Ay, fight and you may die, run and you'll live. At least a while. And dying in your beds many years from now, would you be willing to trade all the days from this day to that for one chance, just one chance to come back here and tell our enemies that they may take our lives.... but they'll never take our FREEDOM!!
Sometimes you wish you could just close your eyes and wish it all away.
That is how I have felt for the past three weeks since Terry Pratchett, one of my favourite authors, came out in favour of assisted suicide. I held my head in my hands as I listened to him lightly dismiss the 'possible abuses' that could result from such a law. I haven't blogged on the subject yet, despite the many posts from others, because I didn't feel able to. That has changed, and what has changed it was Archbishop Vincent Nichols's comments on a 'lack of compassion in the NHS'. My first reaction was the same one that I had to Terry Pratchet; a face palm, looking out through my fingers to see the inevitable cavalry charging towards what was on the face of it, an incredibly naive remark. My second reaction was; 'Actually, he's right.'
How we have arrived there is complicated. It was a process that started many years ago and crept into something far more sinister. Some have been more willing than others in this process, and medi bloggers like Militant Nurse are at pains to record just exactly what is going on with staffing and the like. But the original charge remains; however we arrived there, however we have protested, the NHS is losing its compassion, especially towards the elderly. And we have now reached the point of doom with this process; assisted suicide, the place where all these small steps have been moving towards, is now on the agenda and the pressure is relentless. When people like Martin Amis talk of a silver tsunami and old people stinking out cafes and restaurants, things are getting serious.
Creep is not new. There is a book called 'Defying Hitler', a memoir of Nazi Germany from the 20's right up until 1938, when the writer Sebastien Haffner moved to Britain with his Jewish wife. It is an account chilling in its ordinariness; Haffner charts the whole process from the Nazis being regarded as boors and clowns by the German middle class, to the acceptance that they were going to run the country, to the acceptance that they were going to war. But it is the details that make this book; the day that Haffner arrived at the court that he worked, to find that all the Jewish lawyers had been removed and a young clueless Nazi had been given the job of judge; his attempts to stay friendly with people in his company who also happened to hate Jews; a relationship with a Jewish girl that went on far too long simply because he wanted to defy the Nazis about non-Aryan relationships; the boot camp he was sent to, to undergo 'training' by the Nazis and the humiliating vulgar games that they were forced to play. But the overriding sentiment of the book is disbelief at what is happening, reinforced with a reluctance and perceived helplessness to stop it.
So it is with the assisted suicide debate. We have gone to an initial disgust at the idea, to an understanding of the idea, to an acceptance of its possibility, to a desire to implement it. Underneath the debate is the sly subtext of the 'growing elderly population', 'pensions timebomb', 'silver tsunami' and the solution is waved wordlessly in our faces. And medical staff have been bullied into accepting the unacceptable in hospitals, because they cannot wave a magic wand to make more staff appear. Whistleblow and you're sacked. Report what's happening to the media and it will not be printed. 400 -1000 people dead in Mid Staffordshire? We don't want to talk about that do we? Let's get that nice chap with the fedora hat and funny books on, to talk about euthanasia instead.
As a health campaigner and a carer, I find myself torn. I know what's going on behind the scenes. I understand what is happening with staffing, with bed reductions, with care homes being shut. I understand that elderly care has been getting dismantled. And yet, as a carer, I have seen things that would make your eyes water. I have seen people starved in hospital. They were related to me. I have seen nurses that don't care, doctors that are too busy or unavailable to deal with the situation. I have complained to a manager while they chewed gum all through my protestations. I want it to stop. And it is only going to stop when enough people at the rockface come forward and complain.
I don't underestimate what I am asking here. I am a non-medical medi blogger, an outsider, and I have a cheek to ask it. But I am asking now, at this point, because I understand that if enough medics do not come forward now and crush this, it will be all over bar the shouting. If you want assisted suicide to remain illegal, if you want an elderly care system, if you want people like Jane Barton to be put in jail, then it has to be done now.
