Euthanasia is a term derived from the Greek language meaning ‘good death.’ These days the word refers to the merciful infliction of death in patients who experience a diminished quality of life through intense pain or disability, or debilitating mental illness. This is a subject that evokes tidal waves of emotional responses in all human beings, reactions that emerge out of the place where our deepest beliefs lie hidden. In this post I want to focus on the case of a man whose life has become ‘increasingly intolerable’, and for whom suicide offers the only hope of ending his misery. I also want to explore through this man’s story, the history of our attitudes on suicide, as well as what it is in us that makes issues like this so contentious. I want to examine what it is that places any idea into a ‘right’ or ‘wrong’ category, why some of us hold steadfastly to our beliefs, and what it would take to get us to shift our perspectives on any particular subject.
After living a life of abundance; with glowing health, a bright career, work contracts in exotic countries, travel to fabulous destinations, good schools for the children and a healthy bank balance, losing it all can test everything within the human spirit. For locked-in syndrome sufferer Tony Nicklinson, life, following a stroke six years ago, has become ‘miserable, demeaning and undignified.’ Since then, he has existed in a totally dependent state, unable to move or communicate verbally due to paralysis from the neck down. Unable to speak, he communicates using a Perspex alphabet board and Eye-Blink computer. His basic needs are catered to by both a team of carers and his wife Janet. Tony has to be fed, bathed, and toileted, and spends many hours alone in his room. Tony’s experience is one of loneliness and boredom, and he can never fully express the absolute humiliation he feels at no longer being able to take care of his family. His situation forces him instead to exist on state benefits and handouts from people who care.
Currently, Tony’s story centers on his quest to end his life, with him seeking the legal consent of the British courts. This is not a simple case since technically, he is making an application for someone to kill him. His paralysis prevents him from committing suicide unless he starves himself. He is unable to avoid challenging the British legal system since he is ineligible to seek help from Swiss Dignitas, an organization committed to assisted suicide. Dignitas assists people with terminal illness and severe physical and mental illnesses to die with the help of qualified doctors and nurses. In line with mandates from the Swiss courts, the organization ensures that the people who are assisted are thoroughly assessed by a psychiatrist and are of sound judgment. Unfortunately for someone with Tony’s disability, their regulations stipulate that patients must ingest the lethal substances themselves; his helpless condition obviously precludes his taking this kind of responsibility. Also working against Tony is the law that compels any doctor, or family member found to have assisted him in ending his life, be prosecuted for murder. Tony’s dilemma therefore, finds him to be yet another catalyst for sparking the highly controversial debate of legally assisted suicide in Britain.
Tony Nicklinson’s case opens yet again, a door to a discussion that has been on-going since Hippocrates introduced the oath that obliged all medical practitioners to refrain from administering lethal substances that would end a dying patient’s life. In ancient times, it was common practice for a doctor to euthanize patients, and generally accepted was a person’s right to end their life for whatever reason they saw fit. Libanius,an ancient Greek philosopher whose writings are a major source of information on the political, social, and economic life of Ancient Greece, reported, ‘whoever no longer wished to live shall state his reasons to the Senate, and after having received permission shall abandon life. If your existence is hateful to you, die; if you are overwhelmed by fate, drink the hemlock, lf you are bowed with grief, abandon life. Let the unhappy man recount his misfortune, let the magistrate supply him with the remedy, and his wretchedness will come to an end.’ Yet around 2,500 years ago, when the Hippocratic oath was put in place, legal euthanasia came to an end. Plato, demonstrating dire disapproval of this oath reflected his feelings in his book Republic. Here, Socrates says: ‘The god of healing did not want to lengthen out good-for-nothing lives… Those who are diseased in their bodies, physicians leave to die, and the corrupt and incurable souls they will put an end to themselves.’ Herodotus, also known as ‘the father of history’,said,’When life is so burdensome, death has become for man a sought-after refuge’
In ancient Rome, those who wanted to kill themselves merely applied to the Senate, and if their reasons were judged sound they were then given hemlock free of charge. More recently, Professor Emeritus of Psychiatry at the State University of New York Health Science Center Thomas Szasz asserted his belief that suicide is the most basic human right of all. He feels that if freedom means ownership over one’s own life and body, then the right to end that life belongs to the individual. In his view, if others force you to live, you do not own yourself and therefore you belong to them.Similarly, Austrian-born essayist Jean Amery, who killed himself in 1978 felt that suicide represents the ultimate freedom of humanity, stating in his book On Suicide: a Discourse on Voluntary Death, ‘we only arrive at ourselves in a freely chosen death.’ Most early societies considered suicide to be a means to ending an intolerable existence. Religion had little influence on this aspect of life and until much later, no personal sense of guilt, or judgement of the person committing suicide was attached to such a death.
