Under a crude and ungracious Times headline, Jason Allardyce now quotes Richard Holloway, former bishop of Edinburgh, writer and TV/radio broadcaster, who notes that keeping most people alive into their eighties is one of the ‘successes’ of modern medicine.
He reflects that doctors fight too hard to keep old people alive, leading to “a medicalised existence whose sole purpose is staying alive long after any joy in doing so has fled” and adds that it is having “a profoundly distorting effect on the balance of society as a whole”, placing a huge financial strain on the NHS.
In his new book, Waiting for the Last Bus, which is out in March, he writes: “Care of the elderly is close to swamping the resources of the National Health Service, turning it into an agency for the postponement of death rather than the enhancement of life.”
He claims that “modern medicine keeps too many people alive long after any pleasure or meaning has gone from their lives” and that old age can be bitter if experienced “not as a period of calm preparation for death but as a grim battle to keep it at bay”.
Holloway, who favours legalising assisted suicide, has found that instead of being “sentenced to years of mournful dissolution” many of them “long to be blown out like a candle”.
Assisted Dying 13: Prolonging life at all costs gives a bonanza for private health care, pharmaceutical companies and the financial services industry
“Is it a ‘success’ having thousands of elderly, immobile people in care or nursing homes, with Parkinson’s or Alzheimer’s, post-stroke or myocardial infarction; blind from macular degeneration or deaf; incontinent and catheterised, unable to tend or feed themselves but living out some form of existence? I rather doubt it from a quality of life point of view, not to mention the strain it places on health and social care resources”.
Bronwen Maddox, director of the Institute for Government and formerly an investment analyst in the City and on Wall Street, focusses on the argument that ‘we’ are about to see “the end of inheritance”, stating that the assets of the British middle-class will have to be spent on their own care in their later years.
Ms Maddox adds that some MPs are suggesting that government try to encourage people to see the equity in their homes as a resource while prompting the financial services industry to develop cheaper, more flexible products for extracting it.
Some readers commented:
- My life. My choice.
- Right to die, please.
- Those concerned about care costs eating away their inheritances – and who do not wish to be ‘cared’ for – support assisted dying. It’s a win-win solution.
- I would like the right to die when I become too incapacitated to lead the life that I want. Hopefully when I get to that stage it will be generally available as it is in some other continental countries.
Emma Duncan, editor of the 1843 magazine and former deputy editor of The Economist, wrote today in The Times: “Seeing my mother spend her final years longing for death has convinced me the law on assisted suicide must change”
“My brave mother, who could meet pretty much any challenge with her head held high, was brought low in the end. As her spirit faded, the one thing that still got her going was the law on assisted suicide. It infuriated her. She could not see why she should be kept alive, unwillingly and at great expense. She asked me several times to put a pillow over her head or take her to Dignitas, but I pointed out that I could be charged with assisting her suicide, and it would be tiresome for my children if I were jailed, so she gave up. But she never stopped complaining about the law, or sending money to Dignity in Dying, in an attempt to get it changed.
“To honour her spirit, I shall be taking up the cause she espoused
“Her case, which she continued to put cogently to the end of her days, was twofold. The first argument was about freedom of choice. Our laws are, by and large, governed by the notion that people should do what they want so long as it doesn’t hurt anybody else. My mother wanted to die, but suicide is impossible for the old and frail, though for a while she tried starving herself to death. Why, so long as she was settled in her mind — something which an application to a judge, with a lapse of time between request and confirmation, could establish — would the state not make it easy for her to do what she wanted to do?
“The second point was about cost. She thought it a horrible waste that hundreds of thousands of pounds were being spent on keeping her alive when they might have funded better education for people starting out on their lives. And it was going to get worse as society aged. “Think of the waste!” she would say. “It’s simply ghastly!”
“When I would point out that changing the law might cause some suffering, of old people bullied into suicide by greedy relatives, for instance, she countered that Switzerland and the Netherlands, with liberal regimes, report no such problems”.
Emma’s mother believed that the balance would shift heavily in favour of a law liberal enough to let even those without terminal diseases end their lives.
Emma ended: “We will be cremating my mother’s body tomorrow, but to honour her spirit I shall take up the cause that she espoused. I believe, as she did, that change will come. And the sooner it comes, the better it will be for brave people who want to take control of their death rather than be vanquished by old age”.
There have been years of positive evidence in seven countries and six American states which legalised assisted dying or euthanasia. Despite this and the support of over 80% of people polled in Britain, the BBC reports that Lord Justice Sales, Mrs Justice Whipple and Mr Justice Garnham rejected the claim of Noel Conway (left) who has motor neurone disease and wants a doctor to be allowed to prescribe a lethal dose when his health deteriorates.
