The day after the day before

I can’t say I’m surprised, but I am disappointed. Dignity in Dying (formerly the Voluntary Euthanasia Society) has invested many hundreds of thousands, if not millions, of pounds behind well publicised personal stories and legal cases which have been very effective in persuading general opinion that dying is frequently nasty and that we should have the right to choose when and how to die. That organisation always resists using the term ‘suicide’, which is what they advocate, realising that it opens up the accusation of devaluing life. So I’m not surprised that MPs have after an impressive debate by a narrow majority eventually given way to the pressure. (My highlight speeches: Tom Tugenhadt (MP for Tonbridge, Con) and Preet Kaur Gill (MP for Edgbaston, Lab) speaking against, and lowlight: Kim Malthouse (MP for NWHampshire, Con) speaking for.) 

So… along with many thousands of disabled and chronically ill people our worst fears have been realised. The House of Commons have narrowly voted through Kim Leadbeater’s Private Member’s Assisted Dying Bill (Terminally Ill Adults (End of Life) Bill). The majority of 23 means that had 12 voted the other way, it would have failed. I am disappointed. However in voting for assisted dying/suicide MPs have inadvertently added to our society’s fear of death, our reluctance to accept dying is as much a part of life as birth. In the words of Job, ‘The Lord gave and the Lord has taken away.’ 

Since having my particular rare and slow form of Motor Neurone Disease for 25 years, the idea of taking my own life has occurred to me and to some professionals. I have as a result thought long and hard about the subject. Personally, although utterly disabled and needing 24/7 hour care, I have no desire to shorten my life, but more generally I also believe that any legalising of causing or contributing to someone’s death is dangerous for society. The sanctity of life or right to life is a principle too important ever to be breached. Once one exception is allowed, you give permission to further breaches in the future. Contemporary examples abroad as well as European history teach us that despite all the initial limitations mission creep will happen. Other exceptions will be legalised on seemingly reasonable grounds, if for six months, why not for twelve, or 24? Why not for any length of “intolerable” suffering? Why not for those who are or consider themselves to be a “burden”? Why not for those who will be too disabled to contribute economically to society? There's not one jurisdiction abroad where the first narrow restrictions have not bit by bit been broadened.

One of the most important interventions before the vote was, in my view, that by the Royal College of Physicians and the Royal College of Psychiatrists a week ago expressing their reservations, including: “Vulnerable patients particularly those with remediable mental health or other unmet needs, are not adequately protected by the current bill.” It is very easy, and understandable, for people with long term disability or incurable illness (such as myself) to have severe depression and mood swings. I’m sorry that not enough MPs heeded the advice of the most involved professional bodies. 


However I have a number of friends who disagree with me, often after personal experience of watching a loved one die. I sympathise and I suppose that I must be glad for them that the MPs have represented their wishes. And I would never condemn them if they decided to choose the route of assisted dying for themselves. I hope they won’t have to.

Meanwhile I trust that, when the Bill comes to the upper house, their Lordships will fulfil their function of revising it wisely and effectively. They certainly have relevant expertise, for example, judges, ethicists, and most relevantly in the field of palliative care - which is in danger of being squeezed following this bill. As Gordon Brown pertinently asked, “When only a small fraction of the population are expected to choose assisted dying, would it not be better to focus all our energies on improving all-round hospice care to reach everyone in need of end-of-life support?” 

Fracking indignant of Newcastle!

I have to break my silence! I'm a Geordie - no really, I am. Born in the heart of Newcastle upon Tyne. Then brought up in Durham for the first formative couple of years of life. As far as I can see, Lord Howell has been in politics and journalism all his working life, and is a Home Counties' man through and through. His title is Baron Howell of Guildford of Penton Mewsey (a picturesque village in a sparsely populated bit of Hampshire). I discover that "the village is home to approximately 400 people and has about 110 houses. The name Penton derives from the word Penitone, which is a word for a farm held at penny rent. Until the 1920's the Pentons (Mewsey and contiguous Grafton) were mainly agricultural communities supporting sheep and corn, typical of northern Hampshire at the time. The Pentons are still surrounded by farmland which is currently completely arable" (Jody Cletus). 

