Tuesday, 14 July 2009

Taking ownership of our last great adventure.

Lady Joan Downes and her husband Sir Edward Downes are in the news today for their joint assisted suicide at Dignitas. He was 85, going deaf and blind and she, at 74, had cancer. They’d been married for 54 years. The clerics are rolling out their doleful moaning about how very, very sad and sinister it all is

(please cut and paste this addy, I don't have a hash key!)

I know nothing at all about the Downes’ but my fantasy is that they took their time getting their affairs in order and being with their families, then got on a plane for their next-to-last great adventure. I hope they were with people they loved before going to Dignitas to peacefully, quickly and painlessly die together.

Also today Labour are announcing a vauge ideaish kind of thing about care for the elderly. They’re calling the present system of care ‘a cruel lottery’ which it most certainly is. Unless you are a unspeakably rich with a devotedly loving family you’re very likely to end up sitting in a circle of high backed chairs lining the walls of a room where the telly is permanently on, having been forced to sell your home for the privilege. Which is perhaps better than being maintained, alone in your own home by people who have so little time that they will feed you while you’re on the toilet.

Suicide rates are high in the elderly population. Although people older than 65 years comprise only 13% of the US population in 2000 18% of all suicides are in this age group . . . The elderly generally have a stronger intent to die, plan their suicide more carefully and are more likely to use lethal means of killing themselves than are younger persons.

Many apparently very sophisticated philosophical and clinical treaties have been written about the terrible isolation and psychological pain that leads many people to kill themselves. It is always considered irrational, an aberration of mind, a madness that one can take some kind of pill or psychological treatment for. This is because they are all written by Christians or people acculturated to a Christian society. Most Pagans perceive suicide through a Christian lens too.

But life will end. Usually, the weeks, months or years leading up to death will be filled with misery and pain. Most of us don’t know that because our infirm disappear. It’s all very well for domineering Christians and people who are culturally Christian to insist that voluntary euthanasia can be avoided if only we put more money into palliative and elder care, but beyond wishful thinking is the fact that the very best palliative care often cannot deal with terminal pain; that palliative cocktails are often little more than heavy sedatives, so we can’t tell anyone we’re in pain. Ultimately, it’s the economy, stupid. There are too many elderly people and not enough money to even warehouse them let alone care for them. We voters have no social will to change this state of affairs and it is going to get worse.

Suicide can be an honourable act, as sepuku is, as it was for some periods of Classical Greece and Rome and as it was for the Jews trapped at Masada. It can be a perfectly accepted cultural practice, such as when an elderly person acknowledges that they can’t manage the usual winter river crossing and so stops on the bank, watching their tribe cross to the winter grounds, waiting to die of hypothermia. This has been called quasi-voluntary suicide, the implication being that the youngsters no longer want to care for their elders and so the elder has no choice. I wonder how those tribal people would view our more civilized stockroom approach.

Is there a Pagan theology of suicide? What we have so far seems to’ve come about as a result of our own reactions rather than in considered response to any understanding of Paganism. At the heart of all Pagan practice are two concepts: an immanent Deity, and the implications of our choices.

Deity is part of us rather than some external judge and that immanent part of our Selves cannot be harmed if our corporeal form drops away. If we have a theory of reincarnation – and many of us do not – then how does this affect a proposed journey of the soul? Too many Pagans just echo their dominant culture, somehow suggesting that suicide will mean that the person will just have to go back to the beginning like a naughty child or a sinful follower of a vengeful (but curiously undefined) god. If life is a process of gathering experience then the experience of taking ones own life is simply that.

Ending ones own life certainly can have a devastating impact on those who’re left behind but how much of this is to do with our cultures’ attitude to suicide in the first place? Shock rises from the secrecy and shame surrounding the act, secrecy and shame grows from its illegality. People who kill themselves often leave angry people behind, usually because there are so many pieces left to pick up, and that’s because most suicidal people who start putting their affairs in order are prevented from killing themselves. There’s also a lot of self-righteous gossiping, often in the guise of deep concern, which fuels the anger. A parent who adores their children can find the weight of sorrow greater than their love. They may indeed be psychiatrically ill, and for many depressed people psychiatric services do not help them, it just preserves them in pain. More often, they are alone in their suffering. Life is not perfect.

Many of the people I see in a chaplaincy role are in mental states so enduring and so dreadful that they will never be allowed out of an institution. They will have 50 years or more of living with other enduringly unhappy people, no control over what they eat, when they go to bed, when they wake. Most of them function in barely controlled panic and I’ve been asked a number of times to do a spell that will put them into another world or a picture in a book or back in time so that they can avoid certain behaviours that got them institutionalised. They’re diagnosed as having diminished responsibility – they’re not necessarily bad in the sense that an ordinary criminal is – and they have a life sentence in the absolute meaning of the term. They are in as much pain as the person enduring physical anguish.

Imagine a world where people who were in a permanent state of torment were treated with a compassion that suited them rather than those who have control over them. Imagine if they were given the option – by intelligent people without a budget in mind – to forgo the performance of being a good patient. This alone, paradoxically, might give them the freedom to live as a fully integrated human being for a period of time, something they will never experience on a locked ward, in a locked-down life or a locked-up body.

How much more wonderful would Joan and Edwards final days been if they could have their loved ones around them in their own home and garden, holding hands as they took the drugs that would peacefully and swiftly take away their age, infirmities, fears and pains. What an honour, what a privilege to be with these people in a moment of what could be ecstasy, peace and satisfied completion.

1 comment:

E & H's niece said...

Thank you for this beautiful post, Clare, especially the Pagan thealogy.

My aunt and uncle wanted the kind of deaths you described at the end. Instead, he took sick and died about the time she was no longer able to take care of herself, so she lived for a year in a "care facility," deaf and blind and in pain.

As a Chaplain myself, I have had two elder people within the last couple of weeks tell me they no longer want to live. Because I could see no way that they could carry it out, I didn't have to report their comments, as mandatory reporters are supposed to. At the same time, I felt great sadness that they must continue living when they clearly and thoughtfully don't want to.

I so very much hope that if I ever get to that point -- and so many of us do -- someone will allow me the peaceful death I have allowed all my dogs when they reached that point. I will consider it an expression of love.