assisted dying
Then and now
I was put on the spot recently when I was asked, ‘How different was life when you were young compared with today?’ 
(That’s me with the blond curls at the back.) At the time my mind froze and couldn’t rise above mundane trivia like five year old children walking miles to school along main roads without pavements; no TV or computers; the price of a bag of winter mixtures …
Since then news items have positively leaped out and bopped me on the head as happenings that would have been utterly inconceivable in the 50s – much more dramatic and startling things:
* The provision of ‘gender-neutral’ lavatories for university students who don’t identify themselves within the male-female gender binary.
* World-wide knowledge of the fact that a) two Australian radio DJs made a hoax call to the London hospital where b) the Duchess of Cambridge was being treated for hyperemesis gravidarum, and c) their ‘prank’ had an unforeseen tragic outcome.
* Open support of gay marriage in churches by the British prime minister.
* One in five parents spending £200 on each of their children for Christmas, with the average overall estimated at £104.
* A work of erotic fiction selling over 40 million copies and occupying prominent places in broad daylight in supermarkets as well as bookshops.
* The mother of a seven-year old boy openly defying medical advice and running away with her son rather than subjecting him to radiotherapy.
* A slim 1937 children’s book, Tolkien’s The Hobbit, being made into three major films, more than seven decades later.
* The head of the Royal College of General Practitioners going on record as saying that no organisation – not even one as erudite and prestigious as her own – should trump the views of the general public on the emotive and ethical subject of assisted dying.
Hey, I’d like to wind time back and answer that initial question all over again. With a bit more panache this time.
What would stand out for you, I wonder?
Take it as read
It takes a while to catch up with news after a break away, but in this week’s trawl, two headlines in particular caught my attention.
The first was this one: ‘Take it as read – good fiction teaches us how to be human beings‘, a thoughtful article by Graeme Archer in The Daily Telegraph, where he said:
‘… it’s not the novels where one sees oneself in a character that matter: it’s the ones where you learn to see properly, from the perspective of another. If we don’t see people properly, then we can never empathise with them, and if we can’t empathise with others then we’re not properly human. No matter how socially awkward you are, a great novel will train you to do this.’
Very much the premise upon which I write my own novels.
Indeed, I was thinking about this a lot while I was on holiday in Italy. I took the trusty Kindle well-loaded and managed to read two and a half novels in airports and trains and planes and odd moments of inactivity: 
Emotional Geology and Untying the Knot both by Linda Gillard, and A Sister’s Gift by Giselle Green. Through these tales I was taken into the lives and minds of characters grappling with mental illness, obsessive personalities, infertility, conflicted family relationships, surrogate pregnancy. Easy reads all (as befits a holiday break), but it’s fair to say they enriched my understanding of the challenges and thinking of other people in these situations. I shan’t ever experience most of these things personally, but I’d like to think I’d have empathy enough should I come into contact with those for whom these things are a lived reality.
The second headline was attached to an article my daughter cut out of the newspaper for me: ‘Why did my brother die in agony?’, subheaded: ‘Terminally ill patients are suffering slow and painful deaths because doctors dare not fall foul of the law against assisted suicide.’ Yep, it instantly grabbed me by the throat, as she knew it would.
Well-known cookery expert, Prue Leith, was describing her brother David’s terminal battle with excruciatingly painful cancer of the bones. When the morphine was doing its job, he was pain-free, joking, and sharing quality time with his wife and four children. But the dosage of morphine was sufficient for only three hours out of every four for which it was prescribed. For that fourth hour he was in agony. The solution seems obvious and simple, doesn’t it? Naturally enough, various relatives appealed, nay, ‘pleaded’, for help. The answer though was what shocked me: the nurses ‘couldn’t’ give any more pain relief. They sympathised, even told the family they would personally be willing to increase the dose, but they were powerless to do so; the law precluded it. They also said, no one admitted these situations existed. (By this time I was at fever pitch!)
