The law of the jungle

Here I am sitting in Cornerstone (my favourite coffee shop), enjoying a peaceful cup of coffee. I've just put up on its Facebook page pictures taken at Tuesday's friendly AGM. And now I've noticed on Peter Saunders' blog that the BBC is putting out another programme this coming Tuesday about patients in a permanent vegetative state, and my heart sank, especially when I read how it's billed: "There are thought to be as many as 5000 such people in the UK. The working party will look at concerns that assessment and diagnosis of patients is not consistent across the country and will ask whether the cost of long term care is affordable to the NHS. Ann Alexander examines calls for a reform of the process to end the life of such patients where their families believe their loved one would no longer wish to be alive. The programme reveals how some hospitals appear unaware of the law and hears how the process can be lengthy and costly, putting families under further strain"(Peter's italics). As Peter comments, the old specious euphemisms. (There was rather a witty Mac cartoon in The Telegraph on the subject.)


You can see the way the argument's running. This Monday it was, "Individuals should be allowed to choose when they die (only when their lives are unbearable, of course)." Next Tuesday it will be, "Oh yes, and did we forget to mention those who can't choose? Can we afford them? No. They're very expensive to keep. So let's put them down." The argument flows from choice to non-choice so easily, from patient's decision to family's wish so seductively. "Surely they have no quality of life?" You may remember this was something I touched on in Chapter 21 of I Choose Everything, "Compassion costs":


"With the discovery that we can have some form of communication with some patients in a persistent vegetative state (deep and long-lasting unconsciousness), one of the first questions journalists asked was whether that meant one could get an answer to the question, ‘Do you want to go on living?’ They expected, I think, to be told No, and that this would solve the dilemma of keeping comatose patients expensively alive, but the surprising truth they heard was that the vast majority of ‘locked-in’ patients (perhaps the nearest one can get to a conscious vegetative state) want to stay alive. Contrary to the account in the film, Jean-Dominique Bauby, who authored The Diving Bell and the Butterfly merely by a movement of an eyelid, did not ask for his life to be ended. Just down the road from where we once lived, in Stepping Hill Hospital is a 26-year old mother locked in her body, Michelle Wheatley, who steadfastly wants to live. There is, it seems, a deep-seated instinct to stay alive, and actually to keep alive. We don’t naturally stand and do nothing when someone tries to jump under a train. Something tells us that life is precious. We know it’s good to be alive, even when it’s hard. We value life, rightly."

Who's next? I wonder. The senile who can no longer express themselves at all? Can we afford their care costs? "No doubt they'd rather be dead." I'm sure the Radio 4 programme will have people claiming that ending the lives of deeply comatose patients is only compassionate. But I'm afraid it's not compassion. It's economics, and it's the law of the jungle, the survival of the fittest.  


I reflected on Monday on the irony of Choosing to Die immediately following Springwatch. The latter is presented by jolly, jocular personalities, full of the joys of spring and new life; the former by the saturnine Mr Pratchett, presiding with melancholy solemnity over death. Where's the link? I thought. Then I remembered the pictures of the young buzzards and barn owls who consumed their weaker siblings. "It's the way of things," Chris Packham explains in lugubrious tones. "They have to survive, when their normal food runs short or when the owls can't hunt because of the rain." It's the law of the jungle, but not the law of community. We don't live in the jungle - do we? Individualism brings death; community brings life. And the law of community is love.  

Compassion isn't feeling sorry for someone or yourself;
it's staying with them through their suffering to the very end.

Commission and omission

I wrote a red-hot post about the Terry Pratchett programme yesterday, and then thought I'd see if the Guardian might like it. And so I did, and they did. This was the result: Comment is free: Choosing to Die.

Did you know that today is World Elder Abuse Awareness Day? Funnily enough, it's not been mentioned on the BBC or in the media. I only discovered this from Peter Saunders' blog, which is excellent on medical ethics and policy. In his post today he writes: "It is often argued that legalising euthanasia or assisted suicide would be a recipe for elder abuse. Given the vulnerability of many older people, who already feel themselves to be a financial, emotional or care burden on others, this is a powerful reason for not changing the law. 
"There are too many people already who have an interest, financial or otherwise, in an older person’s death. Let’s not give them any encouragement. And let’s work to honour, protect and uphold the older members of our community." 

Dr Peter Saunders

Peter Saunders is one of our nation's doughtiest defenders of human life. What the media world prefers to forget he constantly reminds us of. He is often in the front line of contumely and personal animosity. For example, I listened to a rather shrill Margo MacDonald accusing him of scuppering her euthanasia bill in the Scottish Parliament on the Nolan programme on Sunday night, as part of the BBC's three-day Pratchett Fest.

The MNDA had asked if I'd like to participate in the discussion, but as I don't trust my voice under stress at that time of night, I instead sent this email, which Stephen Nolan read out. It said it better than I'd have been able to, and expressed the widespread feeling that the BBC is really not presenting a balanced viewpoint on matters of life and death:
"I have PLS (Primary Lateral Sclerosis), a rare form of MND. My prognosis is slow but inevitable. I'm not exactly looking forward to it, but neither am I frightened by it.  I understand you're discussing Terry Pratchett's TV programme broadcast tomorrow.

"As my voice is even more rubbish at this time of night than usual, I'm just emailing.

"Obviously I've not seen the programme, and so I can't comment on specifics.  But I'm concerned about it because it sounds as if it will be one-sided with a gesture towards another view. For one thing it's presented by Terry Pratchett whose views are well known after his Dimbleby lecture. He's known to be campaigning for the legalisation of assisted dying, or suicide.  And it's been widely trailed that it will show a death of someone with MND in the Dignitas facility in Zurich in favourable terms. This could be regarded as encouraging others to do the same.

"I understand that the BBC admits this is not an unbiased programme. I'm all for a debate on the subject, but I'd like to know if the BBC has plans for a programme presented by an opponent of legalising assisted suicide. Otherwise it seems it's not being impartial, which it surely should be.

"The large majority of disabled people in a recent Comres poll indicated they were opposed to legalising assisted dying. The reason is because we fear pressure being put on us as we are costly and less valuable ("a burden").  Were assisted suicide to be legalised, no doubt its proponents would argue under great safeguards, experience has shown in places like Holland that involuntary termination of life follows - and the reason seems to me that life is no longer considered inviolable. 

"Terry Pratchett's mantra is "My life, my death, my choice". The trouble is that my choice has consequences for others - health professionals, carers, the vulnerable and the rest of society. It's taken our society a long time to stop even the state taking life. I don't want to return to the days when life is ours for the taking."