Basildon Hospital Have My Gallbladder, My Trust, And My Thanks

A week ago, I had my gallbladder – and the numerous large gallstones within it – removed. For geographical convenience, the procedure was performed at Basildon University Hospital, part of the beleaguered Basildon and Thurrock NHS Trust. It wasn’t my first encounter with the hospital – I was born there, I’ve had migraines and disc prolapses treated there – and I doubt it will be my last. It was, however, possibly the best.

Speaking as the owner of long-standing and problematic phobias of both hospitals and needles, the experience was never going to inspire feelings of hope and contentment. No-one likes going to hospital, of course, but my fear was liable to make me tense, anxious, and, regrettably, unco-operative toward the medical staff treating me. To give this some perspective, previous visits have demonstrated that it requires no fewer than four qualified, experienced clinicians to insert a cannula into the back of my hand. I was never going to be Basildon’s biggest cheerleader, and stood a decent chance of becoming their fiercest critic.

In the weeks immediately preceding my visit to the hospital, Basildon and Thurrock NHS Trust were named in the enquiry resulting from the Mid Staffs investigation – one of five NHS Trusts to be singled out for special attention. Concerns were initially raised over the hospital’s “persistent high death rates”, but as the story progressed, former patients came forward with tales of unchanged dressings, unheeded toilet requests, missed medications and Legionella outbreaks.

None of this inspired me with much confidence as the date of my operation drew closer. Gallbladder removal – or Laparoscopic Cholecystectomy, as it’s known to professionals – is a relatively commonplace procedure, but is not without risk. An unexpected bleed or overly large gallbladder can compel the surgeon to move from keyhole surgery to an open procedure, increasing healing time and necessitating a longer hospital stay. Given the reports circulating at the time, this wasn’t a possibility I was relishing. As it turns out, and to my considerable relief, the procedure went well.

It now remains only for me to credit the staff of Basildon Hospital and the extended NHS Trust for ensuring that I’ve had such a smooth ride over the last nine months. My GP, for taking my bellyaching seriously, for pushing on for ever more diagnostic tests and anti-emetic drugs, and for calming me down when I thought I’d inherited the liver tumour that killed my grandfather. My surgeon, for answering my nervous questions when he was obviously up against it and keen to get on. His Senior House Officer, for talking to me like an intelligent, autonomous, informed adult with a degree of insight into their own condition. His registrar, for ensuring that the SHO had gone through absolutely everything I needed to know, and then drawing me a diagram so I really was perfectly clear.

Beyond the surgical team, there’s also the Day Unit nurses who clerked me in and helped me push my dodgy leg into the restrictive TED stocking. There’s the nurses in the blood clinic who looked after me when I began to faint in their chair, and didn’t even mind that needles make me panicky and subsequently ridiculous. There’s the Endoscopy team who were doubtless frustrated beyond the bounds of patience when they eventually abandoned all attempts to perform the biopsy I needed, particularly the nurse who succeeded with the cannula where six previous efforts had failed. There’s the doctor in the ultrasound clinic who finally confirmed a diagnosis of gallstones, showed me them on the screen, and looked only a little surprised when I laughed and told her I’d won a bet.

There’s the theatre nurse and anaesthetist who did everything they could to keep me calm when panic really set in, just before I went under. Most of all, there’s the nurse on Laindon ward who was there when I woke up, helped me to the lavatory when I was still dazed from the anaesthetic, carefully and attentively performed observations on six woozy patients every 30 minutes, brought me endless glasses of water, called my family to reassure them when she really didn’t have to, gave me the only painkillers my body would tolerate, kept me calm while she removed the cannulas from my hand and wrist, and discharged me professionally and patiently whilst running the ward single-handed and still called everyone “darling” like she meant it.

