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Real dignity in dying has nothing to do with euthanasia

Dame Cecily Saunders foresaw the threat of euthanasia and created an alternative

By on Monday, 23 July 2012

Dame Cecily brought compassion to the lives of the dying (PA)

Dame Cecily brought compassion to the lives of the dying (PA)

My brother, who lives in a L’Arche community alongside members with a learning disability, has given me a booklet entitled “Celebrating Life in the Face of Death”. It is written by L’Arche members as a guide for those who assist their frailer brothers and sisters when they are dying. In the introduction it says: “The lives of many people with an intellectual disability are steeped in the experience of multiple losses. For some this can be a source of lifelong distress. It is always important to support and minimise the pain of necessary losses. However, some people … are also able to grow in wisdom and self-acceptance. Perhaps the main precondition for this maturity is not being left alone. Being alongside people with learning disabilities, especially as they face their own death, often reveals the essential quality of relationships and shows us what matters most in our lives.”

These words brought back the memory of visiting my brother in the L’Arche community in the Polish city of Poznan and being introduced to a man with Down’s syndrome who was dying. What impressed me was the love with which he was surrounded by others in the community, even though he could no longer move or speak to them. It is the sort of experience we would all wish for when our own time comes and it is a far cry from the kind of dying some experience these days in hospitals in this country.

Tuning in to the car radio the other day I happened to hear a programme concerning “the new Elizabethans”. It was about the life and work of the late Dame Cecily Saunders, pioneer of the hospice movement, and it reminded me what an extraordinary woman she was: utterly determined and single-minded in her desire to bring compassion as well as good medical practice to the lives of the dying. The programme’s producer emphasised several times that Dame Cecily, a committed Christian, was totally opposed to any suggestion of euthanasia. In the 1960s, when the hospice idea was first becoming known, the word “euthanasia” was not being tossed about by some politicians and doctors in the familiar way it is today, but Dame Cecily probably had an intuition that this would happen. Hence her courageous plan to frame an alternative to it.

I blogged recently about the controversial Liverpool Care Pathway. I think Dame Cecily would have been deeply suspicious of a form of medical intervention that first determined someone was dying and then, by a combination of drugs and withdrawal of food and fluids, brought it about. One of our more knowledgeable and eloquent blog commentators, Paul Priest, posted the following in response to that blog: “The LCP is accelerating the deaths of many, murdering the few and denying virtually all the chance to come to the end of their natural life in analgesic consciousness, where they can die with the dignity of saying goodbye to their loved ones. It’s barbaric, it’s euthanasia and it’s a grave evil.”

The L’Arche booklet includes many affectionate anecdotes about the death of community members. One assistant wrote: “I was with Joe when he died and I have come to see that as a great privilege. Joe taught me not to be afraid, just to be silent…through his deep trust he has deepened mine.” This is the kind of dignity in dying that Dame Cecily had in mind and it has nothing to do with euthanasia.

  • Jeannine

    After reading commentaries from people who believe euthanasia is a good choice for those who have  long term debilitating &/or diseases or are just very old, I have made a few general conclusions. These people believe in utiltarianism, the have no belief  in a  loving, omnipotent God, & they fear death, pain & loneliness.

    Subsequent to reading a couple of books by a hospice nurse in Texas (Kathy Kalina) & watching her being interviewed on television, I believe hospice care is a method that gives true dignity to the dying.

  • Acleron

    Just who are these people who say that euthanasia is good choice if you are ill or old?

    All the advocates for legalising aided euthanasia in the UK, that I have seen, want freedom of choice for everyone.

    It is also doubtful that everyone who proposes legalising aided euthanasia wants to maximise happiness. I’m pretty sure some theists support it as well.

    Fearing death and pain is pretty normal in humans. Without that avoidance behaviour, we would be extinct. And as Homo sapiens is a social animal, then fear of loneliness is also a given. 

    And of course, if you don’t believe in some deity and an afterlife, you hold sentient life far more precious than a theist would.

    But at last something I can agree with, well maintained and staffed hospices are a very comfortable way to end your life. But I am reminded of a very dear friend who entered one to die, he told me he was only going to make it more comfortable for his family. However, I’m surprised you bring up an example from Texas, they kill their own citizens, legally and with little dignity, especially if you are black. 

  • Jeannine

    “Just who are these people who say that euthanasia is good choice if you are ill or old?”
     Let’s start with the organizations: Compassion & Choices, & Dignitas to name just 2.
    Or how about Professor Peter Singer from Princeton U?

