Franco's baby trafficking

Spain’s daily newspaper El Pais is running a series on investigations into claims of the trafficking of thousands of babies and young children during the Franco dictatorship (1939-75).

It reports that in the early years the regime took thousands of children away from Republican parents as yet another method of repression. From 1950, the theft or appropriation of children took a more subtle form, the babies often being taken from hospitals and children’s homes; in the majority of cases, these abductions were linked with religious organisations. The mothers were no longer prisoners, ‘Reds’, or wives of left-wingers, but simply young pregnant girls with little money, incapable of coping with the intimidation of doctors and nuns.

The newspaper series is bringing forth much debate and responses from those ‘adopted’ and from couples who ‘adopted’ these children.

In 1981 childless María del Carmen and her husband were advised by friends to see a nun who ‘gave away babies’. ‘Sor María told us to bring her a pregnant woman and she would then give us a baby from another woman. This was so that we would have no idea who the mother of our baby was, and no contact could be made.’ It also guaranteed a continuing source of babies for trade.

With difficulty, Carmen and her husband eventually found a young girl from the provinces who was pregnant by a boy who wasn’t her fiancé and wanted to give the baby for adoption. They introduced her to Sor María and then rang the nun every few days to see whether there was a baby for them:

‘One day Sor María said there’s been two births – one a pair of twin girls and the other a little boy. I decided that the first couple to ring me would get the boy, and it’s you! It was like a tombola. She told us to bring 50,000 pesetas. I have all the papers, but not one for the money we paid her.

‘We were surprised that when we arrived at the Santa Cristina clinic where Sor María worked, she took us to a different hospital – San Ramón – where the child had been born. The doctor told us the mother was a healthy young woman. He telephoned us three months later to bring him the documents. When my husband took them to him at San Ramón, the doctor said No, not here, come to my car … But we didn’t know that any of this was wrong, we were so overjoyed …’

Many instances of other methods of control are apparent:

‘ more immorality and impunity from the Catholic Church comes to light, substituting dead babies with living ones in order to give them to those parents who were more “decent”! The only way of putting a stop to these people and their ongoing abuses is to stop participating in their ceremonies – otherwise we form part of the problem …’

In many cases the mothers were told that their new-born baby had died and that it would upset them too much to see it. Some mothers eventually suspected that their babies had not died, as in the case of a woman from Barcelona who gave birth to a little girl forty years ago. She was told that the child was dead at birth but has recently found her daughter through DNA tests.

And poet Elsa López recounts:

‘I gave birth to a daughter in 1981. They told me the baby was very ill, that she was disfigured and they gave me a baby wrapped up that felt frozen solid! Then they told me she had died and that I mustn’t worry because they had baptised her and she was now an Angel of God.’

In some instances, nuns silenced young mothers saying that they had given their babies to people with whom they would be much better off. Nuns and priests exchanged information about pregnant girls with well-to-do supporters of the regime. The girls were often taken to religious institutions to give birth where they were persuaded by the nuns to hand over their babies. Many girls regretted those decisions made during the time they were so helpless and tried in vain for years to get their babies back but were impotent against the brick wall of rich adoptive parents, expensive lawyers and the Church.

Linked to the Church, the organisation Telephone of Hope was formed in 1971 by Serafín Madrid, a priest, to ‘aid new social and psychosocial problems in Spain’. It acted as a channel to find pregnant women and persuaded them to give their babies up for adoption, often employing pressure, threats and subterfuge. The adoptive parents paid between 50,000 and 150,000 pesetas and were able to choose babies by gender.

Libéria’s biological mother gave her to the local children’s home in Tenerife. Her husband had been murdered by the local cacique (wealthy landowner’s agent) whilst she was pregnant and, with already seven children to care for, she re-married but her new husband would not accept Libéria because she was not his child. The mother visited her child at the home every day.

Libéria described life with the nuns as a nightmare:

‘they would bang girls’ heads against the wall and punish us for absolutely anything. If a girl wet the bed the nuns would make her wear her knickers on her head and carry a notice declaring her sin. They taped excrement to our mouths … From time to time they would dress us in white and parade us in front of prospective parents. These people inspected our teeth, our hair, they lifted our skirts to see if we had rickets – it was like a horse market. A few days later one of the girls would disappear, usually the youngest one ...’

Libéria was never chosen. But one day, at the age of 8, she was chosen by the nuns at the home to be given to a nun whose relatives wanted a child. The nun changed Libéria’s name and hit her on the head until the child could pronounce her new name properly and she was then taken to live with a couple in Valencia. The couple spoke only Valenciano and so Libéria could not understand them. The nuns refused to tell Libéria’s mother what had happened to her.