In 1945, the Americans and British liberated the concentration camps. Their disbelief and anger at the conditions contrasted with the panicked rationalisation of the camp guards, who were only doing their job, who were a cog in a vast wheel of consequences and who could not see a way to refuse to do the job they were asked to do, unless they wanted to take a trip to the Russian Front. In the same way, Archbishop Nichols has spoken from the simple uncluttered view of an outsider seeing the NHS with a clear eye. It is madness rationalised. We are leaving people starving and thirsty. We are turning a blind eye to malpractice. We are letting people die in agonising circumstances like Martin Ryan. And we are doing so, because we are afraid; for our jobs, for our loved ones being treated in case they get worse treatment, for our families in case they are punished as well.
We must speak out now. We must put aside our fear and hopelessness and dare to imagine a different outcome. We must because, unlike the concentration camps, there is no cavalry on the way. We are the cavalry. This depends on all of us; medics, journalists, clergy, carers and celebrities speaking out with a clear voice. If we are afraid, we need to remember that this is going to come to us all, because we all grow old. War is upon us, whether we like it or not.We cannot choose the times that we have been born in; but we can choose how we react to them. It is time we looked our enemy in the eye and marched out to meet him. We will not get another chance to do so.
4 comments:
I too held up my hands in horror at Pratchett's well publicised excursion into the slippery slope that is 'assisted death'. He played into the hands of those that want to legalise that which often happens without consent on the LCP, the DNRO's. The horizon is now clouded for all of us facing old age; clouded with the real danger that we may be swept away on the whim of a doctor who knows little of our history or the needs of our loved one's.
I have long held the view that the politics of medicine has removed all of the compassion. Either by design or just as Militant Nurse details, by sheer volume of work imposed on the few qualified providers of care left in the system. I have also often condemned the Physicians for allowing this to happen, especially the Consultants. It will not happen, I fear, until the incentive to 'do nothing' is removed.
The Doctors and Surgeons have it in their power to effect change but it is likely to remove the train of reward that is theirs when they fulfill Quotas and QOFs. They have negotiated lucrative deals that reward them for undertaking tasks that do little or nothing to advance the healthcare of the patient cohort. Merely to prostitute themselves for the good of the drug companies, fill the QOF for the PCT and NICE, get that test done for the sole reason that it says so on a document from the NHS, for which I get paid. To diagnose the problems of healthcare you simply have to 'follow the money'. If there is no incentive to preserve life, it will be extinguished.
Excellent, thoughtful and moving post Julie.
I have a notion The Oldest Sage Witch with her Scottish genes may join the battle. I'll send her a telegram shortly!
BlackDog:
"The Doctors and Surgeons have it in their power to effect change"
You are absolutely right about that. The reasons they are not doing so I fear are very complex. It probably has very little to do with money. Perhaps My Black Cat will try to explore the deepest corners of the medical psyche.
Julie - an excellent post.
"Underneath the debate is the sly subtext of the 'growing elderly population', 'pensions timebomb', 'silver tsunami' and the final solution is waved wordlessly in our faces."
You are quite right to ask doctors to step forward. The question is why they remain silent. Dr No doesn't know the answer, but he has some idea:
• Cosiness (not just about money) - sad but possibly true
• The Survival of the Conformist. 'Good' independent doctors prepared to say something are squeezed out
• Discomfort at the Nazi analogy. We can see it - but Naziness is just too nasty a concept for many to even want to think about
And - as the Witch Doctor and I have often said - the Devil does not wear horns and a red latex jumpsuit: he sits next to you and I, and looks just like you and I - Hannah Arendt's banality of evil.
Speaking out, as we bloggers are doing, is a first and very necessary step: 'All that is necessary for the triumph of evil is that good men do nothing'.
I'm beginning to understand the importance of what has happened with the GMC and the replacement of real doctors with management stooges, Blackdog. It has made the push for euthanasia much easier. Not to mention it's always good to have your big brother on hand as in the case of Jane Barton.
Dr No, WD - am interested at what the doctors psyche may have to do with their inability to act. I sense that doctors are about as difficult to herd as cats and therefore that might be one reason. By contrast, teachers are very social animals and very ordered about things; they tend to go about in packs and are always in about ten different societies. I know because my mum and dad were both teachers. Will be watching to see your hypotheses on the psychology of the doc.
Jeez, 'psychology' and 'hypotheses' in one sentence. I need to get a life..;)
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