    “Fearing death and pain is pretty normal in humans.” Yes it is very normal. But I propose to ask you 2 questions: Would 1 fear the approach of death as much knowing that there are persons who genuinely care & love that person? Would 1 fear pain as much knowing that it could be kept under control or even eliminated without losing mental clarity before natural death? The answer is no for both questions if a qualified hospice nurse is taking care of that dying person.

    The difference between hospice & those who advocate euthanasia is that hospice ensures quality of life up until & including natural death. My elderly & dementia-diseased aunt was euthanized. There was no concern over her pain just concern over my cousins’ inconveniences as my aunt was forceably starved to death. My very sick & old dog that I put down recently was treated better.

    BTW; I only mentioned that Kathy Kalina is from Texas so that if you research the name for more information, you’ll get the correct person. It is truly a special, God-given vocation that these hopices nurses have. Blogging about Texas is for another time.

  • http://twitter.com/marion_luscombe Marion Luscombe

    Dignity in dying is one thing, euthanasia quite another. Dying surrouned by love, care and compassionate medical attention is one thing, and should be the right of every person making their final journey. The Liverpool Care Pathway is quite another, and whilst I agree that Dame Cecily  established a way to precipitate death with the utmost dignity, the facts that this is generally deemed to be the ‘norm’ are not there.

    Not everyone can die in a L’Arche community, and the average General Hospital has neither the time, the staff, or the facilities for the dying. The most one can hope for is to be transferred to a side-room where approaching death is ‘unlikely to upset the others’.

    My personal experience of LCP is of it being administered without consultation or consent, with the persons final days being spent in a drug-induced coma. In no way can this be considered ‘compassionate’.

    I am led to believe that ‘Hospice’ death is infinately kinder.

  • Jeannine

    You are absolutely correct. Hospice care is the way to go. Please read the books by Kathy Kalina, a practicing Catholic nurse. In these books (Wisdom for Living the Final Season & Midwife for Souls) she writes about her experiences with dying patients & their families, her witnessing of various interesting events occurring around the patients, & of course her medical knowledge on what to expect during the last hours before natural death. One has to be a very special person to be a hospice nurse.

  • Acleron

    I searched ‘Compassion & Choices’ for ‘euthanasia’ and didn’t find anything in the first twenty hits that say ‘euthansia is a good choice’ as baldly as you put. Perhaps you could point to an actual reference.

    You ask me two questions but then tell me what the reply is. Hmm. I beg to differ from your replies.

    1) To fear death is natural, that emotion may be ameliorated by distraction. Emotions can be manipulated that way. So the presence of people around you may or may not take your mind off the awful topic of death.

    2) Pain that is eliminated, is not painful. But some physical pains are not eliminated except by mind numbing doses. Some pain is mental. Being unable to help yourself in the least way can be intolerable to some people. Especially when they know how much of a burden they place on their loved ones. 

    But I come back to the main point of my post. The change in the law that is being requested is to allow people the freedom of choice to die if they so wish. What exactly is so wrong about giving them that choice?

  • Jeannine

    Here is a nice reference on those who are adversely affected by the so called freedom of choice laws: http://www.notdeadyet.org/. These laws often open the door for selected “mercy” killing or forced euthanasia as one can see coming from the Netherlands & some parts of the United States.

    I don’t think you know what hospice care is. Why not read up on that too?

  • Nat_ons

    Sadly, dead has ceased to be a truly spiritual event in one’s life – that is, one of the most intense reminders of life (or spirit) man can experience. It was annexed to the medical field, of course, as a part of ‘dying’ and that gives its greatest media concern. Yet, in reality, the gross materialism of the Enlightenment darkened the human tragedy of death – almost to obliteration.

    Pain, suffering, anxiety, distress, all are now treated as a material bad (unhappiness, never ‘evil’) to be made happy – if not by drugs then by termination (of the material experience). Death, or rather killing, even murder, are made into material goods (happiness, never good per se) to be sought – as ends in themselves. This darkness of mind as the experience of reasoning matter can offer – and indeed accept – no form of light from life or spirit or purpose.

    This unhappy state, passing as it may be, is the only prevailing form of ‘spirit’ sic acceptable to our age – as it has seemed to be to materialists from ageless antiquity. And to such pessimism anything so ‘good’ as God cannot be a reality only a figment; like ‘love’ to those who have never experienced it. So terminating a material ‘life’ is no affront to an imaginary ‘god’, nor the desertion of reason in material life, let alone a crime against it; all it posits is a ‘happy’ individual piece of matter – if a dead one.

