OUR Lives - OUR Deaths

Alf Thomson, 20 August 1926 ~ 28 March 2009

We are not the property of church or state.

I am writing this on 28 March 2019, the 10^th anniversary of my father’s death.  An experience which had a profound effect upon me and which is burned into my memory for the rest of my life.

My dad had both cancer of the bladder and Chronic Obstructive Pulmonary Disease.  The steady deteriation in his health over six years, and his death were anything but dignified, and whilst he never said that he wanted to end it all, he had previously in his life said he would never want to linger, and had he known what lay ahead, I am certain it is not a death he would ever have wanted to face.  Dad was never a very athletic man in his later years, but he was blessed with a hugely inventive intelligence.  To this day I am finding things he built, which show a marked genius and which few, myself included, would ever have thought of.  At the end, he was less helpless than a newborn baby.

My sister and I were called to get to the hospital as quickly as possible on 28 March 2009, as our father was sinking, and was not expected to see the day out.  When I arrived, my sister was already there.  Dad was apparently unconscious, his breathing laboured, as the fluid from his own lungs was slowly drowning him.  I took his hand, and although we were told he didn’t know we were there, his fingers feebly tried to tighten on my hand.  For what seemed like an age, we stood by his bedside.  I shall never get the sound out of my head for long as I live.  A gurgling, bubbling sound, for all the world like a child blowing into a bowl of soapy bubbles.  There was a pained look on his face, and he was obviously struggling for breath.  He was given an injection to ease his breathing, which made things a little easier for him.  His breathing shallowed, and his death rattle was more like a sigh.  He was gone.

Amidst my grief, the overwhelming emotion that filled me was relief.  It was over, and nothing and nobody could ever hurt my dad again.  One of the first things I said to my sister was “Whatever happens to me, I will never die like that.”  To this day I stand by those words.  If I am ever in a situation where there is no hope, and things will only get worse, I shall take matters into my own hands before I lose my dignity and independence, even if I have to do it myself.

What does the law say when it says that we cannot choose to end our lives if we feel that it is the only option?  It is effectively saying that our lives are not our own.  That somehow our bodies, our minds, our very existence – our souls if you choose – are not ours; they are the property of the state.  The state is telling us that they own us, and they are doing based on archaic ideas and laws, many of which are religious-based, which have no relevance in an increasingly secular state, where most count themselves as “not religious” at the least, which do not reflect modern medical science, and which are unfit for purpose in the 21^st century.

UK laws surrounding killing are solidly based in Biblical theology, and the Sixth Commandment, “Thou shalt not kill.” in particular.  But what does the Sixth Commandment say?  It is effectively saying “You will not commit murder.” or literally translated, “You shall not kill unlawfully.”  That’s fair enough, but where does the distinction between ‘lawful’ and ‘unlawful’ killing fall?  For the record, as a pacifist, I make no such distinction between murder and war.  As far as I am concerned war, whilst sometimes unavoidable, is never just and is merely murder on a mass scale, which society paints as heroic to justify it.   And contrary to what many think, suicide by one’s own hands is no longer an offence in the UK.  It has not been illegal in England and Wales since 3 August 1961, when the Suicide Act 1961 ruled “The rule of law whereby it is a crime for a person to commit suicide is hereby abrogated.”  And in Scotland?  Well, actually in Scots Law it has never been an offence to commit suicide.

There may be some who will quote the Hippocratic Oath, stating “First do no harm.”  Well, bad news for them.  “First do no harm.” does not appear in the Hippocratic Oath, but rather comes from another work by Hippocrates, Of the Epidemics.  Certainly, the Hippocratic Oath does state “I will follow that system of regimen which, according to my ability and judgement, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous.”  This is the key paragraph that is the oath equivalent of “First do no harm.” and would seem to rule out any support for assisted dying (AD).  However, one has to consider what is and is not “deleterious” and what is indeed “for the benefit” of patients.  Besides all which, the Hippocratic Oath in its purest form is an anachronism that is simply unworkable in modern medicine.  One line states, “Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course”.  Well, there goes most drugs out of the window immediately.  The Oath forbids abortion, yet it is practiced.  And another clincher is the line “I will not use the knife”, which if the Oath were treated as sacrosanct as some claim it is, there would be no surgeons, and not one operation would ever be carried out.  Indeed, if the Hippocratic Oath were taken to it’s logical conclusion, then your doctor could not as much as lance a boil on your bum.

I am not suggesting that anyone in the medical profession should never seek to do no harm.  People go into medicine because they care about others, none would ever seek to purposely harm another, and for that and the work they do, they have my enormous and undying respect.  However, to do no harm, ever, in medicine is simply not possible.  Some treatments are in fact very harmful in their nature, despite the end result being beneficial to the patient.  Chemotherapy, which destroys healthy cells as well as cancerous ones, is a prime example of such.