Now, of course, no one with warm blood coursing through their veins could fail to be moved by the obvious distress the Leith family all suffered. But the story left me personally feeling frustrated and vexed. This man clearly needed more medication. And it can, it really can be given without breaking the law. Palliative medicine is an extremely well developed discipline; dedicated teams of experts in pain management are fully empowered to administer effective measures (drugs and others treatments) in these circumstances, to ensure ongoing comfort and dignity and a peaceful death. Which they are able to do in all except a limited number of situations. And by Prue’s own admission, David’s pain came into the category of controllable by morphine.
Both the subheading and Prue’s concluding message – ‘The present state of affairs is monstrous. With 80 percent of the population in favour of assisted dying, what are they waiting for?’ – missed the point. It wasn’t assisted death this man needed, it was legal and legitimate, adequate pain relief.
There are indeed exceptional cases where the laws relating to assisted dying need to be challenged (I’ve discussed them at length on this blog in the past), but this is not one of them. Instead of saying they couldn’t give adequate medication, those staff caring for David should have been calling for a man/woman who could. Let’s not confuse the two issues.
Rating and reviewing
It’s commonly said that a bad review is better than no review, but I can’t imagine any author enjoys getting slated by readers or receiving poor star ratings. Indeed some writers deliberately never look at the reviews lest they are derailed by them. But what a subjective thing it all is anyway. Your meat, my poison, and all that.
Let me illustrate. Last week I read The Kindest Thing by Cath Staincliffe. It was recommended to me as ‘your kind of book’, and the Kindle version was a mere 99p, so of course I snapped it up. And indeed it is my sort of book. It’s accessible fiction dealing with a thorny on-going medical ethical issue in a challenging way, leaving me asking, What would I do in these circumstances? Familiar? In fact it’s the closest thing to my own novel about assisted dying (Right to Die) I’ve seen thus far.
Basically it tells the story of 50-year-old Deborah who is on trial for helping her husband Neil to die rather than continue life with Motor Neurone Disease. Her own daughter reports her to the police. Her son’s precarious mental health is threatened. Prison gives her too much time to reflect on the repercussions of what she agreed to. Yep, my kind of thing definitely. And I enjoyed it.
As did many others. Most reviews I’ve seen are strongly approving: ‘beautifully written’, ‘pitch perfect’, ‘page turning stuff’, ‘sensitive’, ‘powerful’, ‘courageous’. The main protagonist is both likeable and believable, they said.
But a few folk, reading the same book, about the same characters, have slated it: ‘shallow’, ‘depressing’, ‘tedious’, ‘predictable’, ‘unlikeable cardboard characters’, ‘offensive and narrow-minded’, ‘cheesy’.
Oh dear. If someone said such things of my work, I’m pretty sure I’d succumb to a horrible sinking feeling. Possibly even go into a temporary decline. But why? One step removed, viewing these comments dispassionately, I can see quite clearly it’s a subjective opinion. The readers are free to express it. They might (or might not) even be having a bad day, or going through a rough patch themselves, or they may have a hidden agenda, or feel threatened by the author in some way.
In any event, it’s a known and accepted fact that we all like different kinds of writing. If you’ve ever belonged to a bookclub, even one made up of like-minded people, you’ll have experienced that reality. And haven’t you ever read a bestselling book that’s had rave reviews, and wondered what all the fuss was about? Be honest now, how many Booker prizewinners have you really enjoyed?
Me, I don’t care if everyone else loves a book, if I don’t, I don’t. End of story. OK, I might analyse the pros and cons more carefully if I’m decidedly out of step with respected opinion, but I’m not tempted to trot meekly along in the wake of the majority just to conform. Because there can be a myriad reasons in my life and belief system and experience and preferences why I personally feel as I do about that particular book. I am perfectly entitled to my subjective opinion.
So, what am I saying? Well, criticism feels very different when you’re on the receiving end. But perhaps we authors are unrealistic from the outset. We shouldn’t expect to achieve unqualified 100% five-star ratings. Remember those famous lines from the poet John Lydgate, later adapted by President Lincoln:
‘You can please some of the people all of the time, you can please all of the people some of the time, but you can’t please all of the people all of the time.’