Tony Nicklinson tells a grim story of his day to day life. Paralyzed from the neck down, he has to be fed like a baby by carers, he suffers the daily indignities of having the more private parts of his body bathed by people who are not family members and is toileted while suspended over a commode when he doesn’t especially need to go. Added to the obvious ignominy of his physical condition is that of his own diminished sense of self-worth. A once strapping man with keen sporting prowess is now confined to a bed. A once intelligent successful individual, with a glowing career now cannot express himself directly to the public without the assistance of others. This man who provided his family with an affluent lifestyle is now reduced to living on state handouts and charity. His sense of failure and humiliation places him deep in the abyss of human despair. His daughter Lauren speaks of a father who is withdrawn and depressed and watches TV all day, alone in his room. To his mind his relationship with his wife and children are no longer adequate because he cannot give them the physical affectations of love and companionship once shared in his healthier days. Tony does not believe that suicide is a violation of any spiritual code, because he does not hold any beliefs that make it so. Like the ancient Greeks, he sees assisted suicide as a compassionate act, and a just way to die when an individual is confronted with unendurable suffering. Finally getting his case heard in the British courts, Tony has asked that in the case of his own position, a doctor be authorized to assist him to die. He has also challenged the courts to consider that the current law on assisted suicide is in direct contravention with his Article 8 rights of autonomy and dignity. While waiting to hear what the outcome will be, we might take pause to ponder the origins of the current stand on assisted suicide.
The first stigmatization of suicide came during the early years of Christianity at a time when many believers deemed self-inflicted death a pious religious act, as well as an escape from religious persecution. These fervent beliefs resulted in so great a number of mass suicides, that Jewish leaders were forced to consider the impact of a greatly reduced populace on the economy and perpetuation of the race. The result was a religious mandate that forbade eulogies or public mourning for those who had committed suicide. In addition to this, they began refusing to bury Christian suicides on consecrated ground, creating shame and religious dishonour in the minds of the remaining families. These directives marked the beginning of a new belief system that associated suicide with sin and guilt and over time, stigmatized the act of suicide in Judeo-Christian culture.
Pragmatic, rather than divinely inspired reasons for stigmatizing suicide was mirrored in Rome where suicide was not outlawed, but was simply not economically viable in certain circumstances. This was recorded by Titus Levy of the colony of Massalia, where an application for suicide to the Senate was judged, and if they could provide good reason to die, were supplied with hemlock. Those who were refused were people accused of capital crimes, soldiers and slaves. Accused people, if they died before they were tried and convicted, the state lost the right to seize their property. Soldiers were necessary ‘fodder’ for their battles, and slaves were needed for their labour.
Following in the footsteps of Jewish leaders, and in an attempt to control the incidence of mass suicides amongst devout Christians, St.Augustine was the first bishop to introduce into religious doctrine suicide as a ‘sin’. Shame and dishonour related to suicide was indoctrinated into the minds of Christians, and continued for the centuries into the Middle Ages where the ritual of dishonouring the body of a suicide became a barbarous act. Bodies would be first hauled through the streets, they would be disemboweled, parts fed to animals and their heads placed on poles. Eventually they would be buried at a crossroads, an interment symbolic of shame and disgrace. Remaining family members would be punished too, having all property confiscated from them; that of the suicide and their own. Absurdly, those who attempted suicide were subjected to the same public humilation, but were also sentenced to death.
These days, we still bear the fear and humiliation of our forefathers, and carry their burden within our own belief structures. In hearing of people who long for death and are contemplating suicide, we are quick to ‘save’ them from their ‘sin’ and ‘consequent punishment’. We still believe in the doctrines fed to us by people of ancient times who happened to be influential thinkers with personal, political and economical agendas. Our governments bow to antiquated belief systems that are hardly relevant to modern man and our quest for freedom of thought. As with the case of modern science, where new ideas, different insights and new perspectives are continuously being discovered, so it is the case of human beings. As we evolve, we are continuously seeing life through different eyes and constantly changing our way of being in the world.
There are no ‘truths’ out there. History demonstrates this very fact. Our religious, social, economical and political ideas are all fabricated by other people, those who have their own insights about life, but who do not necessarily represent who we are as human beings. Yet we continue to live our lives by their doctrines, rules they made up to suit their own personal truths. All ‘truth’ belongs to the holder of an idea and for as long as an individual identifies with that idea, it is not for us to condemn that person as long as their idea is not harmful to another. It matters not if one person believes in the over-arching sanctity of life, while another believes that suicide is an act of personal choice. What does matter is that we honour each other’s choices and shy away from condemnation of beliefs that oppose our own. There is not one person that has ever lived that has seen God. There is not one person that has ever lived that knows for certain what the after-life holds. There is not one person that has ever lived that even knows for sure that there is an after-life. All we have is our beliefs, and it is important when we are judging a man like Tony Nicklinson to remember that. People like him bring us a gift; they are prophets of our own inner wisdom reminding us to question why we think the way we do. Tony Nicklinson is incarcerated in a crippled, life-less body, and we would do ourselves great justice in questioning if he is a mirror of our own unconscious suffering. Are we too imprisoned by beliefs that other people gave us? Are we suffering because of those beliefs? Perhaps Tony Nicklinson’s call to freedom is our own call for emancipation from the ideas that separate us from each other. Perhaps instead of focussing on his issues we could focus on our own. Perhaps by doing so we will be able to allow him his freedom.