Libéria’s adoptive father began to abuse her:
‘I told a nun what he was doing and she told me not to tell anyone and to pray.’

Decades later, Libéria recovered contact with her mother and siblings.

The article underlines the fact that people with an absolute lack of scruples used their privileged position, under the protection of religion, to alter the destiny of other human beings and to use the most vulnerable of people as vehicles for considerable money-making. The confession box must have been an incomparable method for information-gathering, and these events illustrate possible reasons for the Catholic Church’s prohibition of contraception and abortion.

Eleanor S. Davidson

Islam and secularism

To many people today Islam, of all the world faiths, is probably the least likely to declare itself compatible with secularism. Yet a recent publication (British Secularism and Religion: Islam, Society and the State, 2011), that I helped to edit, argues that Islam can be read in precisely that way. In fact, secularism is very important for Muslims in the modern world, as it is the basis for equality, democracy, freedom, human rights and the autonomy of religion itself. These values have a strong resonance with my reading of Islam even though conservative voices may disregard these as ‘Western values’.

Historically, the Muslim world had a very positive relationship with scientific and rational enquiry on the one hand and religion on the other, creating significant innovations in science and mathematics. But while the Enlightenment and the exciting search for emancipation of the human spirit engendered important developments in Europe, intellectual stagnation settled in much of the Muslim world causing it to lose that creative relationship with rationalism. From the late-nineteenth century one could hear calls for renewed thinking (ijtihad) and reform (islah), a movement that only now seems to be gathering momentum.

With the purpose of furthering a conversation among Muslim communities, the basic argument of the above book is for a more nuanced approach to the secular; to move beyond polarised debates on the subject. It is important to distinguish between different forms of secularism: procedural and programmatic, i.e. structural pluralism, neutrality of the state and management of the public sphere -vs. more ideological, anti-religious sentiment. Muslims should embrace the former, while they may debate and dialogue with the latter.

As such, the British model of secularism (a pragmatic, weak form of establishment) is a good starting point for a democratic society, with a secular public culture that also has a space for faith. While there may be room for improvement, the American and French models (which are more secular in constitutional terms) show (differently) that the debate around religion in public life is not easy to resolve by mere constitutional separation.

Despite the fact that some Muslims advocate a return to the ‘Caliphate’, the current tide of public opinion in the Arab world, for example, shows that Muslim masses aspire to freedom and democracy in ways that were not recognised previously. In the early twentieth-century preoccupation with the Caliphate, it was seen as a symbol of Muslim unity and its restoration as vital in defending Muslim interests and procuring justice in a post-colonial context. However, in reality, there has usually been a normative distinction (albeit in pre-modern settings) between the temporal, sovereign authority and institutions of religion in the Muslim world, the latter mainly advocating autonomy and resenting their co-option by the state whenever that did happen. If one adds to the mix the immense disappointment of Muslims with the various ‘Islamic’ state projects – Saudi Arabia, Pakistan, Iran, Sudan, Afghanistan, etc. there is a growing recognition that a liberal, secular democracy is a good model for ensuring accountable, open societies that can protect the rights of citizens.

However, the story is more complex than that: an absence of religious rule doesn’t automatically imply genuine freedom and liberty, given the role of the military in many Muslim countries. Furthermore, ‘secularism’ in the Muslim world has, in the past, been associated with forced ‘westernisation’ (Turkey for example) and/or double standards (e.g. support for dictatorships). This means that Muslim publics are often very sceptical of the term ‘secularism’ (though, as mentioned above, not necessarily the notion of separation).

While advocating secularism, I am not for the disappearance of religion. Rather, I see secularism as a good way of managing the public debate, especially where multiple religious, ideological and belief arguments may collide. So there is a conversation to be had about the extent, nature and mode of religious presence in the public sphere. Given the plural nature of that presence perhaps the Rawlsian notion of ‘public reasoning’ can help - especially in a culture of very low religious literacy? But it seems that we also need to reach a point where (sensible and rationally arguing) religious voices can be given consideration and not automatically disregarded as ‘superstitious’.

The nuanced conversation and reform we are trying to nurture, on all sides, will need time; and yet it often seems like time is running out. But the process of reform cannot be forced, or enforced. For it to be an authentic voice, it needs to be organic. We can, however, catalyse that process by fostering education and critical thinking, by encouraging open and free spaces of debate and by encouraging people to dialogue in safe spaces so they can build meaningful relationships that cut through the polarised impasse of today.