He argued that when he had less than six months to live and retained the mental capacity to make the decision, he wished to be able to enlist assistance from the medical profession to bring about a “peaceful and dignified” death, saying goodbye to family and friends at the right time and in the right condition.
As Saimo Chahal QC, partner and joint head of the International law and public law & Human Rights departments of Bindmans LLP, recently wrote, the debate on legalising assisted dying has been going on for decades in the UK, though polls dating back to the 1970s show that a majority of Britons wish to decide on the time and manner of their own death.
Noel and several others have gone to court hoping to bring about a change in the law. Diane Pretty, a woman suffering from motor neurone disease, sought immunity from prosecution for her husband so he could assist her to die.
The European Court of Human Rights in 2002 found: “In an era of growing medical sophistication combined with longer life expectancies, many people are concerned that they should not be forced to linger on in old age or in states of advanced physical or mental decrepitude which conflict with strongly held ideas of self and personal identity.”
Debbie Purdy, Tony Nicklinson and Paul Lamb also took legal action. The Supreme Court in June 2014 found that their European Convention on Human Rights article 8 rights were engaged, that the court did have jurisdiction to decide Paul’s case but that parliament should have the opportunity to review the law first. Ms Chahal (right) continues:
“Now, a new case is before the High Court, that of Omid, a 54-year-old man, who was diagnosed with multiple systems atrophy in 2014, a condition that cannot be cured and affects the nervous system. He attempted suicide in 2015, failed like so many others, and was then moved to a nursing home. Even with 24-hour care and support, Omid wants to die as he feels that he has no quality of life. Omid wants to change the assisted dying law in England and Wales – a courageous and selfless act considering his condition. He wants to help others and to leave a legacy. . .
“Omid is not terminally ill but has several years to live in this deplorable condition. Previous failed attempts to change the assisted dying laws through parliament restricted access to assisted dying to terminally ill people with six months or less to live. There is no moral or legal basis for such a restriction and it would not assist Omid and many others like him who have incurable conditions.
Since 2002, 377 Britons have travelled to DIGNITAS in Switzerland to have an accompanied suicide. Many people in England and Wales consider that the law is unfair and unjust in failing to provide accompanied suicide at home.
Read the article by Saimo Chahal here.
Tom Norton from Tasmania asked this question in the Financial Times recently.
He set out the paradox: the legal position seems to be:
1-year-old Charlie Gard should be allowed to die with dignity by avoiding experimental treatment that might – had there been no legal delays – have preserved his life.
67-year-old Noel Conway (facing prolonged disability, suffering and a terrible death) should not be allowed the right to die with dignity as he asks.
A reader intends to go to the Dignitas clinic in Switzerland if the time approaches when she will no longer be physically or mentally able to look after herself. She will have to do so far earlier than needed and will do so alone, to avoid legal hassle for her family. The financial cost is minimal compared with nursing care fees and all the horrors of dependence.
Assisted dying is tried and tested in twelve countries
The fears expressed of undesirable consequence – usually by religious fundamentalists – are not borne out by the facts. Assisted dying in several forms is legal in many regions, including five American states, see full list here.
Daniel Finkelstein recently opened his article in The Times by saying: ”Noel Conway wants the right to decide when his life will end and most of us, including the disabled, agree with him”. And later:
“The question is who makes the choice. Am I — or Noel Conway — allowed to make it for myself or will the state make it for me?
“Noel Conway is seeking a simple right, to be allowed to die as he has lived, as a free man. He’s not asking to play God, or have anyone else play God. He’s just saying that he’d rather not suffer avoidable, and unnecessary, anguish as he dies.
“It’s a right — I’m sorry to put it like this, but it’s true — that we wouldn’t deny, that we do not deny, to a cat.
“He doesn’t want to die. He is not choosing to die. He is accepting that he is going to die, and asking for the option of medical help to assist with the means and timing of his death. I think it is unconscionable to say no to him”.
Around 80% support the idea of a change in the law
Most MPs believe that their constituents are quite evenly split on assisted dying. But in fact their constituents are not evenly split. There has been around 80% support for a change in the law for 30 years. Public opinion is consistent and clear and stable.
Polling by Populus showed 86% per cent of disabled people supported the assisted dying reform, broadly in line with the rest of the population (download available)
Advocates for disabled people fear that provision for assisted dying would demonstrate that we do not value disabled people and are not willing to protect the most vulnerable, but that, Finkelstein points out, is not the opinion of most disabled people – see ‘Disabled activists for dignity in dying’.
