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Sadly, there is a fate worse than death

What’s in a name? One of the many minor annoyances of contemporary life is that people change names for no obvious reason. The first time I noticed this was when the Dr Barnardo’s Homes charity became Dr Barnardo’s in the late 1960s, and then Barnardo’s in 1988; many others have followed. The Octavia Hill Housing Trust named after the great Victorian philanthropist, suddenly became Octavia in 2001, and the Royal Mail astonished the world by renaming itself Consignia, and then shamefacedly changing back again only 17 months later. And so on.

It is all very irritating. However, I have to admit that occasionally a change of name might be good. It was right for the Spastics Society to rename itself, even if Scope was hardly the most inspired of choices; the word spastic had become a term of abuse. Similarly it was right for all concerned to drop the distasteful word mongol and to insist on the term Down’s syndrome instead.

So last Monday, when the Voluntary Euthanasia Society announced it was changing its name to Dignity in Dying, I restrained instant indignation for a moment to wonder whether there isn’t perhaps some point in it. Names do matter; they affect the way we think.

Euthanasia is an alarming word. It ought not to be; strictly speaking it just means a good death, which is what we all hope for. However, it has come to mean rather the opposite; it has all kinds of terrible connotations with bad deaths, with murdering people because of their race or mental infirmities, or with hastening the deaths of the elderly sick without their consent. There have been some horrifying cases recently of nurses killing geriatric patients more or less to tidy up their wards.

Possibly for the trivial reason that both words are Greek and begin with “eu”, euthanasia has come in a confused way to be associated with eugenics, which is even more alarming. And eugenics is one of those overloaded words that silences argument and stifles thought. A great deal of unnecessary confusion and anxiety surrounds the word euthanasia; this in part explains the passionate resistance to Lord Joffe’s various versions of his bill on assisted dying; he has had to revise it, reducing its scope and — tellingly — eliminating the phrase voluntary euthanasia.

The society’s new name describes what we all want, whatever each of us may mean by that. Unfortunately dignity in dying is something you cannot choose in this country. It is a matter of luck, and if you are unlucky your dying will be drawn out, painful and frightening, like Diane Pretty’s. It is illegal deliberately to help someone to die. Last week’s launch coincided with the haunting story of Dr Anne Turner, who went to Switzerland to die on Tuesday with the help of a doctor, surrounded by her grown-up children.

Her story is a perfect reminder of why the law must be changed in this country. Turner had seen her mother die in pain with inadequate morphine, she had nursed her dying husband through a terrible degenerative disease, and she had recently been diagnosed with another.

Knowing what lay ahead she tried to commit suicide at home, but failed; clearly suicide isn’t easy even for a doctor. In the end she went to a clinic in Zurich where the charity Dignitas gave her a lethal solution of barbiturates to swallow. That meant that she had to be well enough to do so and fit enough to travel to Switzerland. So she had to go to her death earlier than otherwise she might have done. The day of her death she was talking and singing with her children. Had assisted suicide been legal in this country she would be alive today.

Turner was a member of Dignity in Dying; the day after her death another member and former chairman of the charity announced that he was being investigated by the police, after having said publicly that he had advised five terminally ill British people to commit suicide in Switzerland in the same way as Turner. He is Michael Irwin, the brave campaigner and doctor who was struck off the medical register last September for planning to help an old friend die rather than face a painful death from cancer; he says he is quite prepared to go to prison.

It should not need brave trips to Switzerland or the courage of campaigners who break the law to restore to us our freedom to choose our own death. We hear ceaselessly these days of our right to choose, but when it comes to one of the most important there is no choice at all, apart from a lonely and perhaps botched suicide.

I cannot understand why people are so squeamish about death, unless they have strong religious views. As my eccentric mother-in-law used to say, death isn’t the end of the world. In her case this was distinctly odd, as she was irreligious and envisaged no world after death. But what she meant is that there are things much worse than death, which are, so to speak, the end of one’s own world. One of them, surely, is a drawn-out dying, increasingly cut off from one’s world by increasing pain, disability and dependence. To prefer death in such circumstances is not to deny the value of life — rather the reverse. It is because one loves life that one does not want a living death.

Joffe’s new bill, which will soon have its second reading in the Lords, is now too limited. It deals only with “indirect assisted dying”, in which a doctor may give patients a prescription or oral barbiturates to kill themselves. Given the careful safeguards and constraints in the bill I would not be afraid to include directly assisted dying, in which a willing doctor may kill consenting patients themselves (as often happens in practice); some patients, when they decide they wish to die, are no longer physically able to take their own lives.

The only constant counter-argument seems to be another of those phrases that silence argument and thought — “the sanctity of life”. It is good and indeed essential to respect the absolute value of other people’s lives. But one does not have to think of one’s own life, at every stage, as sacrosanct, if one is not religious. It is what it is, and it is one’s own. As my mother-in-law said, death isn’t really the end of the world.

The Sunday Times | Sunday, January 29, 2006

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