Friday, 22 January 2010

WELL DONE MARGO: WHY SHOULD DIGNITY BE ONLY FOR THE RICH?


Margo MacDonald launched her End of Life Assistance Bill yesterday in which there are proposals to allow anyone aged over 16 and registered with a GP in Scotland for at least 18 months, to request help to die, so long as they have been diagnosed as terminally ill or permanently physically incapacitated, and find life intolerable.

The MSP, a sufferer of Parkinson’s disease, has already said she would like to be allowed to bring about her own death if her condition deteriorated but she insisted her attempt to change the law was not personal, pointing out that there were many who suffered progressive, degenerative conditions far worse than her own. The future, she said, for people in those conditions was very unhappy, unpleasant and undignified.

This is a highly controversial subject from which there has been much shying away over the years. It involves a wide range of potential problems ranging from protecting people from greedy relatives who want rid of a troublesome, time consuming, ill family member, or who wish to inherit sooner rather than later, on one side.... to people who genuinely cannot bear to see a relative suffer horribly, for what may be months or years. It involves doctors being involved in killing rather than saving lives, something which brings the BMA down on the opposing side. And of course it involves religion. Indeed one of the reasons given for the anticipated failure of the Bill is that the religious lobby is so strong. Strange in a country which has little in the way of church going.

Personally I support Ms MacDonald’s Bill.

Life can be wonderful; it is what you make of it. It really is a bit of a gamble. You have to do your best with the cards you are handed. Most people do this and try to enjoy what they can, sometimes putting up with and overcoming horrific problems.

However, there can come a time when there are no good cards left: when you are paralysed, when you require someone to do everything for you. The most personal of things have to be shared with a carer. There is no pleasure in life; there is only frustration, embarrassment, loss of dignity, a feeling of total uselessness, pain (sometimes horrific), horrible, degrading and painful procedures to keep you alive. And for what?

Perhaps for those with vast amounts of money to spend in private clinics with first class care, this may be, not bearable, but not too unbearable. The state funded alternative does not stand thinking about.

Surely it should not be beyond the wit of man to overcome the problems of the greedy and find a way for those who wish to end their lives to do so. Given that we are all going to die in the end, I don’t see that it is so terrible. I wouldn’t want to see anyone forced into it, particularly those who believe that their God forbids it. But for those of us who prefer the idea of dying, to that of living in agonising pain and humiliation, I fervently hope that this Bill progresses the subject.

Well done Margo. Why should Dignitas, and the dignity it offers, be only for the rich?

29 comments:

  1. Tris,

    I remain to be convinced by the whole euthanisia proposal. In a broader sense, there is the ethical dilemma- aren't medical personel trained to uphold and prolong life and strive to cure illness?

    That said, it is equally true that medical personel exist to ease suffering.

    So the moral, ethical and practical arguments for me come down to the issue of how would one summ up in law what would be meant as 'intolerable suffering'.

    This is where my objection comes in with Margo's proposal. I read the Times today, and it seems that despite the MSP free vote, only 20 MSPs have stated their intention to vote for her bill- given she requires 60- it seems others have concerns about the practicability of this legislation in law.

    Finally, I wish to state that I do not neccessarily agree with your conclusion that "one of the reasons given for the anticipated failure of the Bill is that the religious lobby is so strong".

    The Times also concluded as much, but I simpy do not expect that the churches are influencial enough to alter MSPs ethical and personal judgements. Would a West of Scotland Labour MSP vote against just because of the influence of the Catholic Church? I doubt it, especially givne the large numbers of Priests and lay-followers who now follow the SNP instead.

    And the Scottish Kirk? While it is still influencial in the islands, I simply cannot accept that MSPs from the LibDems would suspend a rational discourse concerning Liberal Democratic values just because of the Kirk.