Religious principles make it impossible to contemplate allowing someone to end their life before it ends naturally.
As Finkelstein says: “That is a choice for them. I am seeking a choice for me. And for Noel Conway”.
The current ‘arbitrary and disturbing mess’ is a lottery, where a person who helps someone to die might know what they are doing, or might not – or who travels to Switzerland with a friend or family member might end up in jail or might not.
Instead of this, a ‘concrete legal and medical procedure’ is sought to permit assisted dying, with careful consideration and legally clear deliberation of the evidence of the various models working well in other countries.
As the media is reporting the case of a couple described by their son as being ‘fiercely independent’ in which the wife begged her husband to kill her, with appalling consequences, we publish the reflections of a reader whose terminally husband begged her and her son to end his life. She writes:
People in incurable pain or dependent on others to clean, dress and feed them should be given the option of a medically supervised peaceful end in the company of those who care for them – without the journey to merciful Switzerland.
Is this the way YOU want to live?
I asked a young friend who would advocate depriving people of a planned and peaceful departure – apart from a religious minority who should not decide the conduct of others with different beliefs; after a moment’s thought he replied that the vast and growing number of corporations (some listed below) setting up and running care homes and other nursing establishments would be deprived of many years’ income from the patients’ savings and property.
Will we get a more caring government which puts the welfare of human beings before that of the privatised healthcare lobby or will Britain continue to be ruled by multinational interest?
And before anyone writes in about the possible dangers it should be noted that this merciful option – assisted dying – is working well in seven countries and six American states – see https://en.wikipedia.org/wiki/Assisted_suicide#Legality_by_country.
Assisted Dying 9: Pretoria judge approves the right to die with dignity, legally exercised in some American states, Switzerland, Denmark, Holland and Belgium
Breaching the evangelical Christian consensus, former archbishop, Lord Carey, and Archbishop Emeritus Desmond Tutu have declared themselves to be in favour of assisted dying for the terminally ill and those in a situation of intractable, unbearable suffering.
In April this year, Judge Hans Fabricius of the Pretoria High Court found that terminally ill Robin Stransham-Ford (left) – who had approached the court to allow him to commit assisted suicide – had a constitutionally protected right to die with dignity. He ruled that a doctor could give the 65-year-old a lethal injection, saying:
“The medical doctor who accedes to the request of the applicant will not be acting unlawfully and therefore shall not be subject to prosecution”.
Robin Stransham-Ford (right) a member of the active Dignity SA, had lived his professional and athletic life to the full. Educated at Stonyhurst, he took a law degree at University College London, becoming a member of the Black Lawyers Association and Advocates for Transformation in South Africa. Lawyer, accountant, tax practitioner and a Chief Executive of a group of reinsurance brokers at Lloyds in the City of London, he served as a wartime commissioned army officer and completed the world’s longest triathlon from London to Paris and the world’s longest non-stop canoe race from Devizes to Westminster.
He had been suffering from prostate cancer and died of natural causes on the same day that the court granted him the right to end his life.
Will British sufferers ever have the opportunities available in some American states, Switzerland, Denmark, Holland and Belgium?
An email correspondent, with whom the writer shared support for assisted dying and Scottish independence, died today. Read her obituary in the Scotsman – avoid the grudging and mean-spirited text in the Telegraph.
The best tribute is to make sure her thoughts are kept alive. Here are a few sent by email in 2008:
In talking about the end of life, let’s start at the beginning … I don’t support euthanasia. I do support having the best-possible palliative care, whether at home, in a hospice, or any other place a terminally ill person wishes to be when life ends.
But I also support the right of terminally-ill people to end their lives should they become unbearable, and to be able to obtain assistance to do this legally. That’s why I attended the debate, initiated by the Lib Dem MSP Jeremy Purvis, on assisted suicide. I intended to show support for his persistence and to listen and learn.
A few years ago, a UK newspaper published an opinion survey showing a very high percentage of its readers to be in favour of the principles enshrined in Jeremy’s motion. Only one correspondent has expressed opposition to my stance.
The effectiveness of palliative care varies from patient to patient, and unfortunately for some, offers minimal relief. It’s amongst this group that the wish to have a choice of assisted dying is of real interest.
I’m lucky, my Parkinson’s is mild, and in the thirteen or so years since it was diagnosed, I’ve worked normally and exercised regularly. But my luck might not hold up and my condition may degenerate more severely than the present prognosis. In that circumstance, I’d like to be able to count on obtaining assistance without asking anyone to commit a crime in helping me to die.
