Killing them with kindness

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The Independent Online
LET'S GET this clear at the outset. If you ask me whether I would want the action I am about to propose applied to myself or my parents, I can honestly say: yes, I would. I have been on the point of death, and refused any temporary, drug-induced reprieve. Because I was young and strong I recovered. But one of my father's last questions to me was, 'Angela, how does one die?' and my inability to help him out of his long-drawn-out misery still haunts me.

Consider the following individuals. A widow aged 91, stubborn and gnarled as an old oak tree, insists on remaining in the cottage where she has spent the last seven decades of her life. She has no children, but thanks to the devoted support and help of a friend, the generosity of her neighbour, the daily assistance of three carers, and regular visits from Meals on Wheels, her desire to stay put can - just - be met and the dreaded retirement home staved off. Her heart is strong; if she is allowed to stay in her home, she may yet survive to receive the Queen's telegram.

A man of 78, far gone with an incurable disease, lies immobile in the nursing home room where he has spent the past six years. He can no longer feed himself; he cannot speak; his mind is cloudy. In his present, expensive surroundings he is moved every two hours to prevent bed sores, washed, changed and spoon-fed like a baby, and given antibiotics when he develops coughs and colds. He may live for a few more years, or he may not see another spring; but the money realised from the sale of his flat is running out. His children ask themselves how, when that happens, they can possibly find the pounds 475 a week needed to keep him in private care.

An old lady in her late seventies, blind, deaf, incontinent and paralysed, is looked after by a 24- hour rota of eight carers, in addition to her devoted elderly husband. She says it would kill her to leave her own home, and in any case she wouldn't go without him. He is in reasonably good health, and has even less desire to enter a retirement home; yet she may live on, if living you call it, for a year or two.

All these old people are kept warm, clean, and well fed. They are also dosed with whatever medication is required to ward off the illnesses, such as pneumonia, that used to terminate elderly lives. None derives any apparent pleasure or satisfaction from their existence. They are a heavy - and in my own view, unjustifiable - drain on resources, financial and emotional.

These are real-life examples arising from a recent discussion with friends about the prolonging of elderly lives. It is a topic that has come to obsess people over 50 with regard to our parents and, in time, ourselves.

It is a mystery to me why a society that has largely come to terms with the ethics of abortion, and (apart from the extreme pro-lifers) shows little disapproval of a couple or a young woman who choose to terminate an inconvenient child, should tie itself into ethical knots over what to do with the unhappily long-lived old. The problem looms large; it will not go away.

We say 'Every child a wanted child'; why can't we say 'Every granny a wanted granny'? Why do we feel obliged to cup our hands around the frailest spark of elderly life until its final flicker; yet are prepared to snuff out the foetal spark?

I do not oppose abortion, nor do I support it. I have never chosen that option for myself, which is why I have three unplanned but passionately loved children; but I do not criticise women who took the other option. What I cannot understand is why our relative compassion and tolerance towards those who put an end to foetal life is not extended to old, ill people who who believe their lives are, to all intents and purposes, over, and want desperately to end them.

Surely it is time for a system whereby benevolent panels of citizens could make such decisions on behalf of old people who have requested euthanasia. This would spare their relatives the guilt of having made the decision and preclude other considerations like inherited money or property from contaminating their motives. Let us call such panels Merciful Release.

Each panel (I envisage hundreds, all over the country) would have three members: one with medical qualifications, one legal, and one ethical, philosophical or religious. A panel might consist of a magistrate or retired barrister; a doctor or nurse; and a rabbi, philosophy lecturer or theologian. The point is not that these people should be experts, but that they should be qualified to weigh the arguments adduced by those who are.

In deciding whether to permit elderly people to terminate their lives, the panel would consider the following questions: Is X's mind clear and speech lucid? As far as can be ascertained, does X want to end his or her life? Is there someone very close to X who truly wants X's life to be prolonged? Is X over 70? Does X have an incurable disease? Is X in constant pain?

Depending on the answers to these questions - which, I would argue, are stricter than those used to permit abortions - the decision could be taken to end X's life - to grant, in other words, a 'merciful release'.

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