    The influence of these institutions I believe are overstated. Just look at the numbers who actually attend, or even practise these faiths. Less than 50% say they go to church regularly at thre last census, howeverover 50% do define themselves as 'Christians'...but does this mean that over 50% of the electorate even listen to the statements of these faith group leaders? I strongly doubt it.

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  2. Dean: I’m trying to see the issue from all points, and I take the point that doctors are there to keep people alive, not to kill them. It probably could be looked at from the point of view that giving a life ending drug (which doctors eventually do in many cases anyway, particularly cancer cases, where pain becomes unbearable), is part of the treatment, but I would agree that it is splitting hairs.

    Intolerable suffering is difficult to define, although I’m sure that the Bill will have tried to define it. It is different for everyone I suppose. There is pain, not always controlled by drugs; there are the indignities of not being able to attend to bodily functions without help... some might consider that intolerable, I know I would. I think it would be difficult to decide. I think however that the Bill will take this into consideration. It excludes people who are suffering from dementia for example, because to qualify they need to be of sound mind.

    I think it highly unlikely that it will be successful. As you say only 20 MSPs will vote for it. But it right that we discuss it in parliament and have the rights and wrongs discussed.

    As for the religious aspects, I took that information from an article in the Herald. I know that, in the past, the strong voice of the Church of Scotland has affected legislation which has moral implications. I do not understand why myself, but it may be that MSPs feel that there is a strong enough draw from the church to affect their voting.

    My view is a very personal one. I feel that my body is mine; I don’t think that it belongs to the state, to my family, to the doctors in the local hospital or to anyone else. If I ever had the misfortune to have a degenerative disease I would prefer to die (something that I am going to do anyway), at a time of my choosing, while I can still call my life my own. I have recently had experience of seeing people being kept alive, horribly disabled, and clearly in distress. It was heartbreaking, particularly as the level of care was at times quite shockingly low.

    I say my view is personal. I would never want to interfere with the wishes of someone who, for example, thought that God’s will must be done.

    As I say, I doubt if this Bill will succeed. However, I hope very much that it will encourage the Cabinet Secretary for Health to look at how we treat people who are unlucky enough to find themselves in this situation and too poor to head off to Zurich. Fortunately for me, I can afford the plane fare there, and Dignitas’s fee.

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  3. Tris,

    It is true that the decline into old age is not always graceful. At the nursing home where I work I also am faced with the reality of old age for the majority of working class folk.

    It is hardly pretty as the rose tinted lenses sometimes paint for us. But still, a free vote enables all views to be heard and so agree with you that this is no bad thing at all.

    But I still hold to my view that implimentability concerns me.

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  4. I think the main problem is that it means the people must rely on the state to explain how ill our relatives are.
    Trust in the state has been eroded to such an extent that no one believes them anymore.
    Ian Tomlinson was killed by a policeman. The state said that they didn't know anything about it, next that they knew about it but couldn'r help, next they knew about it but tried to help but were showered by missiles, next they knew about it and weren't showered by missiles, next they knew about it and it was an accident, next they knew about and it wasn't an accident but that the officer who hit him and killed him wouldn't be charged.
    So basically the state will happily kill you. Cover it up. And if found guilty won't punsh their officers.
    Why would you possibly trust them to put you to sleep ?
    And after a lifetime of believing in capital punishment I've definitely changed my mind on that one ! The stae with the power to put people to death. A DNA database to plunge. They would fill their boots and hang you high.

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  5. It's not just 'not graceful' Dean. In some cases, it is horrific, as you may have seen.

    However, I totally agree with you that the implimentation of anything like that will be difficult.

    Howewver, one of the most civilised nations on earth, Switzerland, has managed to organise it. It may be that Scotland (also extremely civilised) will be able to do that too.

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  6. Anon: I think we all know you can't trust the state. I personally find it pretty hard to believe anything that the tax office, or the DWP, or any of them say. Clearly the War Office (which is what it is now... nothing at all to do with Defence) lie through their teeth.

    As for being put down... well, yes, if you are unable to afford a private doctor, you will have to rely on a state paid one to tell you whether you can been put out of your misery or not.

