Saturday, 20 September 2014

Oh, OK then....

OK, in the last week alone several people have asked if I've given up on blogging. Of necessity, I did have to stop for a while to attend to other things, which took longer than I expected. But numerous times in the last month or two I started looking at a local topic, then prevaricated so long that posting would be irrelevant. Anyway, I gave my word I would be back online within the week and I've stalled long enough, so here goes......
Assisted Dying then, as it is back in the news (see http://www.iomtoday.co.im/news/health/looking-at-the-issue-of-assisted-suicide-1-6846326), though I wish people would pay enough attention to get the terms right. Ten years ago, as is public knowledge, I helped Patrick Kneen and, after his death, his widow to run the Manx Death With Dignity campaign. It started as a personal favour for friends who nobody else wanted to go out on a limb for. As I said to Patrick at the time, I was actually fed up with talk about older people dying well and wanted a bit more talk about younger folk living well. But oddly enough, despite the grim subject matter, it was mostly fun and a year or so of life lived as fully as it can be when you have the courage to - though in the process I also learnt just how devious, dishonest and plain nasty powerful local people with no interest in human rights or democracy can be if nobody smacks them down.
So, as something of a reluctant expert, I think it necessary to explain why the terminology matters, especially when exponents of emotional fascism use it to misdirect us (though all fascism works by excluding logic and provoking a pure emotional response).
First, discard anyone who still uses the term Euthanasia as they are either lying or too idle to keep up. The term euthanasia originates in the ancient Greek concept of mercy killing, which was inevitably involuntary in a society where “democracy” discounted 90% of potential voters and politicians as it did not consider them adult - or even human. Modern advocates of Assisted Dying first used it in the na├»ve belief that anyone joining the debate would be educated enough to know and intellectually honest enough to discuss it in those terms.
Dumb mistake, sadly, when arguing with pathological liars with an economic interest in perpetuating the dark ages, though in fairness not helped when the Nazis made euthanasia as oxymoronic a term in the 1940's as, say, military intelligence or social security in the early 21st century.
Involuntary Euthanasia happens quietly anyway. If that alarms you, fund the health service properly, abandon semi-privatised end-of -life care run by greedy faith-heads at public expense and change the focus of management from economic bead-counting to deciding (1) what the objectives are of optimum socialised medical care and (2) the reasonable expectations of those who use and pay for it, then deliver it. Simples.
Assisted Suicide is helping someone who would like to commit suicide but is physically incapable of doing so to overcome those physical barriers to kill themselves - for example by self-administering pills or an injection. It is not the same as the broader term Assisted Dying, which recognises that the potential suicide is not able to self-administer and so someone else will have to administer the medication. Too often we unconsciously assume this has to be a doctor, but this is a lazy assumption, and I suspect that many friends of physically incapable suicides who quietly help illegally may not be medical professionals but will be intelligent and well informed enough to know what they are doing. By the way, for a broader discussion of the unconscious but strictly speaking illogical privileging of state-determined medical 'professionalism” try Ivan Illich's excellent 1970's classic “Medical Nemesis”.
All clear? Can we move on?
I just wish the discussion as outlined in the press could. Inevitably, if you get an overdue discussion going then the politicians sideline it for a decade new people come to it without the benefit of prior knowledge. Fair enough, but there is no excuse for the current Bishop not to have studied the joint response to a Tynwald committee on a possible Bill drafted by a previous Archdeacon and approved by his predecessor and three other faith leaders (but without daring to consult their flocks).
All this talk of slippery slopes and failure to acknowledge that, in every objective survey, around 80% of the population of any country (across all ethnic and faith subcultures) want legal Assisted Dying makes it look as if he is disinterested. Manx DWD also did a strictly confidential survey of local doctors (somewhat hindered as the GMC list of Manx doctors was so old around a quarter had moved on or died) which showed cautious acceptance of the case for tightly controlled legalisation in very specific cases.
I also know from that survey alone that, in a community of around 80,000 people, it is perfectly possible to find one or two doctors prepared to help if subject to a strict medical and legal process. To put things in perspective, this would be about the same as the number of Manx NHS surgeons legally permitted and expected by their contracts to carry out an abortion in tightly defined circumstances but who, oddly, always seem to be “unavailable” when such circumstances arise. Incidentally, a bogus survey passed off as representative of local medical opinion was also presented to the Tynwald committee, but it bears no serious analysis. According to some who were “consulted”, it was done by a senior Hospice figure, face to face only and in a somewhat disorganised fashion, and they had the distinct impression that “wrong” answers would lead to a very short medical career on the island and bad references for work elsewhere.
Finally, while I have little time myself to get seriously involved in a new campaign, I wish it well. In particular I applaud one Manx politician who is willing to make an informed stab at long overdue change and stop playing to the idiocracy in order to get re-elected.

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