Basildon might be struggling as a hospital. It might be a victim of circumstance, or it might genuinely have a minority of staff members who are incompetent or lazy or both. In this way, it differs from no other workplace. But what it also has is staff who are dedicated to their jobs and their patients, even difficult patients like me. Many of their staff are probably overstretched and might feel underpaid, and many departments are likely underfunded and potentially understaffed sometimes, even if only due to occasional staff sickness. Basildon has its problems, but it also has a body of staff who perform difficult and often unpleasant jobs with professionalism, dedication and grace, and without whom all patients would be at a complete loss. When you denigrate Basildon Hospital, you denigrate them too.

Words Matter

Some time ago, I got involved in a Facebook debate over offensive humour, which rapidly disintegrated into an argument over free speech. We managed to avoid invoking Godwin’s Law, but we did successfully provoke the following comment, which typifies the public attitude to free expression: “FREEDOM OF SPEECH means you can say anything to anyone! That does not mean you are right or even moral but you can say it!”

To anyone that’s encountered the UN’s Universal Declaration of Human Rights, the error will be obvious. Free speech is not an absolute right - most countries have laws which state that freedom of expression may be limited in "the interests of national security, territorial integrity or public safety; the prevention of disorder or crime; [or] the protection of health or morals”. Most mouthy schoolboys and drunken racists will insist that they have a right to say what they like about who they like, but a quick examination of statute will reveal that it's simply not so.

Additionally, the Malicious Communications Act and recent Hate Crime legislation, not to mention defamation law for attacks on specific individuals, have clarified the law on what you may or may not say in a public arena such as Facebook or Twitter. Freedom of speech should be invoked in countries where you're imprisoned indefinitely without trial for criticising your government, not bleated about by people who are cocky enough to think that their need to be funny is more important than respecting the feelings of other people around them. Freedom of speech is a conditional right, not an absolute one, and when you think about it, there’s a good reason for that.

The truth is, words matter. Words are how we make contracts, build relationships, connect with others, and describe the human experience. We’re by no means the only species that communicates meaningfully, but we’re the only one capable of such subtlety and nuance. Albanians, for instance, can distinguish between 15 different types of facial hair, and are similarly specific about eyebrows. Perhaps unsurprisingly, Italians can name 500 different types of pasta, and the descriptions of colour in Webster’s dictionary are a symphony of shade and comparison.

There are currently more than a million words in the English language, their ranks swelled by new coinages like “vajazzle” and “selfie”. A tabloid newspaper will use about 8,000 individual words in a single edition. The average person regularly uses 35,000, a university graduate 50,000, and a writer as many as 75,000. Many are beautiful. Some are ugly, inelegant, or too often overlooked. All are powerful, but some are more powerful than others.

Of course, with great power comes great responsibility. Some words can comfort, praise, and reassure, but others can sting, wound and affront. For some people, it’s difficult to respect the broad vista that language opens up for us. They would use it like an indentured servant, all the while claiming that by doing so, they protect its freedom from those who want to see it muzzled and caged.

Instead, we must treat language – all language – like the rare and delicate gift that it is. Where in the past we’ve hurled shards of it at women, disabled people, those of other races, religions and sexualities, to mock the wounds it makes on impact. The time has come to pick up the pieces. This isn’t being ‘PC’ or ‘leftie’ or any other such ridiculous notion; this is about not deliberately insulting the other people we share the planet with. It’s easy to imagine that our house, our marriage, our family is a tiny ship tossed on a stormy sea of outsiders, battered by the wind and waves – in fact, that’s how we should view our planet.

In an unimportant solar system, in a modest galaxy, in one corner of an infinite and uncaring universe, intelligent life has struggled from a swamp and established an empire greater than that of Rome or Britain – the empire of the Earth. We have developed language, enabling us to begin to comprehend the vastness of our reality, or just gossip about inconsequential details. As I’ve said before, we have only each other – seven billion of us against the infinite coldness of space. We are fellow passengers on that storm-tossed sea, and yet we don’t huddle together for warmth and security; we keep confined to our quarters, the doors and stairwells blocked by obstructive, angry words. The worst of it is, we put them there.

