Very Interesting Kathleen Stock article

[TempestTost]

I found this article one of the best I have read about assisted dying. It is the only one I've seen articulate so clearly the concerns around how it might change people's ideas about what counts as unbearable suffering.

She clearly draws a lot from her experience looking at what has happened with gender ideology, both legally and socially and psychologically. And her philosophy background clearly helps her frame this in a way that is clear and exact, which is so hard to find.

Anyway, I thought people might find it an interesting comparison. It's from Unherd, so you might need to register to read it but you can do so for free.

https://unherd.com/2024/10/theres-no-dignity-in-assisted-dying/

I'm shocked at not just the content but the tone of this article. I expected more rigour, objectivity, neutral language, balance, understanding ..

To take a sentence at random:
Deep down, everybody knows that the introduction of assisted dying legislation will create a new tier of vulnerable people who decide to jump before nature pushes them, and who would not have done so otherwise.

'Everybody knows'? Any evidence, back-up, justification - anything at all?
'queasily syrup-laden'
'lazy heartstring-plucking'
'a pillowy, feminine-coded assault.'
'happy to talk simplistically of kindness and cruelty as if they are in primary school'

Linking incurable illness or intolerable suffering [I'll decide what's tolerable for me, thank you] to gender surgery is offensive - my medical conditions are unfortunately very real, not like 'a badly fitting body that required hormonal and surgical realignment to fit the inner world. ;

Some disabled people are against assisted dying; others, like me, are in favour of it. Both sides have voiced their opinions. But according to the writer
Protests from disabled people, ....seem to be falling on strategically deaf ears.
'Deaf ears'? Appropriate language when talking about disability?

I could go on, but I'll stop because I actually find this article deeply upsetting and dismissive of lives lived in real pain, real distress. The subject, and the people involved, deserve better.

"The people involved" is every one of us. Whether currently healthy and looking after elderly family members or nearing end of life ourselves.

The idea that introducing an assisted dying law will only affect some is foolish,

I don't see anything wrong with her article, it's an opinion piece setting out the problems with such legislation. I find it very worrying because it changes the emphasis from relieving suffering to just ending lives.

I just don’t see why the autonomy of the sufferer should be removed because of the qualms of others, including the religious beliefs of third parties. If I’m in unbearable pain in the future, I want to be able to say “enough” and I want my loved ones to have the same choices, whether the Archbishop of wherever thinks it’s a good idea or not. Canada is a basket case on assisted dying, but other countries have such laws that seem to work effectively.

Thank you for sharing it - I find it really interesting that some of the most articulate challenges to this come from gender critical writers - as Stock suggests, they’ve been here before with the boundary-pushing, dressed up in the language of kindness. Sonia sodha wrote a very good column a few months back, focusing on the vulnerability of domestic abuse victims https://amp.theguardian.com/commentisfree/2024/apr/07/conflicted-legalising-assisted-dying-sonia-sodha I would never downplay the distress degenerative illness causes but I really think the celebs and mps pushing for this need to think beyond the confines of loving, middle class families and take seriously the likely effect on extremely vulnerable people.

I find the autonomy angle a little misleading. Assisted dying is not about autonomy.

It's very much about society and others, including legal and medical institutions, being involved.

Which is why it's a social question, not an individual problem.

I am deeply worried about the idea of “assisted” dying. I thought her article was brilliantly put.

Never trust the state to get these sorts of things right.

And she highlights that with the lack of sensible debate from our politicians, this proposal cannot be trusted.

@MarieDeGournay i deeply respect your own desire when it comes to the end of your life, but i have no faith in the state to keep all people safe.

I give thanks to the TRA’s for hoiking our Kathleen out of obscurity into the public domain, her musings and work are a wonder to behold.

I think what I found most interesting, because I haven't seen it discussed in such a precise way before, was the way in which our sense of what is "unbearable suffering" is culturally contextual, and how that could change - and has changed in places where laws have changed on this. How people's sense of what is right, or good, can shift without them really realizing it.

People seem to assume that moral lines will stay in place from generation to generation. In reality, we see that they can move significantly even with a person's lifetime.

