Shaking hands with death

I picked up Terry Pratchett’s little book “Shaking Hands With Death” at our local Waterstones. It was available as a promoted book at the counter. There alongside all of the usual fun books and novelty items was a little booklet aimed at changing our attitude to suicide.

I want to offer some fairly broad ranging reflections here, not just on the question of assisted suicide but on how we debate controversial subjects, come to conclusions about what we believe and make decisions together.

What’s it all about?

Shaking Hands With Death was the Richard Dimbleby Lecture in 2010. Terry Pratchett, author of the Disc World fantasy books, had been asked to deliver it following his diagnosis with a rare form of Alzheimers. He prepared the lecture but, due to the state of his health, made the introductory comments before handing over to Tony Robinson who read the rest of the lecture on his behalf.

Pratchett starts by calling to mind Richard Dimbleby’s death in 1965.

“Two pieces of information shook the nation: one was that he had died and the other was that his family said that he had died of cancer. At that time it was the disease whose name was unspoken. People died of a ‘long illness’ and as journalists we connived at this furtive terminology.”[1]

He goes on to say that “before you can kill a monster you must name its name” and at least implicitly draws the comparison with Alzheimer’s today.[2] Certainly, in my experience, dementia generally and Alzheimer’s specifically have become the diseases whose names we dare not speak. I suspect that this is partly because, in the modern world, we tend to treasure our minds and partly because with an aging population, this is the disease many of us fear the most.

“Death” appears as a character in the “Discworld” books and Pratchett describes him as “one of the most popular characters.”[3] He notes the importance of the “Grim Reaper” in traditional culture.[4]

“He is in short a kindly Death, cleaning up the mess that this life leaves, and opening the gate to the next one. Indeed, in some religions he is an angel.”[5]

He movingly describes his own father’s death and a sense of frustration that his last lucid moment was not in fact his last moment as Pratchett believed it should have been but instead, his father lingered on in a hospice for another fortnight.[6]

Pratchett then goes on to describe his own diagnosis with Alzheimer’s and his experiences of living with and trying (often ingeniously) to work around the condition.[7] For me, two things stand out here. First of all he describes our tendency to collude in refusing to face the possibility of a diagnosis.

“We say, ‘I’ve had a senior moment. Ha! Ha!’ We say, ‘Everybody loses their car keys.’ We say, ‘Oh I do that too. I often go upstairs and forget what I have come for!’ We say, ‘I often forget someone’s name mid-sentence,’ and thus we are complicit in one another’s determination not to be mortal. We like to believe that if all of us are growing old, none of us are growing old.”[8]

Then, he talks about the way that he was just sent away with the diagnosis of his particular condition but no plan in place for what would happen next.[9]

“I felt alone. A cancer sufferer, just diagnosed, can at least have some map showing the way the future might hopefully go. And I don’t want to minimise how dreadful that disease would be, but there would be specialists, there would be tests. Hopefully, you would receive sympathy and hopefully you would have hope. But at that time the Alzheimer’s patient was more or less told to go home.”[10]

He concludes the story of his experience with his decision that he would not let the disease defeat him but would live life to the full and then die at a time and place and in the manner of his own choosing.[11]

So Pratchett then goes on to propose that assisted dying should be legalised in this country. He suggests that a government appointed committee should be set up to ensure that decisions are genuine and that vulnerable people are not taken advantage of by relatives or doctors encouraging them to take their own lives or claiming that they had.[12]

He states that.

“There has been no evidence in those areas where assisted dying is currently practiced that it leads to any kind of ‘slippery slope’. It seems to be an item of faith among those opposed to assisted dying that it will open the doors to abuses all the way up to the culling of the elderly sick. This is a nightmare and only a nightmare. This cannot be envisaged in any democracy unless we find ourselves under a tyranny.”[13]

I will return to the subject of slippery slopes later, but even at this point, I wonder how many people would share this quite naive optimism about democratic society. Even at the time he was writing, our confidence in western liberal democracy had already been severely weakened by the questioned legitimacy of the Iraq War and the flagrant abuse of the expenses system by many MPs and peers. In the last five years our confidence has been if anything further shattered by the now seemingly daily allegations against politicians, TV presenters and musicians.

