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Cheers - AE

Sunday 4 October 2009

Good intentions paving a road to somewhere nasty.

I have nothing but sympathy for the family of Kerrie Wooltorton, the suicidal woman who recently took an overdose and then called an ambulance only to refuse anything but palliative treatment. Not only are they coping with a bereavement but they are also dealing with the death of their offspring, something which we seem genetically programmed to find completely unnatural, and must also cope with the awful knowledge that she actively chose death. However, this isn't an answer.
The family of a suicidal woman whom doctors allowed to die because she had signed a “living will” are planning to sue the hospital for failing to intervene.
Even if they sue solely to create a precedent and demand only nominal damages NHS funds and resources will be used up on a legal matter instead of on patients. I'm not a huge fan of the NHS, its monopoly position and particularly the way everyone is forced at the point of a metaphorical gun to pay for the inefficient monster, but suing just doesn't make sense. Who pays if you win? Answer: everyone pays, including the people who sued in the first place.

But that's almost a side issue to the point that really troubles me.
The parents of Kerrie Wooltorton are also calling for an urgent change in the law to stop rules which gave the terminally ill the right to decline treatment being used by those wanting to kill themselves.
As I said, I have a lot of sympathy with the Wooltorton family, but their daughter's life and body were not theirs but her own, and I feel that their desire to solve the problem by giving the state ownership is highly immoral. I've watched someone drink themselves to death, and while I wished like hell they'd just stop drinking I'd already recognised two painful truths years earlier - that they were probably going to die and that it was through their own choices. Would we accept some kind of pindown regime to prevent another boozer drinking themselves into the grave? I'd hope most people would find the idea of treating a rational adult that way abhorrent, yet is it so different from forcing life saving treatment on someone who has decided that they don't want their life to continue? Okay, clearly someone who keeps drinking - or smoking, or taking a drug, or eating lard pies with double salt, or whatever - at a rate which is harming them because they're enjoying it isn't quite the same as someone who's suicidal. I accept that the decision to end one's life is often, though far from always, irrational. But if genuine mental illness is involved does there really need to be a change in the law when people can already be sectioned? And if there is insufficient cause to section someone why can we not assume that they are closer to rational than not and have arrived at their decision after thinking about it carefully? I don't know which would have applied to Kerrie Wooltorton but I'm sure that if I chose to end my life in a similar way I'd be pretty pissed off with her family if my rational choice was denied and treatment was forced on me against my will. However, the coroner found that despite a personality disorder and a history of depression:
... Miss Wooltorton had “full knowledge” of what she was doing and said that it would have been “unlawful”for the doctor overseeing her care to intervene.
Now I can understand the family saying things like being ashamed of British law when it allows this sort of thing to happen - it's the grief talking*. But what is the excuse of people like The Telegraph's George Pitcher when he says:
Kerrie Wooltorton's death shows how we have lost respect for life.
Have we, George? Have we really lost respect for life, or are we simply starting to wake up to the fact that freedom is actually of even greater importance? And since freedom is very much an individual thing perhaps this is not so much an erosion of the respect for life as feared by George Pitcher but an elevation of the respect for personal choices, including the ultimate choice anyone can possibly make in their life - the decision to stop it.

George asks that we
Try this: just for a moment, imagine that the police visit your home to tell you that your child has committed suicide. Now imagine that they tell you that the ambulance and hospital staff could and would have saved her life, but she handed them a letter asking them not to.
So they didn’t.
This is where we have arrived in our attitude to suicide in Britain today. A disturbed young woman, with all the promise of adult life before her, is left to kill herself, because under her current circumstances she wants to.
Well, George, according to the coroner she wasn't that disturbed. It's very sad but she made a decision, and unless people are to be treated as little better than property such decisions must be respected. As I said above, would you force treatment on a rational adult who'd arrived at death's door from simply abusing their body? The NHS have a track record of refusing treatment to people such as smokers, drinkers, fatties, etc., ostensibly because they're the architects of their own misfortune but possibly as a cost saving measure too. Even when a patient begs for treatment for a self inflicted condition they might be refused and allowed to die because of the guidelines the NHS works under, so isn't it just a bit inconsistent to force treatment on someone who'd calmly decided to take a big overdose in order to end their life?