What I’m trying to say, I suppose, is best summed up by a seasonal message that we let our children sing but never actually heed. We’ll pick it up, remove its historical gender bias, and repackage it for use all year round. Dickens said it, Dawkins implied it, and I can only echo it: peace on Earth, and goodwill to all humanity.

Rape And Responsibility [Trigger Warning]

In today’s Mail on Sunday, Mariella Frostrup’s column focuses on a report prepared by Deputy Children’s Commissioner, Sue Berelowitz. The report, entitled Child Sexual Exploitation in Gangs and Groups, was released last week and describes the number of girls forced into sexual activity by gang members. In response to the report, which is no doubt truly disturbing reading, she argues, “we need a Man Army determined to change cultural stereotypes, full of blokes that boys revere – footballers, musicians, actors and even Top Gear presenters (not normally short of opinions) – saying, loud and proud, that rape is for cowards, child abuse is despicable and treating girls like pieces of meat is simply unacceptable.”

Frostrup presumes that men can be immunised against committing rape by seeing anti-assault messages from men they respect and admire, an approach that suggests that men commit rape because they believe it’s somehow acceptable. She is sorely mistaken – men commit rape precisely because they know it is not acceptable. The power imbalance implied by the act, the misuse and subjugation of a victim by that assault, is very often the entire focus of the act.

For rapists of this type, rape is rarely about sex or the lack of it; it’s about power and domination, control and shame. It’s about telling a person that they mean so little that they can be used in whichever way their attacker chooses. Sexual assault, like domestic violence and emotional abuse, is a way to dehumanise someone; their aggressor shows them that they have so little power that they cannot prevent their own mistreatment. They become, as the article suggests, a piece of meat, lacking agency and control – the shock of rape emanates as much from the complete denigration of the victim’s personality and humanity as it does from any violent physical act.

There is, of course, another type of rapist – one who misreads signals, assumes consent where none has been given, or fails to notice that his partner has lost interest in continuing. These men are not psychopaths, nor do they necessarily set out to cause harm, but the effect on their partner can be no less powerful. Some of these men notice their partners’ waning interest and stop in good time, some never notice and so continue, and some notice and make a conscious choice to keep going.

Some months ago, a discussion on Reddit emerged that allegedly contained contributions from men who had committed rape. Most were from young men who took a previously consensual act too far; few seemed to exhibit the psychopathic aggression we’re led to expect – perhaps these men were present but declined to post, understanding the negative reaction they’d receive. All those who posted were aware of what they’d done, and many knew they were committing rape when they were still in the moment of committing it. The following quotes are taken directly from the discussion, and seem to make little effort to excuse the acts of each correspondent.

“I ignored her and did it. She realized what was happening and tried to clamp her legs shut, but it was too late and I was much stronger than her.”

“My hormones were going insane, I didn't have any empathy in my heart at that moment just my own concerns. She wasn't a person anymore just a path, a tool, a means to an end. Then once again, I can't remember. I don't remember what happened, I never asked her. I almost don't want to know. But I know I got off. I hate to say it but after it was done I went to bed, she stayed up crying. It wasn't until two days later that I realized I had done something awful.”

 “Most girls don't really understand how horny guys are, how much stronger guys are, how guys will rationalize what they do. I see feminists and women on the Internet saying that no means no and women should be able to get as drunk as they want and not be sexually assaulted, and I couldn't agree more. But the reality of the situation is that women have to be careful because guys are one way when they're hanging out and another way when they're horny or worse drunk and horny.”

“My rapist (ex's best friend) told me he knew it was wrong, but would have probably done it again given the chance. He also was surprised that forced sex didn't make me want to be his girlfriend.”

A further objection can be raised to Frostrup’s assertion that perpetrators of rape and sexual assault “steal their [victims’] innocence and their futures”. In recent decades, the feminist movement has made efforts to transform the perception of the raped woman from ‘victim’ to 'survivor’ – a semantic shift, but one that can make a powerful difference to the way a woman experiences the time following her assault. Tell her that her life is ruined and she may well believe you, but tell her she can recover and you give her the power to overcome the experience; it’s not difficult to imagine which is the better impression to give someone in that position.