Then he says:

“And finally there is

the God argument, which I think these days appears to have been subsumed into concern for the innocent who may suffer if assisted dying were allowed. The problem with the God argument is that it only works if you believe in God, more specifically Jehovah, which I do not.”[14]

He does go on to admit to a “sneaking regard for the Church of England and those I disagree with.” [15] He says that:

“We should always debate ideas that appear to strike at the centre of our humanity. Ideas and proposals should be tested. I believe that consensual ‘assisted death’ for those that ask for it is quite hard to oppose, especially by those that have some compassion. But we do need in this world people to remind us that we are all human and that humanity is precious.”[16]

Something missing

And there we have it. And, dare I say, that in those very few but gracious words about his opponents and more so in the silence about their arguments we have the nub of the problem. You see, I’ve just read the transcript of a lecture on a deeply controversial topic delivered by a publically owned broadcaster. So, there are some things that I should be able to legitimately expect with such a discourse.

The Oxford Dictionary describes a lecture as “an educational talk to an audience, especially one of students in a University.” Now, the audience need not always by University students, but the educational nature of its purpose means that it comes with certain standards. We hear the word “lecture” and it has immediate connotations.

The BBC Royal Charter describes its purposes as

 

(a)sustaining citizenship and civil society;

(b)promoting education and learning;

(c)stimulating creativity and cultural excellence;

(d)representing the UK, its nations, regions and communities;

(e)bringing the UK to the world and the world to the UK;

(f) in promoting its other purposes, helping to deliver to the public the benefit of emerging communications technologies and services and, in addition, taking a leading role in the switchover to digital television.”[17]

Therefore, one should be able to expect a “lecture” delivered via the BBC to be educational and with the interests of civil society at its heart. So this is where I have a big problem with the lecture. It does not claim to be simply a piece of entertainment, nor purely biographical; we can surely expect more from a lecture that a mere comment/opinion piece. A lecture because it is intended to be educational should aim to inform. It should aim to be truthful; it should aim to help the informed, reasonable listener to reach a conclusion on the matter.

Now, a controversial subject has (as Pratchett acknowledged) at least two sides to the argument. In a debate, the sides of the argument are represented by their supporters. Debaters set out their position and seek to defend it against their opponent. Usually in the debate, the participants will be given time to cross examine each other so that their thesis can be tested and challenged.

In a lecture, only one side of the debate is represented. This therefore puts the onus on the deliverer to accurately represent not only his or her own position but that of their opponents too. An opponent should be able to listen and say “Yes, exactly, that’s what I would have argued.” The aim then is for the speaker to identify the strongest element of his opponent’s position and then attempt to refute it. You will realise if you read the lecture or if you heard it first time around that this simply did not happen. Yes, one or two “objections” are raised and dismissed, but there isn’t a systematic engagement with why and how people disagree with the pro-euthanasia position.

Now, perhaps I will be told that I am being too pedantic. The BBC are not being so careful in the use of the word “lecture:” they just want to create a certain ambience and indicate that the programme content is serious rather than light entertainment. Perhaps as well I am being unfair; to be sure, my general expectation for a lecture may be one thing, but this was one celebrity author being given the opportunity to share his heart on a matter that was personally important. After all, even the Oxford Union mixes its debates and lectures with less academic visiting speakers.

If this was a one off, then I would say fair enough. However, what we have increasingly seen is a departure from that high expectation for reasoned argument. I would suggest that what we found in “Shaking Hands With Death” was far too typical of how arguments are presented in contemporary society. An opinion was asserted. What was the basis of that opinion? Why are we expectedto give the opinion a hearing? Very simply, we are asked to hear the opinion because

  1. The opinion former was famous
  2. The opinion former had experienced a form of suffering.

Now, we will probably never get away from the fact that celebrities are more likely to get an audience and that many celebrities use this face to put forward positions, sometimes for good and sometimes for evil.

Furthermore, the correct response to Terry Pratchett’s life story should be both respect for his perseverance in continuing as an author, compassion for his suffering and a righteous anger at the evil of suffering and death. Where we have gone wrong is that we have increasingly allowed personal experience to trump all arguments and to become the basis for making wider decisions.

