The right to die

If you’ve seen the screen adaptation of P.D. James’ Children of Men, the dystopian film where the birth rate has fallen to virtually nothing, you can’t fail to notice the euthanasia kit advertisements all over the city. The self-esteem of its human inhabitants had ebbed to worthlessness.

But our (and by ‘our’ I mean ‘the global’) birth rate is high. Like John Humphrys and Arthur Koestler, when I die I want a good death by my own hand and at a time of my choosing. I consider it my right to stop existing at any time and for any reason. But if I stop existing because I feel like an unwanted, useless or – worse, burdensome – piece of trash, and if I am typical of those who take their lives, then it’s fair to surmise that my society will have participated in killing me.

Arthur Koestler was  a longtime member of the Hemlock Society and former vice president of the voluntary euthanasia charity EXIT (which changed its name to the Voluntary Euthanasia Society, and then to Dignity in Dying). He was terminally ill when he killed himself. He took a cocktail of drugs, died efficiently and tidily in his chair, and was found on March 3rd 1983.

But he took somebody with him – his healthy wife, Cynthia. His biographer David Cesarani is carefully speculative, but Arthur Koestler had bullied, harangued and demeaned her all their married life. Her self-esteem was low. There are many reasons to suppose that she felt pressured into a suicide pact. Arthur Koestler was a shit and at the same time he brimmed with humanity. We will never know why Cynthia died.

Arthur Koestler was very sensitive about the people a suicide bereaves. In his work for Exit, he created guidelines on what to leave behind to smooth the aftermath of such a death, of what to tell loved ones and of how to fix affairs.

Here’s an overview of the law from Dignity in Dying:

  • Assisting a suicide is a crime punishable by up to 14 years imprisonment in England and Wales
  • Section 2 (1) of the 1961 Suicide Act states:  A person who aids, abets, counsels or procures the suicide of another, or an attempt by another to commit suicide, shall be liable on conviction on indictment to imprisonment for a term not exceeding fourteen years
  • Section 2 (4) of the 1961 Suicide Act states: No proceedings shall be instituted for an offence under this section except by or with the consent of the Director of Public Prosecutions
  • To date no one who has accompanied a loved one to Dignitas has been prosecuted. However, people have been questioned by the Police and threatened with prosecution.

In The Observer John Humphrys writes that over the past few years more than a hundred people have made the journey to Dignitas, the assisted suicide clinic in Switzerland, to end their lives. On their return, none of the loved ones who helped them has been prosecuted. And yet Parliament has still to decriminalise assisted suicide. He writes:

“Those who defend the status quo are afraid that once we allow any form of euthanasia or assisted suicide we are launched on a slippery slope. Before you know it, doctors will be knocking off every elderly patient who worries about becoming a burden on their family and destroying the sacred bond between doctor and patient into the bargain. The evidence suggests otherwise. In the Netherlands, which has the most liberal legislation in Europe, the number of people asking their doctors to help them die has been falling steadily, from 3,800 in 2001 to 2,120 in 2007. If the law is changed in this country, it will be along the lines of the legislation in Oregon and Washington State where the safeguards are stronger. In the first 10 years since the Oregon law was passed, 341 people were helped to die – fewer than 2% of all deaths.”

So I was as satisfied as alarmed to read in The Observer today that an Australian doctor Philip Nitschke has made barbituate-testing kits available which allow people to ascertain that the drugs they have obtained can be relied on to kill them peacefully. It relieved the feeling of entrapment I have always felt about my own life*.

I just wish the kit hadn’t been launched in the middle of the worst economic situation the world has ever seen. And naturally, when he comes to the UK in May, it will again be Eastbourne where he promotes his organisation (Exit International) and its DIY suicide video. As well as being the most likely demographic to experience terminal illness or life-destroying debilitation, older people, for which Eastbourne is renowned, are the most likely demographic to experience social isolation and great loneliness. In order to support the right to die, we absolutely must address the latter. Dutiful ministrations can’t be as good as it gets – I for one will hose the do-gooders out of my house if they come calling when I’m old. We all value affinity and variety. Maybe there’s a way for people like me (those who chafe against their social duties in this respect of providing company – as if good company were something you could deliver or muster on demand) to help address the social isolation of older people – and (incidentally) make our own beds while we’re at it.

This is what it boils down to, for me. The right to die requires an ongoing campaign to irradicate the circumstances under which individual self-esteem can ebb to nothing.

*No, I don’t have suicidal thoughts. No, I’m not planning on dying until I’m terminally or chronically ill (or incarcerated for life, or knocked down in traffic as happened the other week – a motorbike slammed on its brakes and bumped me lightly enough for me to say sorry and hurry away – or at the hands of a young knife-wielding bandit, or in a fight with a player of music without headphones). It’s just that I tend to think far ahead and when my time comes I want the right to die in peace.

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11 thoughts on “The right to die

  1. Nicely done. I’m very supportive of the principle that people should have the right to end their life, at a time of their choosing, with the support of their loved ones, without the loved ones risking prosecution. I think comfortable assisted suicide should be available – but I don’t think it should be *easily* available. It should be something that has to be actively sought, rather than something that can be done impulsively.

  2. Yes, impulse can be lethal. I have no argument with the web trade in barbituates, but in my ideal world lethal drugs, their antidotes and clear instructions would be bundled together and you wouldn’t be able to buy the former without the latter.

  3. “But our (and by ‘our’ I mean ‘the global’) birth rate is high. ”

    One sentence and about ten pitfalls. I better abstain from commenting then.

    Hiding home for a quite Fool’s day.