Therefore we see that however well intentioned, the Hippocratic Oath is simply unworkable and anachronistic in the modern age.  As every bit as so as the Bronze Age books written by men (and I do mean men – people with penises) who were trying to make sense of the world around them, and who had zero in the way of scientific knowledge.

The entire issue comes down to the question of the quality of life, and that is different for every individual.  There is only one person who is the expert upon the quality of any given life, and that is the individual concerned, nobody else.

When there is no hope left, when the individual only faces further pain and torment, when they are going to lose all dignity, then there is no more quality of life, and it thereby ceases to be “sacred”.  Under such circumstances it should be the right of the individual to make the decision when to end that life, and there should be provision within healthcare to assist in those wishes.

When the question of terminal diseases and assisted dying comes up, many say that we would not allow an animal to suffer in such a way, and ask so why should we allow it in a human being.  This is a fundamental truth, but I do not think many realise the full enormity of that observation.  When an animal is suffering and in pain, it does not understand what is happening or why.  It is confused and knows only the pain of that moment, and wants it to stop.  Human beings however are sapient creatures.  When we are diagnosed with an illness or condition, we are informed of the facts of such, given a prognosis, and as it progresses, we have the foresight to know what is yet to come, and if it is terminal, that it can only get worse, with more pain.  To subject any human being already suffering to that form of terror is cruelty of the highest order, and to refuse them the option to avoid that is the most abject hypocrisy.

And the mind is an important point here.  When people speak of assisted dying, they immediately think of terminal diseases of the body.  Yet there may be an argument that mental torment may be grounds for assisted dying, and indeed, there is a precedent for this.  Nathan Verhelst was a Belgian transgender man who was assigned female at birth, but who identified as male from an early age.  Due to familial and societal pressures, Nathan never came out until he was in his 30s, and after living as a man for a number of years, finally underwent gender reassignment surgery in his 40s.  However, the surgery went terribly wrong.  First his double mastectomy was horribly botched, leaving him with terrible scars, and then his body rejected his newly formed penis, which had to be removed.  The doctors informed him that nothing more could be done, so faced with living the remainder of his life, which could be up to 40 years, as neither biologically male nor female, Nathan instead decided that death held less horrors, and opted for assisted dying.  He passed away by lethal injection on 1 October 2013. aged 44.

The case of Nathan Verhelst is tragic, and unbelievably sad.  Some have said that he should have been given more psychiatric therapy.  He was already in therapy, and just how could any therapist empathise with Nathan’s circumstances?   Are there any therapists, anywhere in the world, similarly “neutered”?  Who are faced with a life of being neither male nor female?  The facts are that the grounds for Nathan Verhelst’s euthanasia were that he was suffering “unbearable psychological suffering” and it was under those grounds that the Belgian courts allowed his assisted dying.  And the important point here is that in the end it was Nathan’s decision.  His body, his life; he chose to retain his dignity and do with that body and life as he saw fit.

The entire question of where the mind comes into assisted dying must therefore be taken into account.  It beggars belief that in this day and age we still seem to consider mental conditions to somehow be considered to be of lesser importance to physical ailments.  I once heard a psychologist being interviewed who summed it up; that the brain is an organ, every bit as important as any other organ in the body.  Therefore, when the mind is injured or impaired, then that effectively is a physical injury.  I would actually go further, and suggests that as our minds are what make us, then any impairment or injury to the mind is more important than a physical injury.  After all, most of us could live with losing a limb, but it is the mind alone that would make us realise that limb was missing.  Likewise, the very question about AD is one of dignity, yet dignity is purely a mental construct, and one which is unique to every individual’s perception of such.  Therefore psychological issues must be given as much credence for grounds for assisted dying as physical ones.

There are many who object to assisted dying on various grounds.  There are those of religious persuasions who will be quick to cry out that “All life is sacred”, and that it is a “gift from God”.  Well, sorry (not sorry) but as I have pointed out above, when quality of life is gone, that life ceases to be ‘sacred’.  And as to their god, an increasing number of people in the UK do not even believe in that god, by seeking to maintain the law, they are imposing their beliefs upon others, which happens to be against both the UN Convention on Human Rights and the European Convention on Human Rights, as well as completely against basic human dignity.  To put it bluntly, if you believe in a god, then as happy as you are in that, it is not your place to enforce those beliefs upon others who do not share nor have any interest in them, and what others do with their lives is none of your damned business.