Now, here’s the problem. Personal experience is just that. It is “personal,” unique to that person and it is “experience” which suggests transience and change. What happens if, with time, a person’s changing experience leads to a changing opinion? What if someone else has a different experience and comes to a different conclusion?

I don’t mean here that one person will have experienced suffering and another not. I mean that two people will experience suffering differently because of their starting world view and because of the people around them. One person experiences a painful syndrome and is unable to go on with working life, retreating into the home so that they rarely get out. Another person experiences the pain, but finds that they are able to continue with work, social and family life and in so doing find a way to keep going through the pain and maybe even for the pain to be lessened.

One person says “I have been diagnosed with a terminal condition and I want to be able to end it all.” Another says “I have a terminal condition, but the last thing I want is to end it all and for someone else to hit the switch.” Whose argument wins out? I worry that we will end up trying to outbid each other for whose experience is the most painful or lacking in hope.

What is more, I get the sense that there is a little bit of dishonesty here. The decision has been made without any real argument at all and even the “experience” isn’t really seen as evidence. Just this week another famous person has made some controversial comments about rape and responsibility. The comments have been routinely condemned in the strongest of terms. And yet, the person making the comment was themselves female and had experienced a severe sexual assault. The mistake they made, however, was to no longer own their experience as a victim. It’s almost as though as soon as they chose not to be the victim in the situation that others stepped in to possess her victimhood for her.

So, in reality, what we have is not arguments but mere assertions and the assertion that wins is the one that fits the feel, the zeitgeist, of our age.

Slippery slopes

 

I promised to return to this point. Pratchett rejects the idea that there will be a slippery slope. I think the problem here is that talking in terms of “slippery slopes” tends to be very one dimensional, As soon as I suggest that we are opening the door to something terrible with euthanasia, you assume that I mean there will be Nazis on the streets in ten years’ time rounding up the misfits of society and transporting them off to their deaths.

Well, 1930s Germany reminds us not to underestimate what might happen within ten years, but normally the danger tends to be much more subtle. My immediate concern is not that this will suddenly lead to lots of abuse, though, as I indicated earlier, I do not share Pratchett’s optimism.

Rather, this is the big risk. Changing the Law will change our culture and our broader attitude to life, death and humanity. Isn’t it weird that in concluding his comments on his opponents Pratchett says “But we do need in this world people to remind us that we are all human, and that humanity is precious?” One is left thinking “Do the proponents of assisted dying not do this then?” But I am being a little bit mischievous here.

More substantively, this is how our perceptions and attitudes are altering. Go back several centuries and suicide was regarded as an evil, a terrible thing. It was a crime and a sin not just to assist suicide but to commit suicide. Some denominations treated suicide as an unforgiveable sin. If you took your own life, you were buried outside of the main grave yard, not on consecrated land. Then opinion shifted. Those who committed suicide became seen as victims to be pitied, not to be judged. I think there’s something important there and I hope we never go back to the day when suicide was represented as the unforgiveable sin. The understanding of what drives someone to take their own life is so important. Yet I wonder if we haven’t already even lost some of the sense of wrongness. As seen with the other ethical example above, our society struggles with the idea that someone can be both a victim and responsible; a sinner and sinned against. The Bible does get this. It shows the mess and the pain of living in a sinful world; we have saviour/healer who comes to help us, to deliver us from slavery and death. At the same time, we are under the just penalty for our sin and rebellion. So, with suicide, I want to say that I sympathise with the deep distress, the loss of hope, the emotional turmoil that causes someone to take their own life. I want to express anger at those who bully and torment others into taking an overdose or hanging themselves. The suicide victim is a victim. But, at the same time, I want to say that suicide is a wrong response: it is a cry of defiance that I will keep control, not just against others but against God (more later). It causes great pain and distress to others.

But, at least, there is the recognition there that suicide is a terrible, tragic thing. It’s not good. However, when we start to say that suicide is not just tragedy but actually a legitimate choice, then we have moved our ethical understanding still further.

Think through the following scenarios. First of all, take the person who has been hit by the news that they have been diagnosed with a serious illness. You know that there is a likelihood that they will be overwhelmed by this. They may feel that life is not worth going on with. At the very point where you would want to be saying “there is hope, hang in there,” our culture is moving towards saying “yes, ending it all is a valid option and we can help.”

