Second Annual SOARS Lecture (London - October 14, 2011)
The second Annual SOARS Lecture was given by Virginia Ironside, the author (her two recent books are "No! I Don't Want to Join a Bookclub", and "The Virginia Monologues - Why Growing Old is Great") and journalist (she is a regular columnist for The Independent newspaper and The Oldie magazine).
Her talk, and the subsequent discussion with the audience, focused on "Personal Views on Life, Old Age, Death and other Mysteries". While this is a subject which is not usually considered by right-to-die societies, this event produced numerous comments regarding some of the reasons why many individuals want various choices at the end of their lives.
Among the observations made by Virginia Ironside were the following:
"A discussion of death is perhaps the most important topic in the world - which makes it so odd that so many people avoid it.....The only reason I can think of, for this, is that so many are afraid of it. Why? - when from the moment we are born, we know we are going to die.....I think this fear of death comes from the religious idea that life is a gift from God and that it would be rude to throw it away. But, life is only worth living if it is worth living: and, for many people, life is not worth living, particularly if they become so ill that they are unable to function at all.
"If I ever say, while chatting to someone, 'I must do this before I die...' they usually butt in and say 'Oh don't say that...you've got lots of time left!' Total rubbish. I've got far less future than I have a past, and I'm delighted. It means I have fewer options open to me, and I can cut out all the rubbish, refuse unwelcome invitations, walk out of boring films. Being young is like being in a huge supermarket, mind bamboozled by all that choice. Being old is like going to the village shop.
"I see death as something rather wonderful to look forward to. I see it like coming home. I see it as a merciful relief from all life's anxieties and troubles.....It is going to happen to all of us. So why not welcome it and accept it rather than dread it?
"When old people ring up and say, tearfully: 'Oh crikey, I've been told I've only got a few months to live,' I tend to think, 'Well, what do you expect at your age, dearie? I don't imagine you were expecting to live for ever.'
"Us oldies have had years and years to get used to the idea of death. We shouldn't be so weedy about it, we shouldn't dread it. We should set a good example to the young, and teach them, too, to welcome death, when life gets too wretched or, even, when it's clear that we've spent quite enough time at the party and our hosts are starting to yawn and look at the clock. We've got to move on - otherwise we'll be parents of children who are bent and bald.
"Even Freud said, in a letter he wrote to a friend in 1936: 'I still cannot get used to the grief and afflictions of old age, and I look forward with longing to the journey into the void.'
"They say that old age isn't too bad when you consider the alternative. But what is the alternative? Everlasting life? No thanks. Nowhere is the desire to live long seen so clearly as in Miami, a city also known as 'God's Waiting Room.' It's rather like Hove, with gangsters.....Certainly many in Miami look fantastically old. You see alarmingly pulled-backed face-lifty faces atop crinkled bent old figures, all out of kilter.....In my hotel lobby, there was a book for sale called 'Secrets of Longevity: 100 tips on how to live to 100'. Heaven preserve me.
"To be fair, most people I know do say they're not frightened of death so much as frightened of dying. And, none of us wants to enter a strange half-life of pain, blindness, deafness, the loss of our faculties and, often, a complete change of personality.....That is no life for anyone.
"So when some argue about keeping people alive, come what may, I feel like saying: 'For heaven's sake, what's the big deal?' I've already lived far longer than most people were expected to live a hundred years ago. Now, I feel I live on borrowed time.
"It's not good for our children if we hang around too long. I certainly didn't even begin to feel like a grown-up until both my parents had popped off.....I have friends of 75 who are still looking after a bonkers old parent, still staggering off to the nursing home to sit by the bedside of a wheezing semi-corpse which doesn't even recognize them...I have friends whose lives are dominated by their elderly parents.....How will young people ever have a chance to develop if they're forever shadowed by our ailing, brooding presences?.....Baroness Warnock said that she would far rather die than be put into a nursing home and spend large sums of money which could be better used by her children. My thoughts exactly.
"And, if you think that I'm being creepy, apparently 70% of us welcome the idea of assisted suicide when we get too old, or too ill to enjoy life any more.
"And, finally - famous last words. Yes, you can start dreaming them up right now. Here are some hints - 'Another sunny day! Thank God I don't have to go out and enjoy it!' Or - 'I long to be nothing and nowhere, and that will be such a relief: to be something and somewhere is very tiring."
During the subsequent discussion - with SOARS supporters, FATE members, and their guests - the following points were made:
"Death" should be openly discussed, in honest terms: expressions such as "passed away" should never be used. And, worst of all, it should never be said that someone has "lost" his wife or her husband!
In many ways, "Life" is a rather ridiculous situation - homo sapiens is apparently alone in this universe, based on Earth, which is a tiny speck in a vast cosmos, travelling through outer space at nineteen miles a second.
Furthermore, homo sapiens is a recent (accidental?) arrival on Earth - if one's arm represents the age of Earth (about 4.5 billion years), then the presence of homo sapiens is equivalent to one shaving off a fingernail.