Dilwar Hussain

Head of the Policy Research Centre, Islamic Foundation, Markfield

The need to adopt ‘real economics’

The greatest threat facing humanity now is undoubtedly ecological disruption – greenhouse gas emissions and the decline in biodiversity. If this threat is to be addressed there will have to be a big cultural change worldwide. The attitudes which cause people to accept and even promote continuous ‘economic growth’ are based on a culture of individualism and competition. Since the victory of ‘capitalist roaders’ in China and the disintegration of the Soviet model of communism there is little serious challenge to this culture. Former notions of a socialist order emphasising communal values and co-operation have almost disappeared. Their rapid dissolution was made inevitable by the operation of ‘actually existing socialism’. In Soviet communism such grand talk was actually a smokescreen to hide the brutal self-aggrandisement of elites. In China the brutal elites have switched to capitalism with gulags. Such an understanding of socialism has always shared with capitalism the view that economics is a search for prosperity based on production. But it’s not. The original Greek term is actually ecos nomos – ‘management of the household’. Its parallel idea is ecos logos, origin of the word ‘ecology’, where logos translates as ‘study’. The history of language is full of surprises. If we consider that in ancient Greece those who ruled the roost were rich landowners and merchants, we can see that ‘the household’ that needed management and study was in fact an extensive affair with perhaps dozens of slaves as well as members of an extended family. Those charged with overseeing such estates would have been the original ‘economists’ and ‘ecologists’

Good land management has always been about careful consideration of the interdependence of life forms – a concern sadly absent from today’s industrialised agriculture. And in the end we all depend on the supply and wholesomeness of food. In fact real ‘economics’ is still about the management of the planet’s resources - not least food and water. The extent to which economics has departed from its original basis is actually a reflection of the extent to which the interests of the rich and powerful have moved away from any concern with the fundamentals of life. But our continued prosperity as a species– even our continued existence as inhabitants of planet Earth - requires a rediscovery of those fundamentals and a return to ‘economics’ as the management of our survival.

The cultural revolution that such a rediscovery requires is something we should all turn our attention to. Unsurprisingly, considering it’s the future that’s at issue here, those who are in the lead in attempting such a revolution at the moment tend be younger rather than older. It’s with the climate campers in the UK and the democracy advocates in Tahrir Square that our hopes must lie. Yet even those of us for whom life under canvas or demonstrating in the street may no longer retain its attraction there is a role – to press by any means we can for a revolution in basic attitudes. As secularists this should present us with little difficulty. Whether they be oil-rich Saudis or born-again Christians, fundamentalists among our religious adversaries are all enthusiastic proponents of the old cultural order. Whatever their beliefs are supposed to advocate – brotherly love or submission to a higher authority – their actual values are those of selfishness and unbridled competitiveness, involving denial of any significant ecological problem. It’s up to us as secularists to demonstrate a more rational and altruistic set of values. Genuine prosperity is based on efficient management of the planet not on an economic ‘growth’ which is in fact a malignancy.

Doug Holly

I wish to tell you about Gaza

"So much of what I saw and heard in Gaza has left a deep black hole in my consciousness for I am aware that the crimes committed by the Zionists of Israel and completely complicit with the US are one of the greatest crimes against a population that fails to be seen as human beings. Instead Palestinians are demonised, dehumanised in an attempt to obliterate their history, their dignity and their right to exist in safety and peace. From my perspective, this is nothing short of the final chapter of the Holocaust, a tragedy from which there is no forgiveness."

By Lillian Rosengarten / The Palestine Chronicle 24 / October 2011

http://www.palestinechronicle.com/view_article_details.php?id=17201

Gaza life exists in a cage, an open-air prison that has been kept mostly isolated from the world. Its citrus trees have been uprooted. Flowers are no longer exported. Nor are vegetables, fruit or olives, formerly a thriving export business. Since 2000, the Israeli Army destroyed 114,000 olive trees. The rest were destroyed during the 2008-2009 war, much of it uprooted from white phosphorus and other chemicals. Farming is now difficult and in some areas impossible. Much of Gaza looks like a war zone, bullet holes visible on the sides of buildings. Gaza is without proper sewage pumps, bombed as they are rebuilt. Mediterranean waters are infested with raw sewage, while a three-mile limit, closely watched by the Israeli Navy collectively destroys a once flourishing fishing industry, the waters now stagnant from sewage and overfishing.