Or what if you spot that someone is depressed? Perhaps their marriage has ended or they are struggling with pressures at work. You express your concerns to someone responsible – a senior colleague, pastor, whoever. You are worried that the person may be suicidal. Imagine getting the response back: “Well, if they choose to take their own life, then that’s their personal choice.” By making assisted suicide a medical option, we are normalising it as a general life option. This is specially so given the way that our society has medicalised so much of life.

Now consider what would happen today if someone was arrested. As they were detained, they would be expected to hand in anything that they could use to try and kill themselves with. If there were concerns about the prisoner, then they would be put on suicide watch. If someone did take their own life, there would be an investigation and the responsible officer would have to demonstrate that procedures had been followed and that they had not been negligent. But when we normalise suicide, then what does it matter if a prisoner decides that today is the day when they want to die?

It’s not just about our attitude to assisting in a suicide and whether or not it is okay to do this. It’s about our life and death itself and towards suicide.

Then there is the God argument

In the end, I think Terry Pratchett was almost there on this one. He got it. Your attitude to life and death, to suicide to medical ethics, depends on your view of God. If you do not believe in the God who created the Universe, who is in control of history, who made you and holds your life in the palm of his hand, then that will affect your view of life and death.

If God has not made us, we are just the result of chance, the by-product of genetic mutation. If this is so, then death is just an option. Death then is no big deal. In fact, we have no reason to be angry at suffering and death: they are just processes.

However, if we believe that there is a God who not only made us but in the person of Jesus has stepped into history, that puts a different perspective on things. Jesus has suffered and died in our place. The New Testament sees suffering as having a purpose. God uses our suffering for our good. Even long term suffering can be faced knowing that this life is not it; there is life after death, and there is eternity. The believer does not face suffering and terminal illness without hope.

Hopefully by now you will be starting to draw some connections between some of the stuff we’ve been learning here about. Our view of God will affect how we make ethical decisions. Also, our view of Revelation will affect our decision making. Do I think that we are left to make decisions on our own based on either our reason or our feelings? Or do I believe that the God who made us and who loves us has also revealed truth to us about how we are to approach matters of life and death?

The Urgent and Pressing Matter

We’ve started to consider some of the wider implications about how we think, argue, persuade, decide and these are important things to be concerned with.

However, there is a particularly pressing issue and I’m sure that the re-publication and promotion of “Shaking Hands With Death” is no co-incidence. This week a Private Members Bill will be put to the House of Commons which, if passed, will legalise “assisted dying.” This is massive. It will fundamentally change our society and yet it is passing quietly under the radar.

So, please don’t let this happen. Take time to pray this week for our Parliament. Pray that as the Bill is debated that our politicians will be motivated by justice and mercy, that they will be given wisdom and that they will listen to God, not just to human emotion and reasoning.

[1] Terry Pratchett, Shaking Hands With Death (London. Transworld Publishers, 2015).

[2] Terry Pratchett, Shaking Hands With Death, 20.

[3] Terry Pratchett, Shaking Hands With Death, 23.

[4] Terry Pratchett, Shaking Hands With Death, 22-23.

[5] Terry Pratchett, Shaking Hands With Death, 23.

[6] Terry Pratchett, Shaking Hands With Death, 26-27.

[7] Terry Pratchett, Shaking Hands With Death, 28-45.

[8] Terry Pratchett, Shaking Hands With Death, 28.

[9] Terry Pratchett, Shaking Hands With Death,33.

[10] Terry Pratchett, Shaking Hands With Death, 34.

[11] Terry Pratchett, Shaking Hands With Death, 45-46.

[12] Terry Pratchett, Shaking Hands With Death, 50.

[13] Terry Pratchett, Shaking Hands With Death, 54.

[14] Terry Pratchett, Shaking Hands With Death, 58.

[15] Terry Pratchett, Shaking Hands With Death, 58.

[16] Terry Pratchett, Shaking Hands With Death, 58-9.

[17] BBC Royal Charter, Section 4. Available at http://www.bbc.co.uk/bbctrust/governance/regulatory_framework/charter_agreement.html#heading-the-charter

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