Tuesday, June 14, 2011

Choice in dying

There was a documentary by Terry Pratchett last night about assisted dying. You might still be able to see it on iPlayer if you’re quick.  It’s a topic of some concern for him because he was diagnosed in 2007 with early onset Alzheimer’s disease. He wants to be able to die when he’s ready, in peace, without having to worry about those he’ll be leaving behind. He’s famously said he wants to die while sitting in a chair on his lawn in the sunshine with a glass of brandy in his hand and Thomas Tallis on his iPod.

Pratchett and his assistant went to Switzerland to visit the Dignitas clinic to find out about how they operate. The guy in charge showed them round the apartment where the dying takes place and described the procedure: you’re met by two people – not doctors – who ask you many times at each stage if you’re sure you want to go ahead.  If you are, you first drink something to prepare your stomach, then – if you’re still sure – you drink the poison, quite quickly go to sleep and then stop breathing.

Pratchett then attended the death of a motor-neurone disease sufferer, Peter. Peter was perfectly clear about his desire to die now, while he could.  He’d obviously made his mind up and understood his options. He’d discussed it with his wife – who was there with him – and although they disagreed on the timing (she wanted him to wait a bit), she’d accepted it as his decision and was obviously as well-prepared as she could be under the circumstances. Peter very calmly and not at all mournfully took the poison and died.  It was very moving: sad, obviously, but there was a very strong sense that this is what Peter wanted and in the end he got it. As he was dying, he thanked Pratchett and the film crew: it was all very British.

The striking thing about the documentary was that Pratchett and his assistant were clearly struggling to decide what to think about the whole business.  They were quiet, sad and rather shocked at what was happening.  They seemed to show some distaste about the location (a rather garish flat on an industrial estate, sometimes with two families occupying it at once) but Pratchett in particular praised how the assisted suicide was carried out.

Pratchett’s case highlighted the problem with the Dignitas approach (which I’m sure is the only approach it can take).  The organisation made it clear that if Pratchett wanted to die now, while mostly in control of his faculties, that would be OK, but if he were to leave it much later when his mind had largely gone, they wouldn’t be able to help him. They’d have to be sure it’s what he wanted at the time and as his illness progresses, there’ll be a point at which they could no longer be sure.  So if Pratchett wants to die at Dignitas, he’ll have to do it earlier than he might otherwise have wished.  Assisted suicide is about controlling your own death and with some illnesses, this choice is at best limited, even in Switzerland. 

There was a Newsnight programme immediately afterwards, but I couldn’t bear to watch it.  From what I’ve heard, this was a good decision. There’s a description here including some bizarrely edited video of Jeremy Paxman interviewing Pratchett.  It was Paxman I wanted to avoid. The documentary was very sensitive, plainly striving for the dignity those people featured desired. I’ve little doubt that Paxman did his usual in fixating on some  footling aspect of a turn of phrase with lurid glee and at blaring volume.  I didn’t want to see that.  Naturally, there was a Bishop there.  Just what we need:

The Bishop of Exeter, the Right Reverend Michael Langrish, said: "I want to see much more emphasis put on supporting people in living, than assisting them in dying."

If there’s one thing we can actually be certain we own, it’s our own lives. But Bishops, of course, will tell you that we don’t even own that.  They’ll tell us what we’re allowed to do with them when we’re alive and won’t let us give them up if we want to.  Of course we want to see more emphasis placed on supporting people in living, that was never the argument and nobody is saying otherwise. Plainly the Bishop was using a banal rhetorical ploy to deflect attention from the fact that he’s advocating the suffering of others to preserve his personal ideals, which he got from a book. Sadly – very, tragically, sadly – he gets to impose his views on countless others and influence the law just because.

There was also some shameful hyperbole:

But Alistair Thompson, a spokesman for the Care Not Killing Alliance pressure group, said: "This is pro-assisted suicide propaganda loosely dressed up as a documentary."

It was hardly propaganda. It was very sad and didn’t hide any of the realities of assisted dying.  As I said, Pratchett, despite being in favour of assisted dying, is clearly somewhat disturbed and doesn’t quite know what to think about what has happened. This isn’t exactly the way propaganda is done.

Mr Thompson said: "The evidence is that the more you portray this, the more suicides you will have.

Well, perhaps, although I’d want to see some impressive evidence before I accepted that claim. But it begs the question anyway: it assumes that suicide is automatically bad.  So I guess it’s just more of the usual: thoughtful, moving documentary, stupid, knee-jerk reactions, with clergy stoking the fire.

For more about assisted dying and other topics, see Choice in Dying.

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