The kind of person inclined to commit rape for power will not be swayed by the words of a TV presenter or a football player, particularly words that have been put in their mouths by well-meaning authority. When one person decides to violently assault another, logic and government-sponsored messages play no part in the thought process. The kind of person who commits rape through misreading signals is unlikely to consider such advice in the heat of the moment; how can they, if they don’t realise they’re doing anything wrong?

Rapists commit rape for various reasons, none of which excuse the trauma they inflict upon their victim. Some do so to intimidate or punish, to inflict fear and denigrate their victim. Some do so because they misread signals or inaction from their partners, some do so because they simply don’t respect their partner’s wishes enough to stop. None of these situations can be remedied by a public service announcement or advertising campaign.

Rape is a cultural problem, but one that occurs in all cultures and throughout history. It’s not the job of public figures to tackle it with good intentions and a public service announcement; instead it’s the job of parents, teachers, sex educators, and then the media. From films like Grease onwards, certain media products have positioned men as pursuer and women as the person who must exercise control and resistance; through these stories, we normalise sexually threatening behaviour. Young women come to expect and tolerate it, and young men feel they are excused to act as their hormones allegedly dictate.

To lower rape statistics, we much challenge the culture that excuses male sexual aggression and tells women that they must take sole responsibility for their own safety. We must abandon the macho culture that places to much emphasis on sexual experience, and instil a sense of respect and consideration for one’s sexual partners. It’s a difficult task, given the extent to which modern life is permeated with messages about sexual behaviour, but it can be done. We must start at the beginning and maintain a consistent message, and in doing so we can ensure that another generation of young women aren’t exposed to the same fear and exploitation as the ones that go before them.

How We Failed Savita Halappanavar

On October 21^st, Savita Halappanavar walked into Galway University Hospital complaining of severe back pain. A week later she was dead, fallen victim to septicaemia and e. coli. But Savita could have lived had she been offered one simple and common medical procedure – termination of a failing pregnancy.

When Savita was examined upon admission to the hospital, she was found to be miscarrying, but doctors could still detect a foetal heartbeat. For this reason, she was denied the termination – Ireland’s strict abortion laws forbid the procedure unless the mother’s life is in imminent danger. Instead, she was left to endure the pain and sorrow of a miscarriage, refused the option of inducing labour to hasten the process.

The distress of the experience, prolonged by those who doubtless wished they could help her, is unimaginable to someone that hasn’t experienced it. Savita’s husband, Parveen, said that she dealt with the situation well, even discussing trying for another baby. Savita seemed determined not to let the experience ruin her life; instead, it ended it.

The doctors and nurses who cared for Savita surely saw how she suffered; even though they must have been wracked with compassion and remorse, an unclear law said they could not help her. Whatever their personal politics and morals, regardless of their religious position or Hippocratic oath to protect life, they were compelled to manage and oversee the death of a young woman that they could otherwise have saved.

Savita's foetus was not viable, there was no hope of survival; instead of working to save one life, her doctors were forced to witness the end of two. They will have worked to combat the septicaemia that is believed to have killed her; they will have tried to keep her liver and kidneys healthy and functioning for as long as they could. But the awful truth is that one procedure could have obviated the need for all of that, and she was denied it - not by her doctors, but by the law.

Had Savita refused a termination, we could respect the decision that she had made, assured that she had her reasons for doing so. Had her doctors performed the procedure, there would be no news story; Savita and Parveen could have returned home and slowly come to terms with their loss. Instead, Parveen has lost not just his wife and his child, but his hopes and dreams for the future; everything he thought his life would become has been taken from him because of cruel and unsympathetic legislation.