    Life, then, is only a material experience, as if one ‘experience’ sic among many alternatives, not the whole, fundamental and ultimate purpose of rational beings – even material ones (making the matter which gives it the possibility of an animated basis of experience – men, beasts, bio-chemicals et al – a passing accident rather than of the substance of that form of ‘being’). 

    The breath of life, the spirit, is not a precious gift, a miracle, an undeserved favour to be marvelled at and cherished in all its stages and misshapes and mishaps to such ‘rationalist’ sic materialism – in practice at least; in theory, naturally enough, even the materialist seeks to express the glory of life .. but only in so far a basic pessimism (in the character of transient matter) can allow.

    Given this prevailing materialist, pessimistic, happenstance understanding of ‘life’ it would seem that presenting a spiritual or transcendent or God-focused picture to the tragic connection of death and dying to life and living is on a hiding to nothing, this is received as airy-fairy, pie-in-the-sky, wishful thinking; all one can continue to do (I suspect) is to continue to present the joyful, peace-filled, yet still eventful life up until death that proper hospice/ terminal/ persistent vegetative state care can offer .. not dragging out life for the sake of medical practice (which aims at the healing of the material body or the spiritual mind), rather allowing the person to live with his dying and permitting him a happy, spiritually fulfilled, life-filled death .. when it comes (even if it is the drugs used/ interventions withdrawn which incidentally speeds its occurrence).

  • Acleron


    I don’t think you know what hospice care is’
    Care to mention anything I have said about hospices which is incorrect?

    Aah, so you are not arguing about the present change in the law that people in the UK are requesting, just some hypothetical future change that nobody has requested. Pretty much a straw man.

    I can appreciate that some people may be worried about the sort of change you are discussing. It behoves you to make it very clear that you are not discussing the proposed changes and unnecessarily cause distress to anyone. If it concerns you that such a change may be changed in future to allow mercy killings etc, you should be pointing out any faults in the way the proposed changes are written to avoid that happening.

    But you have still not said what is wrong with giving people freedom of choice to choose for themselves whether to die or not.

  • theroadmaster

    Dying with dignity as represented by the morally holistic approach of the L’Arche or Hospice movements, stands in complete contrast to the bleak and nihilistic finality of a needle in the arm or the ingestion of tablets, as represented by euthanasia.  The former fully respects the human and spiritual integrity of patients at the most critical moments in their lives, while the latter consists of ending human life when it fails to be productive in a very narrow, materialistic sense.  Death is not seen as entry into a dark void by the practitioners of end of life care in the Hospice tradition, rather there is a metaphysical dimension to our lives which has to be factored in to overall treatment that one receives as opposed to the purely utilitarian and atomized view of life of the euthanasia supporters.

  • theroadmaster

    The slippery slope argument can be applied to the reality of countries effected by legalization an evil like euthanasia as in the case of abortion in countries like GB.  The law which legalized abortion in GB was enacted in 1967 and it’s promoters promised the British public that it(abortion) would only be used in a small minority of situations.  But now we have practically abortion in demand, with figures shockingly reaching around 196,000 in 2011. The same pattern of a creeping widening of criteria to apply a dark ideology can be seen in the case of euthanasia in states like Holland.  Not so long ago(in 2002), Dutch parliamentarians were discussing the feasibility of allowing children(with symptoms like deep depression) between 12-15 years of age, to end their lives on request, with the necessary support of parents/guardians or physicians  Also there have been numerous cases in Holland of medical practitioners deliberately applying an overdose of drugs to expedite death in patients suffering from grave illness, rather than trying to ameliorate their suffering. Support for euthanasia or assisted suicide, is a damning indictment of the rather narrow and cynical view of life promulgated by their supporters which stands in mark contrast to the civilized and holistic approach of the hospice movement or L’Arche.

  • theroadmaster

    The slippery slope argument can be applied  to countries which have legalized in favor of an evil like euthanasia, and we have seen it in relation to abortion in GB.  The law which legalized abortion in GB was enacted in 1967 and it’s promoters promised the British public that it(abortion) would only be used in a small minority of situations.  But now we have practically abortion in demand, with figures shockingly reaching around 196,000 in 2011.
     The same pattern of a creeping broadening of criteria for the application of these evils, can be seen in the case of euthanasia in states like Holland.  Not so long ago(in 2002), Dutch parliamentarians were discussing the feasibility of allowing children(with symptoms like deep depression) between 12-15 years of age, to end their lives on request, with the necessary support of parents/guardians or physicians  This was passed into law by them. Also there have been numerous cases in Holland of medical practitioners deliberately applying an overdose of drugs to expedite death in patients suffering from grave illness, rather than trying to ameliorate their suffering. Support for euthanasia or assisted suicide, is a damning indictment of the rather narrow and cynical view of life promulgated by their supporters which stands in mark contrast to the civilized and holistic approach of the hospice movement or L’Arche.