It is the grimmest of war stories, unimaginable horror where tunnels, miles of mazes function to alleviate the suffering as goods are brought in from Egypt. Dangerous are the tunnels for they are regularly bombed by rockets and missiles. Many of the young brave men who work in the tunnels to bring needed goods to Gaza take a daily chance on their lives. Articles to sustain life come through the tunnels. Diesel oil and gasoline are pumped through the tunnels at 1/3 the prices the Israelis charge. In addition, building materials, cement, medicines, bandages, first aid, even cars and washing machines find their way into Gaza. Articles sent through Ashdot, Israel, often must wait months before they are inspected and often never arrive in Gaza.

Electricity remains scarce and back-up generators used in hospitals can turn on 12 times a day. They consistently break down, often during surgery. Repair of generators and equipment in general is a difficult problem since replacements take months to arrive from countries that have donated the generators. The same is true of new imaging equipment that stands idle when often the smallest repair is needed. Once something breaks down, one must wait, often more than a year, for replacements which come from participating NGO countries who support the Palestinians. Sadly (as far as I can learn) the US no longer contributes and Congress recently defeated the use of funds for NGO agricultural development. This is a tragedy for the Palestinians in Gaza who feeds its own population.

Many who are ill are unable to receive advanced treatments. Forty per cent of medication for necessary treatment is not available. Chemotherapy drugs do not exist, for they are too expensive. Also missing are gloves, needles, sutures, antibiotics and frequently the most basic necessities. Some wheelchairs are donated from participating countries. They are in working condition for the many young people who have had limbs blown off. I was told a wheelchair sent by Israel was not usable as many parts were missing. How can this be? Hospitals are bombed and rebuilt. Without the tunnels, there would be a total paralysis in rebuilding construction.

Only the sickest who need advanced treatments, the most vulnerable patients have been sent to Israeli hospitals. The trip is long and arduous, with many checkpoints. Some cannot survive. Children must go unaccompanied, for parents are not given permission to accompany and comfort. Now patients are more readily sent via Rafah to Cairo for treatment, also an arduous undertaking but preferable since border restrictions create more of a possibility to arrive at an Egyptian hospital for treatment. It remains, however, still difficult and lengthy. I have seen the crowds wait for hours at the border to have their passports and documents approved, a tedious procedure even for those who are physically well.

Al-Shifa Hospital (translates as” Healing” in Arabic) is the largest and main referral hospital in the Gaza Strip. It has 700 beds and sees 1200 patients a day. The effect of the Israeli Siege on Health has been nothing less than devastating. I am exceedingly impressed with the commitment of the hospital staff workers who care for the sick and wounded with limited equipment. Palestinian men and women work side-by-side. I am impressed by the beauty of the Palestinians and their drive towards dignity and freedom. I am impressed by the parents of their sick children who tend them with love and much tragedy etched on their faces. So much of what I saw and heard in Gaza has left a deep black hole in my consciousness for I am aware that the crimes committed by the Zionists of Israel and completely complicit with the US are one of the greatest crimes against a population that fails to be seen as human beings. Instead Palestinians are demonised, dehumanised in an attempt to obliterate their history, their dignity and their right to exist in safety and peace. From my perspective, this is nothing short of the final chapter of the Holocaust, a tragedy from which there is no forgiveness.

I will continue to write about the land of sad oranges, the land where citrus plants have been pulled out of the earth and trees have been exported to Israel for their profit. Everything is for profit and greed while human beings cease to be human. I wish to tell you about the depleted uranium and white phosphorus found after the war, three weeks of endless bombings night and day. I have seen teachers in the “Save Our Children” project work with two eight-year-old boys who, to this day, are not able to speak after operation Cast Lead. Still to this day, one finds the continued use of chemicals in the soil and in the bodies of the children who are born prematurely with cancer and disfigurement. Yes and 33 additional toxic chemicals that change with each round of bombings have been isolated. In case you do not know this, over 55% of the population of Gaza are under 18. I shudder to think of what the continuous brutalisation of this young generation will lead to in the coming years. Still the Palestinians, with the help of the NGOs, are trying to preserve the wellbeing of the Palestinian children who are crowded in refugee camps and have the most beautiful faces. There must be hope as the children come up to me with peace signs and we chant Viva Palestina together.