Ireland's legal position on abortion is well-known; a historic cause for concern. For generations, girls and women have been forced to scrape together all the money they could and travel to England in secrecy - once by ferry into Liverpool, now by Ryanair and Easyjet flights into Heathrow and Luton. We cannot know their stories, but we may be assured that every one was different: some were young girls in the first flush of love who hadn't expected to conceive, some were victims of rape who now faced an additional burden of Catholic guilt to add to their trauma, some were women whose physical and mental ill-health meant that the strain of carrying a baby was an unthinkable challenge.

Thousands of men and women have marched in London, Dublin, and New York in Savita’s name. Across India, political and journalistic voices have been raised, questioning the Irish system. Savita’s parents and her husband have challenged the Irish authorities to explain why an Indian Hindu should be killed by a law intended for Irish Catholics – they have yet to receive an answer.

No-one who claims to respect the sanctity of human life could pardon this unpardonable offence. Anyone who believes that Savita's death was justified and that Irish law is correct has no right to call themselves pro-life; they are pro-foetus, no more and no less. We have permitted a religious position to influence the state, and by doing so ensured that a Christian moral has killed a Hindu woman. If we do not insist on the reassessment and abolition of this murderous legislation, we lose our claim to humanity and empathy.

It would be easy for us as atheists to exploit Savita's death to serve our own moral argument; we must resist the urge to do so. As feminists, we could hold her experience up as damning evidence of the sheer ignorance and foolhardiness of the pro-life movement; we must not. We must instead act in Savita's memory to ensure that this miserable, barbaric chain of events never befalls another woman.

Perfume, Professionalism And The Perfect Gentleman

This week, I’ve mostly been deciding whether my body is a weapon or a vessel, and whether I’m more devoted to integrity or the drive for success. Like most people, the flesh-and-bone part of me seems to be there to extract energy from food and move me around; it’s not until something goes wrong with it, or until I’m surprised by someone’s reaction to it, that I really even notice it’s there.

As usual, this self-discovery trip has been prompted by a couple of incidents; goatish comments from a trusted advisor, the realisation that I perform better in job interviews when one of the interviewers is a man, and being approached and sniffed at uncomfortably close range in a supermarket by a stranger who was apparently so intrigued by my new perfume that he was willing to risk (and return) an aggressive reaction from both me and my fiancé.

We confronted him angrily and, despite the presence of his young son, he became abusive and threatened us. Plainly he felt it was reasonable to place his own face six inches from the face and neck of a temporarily unaccompanied woman, inhale deeply, and tell her she smelt good, and that she should “cheer up” when she looked perturbed; we disagreed. He eventually went away; I doubt my concerns will be so obliging.

I’m currently in the process of taking on freelance writing work, with the help of a self-employment advisor on a Government-mandated employment program. When discussing the necessity of approaching publications and pitching articles - an intimidating but necessary part of the process - various people have suggested using my gender, “attributes” and “engaging personality” to “intrigue” editors; essentially, flirting my way into a job.

I remain incredulous. I’m not Samantha Brick; I’m simply not confident enough in my own looks and personality to try that. When I look into a mirror I see my father, and he’s overweight and bald with a face like that of a veteran scrum-half. Besides which, even if I looked like Angelina Jolie, shouldn’t a good feminist be outraged by the very suggestion?

This is, at its heart, an entirely sexist issue: male colleagues are not forced to make the same decision. I’ve worked for male managers who flirted remorselessly with contacts of both genders, and for female managers who dispensed with sparkle and charm and got by on talent and professionalism alone, but it’s easy to understand that women surely spend more time agonising over their professional appearance. We must also consider if this approach confers an unfair advantage to attractive colleagues – an anecdote tells of a man who hired pretty girls to work in his office, “because they cost the same as plain ones.”

We know shouldn’t happen, but we know beyond a doubt that it does. It’s just another dubious journalistic practice, and it carries over into other trades too. The approach is likely to be of limited use against female editors; not only is it unlikely to work against them, it will also prove utterly transparent to a woman who has at some point faced the same decision. That said, it’ll prove transparent to anyone, male or female, who is shrewd and perceptive enough to have made it to the top of their industry. A good journalist can read people, break down pretences, and identify dodgy motives in a heartbeat – there’s no way a self-consciously flirty woman in a too-low sweater is going to get past them. Editors will notice it, and colleagues will surely resent it.

