Yvonne Roberts 

Dying for guidance

Yvonne Roberts: The UK's legal stand on euthanasia is too muddy – with an ageing population, we must get off the fence and face facts
  
  


Sometimes, heroes come in the most unprepossessing of guises. Last year, Sydney Norton, 86, of New Cross, south London, smothered Betty, his wife of 57 years, while she was being treated as a patient in Lewisham Hospital.
Betty had suffered a stroke in 2000 and more recently had been diagnosed with Alzheimer's disease. Sydney had refused the help of social services – but even if he hadn't, experience says the aid given would have been chronically short of what he required.

Last week, Judge Brian Barker, commons sergeant of London, told Norton, "I am totally convinced you are a thoughtful, kind and honest man and had been a devoted husband … Society may understand this act but it cannot condone it."

Sooner or later, "society" is going to have to get its backside off the fence. Understanding but not condoning creates a state of total hypocrisy. And injustice. What if Betty had been smothered not by her husband, in his 80s, but by, say, a niece in her late 20s – out of love and concern for her aunt. Would the court have shown the same leniency?

Dignitas is a Swiss assisted suicide (euthanasia) group that helps those with incurable physical and mental illnesses to die with the aid of doctors and nurses. Swiss laws on assisted suicide hold that a person who assists in an assisted suicide can only be prosecuted if they are motivated by self-interest.

According to the charity Dignity in Dying, since Dignitas was established 10 years ago, none of the relatives of the 92 British people who have made use of the organisation have been prosecuted. Many have been questioned by the police and some have had to wait several months before their case was eventually dropped.

In theory, a person risks a prison sentence of up to 14 years for aiding or abetting a suicide. Earlier this month, 45-year-old Debbie Purdy, who has a progressive form of multiple sclerosis, launched a two-day judicial review at London's high court in an attempt to force the Crown Prosecution Service to spell out exactly what actions would lead to a friend or relative being charged under the 1961 Suicide Act. Purdy has accused the director of public prosecutions, Sir Ken Macdonald, QC, of "cowardice" for refusing to give guidance on the law. When it comes to discussions around the one aspect of life we share in common, namely the end, we all display some degree of cowardice. The mystery is – why?

In an effort to challenge this taboo, a small charity in Australia, Pilotlight, founded by British-born Jane Tewson, co-founder of Comic Relief, has published a beautifully produced booklet, Dying to Know.

Drawing on consultations with friends and relatives, palliative care workers, people with terminal illness, undertakers, philosophers and others, Dying to Know frames a conversation about the nature of living and reality of dying in a way that is engaging rather than depressing.

We need a similar publication here and a lot more besides. In the US state of Oregon, for example, assisted suicide has been legal for a decade. Only once we start talking about death realistically, can we can begin to think about it a touch more openly and rationally.

Dying to Know quotes, among others, Jean de la Fontaine: "Death never takes a wise man by surprise. He is always ready to go." Ready to go perhaps, but whether he is allowed to go is another issue altogether.

The Christian right imply that legalised euthanasia will result in a mass cull. Euthanasia is against this group's moral code and they obviously have a right to their beliefs. But that doesn't mean the choice should be denied all.

The government recently announced a 10-year End of Life Care Strategy for England. It will allow the terminally ill more choice over whether they die at home or in hospital. Medical staff will be given better training. Palliative care will be improved.

The budget, however, is infinitesimal and, more importantly, unless the context in which these discussions and negotiations take place is drastically altered, a reluctance to talk about one's exit from this world will continue – not least for fear of upsetting loved ones; yet more hypocrisy.

In June, Dignity in Dying published a charter for dignity at the end of life. Its 10 points include the opportunity to create an end of life care plan and the right for terminally ill, mentally competent adults to have an assisted death.

Has there been much debate around the issue? Barely a whisper. It's ironic that while we can come up with endless euphemisms around death (passing away, croaking, kicking the bucket, pushing up daisies etc etc) we mostly remain mum about the business of taking our final bows. And yet, often, it's the one thing that doesn't look after itself; not unless you are very, very lucky.

In the case of Norton, of course, he wasn't following his wife's wishes. He was performing what is known as a "mercy killing". And like others who have followed a similar path, he was given a suspended sentence by the court.

Those accused usually plead guilty to manslaughter on grounds of diminished responsibility. Again this a sham, since some relatives, out of love/pity/respect, have to weigh up the consequences for themselves and others very carefully before they kill. It could be the most responsible act of their lives.

My father has Alzheimer's and a couple of times now he has been brought back from the brink by the well-intentioned actions of physicians anxious to "cure" his pneumonia and numerous other infections. Why?

My dad never discussed what he would wish to happen in the event of him falling prey to a disease that reduces its victims to the condition of babies.

What I do know is that many times, as he grew older, he would say that if he lost his freedom and his independence, life wouldn't be worth living. Both are long gone, yet, still, I lack Norton's courage.

Once my memory had gone; my speech destroyed (and every person will have a different threshold), I would want to be "put to sleep", in the language of those tiptoeing around father time, out of fear that – what? He might unexpectedly strike?

However, in strange limbo that now exists in which euthanasia happens but we pretend it doesn't, by asking my children to lend me a hand, I run the risk of turning them into criminals. Some inheritance.

 

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