Death doesn't become us - revisiting the case against 'assisted dying'

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My Mum has just gone into a nursing home. It hasn't been an easy time for my Dad and I feel slightly guilty that, for reasons of distance and business, I haven't been there as much as perhaps I should. But this isn't about me visiting my angst on you, dear reader, but rather about what it costs. Not because I think that johnny taxpayer should pick up the tab willy-nilly but rather to demonstrate the financial advantages - for families and the government - of people dying more quickly.

The fees at Mum's home run to about £1000 per week, which my maths tells me is £52,000 per year. And this is a hell of a lot of money. More, I suspect, than my dad ever earned in a year and comfortably more than the average earnings of people today (my Dad retired in 1997). Again, let's be clear that I do think our savings and assets are best directed to our own interests and this includes providing care - I really do not feel that I have any right to demand that young people with big mortgages and families to raise pay more tax so I can inherit Mum and Dad's house.

But this cost - £26,000 in a six month period - is one very good reason to question the seemingly inexorable move to what is called 'assisted dying'. Now when I read the advertisements placed by Dignity in Dying I am, like you will be, touched by the stories there of people's last days and how a quick exit would have saved them suffering. I don't doubt the sincerity of the people involved - knowing their beloved brother, wife or mother was dying they sought only to make what was left of their life less painful. And they think that helping these people to die would have been a release from that pain.

It's hard not to find the case compelling. So to help you understand my doubts, let me tell you something else about my Mum. Something I wrote some while ago in a little article called, "Death doesn't become us":

My Mum spent 25 years and more working with old people in and around Penge – delivering meals-on-wheels, driving the mini-buses and running Penge & Anerley Age Concern’s lunch club and day centre on Melvin Road. In this time she saw every sort of folk – from Mr Squirrel who worried that he couldn’t (at 96) dig the garden as in times past to Dr Arnott, communist party member, academic historian and employer of a maid.

Every day, my Mum would tell us, one or more of the people she saw would proclaim – in that depression of loneliness so common among the old and infirm – “I’m just a burden, I’d be better off dead”, or some similar formula of despair. Mum’s response would be to tell them not to be so silly, have a cup of tea and a chat.

But Mum’s view – informed by bitter experience – was that not all the relatives and carers took the same view as she did.

And this last sentence captures my concerns. You and I may be good, honest folk who wouldn't dream of having granny bumped off so we could inherit earlier. But can you be certain that others have our scruples? That there is no circumstance where 'six months to live' is liberally interpreted:

...where a depressed, slightly confused, sad old person signs to say they want to die, where the bureaucracy takes this as consent and Auntie Sissie or Grandpa Geoff is shipped safely across the Styx leaving his worldly goods behind for the inheritors to enjoy.

I know there will be safeguards. I'm sure people have considered how they would mitigate the possibility of the six months rule being abused. But I am less sure. My Mum told too many stories of rapacious and uncaring relatives, of useless solicitors and deadening, rule-bound social workers or doctors for me to be so sure that, despite the agony of those stories in Dignity in Dying's advertisement, we can go to a place where we deem it acceptable to kill another human being.

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Want to die? Or you could run...

The path towards mercy killing and euthanasia is opening up - death will become us as our misery provides the justification. Is this what you want:

A private charity operates mobile euthanasia units, which travel from one care home to another – door-to-door – to help anyone to die who has been denied the opportunity by a doctor. They only visit each home once a week to relieve the potential psychological burden – but it must still be quite a shock when a group of smiling nurses turn up at your door and politely ask if you'd like to die today.

What science fiction writers of the past imagined as a fantastical reflection on the lack of humanity of their contemporary society has become concrete reality in ours. If you want, we can now kill you in an afternoon. Belgium and the Netherlands list "death" among their accepted forms of medical therapy, performed with a chilling bureaucratic efficiency that has the effect of making it all appear perfectly normal and entirely routine. What was once forced upon people by authoritarian regimes is now becoming vogue by means of the ballot box. Societies are shuffling towards a culture of death. Willingly.

It is but a short step from ending a miserable life to ending the burden on society. We get ever closer to a world where the inconveniently old or ill are quietly disposed of, guided across the Styx by a little pin prick.

Dreadful.

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The case against euthanasia...

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...is a practical argument not one wrapped up in specious argument about life's purpose or value. To allow euthanasia is to licence the killing of another human. And that person may be in such a pit of despair and mental anguish that the mutter those terrible words: "will someone rid me of this misery and end my life".