This isn’t a problem of my own creation; left to my own devices, I’d make the same effort when I meet with people as I do on any other day, the self-defined minimum appropriate degree of care and attention. The conundrum is thrown up by other people’s reactions to me, not my own opinion of myself. This is another point, one of many, at which I have to decide what kind of person I am. Can I really adopt this approach? Does it devalue my education and skills? What does it say about my feminist principles? Could I – or anyone else – respect a career based on titillating middle-aged men in positions of power? Can I be confident of the integrity I thought I had, or am I as motivated by money and success as the people I thought I stood against?

Romney, Republicans, And Rape

Ladies and gentleman, welcome to the uterus. A number of important and complex things happen here, and each of us owes our existence to this useful and multi-talented organ.

You've seen one before, of course, and understand what it spends its time doing. Of course, depending on our biology and education, some of us have a better idea than others of its purpose and function. Women, for instance, will understand it, perhaps, as something they don't have cause to consider unless something unusual happens there. Some men may think that it transforms the normally placid and genial women in their lives into raging hellbeasts with no grasp of logic or reason - indeed, some women may agree with them. But if you're a male Republican politician in the United States, you may believe that it's equipped with a top-of-the-range security system to repel invaders, or that it's an item that women aren't responsible enough to control independently and so must be marshalled and regulated by legislation.

If you are a Republican who subscribes to this school of thought, there's an excellent chance you've already shared your profound insight with the rest of us. Below, with the assistance of many of righteously angry bloggers and commentators, I present a list of some of the most  ignorant and insensitive statements ever to issue forth from Republican mouths.

• Todd Akin: “If it’s a legitimate rape, the female body has ways of shutting that whole thing down” - 2012 Senate Campaign 

• Clayton Williams: “If it’s inevitable, just relax and enjoy it” - 1990

• Chuck Winder: “I would hope that when a woman goes in to a physician with a rape issue, that physician will indeed ask her about perhaps her marriage, was this pregnancy caused by normal relations in a marriage or was it truly caused by a rape. I assume that’s part of the counseling that goes on.” - March 2012 

• Ken Buck: “A jury could very well conclude that this is a case of buyer’s remorse … It appears to me … you invited him over… the appearance is of consent.” - October 2010 

• Rick Santorum: “I think the right approach is to accept this horribly created — in the sense of rape — but nevertheless a gift in a very broken way, the gift of human life, and accept what God has given to you… rape victims should make the best of a bad situation.” - January 2012

• Richard Mourdock: "I struggled with it myself for a long time, but I came to realize that life is that gift from God. And, I think, even when life begins in that horrible situation of rape, that it is something that God intended to happened." - 2012

• North Carolina state Rep. Henry Aldridge: “The facts show that people who are raped — who are truly raped — the juices don’t flow, the body functions don’t work and they don’t get pregnant. Medical authorities agree that this is a rarity, if ever … to get pregnant, it takes a little cooperation. And there ain’t much cooperation in a rape.” - 1995

• Delaware state Rep. Stephen Freind: “The odds that a woman who is raped will get pregnant are one in millions and millions and millions […] The traumatic experience of rape causes a woman to secrete a certain secretion that tends to kill sperm.” - 1988

• Dr. Richard Dobbins, 20-year GOP contributor: “Most women either are not fertile during assault or do not become pregnant because the trauma prompts a hormonal response that prevents ovulation.” - 2006

• Judge James Leon Holmes, Bush appointee - “Concern for rape victims is a red herring because conceptions from rape occur with approximately the same frequency as snowfall in Miami.”

I don't even know where to begin addressing these, and I'm frankly disgusted that I should have to. If a British politician said something so crass, so ignorant, so entirely devoid of fact, he would be seeking new employment within days. In May this year, Justice Secretary Ken Clark was broadly castigated for making a reference to "serious rape" (which he later clarified as "forcible rape... with a bit of violence") - in response, his party were urged to sack him, and he will surely struggle to escape the contempt his comments provoked. Beyond a considerable online outcry, few of the men (and it is usually men, isn't it?) quoted above experienced any censure.