  • Acleron

    Yes, yes, we know you don’t like it but marking your dislike with words like evil and darkness shows the paucity of the argument.

    The abortion act has not changed since 1967, the only difference is that Doctors, quite rightly, are more concerned about dangers to the woman. This is a result of changes in society and the realisation that pregnancy, even under modern care, is dangerous. It is no longer acceptable to consider half the human race as just wives and mothers. But if you don’t like the number of abortions, start educating kids in your schools about contraception, that would be doing your bit to reduce the frequency.

    Holland may have debated a change but it doesn’t seem to have been enacted. So no creep in the law.

    Support for assisted suicide can hardly be considered as anything else than freedom for the individual. And all the time you try to make out that greater freedom is somehow a narrow and cynical view, you disclose that your objection comes from your religion. Perhaps it is time we as a society threw away any respect for a book that was written by people who had no idea of modern society or the opinions of people who reference such book without considering the individual.

  • http://jessicahof.wordpress.com/ JessicaHof

    In a society where want of faith in Christ encourages people to think that this life is all they have, and where medical doctors seem to feel the need to play a god-like role in prolonging life until they feel not need to, we end up with the sad situation we have. Thank God for places like l’Arche and for the Hospice movement where people can be properly cared for as they prepare for the next world.

  • theroadmaster

    So you overlook the terrible reality of the annual abortion figures which amount to abortion on demand and talk instead about doctor’s concerns for the medical health of women. We should all be concerned about the health of women, both pregnant and non-pregnant, but we cannot seriously believe that 100,000-200,000 nascent human lives are being cruelly butchered on a yearly basis, merely because of “health” risks to women.  The reality is that the vast majority are carried out for social reasons, contraception failure, inconvenience in having a child or for a medical condition the embryo or foetus is carrying.  Even the criteria which is used to cover physical or medical dangers to women during pregnancy, is so amorphous and flexible, that we cannot be sure that it is logically consistent.  Abortion in effect has become too easily accessible and society must reflect on it’s terrible moral and physical consequences
    Holland has legislated itself onto an immoral slippery slope and it’s consequences can be seen in the cases of doctors secretly prescribing or administering drug overdoses to precipitate death in patients, as distinct from intentionally relieving them of pain.  Freedom to kill one itself you call a progressive move, while others would more accurately describe it as symptomatic of a society in moral crisis, valuing people in a narrow, utilitarian sense rather than in their whole personhood, both body and soul.   Christianity as embodied in Catholicism puts people front and centre at the heart of it’s philosophy and stresses their innate worthiness from conception to natural death.  Euthanasia and assisted suicide in stark contrast offer only despair and bleakness without any hope or consolation for those who go down those terrible paths.

  • Acleron

    Assisted suicide is a choice. Nobody is asking you to undergo it and you have no idea of the pain people can experience either mentally or physically or you wouldn’t want to deny people that choice because of an outdated list of  rules.

    Suicide is always a bit of a problem for those who run after-life belief systems. You can’t have people dropping of the mortal coil to get an early pass to heaven, you’d run out of punters pretty quickly. So another layer of rules have to be invented. 

    But please don’t tell me that catholicism puts people front and center, it doesn’t.

    It doesn’t in human rights,  condemning swathes of humanity to second class status. It doesn’t in health by trying to deny condoms to HIV positives. It doesn’t when it tries to deny contraceptives to women. And it doesn’t when it denies incurably ill patients the choice to continue or stop their suffering.

  • Trevor Moore

    On his visit to Dignitas, Professor Craig Stewart spoke forcefully about HIS right to choose – not someone else’s, however well-intentioned.  Pain and suffering are subjective – it is patronising to think that you know better.  The idea that giving people the right is a charter for killing the vulnerable is specious and clouded by your beliefs.  Let grown up people choose – and like Oregon, Belgium etc, build in legal protections for others.

  • Dmcinnes6

    How patronising you are!  Your whole view is based on your religious beliefs which are not shared by overwhelming numbers of people.  How dare you presume that you have the moral high ground, again based on unproven assumptions.