My work has just begun. I too must hang on to hope. The world must listen and resist.
~~~~~~~~~~~~~~~~~~~
Lillian Rosengarten, a refugee from Nazi Germany, is a Buddhist practitioner, poet, writer and a pacifist. She contributed this article toPalestineChronicle.com. Contact her at:truthpoem@gmail.com

On assisted suicide

From pre-history until today we know all too well that many people have had and will continue to have their lives ended by brutal and inhuman means as the result of wars, torture by oppressive regimes and other forms of violence. Causing the deaths of others is not at all unknown to civilisation and in some societies where such deaths are not infrequent it is commonplace to say that human life is cheap.

However, in recent times using the notion of human rights that civilised societies have devised we emphasise the value of human life and this is institutionalised through laws and conventions as a means of collectively protecting ourselves as individuals from arbitrary slaughter. This is one of the foundations for our potential to live lives worth living, free of misery, terror and anxiety. Placing such a high value on human life means a decision to end it is of considerable significance for the individual and those around him or her.

Historically the Christian churches, especially the Roman Catholic Church, have participated fully in the slaughter of innocents. From the persecution of pagans in conversion campaigns to the Crusades against Muslim infidels, from the burning of ‘witches’ at the stake to the Holy Inquisition to root out heretics, from the conquistadors in south America to pogroms against the Jews in Europe, the Catholic Church has been no stranger to murder. Until recently, that is, when it has transformed itself into the defender of life at all costs. So it is that clinical abortions and assisting in the suicide of terminally ill people have recently become among the most heinous sins imaginable. It is on the latter that I want to focus in this article.

Terry Pratchett’s recent TV documentary showing an assisted suicide at the Swiss Dignitas clinic has opened up the subject of euthanasia once again. This led to a poorly argued Mercury ‘First Person’ article by the Catholic priest Leon Pereira to which I replied in the letters page. Since then a torrent of letters have appeared with most, I think, favouring the introduction of a law permitting euthanasia.

I thought it worth looking again at the arguments and came across a detailed statement by the United States Conference of Catholic Bishops explaining their opposition. This was interesting. Apart from the arguments based on what might be called secular sociological and philosophical concerns they made their theological arguments (such as they are) explicit. This is helpful because for once we see the real foundation for Catholic opposition to euthanasia.

I will look at the reasoned arguments later but before I do it is worth running through these religious arguments:

· … Christian hope sees our final days as a time to prepare for our eternal destiny;

· … suicide is a grave offence against love of self, one that breaks the bonds of love and solidarity with … God;

· … to assist another’s suicide is to take part in an injustice [against God?] which can never be excused, even if it is requested;

· … life is our first gift from an infinitely loving Creator. The most fundamental element of our God given human dignity;

· … by assuming and sharing our human nature, the Son of God has more fully revealed and enhanced the sacred character of each human life;

· … palliative care allows patients to devote their attention to the unfinished business of their lives, to arrive at a sense of peace with God …;

· … as Christians we believe that even suffering itself need not be meaningless – for as Pope John Paul II showed during his final illness, suffering accepted in love can bring us closer to the mystery of Christ’s sacrifice for the salvation of others;

· … as disciples of one who is the Lord of the living we need to be messengers of the Gospel of Life.

It is my opinion that these religious arguments against euthanasia have no substance unless you are already a committed believer in the existence of the sky god so for the vast majority of rational people they can be safely ignored.

However, the bishops offer a number of more substantial secular arguments that cannot be ignored. Indeed, several are quite powerful and must be answered rationally by anyone who wants to see a reform of the law in this country to allow for assisted suicide in certain circumstances.

Personal autonomy v. protection of life?

First, the definitions used in this paper.

The relevant cases of people voluntarily making a current request for assistance to end their lives fall into three categories:

• ‘Assisted dying’ (AD) refers to a life-ending dose of medication being prescribed to a mentally competent, terminally ill adult who then administers the medication themselves. (This is the objective of Dignity in Dying and is supported by the BHA.)
• ‘Assisted euthanasia’ (AE) refers to life-ending medication being administered by a third party to a person with a terminal, degenerative or painful illness to cause a ‘gentle death’.

· ‘Assisted suicide’ (AS) refers to providing assistance to die to someone who wishes to die but who is not physically able to kill themselves. (They may be, though need not be, dying, terminally ill, or suffering from a degenerative or constantly painful illness.)

Earlier I dismissed the specifically Christian religious arguments against AD/AE/AS.By themselves they demonstrate how a religious ‘absolutist morality’ (i.e. unchangeable rules derived from some ancient text) clashes with the collective judgements of reasonable people about what laws should govern matters of life and death now.

