Hinterlands between the living and the dead

We didn’t cover the Dia de los Muertos, the Day of the Dead celebrations on 1 & 2 November. Perhaps that was an oversight. It’s a colourful and intriguing festival of great interest to Westerners. Those from cultures influenced by Protestantism tend to be a bit tongue-tied in their relationships with their dead.

The Dia de los Muertos is much envied by those who feel that their own culture has forgotten how to commemorate the departed. But is it culturally informative, or is it no more than a cultural curiosity?

Held to coincide with the Feast of All Souls, the Dia de los Muertos is the result of the incomplete colonising of a pagan festival by militant Catholics. Its origins are Aztec and it possesses a quality of incoherence which seems not to bother anyone very much. In its original Aztec incarnation the Dia expressed the belief that the living and the dead co-exist. Christian teaching, on the contrary, tells us that our dead go far, far away.

Our own Hallowe’en is, of course, the product of another such marriage of incompatibles, in this case between Christian All Souls and the pagan Samhain, held at that time of the year when the door to the Otherworld opens wide enough to allow the souls of the dead to return for a brief time. Again, not at all Christian.

In an increasingly secular society, where the spectrum of spiritual beliefs is very great, it is useful to have the examples of other cultures to plagiarise and adapt – repurpose, to use the modern idiom. We can probably expect to see a growth in the variety of commemorative observances as people increasingly find the courage to do whatever it is they feel they need to do no matter what anyone else might think.

Maurice Saatchi, for example, breakfasts every day with his dead wife, Josephine Hart, at her grave. He’s not a fan of the moving-on/closure school of grieving. He says, “In my view, to move on is a monstrous act of betrayal and to come to terms with — I think I’d call that an act of selfishness.”

Saatchi’s wifes’s death has even enabled him to redefine his own identity: “The reality of it is that she is me, I am her, we are one . . . I am Josephine Hart, I can put it no stronger than that. It is no different now from what it has always been; we have always been one person.”

The on-trend hinterland between the living and the dead is currently that occupied by zombies. Of ancient African origin, contemporary portrayals of zombies are derived from the slave culture of Haiti, where, according the Amy Willentz, ‘the only escape from the sugar plantations was death, which was seen as a return to Africa, or lan guinée (literally Guinea, or West Africa) … The zombie is a dead person who cannot get across to lan guinea,’ and is thereby condemned to an eternity of backbreaking toil in the sugar plantations under the rule of cruel overseers.

Wilentz goes on: ‘There are many reasons the zombie, sprung from the colonial slave economy, is returning now to haunt us. Of course, the zombie is scary in a primordial way, but in a modern way, too. He’s the living dead, but he’s also the inanimate animated, the robot of industrial dystopias.’

Leaving aside industrial dystopias (together with ghosts and angels), let’s finish by considering the living dead – those kept alive by modern medicine; those who inspire all the debates we’re having these days about assisted dying.

The Liverpool Care Pathway has come under fire in recent months. Doctors have been prescribing it without consulting some families. Hospitals have been incentivised to apply it to living dead people in order to effect economies in healthcare.

The Liverpool Women’s NHS Foundation Trust received £1.03m for doing just that in the last financial year.

Seeing it through

In the summer edition of the Oldie magazine (strapline: ‘Everybody buys it eventually’), Mavis Nicholson discusses the case for the ‘right to die’. She says:

I had a conversation with an even more elderly chap than me, a GP all his working life, who was in very bad shape. He said he thought it was too potentially dangerous to allow people to choose their death or for relatives to have a say in the matter — or doctors and nurses for that matter. “It’s not that I don’t trust people,” he told me. “On the whole I do, though I think I am pretty wily and watchful as well.” No, he thought we should see it through to the end. “That’s what I have done in my family affairs,” he said “through all the trials and tribulations there have been in that quarter. I fought in the last war and saw that through with gritted teeth, I must admit. My job has been very full on, but in the end I am glad I have seen my way through the undergrowth and found life’s clearings, you might say. And I’ll see myself into the final clearing, I hope.”

Who says?

“The current law exists to protect those who are sick, elderly, depressed, or disabled from feeling obliged to end their lives. It requires every case to be reviewed by the police and the DPP to determine whether a prosecution is appropriate. The present law protects those who have no voice against exploitation and coercion, acts as a powerful deterrent to would-be abusers and gives discretion to judges to temper justice with mercy in hard cases. The current law does not need changing.”

Dr Peter Saunders, Campaign Director of Care Not Killing

The Commission finds that there is a strong case for providing the choice of assisted dying for terminally ill people. Even with skilled end of life care,
the Commission finds that a comparatively small number of people who are terminally ill experience a degree of su+ering towards the end of their life,
which they consider can only be relieved either by the ending of their life, or by the knowledge that they can end their life at a time of their own choosing.

Download (free) the Commission on Assisted Dying report here

Quote of the day

“All doctors have the knowledge and – usually – the means to end their lives … and quite a few use this privilege, even if it doesn’t appear on their death certificates. Doctors are also more likely to have medical friends and relations prepared to assist if necessary. As a doctor, this is a great comfort to me and I don’t see why enabling the unmedical to share this comfort is wrong in an age when deference and privilege are increasingly unfashionable.”