Yesterday I put a rather knee-jerk reaction to a comment the noble lord made in Parliament yesterday on Facebook, which has provoked an interesting discussion. According to The Daily Telegraph “There are obviously in beautiful rural areas, worries not just about the drilling and the fracking, which I think are exaggerated, but about the trucks, the delivery and the roads and the disturbance,” Lord Howell said. “And those are quite justified worries.”
“But there are large uninhabited and desolate areas, certainly up in the North East where there’s plenty of room for fracking well away from anyone’s residence where it can be conducted without any kind of threat to the rural environment.”  And I must say I wasn't too impressed by the widespread mirth with which his remarks were greeted by his colleagues. I commented on my status, "As Geordie, what can I say - except I'm desolated!"

Someone pointed out to me that desolate means "devoid of inhabitants, deserted", which is true; but it also has the sense of "bleak and unwelcoming" - which is not true. As Justin Welby, who was Bishop of Durham before being moved to Canterbury, tweated: "North east England very beautiful, rugged, welcoming, inspiring, historic, advancing, not 'desolate' as was said in House of Lords today." I'd suggest the three pictures confirm this perspective.

My real beef with the noble peer is his presumption to know what the North-easterners would like done with their back yard. What he calls large "uninhabited and desolate areas" are the lungs and recreational facilities for the millions living in the large conurbations of the area. It may be that they would like the employment that fracking would generate. But he should first ask himself whether he'd welcome the industry, with its associated infrastructure, to the Test Valley, or wherever his favourite place of unspoiled beauty is. One of my interlocutors argued stoutly in Lord Howell's defence on the grounds of our need for cleaner energy sources and of the North east's need for employment. I tend to agree that the evidence for associated seismic activity and pollution of watercourses is dubious, though not disproved. On the other hand another uncertainty is whether our reserves would prove sufficient to contribute significantly to our energy security. It's very doubtful. Sadly because of our and Europe's inaction we have almost lost one of the renewable energy industries in which we were world leaders, the production of top-grade silicon wafers, essential ingredients of solar panels, to a hugely subsidised Chinese industry. 

As a heavily populated small island, the scope for producing sustainable energy without adverse environmental impact is indeed taxing. Every scheme that's proposed should be weighed against what will be lost. Lord Howell's defender lives on the West Sussex coast. I asked him, "I agree about energy supplies, and that our rather feeble efforts at renewables aren't enough. But the question remains: would YOU be happy to see the infrastructure accompanying fracking on the South Downs?" To give him his due, he replied, "I would accept it, if somewhat reluctantly." I wonder if Baron Howell of Guildford, Penton Mewsey, would be so noble... There are tracts of uninhabited desolate arable land and copses just north of the village, I see from Google Earth. I'm sure gas would be much more profitable than wheat and pheasants. And there's lots of it in Hampshire, we're told... 

Oh Lordsy Lords

Two things concern me over reform of the House of Lords - well, three in fact. I get the point that there seem to be too many of the chaps and chappesses - and judging by some bishops' expenses they don't come cheap (not to mention those archaic robes). But I'd have thought a reasonable retirement age might sort that out for a start. However here's the thing.

1  We're told there doesn't need to be a referendum about it because the electorate have already been given the opportunity to vote about it - at the general election. A commitment to Lords' reform was in the three main parties' manifestoes, we're told. QED. Eergh? What choice did that give the population then? I suppose, theoretically, if that was the overriding issue for you, you could have voted for the Monster Raving Loony Party. However in practice the choice between 'Yes', 'Yes', or 'Yes' is no choice at all. In other words, the electorate has expressed no opinion on Lords' reform.

2  If it ain't broke, don't mend it, and certainly don't mend it in a hurry.

3  And this is the most significant, in my view. The down-side of electing peers is that you will change the nature of the House. Admittedly some peers at present are career politicians (come up and out through the Commons) and more have taken a party whip (in other words they're more likely to toe the party line), the present house has a distinct weight of those who haven't sought power but who are disinterested and distinguished people who have been asked to serve. The Clegg proposal will radically lighten this weight, and therefore the Lords' will have less of a critical voice and more of a party one. I suspect I'm not alone in wanting less party politics in Parliament and more wisdom.

