, callous killer with no regard for life, but quite the contrary, because I am a kind, compassionate person, who wishes nothing but kindness upon my fellow human beings, and one who respects their wishes to live and do with their lives as they see fit.

20 Years After 9/11 The Wind Of Change Blows Still

On 20 January 1991, the US rock band The Scorpions released their song, "Wind of Change". Following the dismal and depressing 1980s, when many of us thought that a nuclear war was a certainty, it was a powerful song. It was an anthem for the time and for a generation. The Berlin Wall had fallen, and just as the countries of eastern Europe had fallen to Soviet totalitarianism, so communism fell in those countries in a domino effect as the people demanded freedom, until even the Soviet regime in Russia fell. All across the world oppressive regimes were falling one by one, and there truly was a wind of change. US President George H Bush would declare there was a "new world order" (which conspiracy theories would later feed into), and that nuclear weapons would be "weapons of last resort" (which worried me greatly, as I had been given to understand that was always the case).

Even the Balkan Wars, started through the fall and partition of the communist state of Yugoslavia, could not keep going.  In defiance of Croatian neo-fascists, the Bosnian city of Sarajevo carried out a beauty contest, in which all the contestants unfurled a banner as a message to the world; "Don't Let Them Kill Us". The fascists fell, war criminals were prosecuted, Croatia, Bosnia-Herzegovina, and the other Balkan states became modern, democratic states.

The wind of change was indeed blowing everywhere, and you really could "feel it in the air".  As we entered a new millennium, the world was full of hope for a new era; an age of peace, of global justice, of tolerance, and understanding.

Then on 11 September 2001, it all came crashing down.  Crashing down along with the twin towers of the World Trade Center.  Crashing down with one wall of the Pentagon.  Crashing down with United Flight 93, rammed into the ground near Stoyston, Pennsylvania, as US citizens on board decided to fight back against the hijackers.

The terrorist attacks of 9/11 left me stunned for several days.  I recall my boss asking me to get on the internet to see what was happening, and telling him I couldn't as none of the news sites were coming up (due to too many people trying to access them), and me chillingly saying, "They're all dead".

As the news started to trickle out over the next few days, it was still not clear how many people had been killed, with some sources claiming as many as 10,000 may have lost their lives.  This would later eventually be scaled down to 2,977.  I sat down and wrote a letter to The Scotsman newspaper, in which I stated that I wondered if it had all been a bad dream, or memories of a movie that I watched, refusing to believe that it was real.  But no, this was all too real.  An Islamist extremist group, Al Qaeda, had carried out the attacks on the orders of their leader, Osama Bin Laden.

What was to follow in the wake of the 9/11 attacks were curtails on civil liberties, many of which people in their fear actually supported.  The Patriot Act in the USA passed almost without opposition.  Places once freely open suddenly had security barriers.  I well remember that ScotRail only a few years earlier had done away with ticket barriers and fencing in their stations.  Suddenly there were new ticket barriers and even more fencing than ever before.  In a knee-jerk reaction, litter bins were removed from stations to prevent bombs being planted in them; even at Falls of Cruachan Halt, population, zero.

Seeking retribution, the USA first targeted Afghanistan, where Al Qaeda and Osama Bin Laden were believed to be based, then more controversially and without a shred of evidence, Iraq was targeted, with claims of the Ba'ath regime under Saddam Hussein holding weapons of mass destruction, and Al Qaeda training camps; despite the fact that Al Qaeda despised Saddam Hussein and had tried to assassinate him on no fewer than three occasions.  As US President George W Bush decided to attack Iraq, UK Prime Minister Tony Blair decided to go in with the USA, thereby making the war in Iraq being his everlasting legacy, instead of the political reforms he introduced.

Among the public attitudes also changed.  There was open hatred of Muslims.  But not only Muslims, but anyone perceived to be a Muslim, including turban-wearing Sikhs, and even anyone who happened to be Asian.  An Asian shopkeeper near my work was the victim of a racist attack fuelled by the frenzy stirred up by governments and the media.  His shop was trashed and he was beaten up by thugs calling him "Osama".  This poor man is in fact of Goan descent, and as such is actually a Christian.