    I can't think of a way round that.....

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  7. Tris
    I'd never trust the state to put me to sleep and then explain to the relatives that it was my fondest wishes.
    If Margo had a pair then she would jump under a bus rather than ask the state to let her die peacefully and with dignity. There's no dignity in death. You die and rot. End of.
    She must know that her bill is a charter for our nieces and nephews to sit waiting for us to die. Pleading for us with their eyes to do the decent thing and give them a few bob before we pop our clogs. Why waste money on expensive homes ? Sitting googah watching the one show. Just finish it and hand over the dosh you saddo.
    I think we should keep things the way they are.
    Brave folk jump under a bus / dive into the ocean etc.
    Cowards fight for every last breath.
    Relatives who help people to die in Switzerland ignored.

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  8. Anon:

    I have to disagree with you on every aspect of that. It is undignified and criminal to jump under a bus, and cause the bus driver to be responsible for your death, and traumatise/injure/kill the passengers.

    There is dignity in a quiet death.

    My relatives can take a running jump for anything I will leave.

    I know I can go to Switzerland, so does Margo. There are those who can't, and anyway, I'd like to die in Scotland or France... not Zurich.

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  9. Tris
    Obviously "jump under a bus" was just a euphimism for going off quietly and dying.
    My preferred option would be to take up a keen interest in sea angling and get accidentally washed off of the rocks.
    My relatives could say that I had died doing something I loved and I could go whenever I wanted avoiding the stigma of suicide.
    People unable to get to some rocks could save up their pills and enjoy a wee dram with the pill collection while listening to Eddi Reader sing Aye Fond Kiss.
    Must be many other easy ways to go which avoid state intervention or trips to some seedy clinic in Switzerland.

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  10. Just how seedy are the Switzerland clinics?

    I do know that there is a very active domestic political debate going on there about the suitability of assisted suicide. So even in Switz. its not a cut and dry case.

    But Anon does raise a good point- regulation.

    Beyond the unworkability of this bill in terms of implimentation, there is the question of regulatory requirements. Suddenly a quiet and dignified death becomes an administrative machine, where the leap into costs, productivity and cost-benefit analyses could take over. Precious little dignity in a death industry frankly.

    My point is merely about the sheer unimplimentable nature of this idea, not to mention the risky possible unplanned for consequences. MacMillan warned us about events, lets keep that in mind.

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  11. Dean
    Yes "unplanned for consequences".
    It's a certainty that any plans for state sanctioned suicide would be quickly extended to people who were a burden on society feeling obliged to do the decent thing and take a few pills.
    This is borne out by the abortion laws. Initially brought in to allow abortion in exceptional circumstances, abortion is now nothing more than another form of contraception.

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  12. Guys... I'm not saying it would be easy, but I think it would be good to move forward and see what we can do.

    It's a bit primitive to have people dying in agony....

    The idea of doing it oneself is rather naive I think Anon. It supposes an ability to do it, to get it right, not to mess it up, and not to involve anyone else. OK, if you have the power of your legs maybe... but what if it all goes wrong....?

    Why should someone have to do that kind of thing? We have choices all through our lives; we should have a choice to end it.

    Of course, people who do not want to avail themselves of it... needn’t

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  13. Tris
    I think it all boils down to whether or not you trust the state to do the right thing. Personally I don't so would always try and limit the states ability to put me to sleep or to order the death penalty in a court of law.
    There's no need to die in agony. I've done a living will and want to be terminated if I'm incapable of living under my own steam. My relatives now have that power. Hopefully I won't have to use them and will get a heads up before it gets that bad and I can do myself in first.

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  14. I wouldn't trust the state, but equally I wouldn't trust myself to be able to do it right. I'd also not want my family or friends to have to be involved....

    I guess we need to differ on this one Anon....