For all the agony of seeing someone's pain dragged out before the courts and in the columns of the newspapers as the seek the 'right' for someone else to kill them, there still is that problem. A risk eloquently put here by Chris:

A few months ago, curled up around the toilet bowl, chest sore from dry heaving for days on end and every single fibre in my muscle aching from low potassium levels, those words have left my lips. “I wish someone would put me out of my misery,” I moaned. As my intestines failed, so did my strength to bear the pain and indignity of nausea, constant vomiting, pain and the side effects of heavy medication to control my symptoms (and cause new ones). It is difficult for me to live with those words in retrospect, but they made sense at that very point. I understand, perhaps not the depth, but the kind of emotion that can lead us to wish for death.

Every day people who work with the elderly, with the mentally ill and with those suffering painful disability hear these words. And rather than a tidy little injection and an end to it, they give comfort, provide an ear of understanding. We can write a million words of justification for creating a rule allowing someone to kill another but we can never bring back a life ended on the justification of words cried out in anguish. And that is why the so-called 'right to die' is really just a 'right to kill'.

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Statements from Doctors that make me want to scream: No 1

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From the obituary of Dr Anne McPherson comes a quote of hers:

"We have got into a terrible mess about keeping people alive when they shouldn't be."

When did people get so arrogant that they believe they've a right to judge whether someone should or shouldn't be alive - especially a doctor.

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Death doesn't become us - a thought on mercy killing

Anna Raccoon, in that knocked-back, slightly laconic manner she takes, describes yet another travesty of life sourced from the Court of Protection – the tale of Wally which she concludes with:

He was a success story by Court of Protection standards too. Probate had been obtained, building society funds duly accredited, house put up for sale to fund his care home, Statutory Will made out, Receiver changed to local solicitor.  Not much left in the account after all the legal bills had been paid.

I drove past the houses on my way to the next appointment. All one colour now, the second front door blocked up – I dare say the courtyard had been gentrified too. I could guess who’d bought it.

Everybody patting themselves on the back – job well done.

And, like these things do, it reminded me of the stories my Mum used to tell – of rapacious relatives, incompetent and venal solicitors and idle carers. Above all, Anna’s tale reminded me of my Mum’s argument against “mercy killing”.

My Mum spent 25 years and more working with old people in and around Penge – delivering meals-on-wheels, driving the mini-buses and running Penge & Anerley Age Concern’s lunch club and day centre on Melvin Road. In this time she saw every sort of folk – from Mr Squirrel who worried that he couldn’t (at 96) dig the garden as in times past to Dr Arnott, communist party member, academic historian and employer of a maid.

Every day, my Mum would tell us, one or more of the people she saw would proclaim – in that depression of loneliness so common among the old and infirm – “I’m just a burden, I’d be better off dead”, or some similar formula of despair. Mum’s response would be to tell them not to be so silly, have a cup of tea and a chat.

But Mum’s view – informed by bitter experience – was that not all the relatives and carers took the same view as she did. And, Anna’s tale of Wally reminds us of this:

The local Doctor was persuaded to sign a form for the Court of Protection – Wally ‘wasn’t taking care of himself’, ‘had no appreciation of the need to pay his council tax’ – Mrs Wally had been paying for both sides of the house for years, unwilling to let Wally’s negligence lose her a desirable home – it was sufficient. ‘Mrs Wally’ was duly installed as Receiver, and everyone assumed that she was his Mother.

All Mrs Wally did was to arrange to part Wally from his property and cash – imagine a world where that form is placed before Wally and his sort? The one where a depressed, slightly confused, sad old person signs to say they want to die, where the bureaucracy takes this as consent and Auntie Sissie or Grandpa Geoff is shipped safely across the Styx leaving his worldly goods behind for the inheritors to enjoy.

It is a depressing truth that much of the debate about our treatment of the old is informed less by understanding or sympathy than by totting up the banknotes tied up in these people’s homes and chattels. Banknotes that could make some old persons last few years more comfortable but which we leave there instead for the relatives to scrap over after they’ve died. And it’s a further depressing truth that “liberalising” euthanasia would grant the opportunity to bring forward the time for that division of spoils – all it will take is a consent form.

Anna’s tale of Wally reminds me why mercy killing – for all that it’s wrapped up in soft words and informed by tragedy – remains killing. And we shouldn’t make that easier, should we?

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