Dr Colin Brewer in evidence to the Commission on Dying, December 2011

When suffering becomes pointless

In a very good article which addresses society’s need to address the consequences of technological advances in medicine, Dr Alex Lickerman says this:

The notion that dying is a right seems nonsensical to argue:  death is given to all of us equally without the need of anyone’s sanction.  The right to die well, on the other hand—well, that’s another matter entirely.  A good death is, in many cases, something our fellow human beings have great power to grant or deny, and is therefore, sadly, a right for which we must indeed fight. 

The notion that we’d even need to fight for the right to die well has only come to make sense relatively recently, within the last forty years or so.  Prior to that, our ability to prolong dying—meaning, keep extremely ill people going in hopes that they might overcome whatever health problem threatens even when the likelihood is vanishingly small—was actually fairly limited.  But with the advent of modern intensive care units and all the amazing technology that’s emerged in the last four decades, we can now stretch the quantity of out our last days often to weeks or even months.  Unfortunately, a similar stretching of quality hasn’t yet occurred; if anything, we see the opposite (to be fair, the same technology also stretches some lives to years and even decades, meaning it’s enabled some people to recover from insults that in the past would have undoubtedly killed them).

… … …

Though I’m pledged to prolong life where I can, I’m also pledged to alleviate pointless suffering.  Thus, I very much believe in the right of people to freely choose the method and time of their own demise when they find themselves in circumstances where such a choice has become the only option to relieve their pointless suffering.  We remain profoundly uncomfortable as a society with this position, but our own technological advances will eventually force us to embrace it.  As more and more people die in needless pain and more and more people sit watching, eventually, I believe, we will accumulate enough collective experience to make peace with the notion that what we currently do with our pets is far more humane than what we mostly do with each other.

Read the entire article here

Please talk about this

This press release was issued this morning by Dignity in Dying following Geraldine McClelland’s death at the Dignitas clinic in Switzerland:

08 Dec 2011: My dying wish: please talk about my death
In September I decided to travel abroad to die. Having made the necessary arrangements, in October I contacted Dignity in Dying and asked for their help in making my views on assisted dying public. Below is an open letter to anyone and everyonewho is interested and concerned about the issue. I have asked Dignity in Dying to distribute it to the media on my behalf when I am in Zurich.

My name is Geraldine McClelland and I have chosen to die today.

I am 61 years old and am dying from lung and liver cancer, which metastasised from my breast cancer two years ago. I spent my working life at the BBC, producing programmes such as Watchdog, Food and Drink, Health Check and Crimewatch.

I have chosen to travel abroad to die because I can not have the death I want here in the UK. I would like to be able to choose to take medication to end my life if my suffering becomes unbearable for me, at home, with my family and friends around me. But the law in this country prevents me from doing so. As a result I am travelling abroad to take advantage of Switzerland’s compassionate law. I was worried this option would be taken away from me when the Swiss people were asked to vote on whether British people (and other non-Swiss) should be allowed to continue to have an assisted death there. Thankfully they voted overwhelmingly to continue to let people like me have the death I choose, albeit in a foreign country. I was fortunate to be able to retire ten years ago and have been able to thoroughly enjoy my retirement, travelling the world. The lung cancer is now causing me serious breathing problems, meaning I am largely confined to my flat.

I am not sad that I will die today. I am angry that because of the cowardice of our politicians I can’t die in the country I was born in, in my own home, but I am not sad. I feel sure this is the right decision for me and I am relieved that I won’t be forced to suffer any more. Please don’t feel sad for me either. If you feel anything at all when you read this letter then please turn it into a fight to change the law so that other people don’t have to travel abroad to die, and that those who are unable to because they can’t travel, or can’t afford the fees don’t have to attempt suicide at home or continue to suffer against their will. In that respect I am one of the lucky ones.

I believe that as part of my end of life care, which has otherwise been good, I should have been allowed to choose not to endure the last weeks of my life, and I believe you should have that choice when you are dying too. I don’t believe that my brother and sister should have to break the law so that they can be with me when I die. Your loved ones should not be in that position either. My decision is made, I choose to die on my own terms and with my family around me in Zurich, and it’s too late to change the law for me, but please, if you care about this issue at all please make your voice heard. I appreciate that it is a difficult subject, but when dying cannot be avoided, let us be compassionate enough and tolerant enough to respect choice.

Geraldine McClelland

www.campaignfordignityindying.org.uk

Wants out

Since a stroke six years ago Tony Nicklinson’s life has been, in his own words, ‘dull, miserable, demeaning, undignified and intolerable’. Tony can only move his head and his eyes. He has locked-in syndrome. 

And now he wants to die. 

In fact, he’s demanding the same right to end his life that any able-bodied person has. But because he is physically unable to kill himself, he’s issued proceedings in the High Court asking for a declaration that it is lawful for a doctor to terminate his life, with his consent and with him making the decision with full mental capacity.

Full story here

Hat-tip to Kingfisher 

An Instinct for Kindness

From the review in the Guardian:

Last year Chris Larner took his ex-wife Allyson – with whom he had remained good friends – to the Dignitas clinic in Switzerland where she ended her life. It was a life that had become unbearable because of the constant pain, indignities and limits imposed upon her by multiple sclerosis, a condition she had lived with for more than 25 years. Allyson decided that enough was enough.

It is its total lack of sentimentality that makes it so moving, and half the audience is in pieces long before the end. That, and because the redoubtable Allyson is so fully present in the show. Planning her own funeral, she declares: “I don’t want any stiff upper lip. I want weeping and wailing and inconsolable.” This was not a woman to go gently into that good night, and this is a show that reminds us that how we die is as important as how we live.