PAOLA died last Wednesday morning.
She knew the time of her death in advance, having arranged to go to the Dignitas clinic in Switzerland. She knew too she had options – options that many people who don’t have the considerable sums of money needed to follow her example do not.
Paola had terminal bowel cancer. She wasn’t afraid of death, she said in a short film she made before travelling. She was afraid of dying in pain. She had already undergone “brutal surgery”.
I had a friend who chose the same route.
She told me that had she understood how profoundly painful and distressing such major surgery would be, she wouldn’t have gone ahead with it. As it was, it only allowed her a number of painful months before she, too, died.
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As it happens, the latest attempt to bring an assisted dying bill before the Scottish Parliament should be formally introduced by LibDem MSP Liam McArthur before Holyrood goes into its Easter recess at the end of this week.
The late Margo MacDonald, who had Parkinson’s disease, tried in vain to introduce assisted dying in 2010. The cause was picked up by Patrick Harvie in 2013. He was also unsuccessful.
Margo left us 10 years ago but remains one of the few politicians for whom a Christian name suffices for identification.
There are good reasons to suppose that McArthur’s bill has a rather better chance of passing into law. For one thing, the medical profession’s trade bodies mainly pronounce themselves neutral when once they were hostile.
The public too is supportive. During the three-month consultation process, more than three-quarters of the respondents were supportive of the bill.
Many of those opposed cited religious reasons, arguing that only their god should determine when we die. I’m not a believer, but I find it difficult to suppose a loving god would argue in favour of bad, painful death.
The Right To Life organisation mounted a campaign to oppose the bill. They might have been more successful had they not sent all the same similarly worded sentiments from the one email address.
It meant that these particular respondents could not be assumed to be individuals with a discrete opinion on the matter, rather an orchestrated response involving a circulated template.
I think it perfectly fair and reasonable that health professionals with a conscientious objection to assisted dying should not have to be part of the process in the same way as anti-abortionists’ convictions should be respected.
Ditto parliamentarians in any of the UK parliaments.
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What does not seem either fair or reasonable is that the views of less than a quarter of the public should be superimposed on the rest of the citizenry.
The responses to the consultation exercise often contained heart-rending tales of those who had to stand aside whilst those they loved died in pain and distress. I can relate to that. One of the last things my late mother said to me was, “Nobody should have to suffer pain like this”. It haunts me to this day.
In the event, she died in hospital, thanks – I concluded – to what is known as “double effect” palliative sedation. In plain English, given enough pain relief to hasten death.
Most people would like to fall off their perch suddenly and in their own bed. Most people don’t. Invariably, they will contract some illness for which the treatment can involve unwanted side effects.
Usually, they spend their final hours in the embrace of the health service.
People opposed to allowing folk to “take back control” of their lives and their death cite many reasons – none of which seem to have happened in those many jurisdictions which now allow their citizens to determine the time and the method of dying.
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None of these countries or states seem to have experienced an upsurge in the numbers taking advantage of the law in question. What seems to be the case is that those who have life-limiting ailments can have the comfort of knowing there is a legal backstop which they can utilise should their situation worsen.
That legal security blanket allows them to face the future without the gnawing fear of having to cope with what might become unbearable pain.
And that can and does happen, despite the very best efforts of those charged with dispensing palliative care to terminally ill patients. Sometimes the medicine isn’t up to the task at hand. Sometimes the patient is beyond taking it.
Other opponents worry that some people might try to hasten their own demise rather than become a burden on their family or the health service. That particular concern is purely hypothetical and, again, does not seem to have any statistical basis where assisted dying is already available.
The disabled community has its own set of fears, worrying that they might be valued less by a society which practices assisted dying. They have high-profile champions like Olympic medallist Tanni Grey-Thompson – though I venture to suggest that particular baroness may have faced different challenges from those she now represents in this debate.
We certainly need, as a society, to give our disabled citizens a much better deal – and not least those who save the Government many billions by caring for them.
Curiously, whilst many respondents quite rightly want to see robust safeguards attached to any legislation, others worry that a diagnosis of terminal illness likely to result in death in a matter of months doesn’t include those whose lives have become nigh-intolerable as a result of progressive disease.
Going down that road would be much more problematical, I’m guessing – not least as the imperative of keeping on living often seems to outweigh what others would regard as a loss of those qualities which make life desirable.
Was it the campaign to help other MND victims which kept the late Doddie Weir going long after he was incapable of “normal” life? Or, more probably perhaps, was it down to the character and personality of the person concerned?
Art doesn’t always imitate life, but sometimes it is a useful way of illustrating it. Many thousands of people who didn’t read Andrew O’Hagan’s masterful Mayflies were introduced to the assisted dying debate by the television mini-series based on it.
It concerned two lifelong friends, one of whom decided to take the same route as Paola Marra. And when Tully decides to take that final step, he challenges his pal “Noodles” to both accept the decision and celebrate it.
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Both the book and the TV adaptation are tear-jerkers, but much leavened by a rich vein of humour and liberal use of the Scottish demotic.
Paola said that the most difficult part of the last few bureaucratic months, as she dealt with the paperwork necessary to progress her Swiss trip, was having to say farewell to her many friends.
Canadian by birth, she had lived for 35 years in the UK, so there would be no shortage of them.
In fact, she said, there were many people, she couldn’t meet because of an increasingly packed diary. People will say she was brave. And she undoubtedly was.
But, just as importantly, she was pragmatic. She used what she knew would be a limited time to make sure her beloved dog had a new home, and her beloved friends felt valued.
The pity of it is that the one thing over which she had no control was being able to stay in her adopted home since it would have been illegal in the UK to arrange to end her life at a time of her choosing.
Hopefully Liam McArthur’s bill will change that, as might similar legislation being proposed for the Commons. The Scottish Parliament likes to think itself progressive. Long past time to prove it.
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