How someone copes with death may be largely influenced by what that person actually thinks survives when death occurs. A poll of the audience revealed that 8% believed that a "soul" continued to exist; 12% felt that there is a non-specific "life force" which energizes all living creatures; 65% felt that nothing survives death (except one's descendants, writings, photographs, and friends' memories); and, finally, 15% (perhaps the most honest?) were uncertain what survives when someone dies.
Finally, everyone was reminded of the basic rationale for the existence of SOARS when a 2002 statement from the European Court of Human Rights was quoted - "In an era of growing medical sophistication, combined with longer life expectancies, many people are concerned that they should not be forced to linger on in old age or in states of advanced physical or mental decrepitude which conflict with strongly held ideas of self and personal identity".
First Annual SOARS Lecture (London - September 17, 2010)
While the Pope was talking to parliamentarians, in Westminster Hall in London, on September 17th, Lady Mary Warnock, the distinguished educator and moral philosopher, was giving the first Annual SOARS Lecture on “Easeful Death for the Very Elderly”, at the Draycott Education Centre only five miles away.
Lady Warnock’s statement was so clear and direct that the essence of it can be easily given by quoting the following main points:
“The older we get the more realistic we usually become about approaching death, and the more we hope for a good death. Euthanasia in the strict sense is what we all want, whether we will need medical intervention to achieve it or not. This afternoon, I shall speak boldly about euthanasia, and assisted suicide, not hedging it about or sanitising it with the euphemisms of ‘assisted dying’.
“Like many people of my age, I have recently witnessed the death of a close relative, my eldest sister, who died this Summer at the age of 101. She did not have a good death; and though its badness lasted only two months, it was avoidable badness, and too long-drawn out…..She got pneumonia and was taken to hospital where she was given masses of different antibiotics…..It was plain that she was dying, but no one admitted this: they spoke as though their one aim was to help her recover, and get her back to where she had been before…..She became unable to swallow and was doubly incontinent, and increasingly distressed and agitated…..her last few days were spent, mercifully, in unconsciousness.
“This sad story makes me even more convinced than I was before that everyone must make an Advance Decision and if possible appoint someone to make decisions on their behalf…..Universal understanding of Advance Decisions, and access to proper forms on which they can be made are essential now that we are all living much longer, and it is the responsibility of GPs to bring it about. There should be explanatory notices and copies of the proforma in every surgery, and, at least in the case of everyone over eighty, or with particular health problems, doctors should steel themselves to talk about how their patients whould like to die, and what would constitute a good death. And especially they should talk about how to avoid a bad death, and how the doctor is committed to helping in this avoidance.
“Doctors appear to be hard-wired not to mention death, even though they know quite well, as we all do, that all men are mortal. And it is to be hoped that they know that their duty is as much to make death bearable as it is to fend it off, for this is what we all trustingly believe that they will do, until we witness the contrary. The fact is that most doctors are not much interested in death. A dying patient is not their concern, but the concern of relatives and nurses. Once the doctor believes that he has done all he can to cure his patient, that is to prolong life, and has failed, then his interest wanes…..If doctors seem incapable of mentioning death to their patients, how much more incapable are they of bringing it about?…..Instead they could try to embrace the idea that to bring about a good death for one of their patients is simply to continue the duty of caring for that patient, of acting in the best interests of that patient.
“Dying in hospital, though it may be long postponed by advances in treatment and in technology, may also be lonely and horrible, because there are not enough nurses to care for the old in the most basic ways, by spending time with them, by helping them to eat or drink and talking to them. All such neglect contributes to a bad death, even, or perhaps especially, for those who remain mentally competent, and able to recognise with horror what is happening to them.
“Nothing I have said so far bears on what is the most intractable problem of all those we must face when considering the death of the old, and that is, of course, the problem of dementia. We all know the increasing numbers of those old people suffering from some form of dementia; and we all know that the annual rate of increase is rising fast…..There is certainly a strong argument for enabling patients with dementia to have an Advance Decision they may have made fully and properly respected…..This, once again, points to the absolute need for the public to be educated about Advance Decisions. Specifically, it shows the need for early diagnosis of dementia. For in its early stages, dementia does not render its victims mentally incompetent; they are well able to make decisions with regard to their future (witness the admirable pronouncements of Terry Pratchett), and they are still able to retain the sense of who they are and who they have been, which is lost in the final, most bewildering and frightening stages.
“I simply do not want to be remembered as someone wholly dependent on others especially for the most personally private aspects of my life, nor can I tolerate the thought of outstaying my welcome, an increasing burden to my family, so that no one can be truly sorry when I die and they are free…..Our life, for us, is a narrative, with a beginning, a middle, and an end. We want it to have an end that is fitting, not an end that trails pitifully on into chaos and darkness…..Euthanasia ought to mean death that is good, in the sense that it is timely.
“We must hope that Society can get used to the idea of a good death being in the interest of the very old, when they have, one way or another, ceased to enjoy their life. I believe that this change is perhaps not so far off, if only we can persuade the priests and the doctors to listen to those people”.
For the sixty-five individuals present on September 17th, at this lecture, it was a great pleasure to hear Lady Warnock, now aged 86, speaking so eloquently for so many who are nearing the end of their lives.