Hazel McHaffie

ethics

Could I? Would I? Should I?

With all my talk of books lately you might well have forgotten that my blog is also about ethical issues. So, something a little more challenging this week.

QuestioningYou’ve probably heard on the news that a teenager has just become the first to be helped to die by doctors in Belgium, a country that lifted their age restrictions on assisted dying two years ago. This girl was 17 years old and terminally ill. Let’s stop and contemplate that for a moment. 17 years old … on the cusp of life. Terminally ill … a tragedy in itself. Now dead … hard to even contemplate the agony wrapped up in that reality. Sends shivers down your spine just thinking about it, doesn’t it?

Belgium legalised assisted death for adults as long ago as 2002. And in 2014 it became the only country* in the world that allows a child of any age to choose doctor-assisted death provided they have parental permission. There are strict criteria; of course there are. The minor must be terminally ill, fully and rationally understand the difference between life and death, face unbearable physical suffering that can’t be alleviated, and have made repeated requests to die. Two doctors, one of whom must be a psychiatrist, must give their approval.
(*The Netherlands permits children to have an assisted death but requires them to be aged 12 or over.)

How do you feel about this ruling?

Would you allow your child to choose to die?

But hang on a minute. Let’s not rush to judgement without properly assimilating the facts. This is not some wilful youngster throwing a hissy fit and whining about a passing ache. This is a wise-beyond-their-years person who’s known extreme and unremitting pain, who knows he/she’s not going to survive this illness. Given these circumstances, could you bear to stand by? Listening to the agonising screams? Seeing the appeal in the eyes? Watching the dying process be strung out, knowing … knowing there’s a way out, a legal option? Wouldn’t you be begging someone to do something … anything?

An opinion poll taken a few months before the law changed to allow children this choice, suggested that 75% of Belgians supported it. Understandably many churchmen, especially those of the Roman Catholic church, opposed it. OK, we know they have strong opinions and beliefs about the sanctity of life. But so too did many doctors. What does this say? They after all are the ones who care for these tragic families, make decisions about treatment, convey the bad news, feel their own powerlessness. This isn’t theoretical for them; they actually stand at those bedsides, see the agony up close and personal.

Could it be that the doctors baulk at a law that allows the life of the child to be ended actively, because they are the very people who’d be asked to actually do the deed? And they are trained to cure, not to kill. It’s so much easier for a lay person to say, ‘Oh yes, a child shouldn’t suffer unbearably; you should help them to die with dignity,’ when they know they will not be the ones called upon to inject that lethal drug.

So, maybe the question ought to be: Would you be willing to end that life yourself? And if not, is it hypocritical to approve of a law allowing assisted dying?

If so, how many of us are guilty as charged?

I’m ridiculously squeamish. I struggle to kill an insect or an arachnoid, preferring to capture them and return them to the wild. There’s something very, very special about life, especially a human life. And I’m absolutely certain I could not be actively involved in the death of a child … or … am I? Because the alternative appalls me. What right have I to insist a child endures terrible suffering? I’m not at all sure I could stand by and not do something to help if it were in my power. Maybe, just maybe, there are certain circumstances where I might feel compelled to forfeit my own comfort, my own preferences, even possibly my own principles, and put the child and his/her interests first. Whether or not I would actually do the deed is unknown. I’ve never been tested.

We haven’t come close to approving assisted dying for adults in this country yet, never mind for children. The majority of – not all – doctors and politicians oppose a change in the law. But we all ought to thoroughly consider the options and consequences nevertheless. I’m not, thank God, facing this devastating dilemma at this precise moment. You might not be. But there are too many families for whom this is no hypothetical question; this is their ongoing living nightmare. What kind of a society do we want for them?

As the late Sheila Bloom, Chief Executive of the Institute of Global Ethics once said, ‘It isn’t about knowing right from wrong – we can all do that. It’s often about choosing one right over another and finding good reasons for it.’ Or we might add, sometimes choosing the lesser of two evils.

Sobering questions for an autumnal Thursday morning, huh?

 

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One True Thing

Early May it may be, but summer has arrived with a vengeance in my neck of the woods, so I seized the opportunity and took a fresh book into the garden to soak up the vitamins. One True Thing by Anne Quindlen. It’s about mercy killing so very much in my field of interest; just the ticket, then. Hmmm. I note that it was published in 2011 so I’m not sure why it’s taken so long to come to my attention. Anyway …

One True ThingWe know from the outset that Ellen Gulden is arrested and sent to jail accused of willfully killing her terminally ill mother, Kate. We also know that she didn’t do it. First person narrative: ‘I only wished I had.