As the wars in Afghanistan and Iraq continued, the public by and large accepted some terrible acts, including 'rendition', which was no more than a pseudonym for torture, and also men captured flown to Guantanamo Bay, the US base in Cuba, where they were held without charge, without trial, and without legal representation, completely against international law, as well as the very basis of justice upon which western civilisation is built.  Stories started to leak out of Guantanamo Bay, including those of inmates being tortured, and their copies of the Qur'an being torn up, flushed down toilets, or burned.  The Qur'an is absolutely sacred to Muslims, and all these acts did was to fuel further Islamist outrage throughout the world.

In 2005, the G5 Summit took place at Gleneagles, Scotland.  Fearing terrorist attacks, hundreds of police officers were drafted to north of the border, including from London's Metropolitan Police.  But instead of attacking Edinburgh or Glasgow, the terrorists waited until London had let her guard down, and on 7 July that year, the English capital was rocked by suicide bombings on a bus and on tube trains.

All through these and other terrorist attacks, the tit-for-tat hatred continued.  Every terrorist attack was met with retribution from the USA and the UK in Afghanistan and Iraq, with some reportedly having Bible verses inscribed on their guns, and Islamist sympathisers would carry out further attacks in the west. 

In turn, a backlash to the hatred of Muslims would also prove counterproductive, as many ended up finding themselves scared to speak out against wrongdoings, in case they were considered 'racist' or 'Islamophobic'.  This was particularly true in Rotherham, England, where civil services were aware of a paedophile ring, but did not report the men involved, as most of them were Muslims.

Twenty years on from 9/11, I am saddened to a great deal that the hopes for the future were dashed, and the world was changed not the better, but very much for the worse.

I stated in my 2001 letter to The Scotsman that the 9/11 attacks, and no other terrorist attack, would ever make me hate Muslims, because, "The moment we start hating, the terrorists have won.  Division is what they seek, and giving ourselves open to hate is handing victory to them on a plate."  Twenty years later I stand by that.  I have no great love for Islam, and actually find it to be a repressive ideology.  But then, I could say equally as much for Christianity, or many other faiths.  Likewise, I deeply dislike the term, "Islamophobia".  In a quote often misattributed to Christopher Hitchens, journalist Andrew Cummings once described Islamophobia as "a word created by fascists, and used by cowards, to manipulate morons".  I'm no right-winger, but I think that Cummings pretty much hit the nail on the head.  I do not hate the bloke who runs my local grocers because he's a Muslim; I hate him because he's an uppity, arrogant dick.  His parents, also Muslim, are in fact lovely people, and how he could ever have sprung from their loins is beyond me.

I intensely dislike Islam because of the fanaticism it invokes, because of it's oppression of women, because of it's hatred of LGBT+ people, and because it suppresses freedom of speech and expression.  I equally dislike fundamentalist Christianity for exactly the same reasons.  I write this at a time when the state of Texas has instituted Christian-based anti-abortion laws which the Taliban may be envious of, and that US President Joe Biden appears to be powerless to stop that, or won't stop it, in what is constitutionally a secular country is absolutely despicable.

Despite Europe being the tinderkeg of the world for 2000 years up to 1945, only for that title to move to the Middle East, I am not for one moment saying get rid of religion and you get rid of war and atrocities.  That is far too simplistic, and if it were not religion, then the tyrants of this world would have found, and would easily find, other excuses; Adolf Hitler and Saddam Hussein only paid lip-service to their respective faiths for populist reasons.

But at the same time, if the past 20 years since 9/11 are to mean anything, then we must be free to criticise the more fundamentalist interpretations of religion, and other ideologies.  If the fall of Afghanistan to the Taliban proves anything, it is that the 'War on Terror' has already been lost.

Criticising religion, be that Islam, Christianity, or whatever, is not hatred.  And equally, tacit respect of and accommodation of religions is not capitulating.  I don't always agree with journalist Maajid Nawaz, but I do like his tenet, "No idea is above scrutiny.  No people are beneath dignity."

If we want a "world closing in, where we could be as close as brothers", then that can only come about through mutual respect and mutual understanding.  But that must come from all sides.  The west accommodating fundamentalist Islamism does not do that.  Neither do tit-for-tat atrocities on both sides.

The Berlin Wall and Soviet communism did not fall through force.  They started with one young woman demanding to pass through the Brandenburg Gate one night in 1989.  She set off a domino effect which saw what was effectively an entire empire fall.

And that is why 20 years after 9/11 I am not without hope for the future, and that future does indeed belong to today's children and young people, and the generations yet to come.  If we keep them in mind, and keep talking, then you can truly...

"Take me, to the magic of the moment
on a glory night,
where the children of tomorrow dream away,
in the wind of change."