America, you can do something about this. You can prevent repeated challenges to Roe vs Wade. You can halt the decay of women's hard-earned rights. You can protect other countries from following you into disaster; your decision, and the political moves that result from it, will affect people the world over. You have a chance to stop this aggressive ignorance from spreading, and you can achieve it simply making an 'X' in a box. America, it's time to make the right decision.

Assisted Suicide: A Debate

This article first appeared on www.dancinggiraffe.com in April 2012. We reprint it here, entirely unabridged, to mark 10 years since the Dignitas clinic in Switzerland first opened its doors. With thanks to Dancing Giraffe and Peter McAllister, my collaborator and anti-AS opposite number on this piece.

Since this article was published, campaigner Tony Nicklinson has passed away. We have chosen to leave the article intact as a respectful tribute to the discussion that Mr. Nicklinson's efforts produced.

In March 2012, Tony Nicklinson approached the High Court seeking leave to pursue a clarification of the law surrounding assisted suicide. Mr Nicklinson had a massive stroke in 2005 while on holiday in Greece and was left paralysed save for slight movements of his head and eyes – a condition known as locked-in syndrome. His mind is unaffected and he is entirely conscious, but unable to move or communicate.

Since the stroke, Mr Nicklinson has been able to communicate only by using a voice synthesiser that interprets his blinking. When approached for comment following his appeal to the legal system, he has stated that he wishes the doctors in Athens had not saved his life. He described his current existence as, “dull, miserable, demeaning, undignified and intolerable”. The UK legal system is by now well-accustomed to such challenges.

In 2009, Debbie Purdy went through the courts in an effort to discover whether her husband would face prosecution if he accompanied her to a clinic such as Dignitas. The House of Lords agreed that it was a breach of her human rights not to know, particularly since this information was likely to play a large part in choosing when and how to end her life. The BBC reports the case of Tony Bland: “crushed in the Hillsborough disaster [...] allowed to die through the withdrawal of feeding tubes. He was in a persistent vegetative state after suffering severe brain damage and the judges said that it was in his best interests to be allowed to die.”

Yet despite these legal successes, and no shortage of discussion in debate amongst medical professionals and within the national press, little actual legal change has been effected. The consultation process for any change in the law is likely to be lengthy and complex, as befits such a weighty issue. Any change in the law, even a relatively minor one, will doubtless alter our society; our attitudes to disability will affect and be affected by the eventual outcome. To investigate the issue further, Peter McAllister and Christie Louise Tucker present a debate of the issues at hand.

Argument Against Assisted Suicide

Firstly I would like to make it clear, I am not an apologist for antediluvian values, nor is this a polemic discourse on the dangers to spirituality of assisted suicide. My intentions are as much a deep-seated personalisation as they are borne of any religious conviction. I do concede, however that religion has played its part in my disagreements to assisted suicide and indeed suicide, but not exclusively.

One of the most ardent opponents to assisted suicide is the Christian Faith. Suicide of any form is morally wrong because, having given life; God is the only one who has the right to take it away. The Fifth Commandment, 'Thou shalt not kill' (Exodus 20, verse 13), makes the point quite unequivocally. I have always found this particular Commandment non-negotiable.

There are arguments raising the point about serious concerns in legislating assisted suicide due to unsavoury family members and shifty doctors who would rather persuade a person to end their life, against the person’s will. Are there selfish reasons involved from particular family members? Do they stand to gain financially? Surely their motives are not borne out of a selfless empathy?

In free will there is another potential problem, that of capacity. Is the person contemplating assisted suicide competent to make such a decision? Are the drugs that people take for pain relief compromising their ability to make clear decisions? From experience, yes this is a factor. Psychiatric conditions may make someone desire suicide. Conditions such as Depression and Schizophrenia disorder can go undiagnosed; people who suffer such disorders could in fact choose to be unnecessarily supported to take their own lives?