Even within gender ideology, we have seen young people's sense of what counts as unbearable body dysphoria change. And as the concept has changed, their feelings have actually changed. It's kind of fascinating.

I think the problem is that we distance ourself from death and stop ourselves from contemplating what could be a nasty end. I have a friend whose husband begged her to help him end it, just to shorten suffering. I have another friend who has worked as a carer who has been begged in this way by patients. Another acquaintance whose aunt starved herself to death to end it. How can it be right that people should suffer in this way rather than be helped with extra painkiller?

Esther Rantzen has spoken about her husband, mother and dog dying within a short time of each other. She says that the dog had the best death, due to being euthanised. I know that's what I'd prefer too, given the choice.

So you are saying you think people don't support assisted dying because they don't understand they might suffer?

I don't think that's a very credible hypothesis myself, I think most people have some personal experience of death, and I certainly have never seen people who oppose laws like this are less likely to have such experiences. Lots of people in medicine and as Stock said, many of the disability organizations, are very wary of this.

What are your thoughts on her concerns around the effects of legislation like this, and the fact that already, people are pushing to remove the proposed safeguards.

I think people are squeamish and like to put off thinking about possibly painful death.

Medics - My understanding is that doctors are not obliged to carry out abortions, but some do. Similarly it should be up to doctors who are willing to be on a relevant list.

Law - We already have laws which allow people to control others’ money and health decisions. Those laws work pretty well to keep sharks at bay. Laws should be carefully and tightly drafted and enforced and that should suffice IMO.

Well put, I too have many concerns about this - giving the state the power to 'assist' it citizens to die, what could go wrong with that.

And it looks like I'll be on Kathleen Stocks side in the new war too.

Assisted dying is a slippery slope and one thing I've noticed about the debate is how personal and myopic people have been about it.

It reminds me a bit of the Brexit debates where everyone had a personal reason for voting leave, very rarely looking at the actual consequences and how they affected everyone else.

First we have failing social services, care services and medical services and assisted dying would save a lot of money. Second care homes are very expensive and eat into inheritances and elderly people can be easily manipulated.

It's common for elderly people to be depressed and feel like a burden on their families. Dementia patients can't give consent and neither can those with severe mental illness. Drs who have budgets and bed availability to think about may make pragmatic decisions.

I appreciate that those arguing against assisted dying are looking to prevent harm. But if you want to look at it philosophically, also look at it from the other angle - people are currently suffering at the end of their lives and have no agency over this. Is it morally correct for these people to suffer to protect others from a more notional harm (which may or may not materialise). I’m not trying to upset, or cause a bun fight btw, this is just my own view. It is useful for these matters to be aired and discussed I think.

Why don't these people who are suffering at the end of their life have agency, why didn't they end their life when they did have agency, nobody needs the governments permission or assistance to commit suicide.

I used to be in favour of assisted dying. After seeing Canada's maid program I have absolutely changed my mind.

I think it must be hard to decide to kill oneself while there is still a life worth living, when one has agency. I did know of someone who stockpiled opiates and suffered pain as a consequence but bottled out when it came to it, and ended up in prolonged palliative care.

I am in good health now, i like to think i would be able to suffer what agony be at the end of my life, as part of a natural process. But I cannot know how i will feel nearer my time.

I just do not trust the state someone said upthread about safeguards re power of attorney, i know of so many cases where this is not true in reality

Kathleen Stock mentioned the recent case of a 29-year-old woman who was helped to die by Dutch doctors on the grounds of “chronic depression, anxiety, trauma and unspecified personality disorder”.

This is an article about this young woman which contains some disturbing statistics.

https://www.theguardian.com/society/article/2024/may/16/dutch-woman-euthanasia-approval-grounds-of-mental-suffering

Her case has caused controversy as assisted dying for people with psychiatric illnesses in the Netherlands remains unusual, although the numbers are increasing. In 2010, there were two cases involving psychiatric suffering; in 2023, there were 138: 1.5% of the 9,068 euthanasia deaths.

This article gives more detail about her life and her decision to die.

https://www.thefp.com/p/zoraya-ter-beek-dead-assisted-suicide

She seems to have had little support from her family for her mental health problems or her autism which was diagnosed when she was 21, and she was estranged from her mother and sisters. Her father had recently died. She had also suffered the trauma of her best friend killing herself by jumping in front of a train when she was 16.