Having a legal right is not the same as being obliged to act on that right. It’s quite possible that knowing I can legally be assisted to die, if I choose to truncate any prolonged period of severe impairment, might be enough to make the situation bearable.
The people who’ve contacted me face up to what the BMA won’t … that for some terminally ill people a dignified, peaceful end to life cannot be brought about by drugs or even the most sensitive care.
Though some form of assisted dying and/or euthanasia is legal in Belgium, Luxembourg, the Netherlands, Switzerland, Columbia, Oregon, Washington and Montana, and tragic cases in Britain continue to be reported, progress towards a more civilised Britain is appallingly slow.
Patricia Bell was the county archivist of Bedfordshire between 1968 and 1986 and edited the Bedfordshire Historical Record Society’s publications between 1977 and 1991.
The Mail reports that, after making two previous suicide attempts, Ms Bell, who was suffering ‘a great deal of pain’ from breast cancer and was diagnosed with Alzheimer’s disease in 2011, was found dead in a pond. At the inquest evidence was given that she had begun to worry that she might ‘end up in a home’.
In an official obituary published in the Guardian, Ms Bell’s close friend Richard Wildman said: ‘Her greatest fear was that she would emulate some of her cousins and live to an extreme and uncomfortable old age’.
A good servant of the state?
Was it an attempt to maintain the status quo that made deputy coroner Bob Amos record an open verdict, despite reading the letters from friends and hearing the words from her carer about her attempts to take her own life?
Parliament should take long overdue action and set aside the need of the powerful ‘health/care’ industry for clients and the Christian right’s desire to impose religious inhibitions on the majority who do not share them – then legislate for well-regulated assisted dying for those who want and need it.
Is it the government’s desire to control its citizens, the hand of religion, or the vested interest of a set of multi-million industries ‘caring’ for the terminally dependent or dying?
A memo from author Terry Pratchett in the Huffington Post, UK on the guidelines from the Director of Public Prosecutions puts a finger on the danger of a spouse or family friend assisting somebody to die, even if they clearly acted out of compassion and love.
It is the fact that when ‘amateurs’ try to help other amateurs to die, the results he has seen in his life as a journalist were often ‘traumatic to the extent of making hardened police officers vomit’.
He points out that, ‘as a society, we seem to be quite kind even to serious offenders’, but censorious of those with a ‘debilitating and unforgiving’ disease who wish to end such a life.
Is this due to the the ‘dark hand’ of ‘a religion that subconsciously regards illness as a sin requiring atonement’ as he surmises, or is it really a control issue? He ends:
“In fact, the government of the welfare state is not very happy about citizens who take total responsibility for themselves rather than hanging from the teat of the welfare state; apparently such people must be punished.”
– Or are there friendly corporate interests at stake?
To read the article click here.
Follow Sir Terry Pratchett on Twitter: www.twitter.com/terryandrob
The late Geraldine McClelland, a former producer of the BBC’s consumer affairs programme Watchdog, calls for a change to British law
Geraldine McClelland, a former producer of the BBC’s consumer affairs programme Watchdog who was suffering from the final stages of lung and liver cancer, has died at the Dignitas clinic in Switzerland, with her brother and sister at her bedside.
In a letter released hours after her death, she called for for a change to British law to allow assisted suicide for the terminally ill:
I am angry that because of the cowardice of our politicians I can’t die in the country I was born in, in my own home.”
The private health lobby figured prominently in the last Conservative party conference: health insurers, health advisers, consultants, pharmaceutical manufacturers, bankers financing them, and even specialists in ‘cosmetic anti-aging treatments’. Care organisations, whether relating to care in the home or residential establishments, are a growth industry with a vested interest in keeping clients with them, regardless of indignity and pain.
In the open letter, published in accordance with her wishes, Geraldine McClelland said: ‘I have chosen to travel abroad to die because I cannot have the death I want here in the UK . . . at home, with my family and friends around me”.
In a harrowing video on Sky News, Geraldine suggested a change in the law for those who could not afford the clinic’s fees and travel costs or who were unfit to make the journey. She said that the same procedure could be followed as that now practised when abortion was sought: the safeguard of a second medical opinion.
Critics – many of them fundamentalist Christians – have mounted well–financed campaigns instilling the fear that legalisation here would put the elderly, sick and disabled at greater risk. This, despite evidence to the contrary from Oregon, Holland and other areas where assisted dying has been legal for many years.
Though polls show up to 80% public support for assisted dying, it is a strange that a legislative body which readily allows many healthy – but inconvenient – babies to die – will not agree to give the dying a peaceful end.