Many people fear that assisted suicide will create a climate in which some people are pressured into it. The old, the poor, or minorities and other vulnerable groups might be persuaded to shorten their lives, rather than to "burden" their families. Will the definition stop short of a human’s ability to be productive?

People with severe and enduring disabilities may in turn have to justify staying alive. Is this a situation we really want to embrace? Writers such as The Times columnist, Melanie Reid use emotional tactics to further the cause for assisted suicide. But in my view this masks a very self-pitying nature, expounding their self-interested agenda and turning it into an exercise in scaremongering a civilised society.

Argument For Assisted Suicide

The distinction between suicide and physician-assisted dying is at times subtle, but always important. For a coroner to return a clear verdict of suicide, the Government’s legal definition states that it must be apparent that the deceased, “took their own life whilst the balance of their mind was disturbed.” But for a change of the laws surrounding assisted suicide to work, establishing sound mind prior to acting would be paramount.

This is already the case at the Dignitas clinic in Switzerland, where each client must consult an expert psychiatrist and submit medical records to an affiliated doctor before a prescription can be written, and there can be no doubting the value and importance of this requirement. Currently the only medical procedure in the UK to require the consent of two doctors is an elective termination; of course assisted suicide should be the same, and for the same reasons.

The loudest protests against changes to the law are usually from religious groups arguing the sanctity of life, or those concerned about potential misuse of the eventual act. But when retired American Episcopalian bishop, John Shelby Spong states that “the right to a good death is a basic human freedom”, it’s plain that the debate is a long way from conclusion.

Much is made of“valuing life”, the implication being that those who support assisted suicide lack this conviction. Nothing could be further from the truth. Valuing a worthwhile and fulfilling life is central to our argument; not wanting to continue a life shattered by absolute incapacity is merely a continuation of this.

It’s vital to make clear that it is severe incapacity that is under discussion here – the end stages of degenerative disease, or massive injuries caused by accident or injury. The argument is made best by the individuals attending court to challenge the law, and those close to them: the initiator of this current challenge, Tony Nicklinson, describes his life as “dull, miserable, demeaning, undignified and intolerable.” The parents of Daniel James, who ended his life at a Dignitas clinic in 2008, characterised their son as "an intelligent young man of sound mind" who was "not prepared to live what he felt was a second-class existence".

A southern African saying once related to the author of this article comes to mind; upon the death of a relative, the grieving family are reminded to give thanks to God for “a long life, well lived.” Even non-religious readers will acknowledge the truth and value in this. This is truly when assisted suicide should be considered; at the end of a long and full life, when all other options have been exhausted and the loss of faculty is too great for the individual to accommodate.

In Conclusion

The purpose of the assisted suicide debate is not to imply that the lives of disabled people, or anyone else, are in any way miserable or intolerable. Instead, the aim is to enable individuals to make their own decision about when, where and how to die, and to do so with dignity and comfort.

At present, someone seeking physician-assisted suicide must travel to the Dignitas clinic in Switzerland: previously an anonymous, nondescript concrete tower block just outside Zurich, now a pleasant house in a residential district of the city. Many opt to make the journey alone; to have a relative accompany them could expose their companion to prosecution for attempting to “aid, abet, counsel or procure” suicide, a charge that carries a 14-year sentence.

Both sides of the argument talk about dignity, quality of life, control, and ethics, but in the end, the decision is nothing more than a personal choice. What is needed now is discussion – in Parliament, between ministers and the sick and dying, between doctors, between couples and within families. The onus should not be on individuals to ask permission to be allowed to die peacefully.

Assisted suicide is an act of mercy, no less than the actions of a doctor or nurse on any other day in their career. The real enemy is silence and hypocrisy; wishing a dignified death for oneself and others isn’t selfish or unfeeling, it’s human. And our humanity is what necessitates the freedom to make our choice.