The remark that suffering shouldn’t be allowed is widely held, and many would agree with him. Yet suffering is a part of life, just as happiness is, and it is certainly not a justification for ending life. Suffering stalks the wards of all hospitals, but it is not senseless; if it was, all life would be senseless, and it is not. Indeed, suffering is a mystery that we cannot fathom, and never will be able to. The mystics embrace suffering, as one of the steps towards perfection.
I remember a lady whom I nursed when I was at the Elizabeth Garrett Anderson Hospital. I will never forget her, or what she said. She was a nun from a prestigious Roman Catholic teaching order, with schools in France, Belgium and England. She was a Latin and Greek scholar, and was deeply respected not only for her intellect but also for her teaching skills and her administrative abilities.
She was only forty years old, but her body was inflamed and distorted by rheumatoid arthritis. Her joints were virtually locked, like those of a wooden doll, and any movement was agony for her. We made matters worse by administering quite the wrong treatment. At the time it was thought that aspirin helped arthritis. Perhaps it did, sometimes, but this lady was allergic to aspirin, and she developed a duodenal ulcer. Nothing was known about allergies in those days, and it was thought that milk was the best treatment for a duodenal ulcer, so she was put on a milk diet, which meant about six pints of milk a day. This caused an irritable bowel and constant diarrhoea, but still we persisted with milk and aspirin, not knowing that both were causing the violent reaction. At no time of the day or night was this poor lady without pain. She could not move because of the arthritis, and her inflamed gut allowed her no rest. She could barely sleep. We had to turn her hourly, sometimes more frequently, to clear the frothy faecal fluid and blood that poured from her. Moving her was agony for the arthritic-locked joints, but she never complained, nor even let out a moan of pain – yet we could see the suffering in her eyes.
One day she said to me, ‘I used to think that I was doing God’s will in my religious vocation. I used to think that by teaching the girls, and instilling a love of classical learning, and the knowledge of Holy Scripture, that I was serving God. But now I know that I was wrong. God does not need my intellect, my learning, or my teaching. All that God requires of me is that I should lie here and suffer.’
This lady had entered the hell of physical suffering and, in its depth, found spiritual peace.
The prospect of state-sanctioned euthanasia sends a chill of despair down the spine of most medical people. Medicine is a vocation, not a job. It is a calling, comparatively rare, to care for and, if possible, to heal the sick. To promote death is contrary to the Hippocratic oath and inimical to the heart of medicine. If euthanasia became law, medicine, as we understand it, would come to an end.
The vast majority of people are simple, trusting souls who lead decent lives, go to work, raise their families, meet their friends, and, when they get sick, they go to their doctor in the hope that he or she will be able to make them better. If there was the smallest chink of suspicion, especially in the minds of the helpless or the chronically sick, that they could be ‘put down’, the trust would be destroyed. ‘Put down’ is emotive language, usually best avoided, but it is the language of ordinary people, it is the way most of us think and feel about these things.
I am a Christian; with every breath of my body, every beat of my heart, I trust and love God. Christian teaching guides my thoughts and my life. But when it comes to euthanasia, I flounder in a sea of uncertainty. It is horrifying, and contrary to the ten commandments, to think of killing the weak and helpless. Yet I also believe in evolution, and it may be that the necessity to decide the time of death for ourselves and others is part of God’s purpose for the evolutionary development of mankind towards responsible maturity, to which we will have to adapt mentally, spiritually and emotionally. Yet still it shivers me, and I don’t know the answer.
State-sanctioned euthanasia would open the floodgates for the entry of unimaginable wickedness. Not everyone is well motivated, not all families are loving, not all people wish their neighbours well. Doctors are not all wise and good, and it is quite possible to become addicted to killing, as the career of Dr Harold Shipman has shown us. The Devil is alive and well in the twenty-first century, and will no doubt exploit the opportunities for evil.
Yet a paradigm shift in the evolution of man has occurred in the last seventy years, which has altered birth, life and death, totally and irreversibly. Scientists can now confidently say that human life could be extended to two hundred or three hundred years, and some even say a thousand! Having seen, in my own lifetime, the miracles (that is not too strong a word) that medicine can achieve in saving and extending lives, I do not doubt that this will be possible. But given the difficulties this could imply - questions of quality of life, overpopulation, human and natural resources - a cut-off point will have to come somewhere. If it does not come from natural death, or individual decision to die, it will have to be imposed. This is euthanasia.
The personal decision to die at the right time, and in the right way, is the ideal promoted by those who would legislate for voluntary euthanasia. But will it really end there? If medicated life can be extended, decade after decade, with no end in sight, surely someone will have to make the decision to end it?
To ‘turn off the machine’ is the expression most people use to mean ending life by turning off life-support equipment, such as a ventilator or a kidney machine. But, although the ethics are exhaustively debated, and a legal decision is required before it can be done, it involves relatively few people and occurs only in special circumstances. Yet the issue is more complex. As with everything in life, it is the little things that shape our destiny. Millions of people daily take drugs that keep death at arms’ length for a few more weeks, or months, or years. Should that switch be turned off? In other words should we, who are dependent on drugs, cease to take them and allow death to come? And if so, when? This does not require the decision of a judge or magistrate. It is a personal choice.
I have heard several ageing people, who enjoy robust good health thanks to cardio-vascular drugs and other life-maintainers, tell me quite cheerfully that when the time comes they will want to ‘take something to end it all’. When I point out that it would be far easier to stop taking life-maintaining drugs, or have the pacemaker disconnected, their smile vanishes. The muttered response is usually something like, ‘But I couldn’t do that’ and the person looks profoundly unhappy, and sometimes even shudders. The reaction is muddled thinking, certainly, but understandable. Which of us does not cling to life? When dying seems years away, we can be objective, even blasè, about it; but when it is to be next year, next month, next week - oh no! - and we reach for the pills that will prolong our time on earth.
Yet I am convinced that within a short time – a generation, perhaps, or two at the most – we will all have to take responsibility for our own deaths, and we will have to get used to it.
But what of those who cannot take the responsibility, or cannot articulate it? Most people would say that the doctors must decide. Under common law today, and perhaps more subtly, social pressure, doctors have to be very careful of withdrawing life-maintaining drugs. It is not strictly speaking euthanasia, but it is close.