Cath Staincliffe’s ratings have given me new heart. From henceforth I shall not even attempt to appeal to all tastes. I shall concentrate on being true to myself. And if and when a poor review pings in, I shall pick myself up, dust myself off, and get right back on that writing horse. God willing. Oh, and if that fails, re-read this post!
Bigotry? Intolerance? Prejudice?
We’ve heard so much negative comment lately about people with religious beliefs being bigoted and intolerant, I want to share an entirely different experience with you.
When last year I received an invitation to run a series of workshops on the challenges of medical ethics for a group of Christians (from the Christadelphian Church) near London in March 2012, I confess I hesitated for lots of reasons. But the organisers were very persuasive, and I eventually succumbed to their flattery.
The conference was this past weekend. And I’ve survived to tell the tale.
Life has been very pressurised of late and I had a lot of baggage to shed in order to free my mind up to facilitate group work effectively. So I used the journey south to unwind, visiting two magnificent National Trust properties. The first was Fountains Abbey in Yorkshire,
with its awesome architecture and stonework, and its dramatic cloister.
Just standing surveying all this ancient beauty, soaking up the centuries of peace and devotion, is balm to the troubled soul.
And then on to Ickworth in Suffolk, very grand, housing fabulous paintings, and also steeped in history.
(SORRY: photos inadvertently lost.)
Oh, and a quick trip to nearby Ixworth Thorpe to see the house where I was born. I’ve only visited once before, taking my mother round her old haunts, and it holds no memories for me because I was a mere babe when we moved from here, but it’s part of who I am. (No plaque outside yet though, I see!)
Anyway, suffice to say I’d shed a lot of tension before arriving at the High Leigh Conference Centre, in Hoddesdon, Hertfordshire. Another lovely building looking great in the sunshine.
From the moment I introduced myself the team couldn’t have been more welcoming and supportive. The whole atmosphere was warmly inclusive. So far so good.
I had five and a half hours to fill with my workshops so that took care of most of Saturday. My sessions are totally interactive and the course they run is partly determined by the cues I get from the participants, which means I have to be ready for anything. Fairly keeps the adrenaline flowing, I can tell you! But I take a few tricks up my sleeve in case things flag.
It’s my belief that, in order to understand the enormity of the choices relating to the big dilemmas of modern medicine, and to empathise with individuals and their families grappling with such questions, you need to engage emotion as well as intellect. So throughout the sessions, as I presented increasingly difficult scenarios, the delegates imagined how they might feel in such situations (eg being infertile, or dying from a degenerative disease, or suffering from psychiatric disorders, or listening to a child begging not to have any more aggressive treatment), and they moved on a continuum from very comfortable (represented by soft easy chairs with lots of cushions) to very uncomfortable (pebbles on seats and upended chairs). There was a fence to sit on for those who couldn’t decide, and we even introduced a moral high ground (high seat covered in a velvet cloth) for the few who took up a fixed moral position.
Were these Christians bigoted or intolerant? They were not. Were their minds closed to new ideas? Not a bit of it. Were they holier-than-thou? By no means. They were impressively honest and compassionate and realistic. Yes, they live to a high standard, based on a foundation of firm principles, but it was obvious there was no party line when it came to assisted dying, abortion, infertility treatment, organ transplantation … They thought for themselves. They might not agree on the solutions, but they challenged each other healthily, respectfully. They acknowledged their own prejudices, recognised the weaknesses in their arguments, and had the courage to admit there was room for change within themselves. Every single person allowed themselves to be uncomfortable, to alter their position. We laughed a lot. Some tearfully shared painful experiences. We engaged honestly with the issues. And the world is a better place because there are folk like this who have the courage and humility to accept that there are no easy trite answers, who are ready to really listen, to understand, and to support others going through life’s traumas, without thrusting their own opinions on them.
Altogether a thoroughly enjoyable and heartening experience.
Indian proverb: Judge no man till you’ve walked a mile in his moccasins.