A quasi-religious argument used by the bishops is to claim that AD/AE/AS supporters show a false compassion for sufferers from fatal illnesses. While the British Humanist Association (BHA) et al argue that it is compassionate to help a dying person to escape, at their request, from their misery, the bishops argue that the real meaning of compassion is to suffer alongside the victim, giving support and sharing the pain. This really is a metaphysical argument for only the individual sufferer is in a position to judge whether their life is worth living. Being able to gain ‘the moral high ground’ on who is being truly compassionate is clearly felt to be important in winning the war of words but in reality it is only when hearing the pleas of a suffering loved one to ‘help me die’ that anyone is in a position to decide which is being more compassionate – to help them do so or to say ‘No, but I’ll share your suffering’.

There is one final quasi-religious or metaphysical claim sometimes made that needs to be dealt with. This is the claim that AD/AE/AS should not be permitted because ‘life is better than no life’, or that ‘life’ is a fundamental human good. Taking this view, people who wish to die are obliged to keep living because life is a metaphysical ‘good’ regardless of the fact that the person living it is enduring daily misery or pain and seriously considers they would be ‘better off dead’.

Rationalists must reject such metaphysical notions of an abstraction (life) being better than ‘no life’. ‘Life’ is a term for the processes by which living things are animated so ‘no life’ means simply the absence of those processes. It is not a state of being so even the phrase ‘I’d be better off dead’ can only mean that the person finds their life unendurable rather than the idea that there is another state of lifeless yet conscious existence which would be less unpleasant. While from a pragmatic human rights point of view we need to have a presumption underpinning law that establishes as a first principle that human life has supreme value this is not the same thing at all as saying that ‘life is better than no life’.

The secular arguments

I now want to look at the non-religious arguments put forward mainly by the Catholic Church but supported by the Anglican Church and others too. (The Roman Catholic and Anglican Churches made a joint submission to the Lords committee on Lord Joffe’s ‘Assisted Dying for the Terminally Ill’ bill in 2004. That bill failed in 2006.) The Churches may be using these as a stalking horse behind which a theological motivation is hidden but we nevertheless need to deal with them as they represent, in the main, reasonable challenges to the AD/AE/AS positions.

Several of the arguments against legalising AD/AE/AS revolve around the socio-psychological effects on society and the people who might be considered potential candidates for it but who have no desire to kill themselves. It is suggested that acceptance of AD/AE/AS would have the following effects:

• creating a class of people who believe the value of their lives has been diminished because it implies that for them a death by legal drugs is acceptable as objectively good, or even desirable;
• by permitting AD/AE/AS for people of this class the legislature would be communicating the message that they may be better off dead;
• that the possibility of AD/AE/AS for people of this class would lead to pressure by able bodied people that they ought to take this option rather than being a burden on society;
• the expression of a wish to die by a member of this class would then be seen not as ‘a cry for help’ but as a reasonable response to a ‘meaningless’ life;
• those of this class who choose to live on with their problems might be seen as selfish or irrational and encouraged to see themselves in this way;
• all this reinforces the excessively high status our society places on being productive and independent and legitimises discrimination by the able bodied against those with disabilities and infirmities;
• even the apparently free choice of a dying person may be subtly influenced by the biases and wishes of others, so they may act under this pressure rather than making a genuinely free decision;
• by accepting the legalisation of AD/AE/AS society would then feel less inclined to fund decent palliative health and palliative care for the old and terminally ill;
• permitting AD/AE/AS devalues human life across the board. It is the start of a slippery slope where all manner of people (e.g. those with learning difficulties) may be included in the ‘life not worth living’ category, who may be encouraged to commit suicide or have their lives taken.

On the face of it these are reasonable points to make. In a democratic state social norms shape laws and future norms are, in turn, shaped by law. The standard response from the pro-AD/AE/AS lobby is that the right to personal autonomy trumps all of these worries. While I believe that the dangers are exaggerated, especially as the numbers taking up the AD/AE/AS options would be small, still its proponents must acknowledge the dangers and take steps to counter them. We must be concerned that any laws passed in this area do not have significant unintended or perverse consequences.

One way of pre-empting them would be to pass ‘balancing’ laws guaranteeing the right to nursing and hospice care right up to the end of life, however it might occur.This alone would effectively sink most of the arguments listed above.

The Catholic bishops accept that many people want to die through fear of being kept alive by burdensome medical technology while experiencing intolerable pain and loss of control over bodily functions. But they counter this by arguing that a society can be judged by how it responds to those fears. (In this context, of course, it is only the Churches who do the judging.) They argue that people in that state of mind are vulnerable and need to be shown more love and care by society to assure them of their inherent worth.

No doubt all would agree with this as far as it goes, but when this human response slips over, in the bishop’s mouths, to become a veto over personal autonomy it is nothing more than a variation of the ‘life is better than no life’ argument. It dismisses the considered opinion of the sufferer, and their right to autonomy, and says implicitly ‘sorry, but you just have to soldier on for life’s sake’. It is small comfort for the sufferer to be told they have ‘inherent worth’ when all they want to do is to escape into oblivion from what they are experiencing as a pointless life of misery. Kant’s principle that we should treat others as ends in themselves, rather than as a means to an end, implies, in this case, that we should not oblige people to continue living against their better judgement because it serves the metaphysical end of revering the life process above all things, because ‘life’ is ‘sacred’.