  4. I am real torn on this issue.

    In theory I agree that sensible adults should be allowed to make this decision at the end of their lives.

    But I wonder who will decide who is “sensible”? Will it be your doctor or the state? What role will your family have in the decision? Will your decision be limited by condition i.e. yes for cancer but no for Alzheimer’s? How advanced does the condition have to be? etc.

    Another concern I have is how this will impact the prevalence of suicide in general. Suicide is glamorized as it is and I worry this would make it more acceptable. Not more acceptable for people at the end of their lives (which would be legal), but more acceptable for everyone else including youth, i.e. “if grandpa committed suicide to stop his pain, so will I” I don’t mean to be morbid but the likelihood of these sorts of incidents seems likely to increase if we normalize suicide.

  5. @newcentrist: medicalising suicide might have quite a different effect, though – turning it into an event that needs approval and a specialist is (possibly) conceptually distinct from the sort of home-baked suicide your average depressive pulls off. Some sort of comparison of the suicide rates in different demographics in countries with liberal vs restrictive euthanasia laws would be very useful.

    This R4 doc http://tinyurl.com/cdvmya was very interesting in exposing some of the issues in deciding who is and isn’t competent to decide to die: basically, it doesn’t sound like Dignitas are even trying. And the voluntary euthanasia story in Liver by Will Self is worth an uncomfortable read, too.

  6. Snoopy, as an Israeli Jew (I think) in a region whose kids are so often weaned on hatred of your (our, if I may say so) ilk, you have a lot of reasons to worry about minority status in the Middle East, and talking about a global population is largely academic. Is that what you meant? I agree – in this sense I am a Zionist.

    Sarah, thanks for the pointers – I’ll nab that R4 Report podcast, and see if I can hunt down the Will Self.

    NC, I reckon anybody should be able to kill themselves as a basic right, without having to account for it. My (unsubstantiated hunch) is that acknowledging suicide as a right as well as acknowledging it as an act of despair, would radically improve our dealings with each other – particularly children and older people.

    This is very thought provoking but I have to go – Skype from Australia!

  7. Sarah writes:

    “Some sort of comparison of the suicide rates in different demographics in countries with liberal vs restrictive euthanasia laws would be very useful.”

    Absolutely. Does making medical suicide a legal option increase the prevalence of suicide across the board? I do not know. I am very interested in reading studies that support or refute this hypothesis. All I have been able to find are references to a study that shows the incidence of suicide by elderly people with fatal conditions does not increase in places with liberal euthanasia laws (the study examines the Netherlands and Oregon, USA).

    Flesh is Grass, have fun in Australia!

  8. The John Humphrys piece I linked to in the Observer suggests that the Netherlands, which has the most liberal laws on assisted suicide, has seen assisted suicide rates fall. But there’s not enough there to go on.

    I had a disturbing dream last night, suggesting that my sleeping mind is nervous about what my waking mind writes. To summarise, Matt got so depressed about work that he and a colleague opted to kill themselves. My dream me went along with this, resigned to the belief that it was their right to die. The people in our tenement (we lived in a tenement of people who worked in Matt’s workplace) went off to work on one sunny morning and Matt, his friend and I stayed back. I said goodbye to Matt and he went into a little room where the pills and the dispenser were. I left. I got to the bottom of the stairs and then it hit me. It was too late to change anything – the circumstances at work, any other part of his life. I had passively gone along with his right to die as if that were the only right he had – above and beyond the right to respite at work, and other freedoms from life’s badnesses. I woke up confused and stricken to find that he was lying next to me – I had to touch him to find out whether he was alive or not. I was so relieved when he was warm. This dream upset me so much, I don’t feel nearly as sanguine about planned suicide as I did when I wrote that post.

  9. “The John Humphrys piece I linked to in the Observer suggests that the Netherlands, which has the most liberal laws on assisted suicide, has seen assisted suicide rates fall. But there’s not enough there to go on.”

    I have only been able to find similar studies. I have not been able to locate any studies that examine whether rates of teen suicide, murder-suicide, etc. increase or decrease in places with liberal euthanasia laws.

    Very sorry to hear about your dream. I hope you have never had to cope with the suicide of someone close to you. A very close friend of mine (and his family) has been dealing with the suicide of one of his sisters for years. Another good friend discovered his best friend’s body after the friend took his life. And I was the first person to enter a room immediately after a good friend shot himself.

    These experiences have lead me to be extremely wary about anything that would make suicide easier or more “normal”. Again, I am open to any evidence showing liberal euthanasia laws decrease rates of suicide. If they do, I would support the passage of these sorts of laws. If not, the cost far outweighs the benefits.

  10. Ah, NC. I see where you’re coming from now – you’ve seen this in terrible close up – you’ve been remarkably restrained here. I’ve seen it too, but from further away. My oldest friend’s dad killed himself last year after a few years of terrible inner turmoil. My cousin – whom I don’t see much – tried towards the end of the year, but thankfully survived with a working liver.

    I’m not sure where the desire to let life go resides – somewhere between the depletion of inner resource to withstand the knocks, and settled conviction of one’s own worthlessness. And for some, psychosis.

    I agree that we should be wary about suicide becoming easier or more “normal”, but at the same time the right to a good death (and I feel this is very important) leads inevitably to both these things. I’m going to stop there because I think it would be easy to say something crass – I’ve been skating on thin ice for this entire thread.

  11. Just as no one has the right to end my existence, no has the right to impose existence upon me against my will.

    Any person who no longer wishes to live should have free access to assisted suicide.

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