The right to leave a living death

In the guise of humanity, we torture the very old with a painful, drawn-out extinction after they have outlived their senses
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The Independent Online
All day they sit vacantly, some with memories, some without. Burgeoning eventide homes up and down the land are packed with ever more old people, eyes moist with distress or just rheumily empty - some painfully alert to their plight, others afraid because they understand nothing around them.

The smell of cabbage, urine, disinfectant and air freshener varies a little from one home to another, depending on the decrepitude of the residents and the energy of the staff. It is a waft so immediately recognisable to those who visit these places that you imagine you can almost smell it on the air in towns like Bexhill-on-Sea. It is the smell of their main industry - death - as surely as Middlesbrough smells of chemicals, Port Sunlight of soap and Wandsworth of candles and breweries.

Warehousing the old as they wait for the grim reaper in genteel despair is not hugely profitable these days, at pounds 235 a week, but it is a growth industry. Journalists covering the old are eager to seek out some story, an angle: appalled by what we see, we always look for someone to blame - the state, avaricious home-owners or selfish offspring.

Last month Age Concern found someone else to blame - GPs for failing to treat depression in old people in care homes. Prozac might cheer them up, but you could hardly call depression among these people anything other than a rational response to their miserable predicament. Age Concern cites the fact that the over-64s have the highest suicide rate. Well, of course they do.

We look for someone to blame to avoid facing what is staring us in the face: extreme old age can be terrible. A life of pain and loneliness, waiting for death, is a fate most prefer not to contemplate. To be sure, people can be treated better or worse, but the essential truth remains that life in these homes is not life at all, but a drawn-out miserable death. Kindness should oblige us to help those who want to die gracefully.

Visitors to residential homes will know that familiar embarrassment when a casual "How are you?" leads suddenly to someone plucking your hand and asking to die. "There, there, you'll feel better in a moment when the tea comes along," is all we can say, backing away.

That is what we all do, as a society. We back away from the horror of the life these people lead, doing nothing, going nowhere, alone, forgotten. Even those who are visited a little, even those with flashes of memory remaining have a quality of life most of us would regard as torture. So do most of them.

The Catholics have a prayer to St Joseph for the "good death". Mercifully, most of us do die at home or in hospital after a short illness. Only an unlucky 5 per cent of people end up bad enough to need residential care. Moral panickers imagine we live in a crueller society where families care less than they did. Not so. A far higher proportion of the old used to end their days in the workhouse or other institutions 100 years ago. But as the numbers of very old grow, so there are many more demented octogenarians. The healthier we become, the more of us there will be who outlive our senses.

Signing a "living will", as many wisely now do, may prevent doctors keeping us alive with officious medical interventions. But it will do nothing to prevent a life like this. The right to die easily at a time of our choosing ought to be a basic human right - an essential part of the right to life, liberty and pursuit of happiness, because there is no possible happiness for many of these people except in freedom from life.

Objections to euthanasia are trivial compared with the torture carried out in the name of "life". Some say they fear mass extermination of the old by a cost-cutting state or pressure from inheritance-hungry offspring. But it would be simple to establish a tribunal to determine whether someone was genuinely expressing a wish to die. A lethal injection is an easy and gentle way to go. We treat animals better.

The thought is too frightening. What politician would dare stand up and propose it? Yet in this cowardice is dreadful cruelty, measured out in hour after hour of painful despair in homes where nothing ever happens, except the next merciful death. Death row in jail is not more terrible than these dying homes.

There is an urgency in considering the right to die. In America the population is so deeply into denial of death that its existence is virtually a state secret. There, the welfare system - Medicaid - has devised a cruelty far worse, whereby old people only qualify for free care if they are ill enough to be bedridden and fed through tubes. So the frail old with no one to care for them are drugged, tubed, bagged and placed in profitable rows of beds in dying rooms on Medicaid wards. A worse way to die is hard to imagine.

When the novelist Joan Brady discovered this horror, she spent two years researching a shocking book about it - which no American publisher would print, although she is a Whitbread Award winner. Too horrible, they said. No one wants to know this stuff. She turned it into a novel, the moving and very alarming Death Comes for Peter Pan, published here - but not in the US.

Her tale is a warning for us, because already the rules about who the NHS treats for free are being tightened, as they try to turn people out of free beds on to the social services. It seems a long way off, maybe, but as pricing per case becomes a more exact science, we may also start drugging and intubating old people to ensure that patients meet a criterion laid down by purchasers before they pay the provider hospital.

We, like the Americans, shudder and look away from the process of dying. Maybe a lot of people will have stopped reading this by now. Tonight on Channel 4, Paul Watson (The War Game and Sylvania Waters) directs an elegiac film called The Home, about life in one of the nicer than average homes. He thinks many people will probably switch off, rather than watch this living death. The film has a moralising tendency to look for neglectful children to blame for these people's lonely plight - it eases our own fears to blame this misery on someone. But I find a much clearer message than that. Two of the residents want to die. A poor young priest is caught idiotically off guard when he asks deeply religious Elsie, "Is there anything you want me to pray for?" "Just pray I die, that's all," she says. He founders fatuously and instead proceeds "to give thanks to God for the gift of life".

Of course it is easier for us to fulminate about "the system" or the callousness of modern society. But for most of us decrepitude itself is what we fear. The right to escape that fate when we choose would take away that fear. This is the last great frontier in the battle for human rights. The right to life is not enough - we must have the right to refuse life too.