The bishops’ next argument is that allowing doctors to assist in suicide compromises the ethical integrity of medicine as it violates the Hippocratic Oath. This is a fair point though it should be noted that graduating doctors now take a variety of ethical oaths and only 14% of them forbid euthanasia! (http://www.bbc.co.uk/dna/h2g2/A1103798)

The oaths are a safeguard (though evidently not a complete one) against the reckless use of medical knowledge and drugs to end the lives of others. A refinement of the argument is that trust in health practitioners is paramount. If patients come to suspect that medical staff have hidden agendas, that advice or prognoses might be given on the basis that AD/AE/AS is an option then patients would increasingly distrust what they are being told.

A possible pragmatic solution to this challenge would be to permit the establishment of a charity or subscription funded body of non-medical volunteers outside the NHS who would be specially trained to administer lethal drugs under controlled circumstances, so freeing the medical profession from any conflict of objectives.

The final and most frequently wielded argument of opponents is that ruthless relatives who stand to gain an inheritance might manipulate vulnerable sick and elderly people into seeking AD/AE/AS. It is easy to see the point. There are hard-hearted people who would not hesitate for long in making it known to an infirm parent what a burden they had become and how much good their money could do if they passed from the scene a little more quickly. Only a rigorous procedure of checks and double checks can hope to minimise the danger – and these are in place in those countries where AD/AE/AS is already legal. And with AD/AE/AS not only would there be several legal requirements prior to the act but there can also be police investigations subsequent to it. Knowing the scrutiny they would attract ruthless beneficiaries are, in my opinion, as likely to arrange an ‘accident’ as they are to manipulate a vulnerable relative into choosing AD/AE/AS.

On this tack, in an interesting Lutheran Church submission (opposing euthanasia) to the Australian Commission on Social and Bioethical Questions (http://www.lca.org.au/resources/csbq/euthanasia3.pdf), the authors acknowledge the widespread support for the idea of autonomous decision making in end of life decisions but point out the evident difficulties of framing laws and procedures that cannot be abused. Examples are given of where euthanasia laws have not worked as well as intended.

Terry Pratchett believes he has the solution to the problem through the creation of tribunals to hear applications for AD/AE/AS. The tribunal panel would include a legal expert in family matters and a doctor with experience of long-term serious illnesses.The applicant would make their case and have to demonstrate that they were of sound mind and had given it proper thought, along with explanations of why the alternatives of palliative and hospice care, etc. were considered unsatisfactory.

While all the foregoing Humanist and rationalist arguments are persuasive in answering the bishops’ concerns I think they are, to a great extent, missing the point because they get emotionally dragged along by concern for the terminally ill. I now suggest an alternative approach that achieves many of the same ends but deflects much of the criticism and places the aim of personal autonomy for all at its heart.

A different approach

Globally, around 1 million people commit suicide each year (WHO). They use all the means with which we are familiar: drowning in river or sea, jumping under trains, in front of trucks, taking poison, overdosing with prescription drugs, hanging, slashing wrists, gassing, etc. They have numerous motives from disappointment in love to financial failure, from shame or guilt to clinical depression. The one thing they all have in common, however, is that they were capable of doing the deed without assistance.They were able-bodied. They were able to exercise their personal autonomy.

While many might have been dissuaded if a friend, relative or professional had had the opportunity to intervene at the vital moment, many would still have judged, as people are free so to do, that they no longer wanted to live.

An individual may conclude their life is not worth living at any time in their lives.While able-bodied they are able to do something about it – but with some anxiety that things might not turn out as intended and they might end up permanently disabled as a result. There are also potential unintended consequences of successful suicides where they involve third parties who may be traumatised as a result: for example, the train driver who sees the face of the person moments before they die, a vision that may haunt the driver in dreams and nightmares for the rest of their life, or even make it impossible for them to continue in the same employment.

In the light of the risk of abortive attempts or third-party trauma a case can be made that anybody suicidal should be allowed access to medical assistance and drugs to make sure death occurs as desired and nobody else is traumatised in the process. One of the problems with such a view is that almost everyone would find it abhorrent that society might facilitate the suicide of otherwise healthy young people who are acutely depressed through, for example, relationship breakdown or failure in exams.