George goes on to mention the recent law that is involved in the case.
Apparently, doctors who could have treated Kerrie didn’t do so, because they feared that they might have been prosecuted for assault under the Mental Capacity Act (2005). This legislation forms part of a raft of laws and “guidance”, introduced on this Government’s watch, which promotes the individual’s right to die over our society’s responsibility to save their lives if we can.
Wait, what? Did I just read that right? George has a problem with the concept that an individual owns their life being put above "society's responsibility to save their lives if we can"? George, what fucking responsibility are we talking about here? Society has no such responsibility and has no more right to force treatment on a someone who has made the considered decision to refuse it than a wealthy film director has to drug a teenager so as to give her one up the backside without her resisting. Yes, I really do equate the forcible application of medical treatment when it's been clearly and expressly refused as morally equivalent to anal rape. You might protest that unwanted medical treatment would be forced on someone out of a desire, supposedly on the part of society, to do good and to help the person. Fine, and I believe it, really I do. But I also believe that a rapist can genuinely love their victim, but if we all agree that 'no' means 'no' then I think we'd all agree that it's still rape no matter how much love was felt or how genuine it was. So it just boils down to a question of whether we, ah, sorry George, I should say society gives the same weight to "no, I do not want you to perform a quite probably invasive medical procedure on me" as "no, I do not want to have any kind of sex with you, especially penetrative".
It passed onto the statute book to enable terminally ill patients to have a degree of autonomy over their medical treatment. It was intended to allow those who were dying, or who knew that their condition could only end in their death, to refuse medical treatment so that nature could take its course.
In its intent, this is important and altruistic legislation. As medical science advances, we can live to grossly extended, grotesquely burdened and undignified old ages. Within a couple of decades, it is said, we could effectively be immortal, short of the serendipity of accidents and the actions of our own hands.
It follows that we are at a pivotal era in medical ethics and human morality. We are asked to decide whether we want or should live forever, or whether we believe that there is a more “natural” span and narrative to human lives. If we decide on the latter, then we are going to hang on to, like old friends, the diseases and conditions that have carried away our forebears, rather than live out lives in which we forget out youths and watch our children grow decrepit with us.
That kind of hell was, I imagine, what the living wills legislation was aimed at. It can’t, please God, have been intended to allow distressed and depressed twenty-somethings, in otherwise good health, to kill themselves because they want to, with our blessing.
No, it probably wasn't, but then governments are pretty good at failing to see all the consequences of legislation they pass. As a libertarian I'd always say it's better to have less legislation in the first place, which would have the same effect in this instance. A distressed twenty something would be at liberty - by the way, that's a word you should look up in the dictionary, George - to kill themselves because they wanted to without the need for the Mental Capacity Act's living wills, though if that's what it takes at the present time to get some bloody legal recognition that an individual's life is their own then I'll take it for now.
There is a public attitude that is now pro-suicide, fostered by the euthanasia lobbyists Dignity in Dying, Lord Falconer’s frustrated assisted-suicide amendments in the House of Lords the commercialisation of self-destruction by Swiss clinic Dignitas. Want to kill yourself? Of course you do. You have that right. Go ahead.
Yes, there are some people that are pro-suicide, and that might be because the fear of death, or rather being dead, is starting to become smaller than the bit immediately beforehand. People are getting frightened of scenarios like weeks or months plugged into various machines via an array of wires and tubes, or a slow decline into increasing pain until oblivion really is the most attractive thing in the universe, or the gentle decay of the nursing home where the Alzheimer's might even be a blessing if it prevents you from noticing that you've just shat yourself. Again. Yes, those are possible futures and many of us will have seen enough of them to prefer being dead to experiencing them personally, and that naturally fosters a demand for a peaceful and painless exit. Personally I'm not pro-suicide as such, but I'm very much pro-owning my body. If there comes a day when, in Jeremy Clarkson's words, I want to be drunk and happy and then I want to explode the, aha, very last thing I want to happen is for some well intentioned busybody to stop me. I can't reiterate it enough - my body belongs to me. Not to George Pitcher, not to a Church, not to the state, and not to society. It's mine, okay, so if I tell you to bugger off and not put needles into it, or for that matter to stand by and do nothing while I put a colossal needle containing a truly epic quantity of heroin into it, I expect everyone to bloody respect that. Got it?
These people have successfully usurped what generations of humankind have known as the sanctity of life. That doesn’t have to be a religious belief. It is simply the intuition that we hold and value human life over the taking of it.
Again, George, no usurpation of the sanctity of life has taken place**. We can still value human life over the taking of it, but this is not the taking of life at all. 'Taking' strongly implies forcibly ending the life of someone who wants to live, and that isn't remotely applicable to the situation of someone voluntarily ending their life. I suspect George Pitcher talks about 'the taking of life' from a desire to make this sound like murder as opposed to simply respecting, albeit perhaps with sadness and regret, the considered wishes of another human being. Coming from someone who is not just of a religious persuasion or even just another practising Christian but is a working C of E priest this attitude isn't altogether surprising, but George, we're not talking about forcibly ending someone's life at all. I'm as opposed as anyone else to the taking of life, probably as much as you and probably more so than some self professed religious people in this world, but this is not about 'taking' life - it's about relinquishing it.
And the pro-death lobbyists and Lords, evidently, have now infected the intuitive responses of our medical emergency services.
They would argue they were only following legal orders. Tell that to the Woolterton family.
I wouldn't say I'd be exactly happy to, not least because it might earn me a punch in the mouth for being such an insensitive bastard. But I think someone should tell it to the Wooltorton family. It is desperately sad that a young woman has decide to end her life, and as I said at the very start I am sympathetic. But sympathetic to the point of supporting forcible medical treatment? Sympathetic to assuming that all decisions to end one's life are irrational and to be considered the product of an unsound mind? Sympathetic to de facto state ownership of our lives... well, even more so than now? No. Absolutely not. It's a retrograde step in one of the few areas where, and I grant you that it may be serendipitous rather than intentional, towards a more libertarian situation. Try it, and I for one will fight to stop you.


UPDATE: And at the same time as the Wooltorton family and George Pitcher are worrying about how to force treatment on people who don't want it the NHS are again showing how good they are at refusing to treat people who do want it - H/T to the Ambush Predator.

* Maybe. On the other hand maybe they would agree to this even had their daughter been a happy and well adjusted woman who'd never even considered suicide. I'll give them the benefit of doubt and assume that the desire for treatment to be forcibly applied to someone who's made a rational and considered choice to stop living comes from the crushing sense of loss that they're going through.
** Well, it has when you can get stabbed for a mobile phone or blown up in a foreign land fighting a pointless war, but that's really not what's being discussed here.
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