There are some will claim, and the God squad are infamous for this, that dying can be dealt with by increased palliative care.  They could not be more wrong, and anyone who claims this has obviously never witnessed someone at the limits of palliative care.  I know it to be wrong, because I have witnessed it with my own eyes.  While my dad was given something to ease his breathing, which worked, no further medication could be given.  Besides which, prolonging palliative care only means prolonging the suffering of the patient.  So much for “First do no harm.”  And here comes the perverse part; when a patient has reached the limits of palliative care, doctors cannot and may not administer any more medication – in cases it kills the patient.

There are some who claim that assisted dying could lead to a “slippery slope”, whereby more and more people are euthanised for the slightest of reasons, or coerced into choosing AD.  The anti-AD proponents often point to the Netherlands, where it is legal for parents to opt for AD for children.  However, this does not take into account the facts that in those cases the children are in extreme suffering and can only be allowed to die if parents and medical professionals agree that is the best course of action.  The opponents of AD citing the Netherlands may as well campaign for no child to have a “DNR” notice on their file, or for parents to have the right to switch life support machines off.

Then there is the “killing granny” argument that many come up with, that the elderly may be coerced into opting for assisted dying, to prevent them becoming a ‘burden’ upon their family.  Throughout this article, I have continually emphasised that only the individual is the expert upon their life, and has any right what to do with it.  This is the line which most proponents of AD take; that it is a decision that should not be taken lightly, and must be taken only if one is of sound mind.  I would suggest that any elderly person who can be coerced into AD is definitely not “of sound mind”.  And actually, the only instance I have ever seen of anyone suggesting that the elderly and infirm should kill themselves was from Baroness Warnock.  Baroness Warnock is a Peer (member of the House of Lords in the UK parliament) from the Conservative Party; the very party which claims to be “Christian”, and stand steadfastly against AD.  In 2013, Warnock suggested that elderly and infirm people should consider AD, to prevent them becoming a burden upon their families and society – her ‘complaint’ being that they survived on government benefits.  Baroness Warnock was 90 years old at the time, and I sent her a Tweet suggesting that as her income comes from the taxpayer, perhaps she should lead by example.

If properly regulated, with extremely stiff penalties for abuse, there is no reason why a system of assisted dying could not work in the UK.  Would it be abused?  The evidence of such happening in countries that allow AD is flimsy at best, and non-existent in some countries.  But then, anything can be abused.  We allow people to drink alcohol and eat unhealthy foods, that doesn’t mean people are not going to kill themselves by them. 

On 21 March 2019 the Royal College of Physicians dropped its long-term opposition to assisted dying, with the president stating that the college “neither supports nor opposes a change in the law”.  It’s a small step, but it is an important one as it is the first step towards AD in the UK, which the majority of people polled support.

It particularly angers me that the late, great Margo MacDonald, a Member of the Scottish Parliament who suffered from Parkinson’s Disease, twice put Bills on assisted dying before the devolved parliament, and both occasions the parliament threw her motions out, without even debating them.  Margo, one of the best-known, and best-loved stateswomen in Scottish politics, died without her proposals ever even being discussed.  Most polls have placed public support for AD in Scotland to be around 65% in favour, while one in particular returned 75% in favour.  That’s three quarters of the electorate.  In Scotland there is a 700-year-old principle that sovereignty rests solely with the people; not parliament, nor the crown.  This is one area where I am both disappointed in and angry at the Scottish National Party administration for failing the people and ignoring their sovereign rights.

Do not get me wrong.  Life is precious, I enjoy it enormously, always have done, and I have absolutely no wish to shuffle off this mortal coil just yet.  However, I have always been of the view that death holds no horrors.  I actually don’t think that most people are afraid of death, but more of the fashion in which they die.  As the years advance, I increasingly frightened of becoming feeble, helpless, of losing my independence – of losing whom I ‘am’.  That prospect absolutely terrifies me.  Therefore, I would make it clear right here and now that should the worst come to the worst, I and I alone should have the right over what becomes of my life and what to do with it, and should I choose to end it, then there should be the resources in place to do that, at the hands of medical professionals, who are best placed to end life peacefully and painlessly.

Am I angry?  You bet I’m angry.  I am angry, even 10 years later, at what the state did to a man I loved dearly.  How it made my dad suffer.  How it robbed him off all dignity.  How it assumed ownership of his very person and continued to harm him long after that suffering should have ended.  For that I cannot, and I shall not, ever forgive them.  Even if I were offered an apology, I still wouldn’t forgive them.  I simply can’t.

Our lives are just that; ours.  They are not the property of the state, far less of the Christian churches, or of any other religious belief for that matter.  As such, it should the right of every single individual ultimately what to do with their life.

To argue any otherwise is to deny our own personal independence - our very existence, who we are - itself.