Ellen is a journalist (like Quindlen) living an independent life when her mother is diagnosed with untreatable cancer. Under pressure from her father, she returns home to help look after her, resentful that her Professor-of-English father sees no need to give up his life, annoyed with herself that she still seeks his approval. Nor is he the one to offer bail to free her while the case is prepared; her erstwhile English teacher not only does that but offers her sanctuary too.

Caring for her mother isn’t any easier than Ellen anticipated. Kate Gulden’s deterioration is swift and brutal; the author doesn’t skimp on the unsavoury detail. She has to take large doses of morphine to deal with the pain. When the oncologist orders an autopsy, no one questions the means – the morphine was there in large doses, legitimately supplied by the visiting nurse. And the odds seem stacked against Ellen. It’s common knowledge that she is in favour of mercy killing; her prize-winning schoolgirl essay is trumpeted far and wide in the press. Plus she was the last person to see Kate alive. And she wanted this phase to be over, to get back to her old life; plenty of people can and do give testament to that. The evidence appears damning.

So, if Ellen didn’t administer the overdose, who did? And that’s what the book explores. Ellen herself is pretty sure she knows, but I’m not going to spoil it for you by giving away any more of the plot.

However, the book offers more that a whodunnit. It challenges the reader with some profound thoughts.

We cry to give voice to our pain.’

‘It’s so much easier to know just how you feel about things, what you believe, when you’re writing it on paper than when you really have to do anything about it or live with it.’

‘And knowing I could have killed her was nothing compared to knowing I could not save her.’

‘When your mother’s gone, you’ve lost your past. It’s so much more than love. Even when there’s no love, it’s so much more than anything else in your life.’

Would I have ended that awful pain, indignity and suffering if someone I loved begged me to help?

Oh and I loved this sentence: ‘My father’s regular features had lost flesh in some places, sagged in others, his rather thin mouth becoming more of a liability as the parentheses of middle age appeared around it.’

So no new arguments for me personally, but a very readable rehearsal of the old ones.

 

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Pause for reflection

There’s nothing quite like a spot of immobility to challenge one’s priorities. So much of who we are is wrapped up in what we do. If we can’t do, what then?

A rather nasty early morning fall on black ice (who ever suggested pre-breakfast power walking was good for people of my age in winter time?!) and the equivalent of whiplash injury in my lower spine, have curtailed my movements rather too effectively. Please don’t misunderstand me – this is no cry for sympathy; I’ve no one but myself to blame. No one forced me. But the effect is that I’ve been doing rather too much thinking for my own mental well being. (Well, truth be told, I was always pretty borderline.)

Regardless of the accident, March was always going to be a weird time, a kind of cold turkey, waiting for the latest novel to come off the production line. No more tweaking. No more proof reading. What is, is. And most ‘next-jobs’ can’t begin until the book is actually available – next week!

It’s surprisingly hard to concentrate when you’re in constant pain – or maybe I’m just a terrible wimp. And everything feels cack-handed. Imagine said author draped over an ironing board to write, read, eat, and you have a glimmering of the scenario chez moi. Just not being able to sit down becomes remarkably wearisome. Life gets reduced to essentials.

Unfortunately ‘essentials’ includes a lot of travel right now – Ireland, Cornwall, Midlands, London, all within the space of three weeks. ‘Keep getting out of the vehicle and walking around‘, advises my expert osteopath. ‘Try reclining the seat and lying on your side.‘ Hmm. I guess it depends on the vehicle, and who’s driving, and how soon you want to get there.

Right to DieSo, reflections it is then.

The trip to Galway in Ireland was for an event about dying – both natural and assisted. I was invited on the strength of my novel, Right to Die, and my background in ethics. Eire is working on a parliamentary bill on this subject right now so it’s a hot topic over there; it was an honour to be included. And I felt heartened. After eight years in print my little book is still borrowed from libraries large and small, and the topic is still relevant and controversial,. All very encouraging.

Question is, encouraging enough to keep doing what I do? Hmm. Let’s see.

Things about my work I love and want to retain in my life:
Reading
Writing
Blogging
Editing and revising
Talking about my books/pet subjects
Entering into the debate
Exploring new topics
Good reviews
Hearing from satisfied readers

Things I’m less keen on:
Promotion
Marketing
Tax returns!

Inside of Me coverAhh. The tally says it all. I might revisit this once Inside of Me is on the shelves and my back restored. Who knows, I might evenĀ  reinvent myself and go for those four inch crimson stilettos!

 

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