The day after the night before

I listened to the end of the Lords' debate on the Falconer amendment last night (in fact I watched on line). In the event it was defeated by 194 to 141 - a bigger majority than when Lord Joffe's Bill was debated in 2006. To be honest, I heard the result with mixed emotions: mainly relief that a bad piece of legislation hasn't gone any further, but also sadness for Debbie Purdy who had great hopes personally that she could be free from concern for Omar, her husband, if she ever went to Zurich to die. From what Lord Falconer said in his summing up I think she can be free of that as it is: ' The current situation is that the DPP (Director of Public Prosecutions) has made it clear that he will not seek out these cases to investigate. If the cases come before him, he will ensure that they are properly investigated and, as long as he is satisfied that there is good motivation, he will not prosecute.' I hope she believes him, because I have no doubt about her good motivation, much as I regret where she feels it leads.

However, I trust that this is not the end of the discussion. Oddly enough, I think an article in Monday's Independent by Lord Lester, one of the amendment's supporters, might be a good place to start again. In it he said, 'Like many others, I believe that we need a legal framework which would allow doctors and nurses to be able lawfully to treat terminally ill patients to relieve their suffering as well as pain, even though it would be a virtual certainty that the treatment would shorten their lives.' To which I would say, 'I agree - depending on what you mean exactly.' For example, what do you mean by suffering? A large element in suffering can be fear - and a lot of fear associated with dying can be unnecessary on a purely physical level. Not all 'suffering' is negative. For example, unresolved conflicts can greatly disturb a terminally ill person - but the remedy for them is not premature death but positive resolution. The 'legal protection' we need is both for the carers and the cared for. It's there at the moment, imperfectly but effectively. Doctors fear litigation if in good faith they administer pain relief which has the effect of shortening life; patients fear being precipitated into death instead of receiving potential life-prolonging treatment. There's work to be done.

There's one other caution, I think, we need to make and that is, some things go beyond laws. I seem to remember that was a point Michael Sandel made in his last Reith lecture. You can tinker with laws till you're blue, or red, in the face; but unless we have a shared attitude in society, not just on issues, but about the sort of society we want, i.e. the underlying values we believe in, we are on to a loser. That's the real agenda.

More serious reflections

'Death is always tragic,' I said yesterday, and of course it's not true. It isn't always tragic. It's true that the death of the two hostages in Baghdad IS tragic. I had an email yesterday from someone who knew them in Iraq. Yesterday was 'awful', he said. There was so much shared grief over these two young men pointlessly and ruthlessly cut down (one presumes) before their time.

However, in my defence, death is 'the last enemy', and life itself is good. And the taking of life is not. So although it's inevitable, death isn't a positive. It may come as a relief, but that doesn't make it 'good'. It's never appropriate to say, 'Well, it's a GOOD thing THEY died.' It's interesting by the way that the Voluntary Euthanasia Society rebranded itself as Dignity in Dying, and avoids the term 'assisted suicide' preferring 'assisted dying'. On the other side we have Care not Killing, which is trying to make the opposite point. I suppose the implication is that suicide involves intention, and that there is a vital distinction which needs to be preserved. I certainly think that to imply there's no difference between medication intended to relieve pain, albeit shortening life, and medication administered with the intention of ending life is naïve and false.

One thing that Debbie Purdy and I agreed about on Friday was that these are issues which deserve full discussion, in my view fuller than a fag-end of an amendment attached to a bill in the Lords. She felt, I think, that an amendment to provide protection for someone accompanying a loved one to commit suicide abroad was worth having. I feel that this would introduce into British law a principle that isn't there at present. In fact the proposed amendment seems to say that assisting someone to commit suicide abroad should not be treated as 'an act capable of assisting or encouraging suicide'. As Humpty Dumpty said, 'It means what I choose it to mean.'