Is this really the right solution for a mentally distressed young person? Should we really be giving up on people like this and just help them to die?

In two of the cases I mentioned they were too ill - in the last weeks of life in a hospital bed. The third was too old (care home).

I know, I'm the same. I watched my sibling succumb to a horrible, aggressive and rare form of cancer. She had chemo and radiotherapy and major surgery over 2 years but it still spread and she died just after her 25th birthday. It was awful and I remember during the last few months wishing she'd been able to have the pain and suffering taken away.

Now a good few years later I'm experiencing the sadness of seeing my DM in a care home and I see a lot of poorly residents yet at the same time they are happy in their own heads (it's a dementia home). They are well cared for and every day they get entertained and although I am amongst the relatives that will come and sometimes cry seeing my DM when she's having a bad day, I'd feel extremely uncomfortable at the state stepping in and euthanising them. They still deserve a life when it's theirs and I don't think it would be feasible to do assisted dying with those who have no mental capacity. Yet it's apparent that that is what has been happening in Canada. It has gone far beyond relieving the suffering of a person with terminal cancer like my DS and has now moved onto encouraging anyone with mental distress to do it, including homelessness! It's a final solution to what could be (with the right support and help) a temporary problem. How can we ensure the state euthanising lots of elderly dementia patients won't end up being like that too?

It's a tricky and emotional subject matter, I go back and forward on it a lot. But what Canada has ended up doing has really upset me, it's just not something I would want the UK to agree to.

'Why don't these people who are suffering at the end of their life have agency, why didn't they end their life when they did have agency, nobody needs the governments permission or assistance to commit suicide.'

My grandmother deteriorated very quickly. She went from bad arthritis to sepsis in every organ with 24 hours. Unfortunately the medical support didn't recognise this and failed to either treat her or give her painkillers. It took her nearly a week to die, screaming in pain until we finally managed to persuade the hospital to sedate her. They'd resisted even that and were scathing about how feeble we were for being unable to cope.

If assisted dying is not to be passed, there needs to be serious investment in and provision for end of life care with hospices funded by the government and enough places for everyone who might need one. More funding for the NHS so they're not forcing people to be at home without any pain relief because no one can now be trusted with anything other than mediocre amounts of morphine in case of addiction in the last few days.

We all know that won't happen except for the lucky few. Everyone else will be left to muddle through as best or worst they can and hope the end doesn't take too long or they can starve themselves to death quickly.

I had such an argument on MN a week ago. There was a woman who said she just wanted to die and had been depressed for years.

I argued that rather than kill her, society should better support her. That our mental health service is not fit for purpose and with the right treatment and support she could have the chance of a decent life.

I also pointed out that suicidal feelings are often transitory and I knew people who were leading decent lives who would be dead now. I don't believe that people suffering from mental illness have the capacity to make that kind of decision.

Saying that this kind of legislation will bring the state in to involvement in death - the state is already involved in health care, palliative care, social care, setting laws around suicide, etc. It's misleading to imply it's suddenly getting involved and this is to be mistrusted.

And the argument that ill or elderly people worry about being a burden on family - we'll it's natural to worry about that, and some do become a burden, no point pretending that this doesn't happen. You don't necessarily need to think that argues for assisted suicide, but it's a poor argument to say this concern just 'should not happen'.

I find the article hyperbolic. I'm strongly pro introducing legislation around assisted dying. I thought it might be interesting to read an argument with some insight from the gender/trans experience, but I don't find anything here. Yes 'unbearable suffering' is subjective, but death is biological reality - unlike trans-ness.

I disagree with many of the posts on here. But this is a deep and difficult subject, with sincere opinions on both sides, which deserves thoughtful, balanced discussion.

I respect the opinions of those who, unlike me, do not agree with assisted dying, so I will not use language like
queasily syrup-laden'
'lazy heartstring-plucking'
'a pillowy, feminine-coded assault.'
'happy to talk simplistically of kindness and cruelty as if they are in primary school'
against people who happen to take an opposing view.

This serious subject deserves better than name-calling.