The dignity of death

Death is one of those taboo subjects that people skirt around, reluctant to discuss or think about their own death until crunch time is upon them – by which time it’s either too late to prepare anything or indeed any one for the event.

I’m not usually so morbid.  Recent events in the High Court where  Tony Nicklinson was fighting once again for the right to die, after existing for 7 years as a “locked in” patient following a massive stroke while travelling with business colleagues in Athens brought the topic of death to the forefront of my consciousness. Tony wasn’t living – by his own admission his life was “miserable, demeaning and not worth living”. He was completely dependent on his family and could only communicate through blinking to spell out his thoughts – a biological prisoner of his own body . His mind was sharp, lucid and reasoned and he wasn’t coerced into asking to die by his family – if anything his family loved him enough to support his wish to challenge the current legal position where euthanasia is considered murder.

Last week Radio 4 broadcast a debate “In Pursuit of Dignity” and while driving to Caroline’s I got caught up in the debate, listening to various legal, academic and legal minds discussing what they though “human dignity” meant. None of them had a clearly defined answer or idea but they each knew what it meant to them in their own field of expertise. The debates covered issues other than assisted dying but it was this episode than sparked my interest. While they could all wax lyrical about what it meant to their “profession” it was curious that as a personal definition, they were stumped. To me, “human dignity” is complex and almost undefinable.

Dignity, by the dictionary definition is:

noun, plural dig·ni·ties.

  1. bearing, conduct, or speech indicative of self-respect or appreciation of the formality or gravity of an occasion or situation.
  2. .nobility or elevation of character; worthiness: dignity of sentiments.
  3. elevated rank, office, station, etc.
  4. relative standing; rank.
  5. a sign or token of respect: an impertinent question unworthy of the dignity of an answer.

None of these descriptions really help me to define what it means to me. Dignity means respect for others opinions as well as my own. It means doing, or not doing things/saying things/believing things without compromising my integrity or morals – but at the same time allowing others to have the same opportunity. With this in mind, I listened in horror when the verdict from the High Court was one of denial of dignity. When the judges delivered their verdict they did not show dignity (in my opinion). As a nation of animal lovers, we constantly agree not to let our family pet suffer in the event of an accident or illness. We promise them to keep them safe but to allow them a dignified end when the time comes. So why does the law allow people to continue to suffer more than we’d allow a cat or dog to suffer?

I am lucky – I haven’t experienced the death of a close relative nor have I had a family member suffer from an illness where they beg for release. But I know those who have. A friend’s mother has vascular dementia and when I posed the question “what does human dignity mean to you” on the great social bread board of Facebook, her reply was exquisitely poignant. Her reply was “something my mother hasn’t got, lying in a bed left to cry out for her lost love and life”. Unable to walk and completely bed bound, my friend’s mother relies on others for her care. Some might say that as long as those who care for her are kind, gentle, fair and act in her best interests then she still has her dignity. Others might disagree; we’ll never know as it is ultimately the felt by the person being cared for – if they don’t feel like they have dignity left, then who are we as bystanders to challenge their perception?

The High Court’s decision is not a new one. Between 2003 & 2006, Lord Joffe made four attempts to introduce a Bill that would have legalised euthanasia in the UK but it was defeated every time by the Government. Historically, only one medical doctor has ever been convicted of attempted euthanasia and was given a 12 month suspended sentence in 1992. In 20 years, no other case has reached the criminal courts. But why does the High Court continue to block this most basic human need? Are they scared that this “right to die” will be abused? Are they concerned that those wanting to end their lives with dignity will be coerced into ending their life before they are truly “ready”? These and a thousand other questions I want to ask the judges that sat last week and delivered the most undignified of death sentences to Tony Nicklinson and every other patient in the UK who has had enough of just existing in pain, in exhaustion, in abject misery just waiting to die.

The closest power we have to deciding when we die, is to make a Do Not Resuscitate or an Advanced Directive order and making this known to our primary care doctor and relatives. My grandmother has a DNR – something I had no idea about until I found the card on the side table in her hall about 4 years ago.  She has survived 2 husbands and knows her own mind about her own death. A DNR according to the BBC Ethics page “means that a doctor is not required to resuscitate a patient if their heart stops and is designed to prevent unnecessary suffering”.

The usual circumstances in which it is appropriate not to resuscitate are:

  • when it will not restart the heart or breathing
  • when there is no benefit to the patient
  • when the benefits are outweighed by the burdens

For now, for the family of Tony Nicklinson, the damage has been done. While he was left sobbing and furious after the verdict, his continuing pain was short. His right to a dignified death, and the right to allow others a dignified death has once again been tossed aside by those on high. Death shouldn’t be feared or ignored. It is part of life and life deserves dignity. By simple logic, our death deserves to be as dignified as our life .

Tony & Jane Nicklinson

This post is for Tony Nicklinson and his family. I hope the courts eventually amend their continued error and change the law to prevent others having to suffer as you did.

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