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  15. Tris
    The living will means that your family no longer have to worry. Their fear of turning off your life support is cancelled out by your request to be turned off.
    They are able to see in black and white in your living will your true thoughts on the matter. It avoids any doubt and gives them a feeling of warmth knowing that they carried out your wishes.
    They can say goodbye to you without any ambiguity or worry about whether they did the right thing.

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  16. Well, I am fine with that Anon.

    But that's only used if you are on Life Support. In fact if you are dead but for a machine keeping you alive.

    But suppose that you contract (heaven forbid) Motor Neurone and in the end you can only blink. They can't turn off the machinery then, and you could live for 40 years only able to blink....

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  17. Tris
    No you're wrong there.
    The law in Scotland has moved on quite far. Maybe you missed all the changes ?It changed about 3 years ago.
    You can decide from a whole menu of things where you want to be switched off.
    Mine is where I can no longer wipe my own arse and there is no possibiliity of improvement.
    Well not exactly. But where my brain and motor functions won't improve and I will be unable to feed or move or keep myself clean without a permanent helper.

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  18. Oh Anon:

    I did miss these changes. I need to be more up to date before shooting my mouth off.

    I apologise. I need to read up on this.

    Sorry matey..

    Tris

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  19. This is certainly an emotionally charged issue. This can make it more difficult to have moderate, reasonable and sensible debates in Holyrood parliament, as our MSPs aren't imune to emotive arguments themselves, nor are they imune to emotional responses.

    Personally this is very tough, as it will for most people boil down to whether or not it is ethical/moral.

    But for me, as I say it is more of a technical issue of implimentability where I see the biggest obsticle. As I see no problem with the principal of assisted suicide persay, depending on a number of caveats- not least the implications to the medical profession [which as I say should still principally focus on palliative care, and life preservation.]

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  20. Could you two not just get a room?

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  21. Dean, are you aware that the 1967 legislation permitting homosexuality was not passed in Scotland until 1980 due to the influence of the church?

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  22. Dear All

    Here is a question for Margo MacDonald.

    Does her legal suicide bill invalidate people's life insurance policy?

    MacDonald is unfit for public office and should resign.

    Public office is all about making people's life better.

    Yours sincerely

    George Laird
    The Campaign for Human Rights at Glasgow University

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  23. George:

    If you are in agony, and there is no hope whatsoever for you of getting better; if you have to have your personal body functions overseen and assisted by a nurse, if you cannot eat, or talk.... etc, don't you think that your life would be made better by ending it...?

    It is I know, a matter of personal interpretation.

    I repeat Margo isn't doing it for herself. She can easily afford to go to Switzerland.

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  24. Munguin I'd forgotten about that. It is true, despite the English passing the legislation, it could not be enacted for Scotland because the Church interfered.

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  25. I don't think Dean, that there is any doubt, that a Bill passed would have to make it very clear that the killing of a patient would be a last resort.

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  26. Thank the Lord for Margo! She is trying to bring a human touch to the legislation around death. Humanity contains a huge diversity of views on death and our law should reflect that. I want to die in Scotland, and if I do have any control over my death when it comes, I wish to exert that control toward making my own death dignified and peaceful, for me and my loved ones.

    She only wants to allow a choice, not force a change on anyone.

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  27. Yes Sophia, that was original thought.

    I do see the arguments that people may feel obliged to die to stop being a burden..... but, if they feel they are a burden, and that weighs heavily with them, is that not the right thing for THEM to do...?

    For me it's all about human life amd its importance.... and I'm not that sure it IS terribly important, not any more so than the life of a dog, or a penguin or a bear or a donkey, a lion, a hippo. If it were, perhaps god or nature would have spared us some of the suffering of death, or spared us death altogether....

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  28. Tris, munguin,

    No, I was not aware of that fact. However that was a different time and era. I would content the kirk has lost much of its relevence since then. Not least when it stood [wrongly] behind section 28 in the late 90s [alongside my side sadly. What can I say, the long dark shadow of Maggie]

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