Clearly, in both types of case we would want to prevent young people acting on their impulses because older and wiser heads know that such states of mind are perfectly normal – and temporary. We can objectively judge that a person early in life and facing a deep emotional crisis has every chance of getting through it (and ‘growing’ in the process) and as such is quite different from a person late in life facing a certain decline to an unpleasant death. People with clinical depression, such as sufferers from bipolar disorder, also often take their own lives when their mental state is at its bleakest. Again, most people would judge that such cases ought not to be aided as they can be managed relatively easily by medication and counselling, giving the sufferer a quality of life they find perfectly acceptable for much of the time.

What about those relatively fit older people who feel they have just had enough? They may say their lives are not as fulfilling as when they were younger when they played sports, travelled the world freely, went to parties and dances, etc. They are often tired, have aches and pains, their teeth are deteriorating, their hair thinning, they’re unable to play with the grandchildren, cannot trek across the fells, ski or play rugby as they used to. Is it not reasonable to accept their judgement that they feel the loss of their powers so badly that they no longer feel their lives are fulfilling enough to continue? Here they are, not depressed or emotionally disturbed, perfectly rational but feeling they have already had a good innings and are now tired of life – and there’s no amount of watercolouring, Scrabble or web surfing that can change their minds!Well, the fact is that if they seriously want to die they can take their own lives as easily as any younger and fitter person. This is one key reason we do not generally feel they have a case for assisted suicide.

However, much of the campaigning for assisted dying legislation in Britain and elsewhere aims to create a class of people – those with terminal, painful or debilitating illnesses – who are entitled to assistance even though they may be perfectly capable of throwing themselves off the Severn Bridge. I think this an important point for it makes a terminal, painful or debilitating illness not just a necessary but also a sufficient qualification to be entitled to receive assistance – even though they are quite capable of taking their own lives. It seems to me that this creates a very unsatisfactory situation. What could be the justification for such legislation that makes a distinction between people with equal capacity to take their own lives? Only that we as a society might conclude that people with terminal conditions are living lives not worth living despite many of them being relatively able-bodied.

In other words, such AD/AE/AS legislation would amount to society saying ‘we disapprove of suicide by able-bodied healthy people, but having a terminal or unrelentingly painful illness entitles you to special consideration regardless of the possibility that you might be capable of taking your own life’. This creates a privilege without any rational justification.

I believe that the key question we must keep in front of us is not whether a person is terminally ill but only whether a person is unable to complete the act of suicide reliably on their own. By following this route and restricting assisted suicide (AS) only to people who are incapable of carrying it out themselves we would be effectively categorising it as a support service for a person with a significant incapacity, putting them in an equivalent position to able-bodied people. The character of the act then becomes something quite different from AD and AE. Such an approach has the significant advantage of not labelling all people with disabilities as burdens on society.It simply establishes a level playing field for all. Anybody assisting would then only have to show that their motivation was unselfish and altruistic in fulfilling a person’s wish when they were unable to fulfil it for themselves.

In conclusion, then, my position is that people have the right to autonomy, to control their own fate. Therefore, people should face no legal impediment to taking their own lives at any time. Further, that where they are incapable of doing so and have freely and unequivocally expressed a considered wish to die (possibly before becoming physically incapable of carrying it through) they should be allowed third-party assistance without fear of prosecution of those who provide it. In this way their right to autonomous decision making is ensured.

The reader will note that this position is dissimilar to the general aim of euthanasia campaigns for AD/AE only to be available to anyone with a debilitating or terminal illness. I think that approach is a mistake for some of the reasons put forward by the bishops – specifically because it gives out the message that society believes their lives are not worth living. I favour assisted dying being permissible only for those whocannot realistically take their own lives by ‘standard’ means. This would include those who have previously stated their wish to die in those circumstances but are now unable to communicate, and those with ‘locked-in syndrome’ and similar where they are able to state unequivocally a wish to die but are incapable of carrying it out without assistance. (As with the current case of Martin, 46, who has suffered a massive and almost totally incapacitating brainstem stroke.)

The effect of my position is to do no more than disability rights legislation does generally – to place people with incapacitating disabilities on an equal par with able-bodied people. This position will subsume the cases of many people with terminal illnesses and/or in constant pain but those conditions should not, in my opinion, be sufficient in themselves to qualify. Nor should they be necessary conditions. As long as a terminally ill or chronically pained person is physically able to carry through a voluntary act of suicide they will be in the same position as any other able-bodied person. To create a special class of people who have access to assisted dying or voluntary euthanasia because they are terminally ill or in constant suffering and yet who are physically able to commit suicide is to discriminate in a very real sense against all other able-bodied people who might wish to commit suicide.

Harry Perry

August 2011