Nicklinson ruling was the right one

Picture of Tony NicklinsonTony Nicklinson died on the morning of 22nd August 2012, having contracted pneumonia over the weekend.

Last week the British High Court ruled that the courts could not allow doctors to end the life of a man who is severely paralysed following a stroke in 2005 at his request; their reasoning was that to accept the request from Tony Nicklinsnon would be to make a major change to the law, something only Parliament could do. Nicklinson said he planned to appeal, although he has precious little chance of succeeding as murder has always been illegal both here and in Europe. The BBC reported on the case here and featured an article by Nicklinson himself here.

There are two myths which have been repeated again and again about this case. One is that Nicklinson has locked-in syndrome. He does not. A brief watch of some of the videos of him showed that he has much more movement although little of it is purposeful. He also has a voice, although he does not have enough muscle control to speak and uses an eye-gaze system to communicate but it does enable him to express emotions to some extent. Genuine locked-in syndrome means having no movement except in the eyes: there is no facial expression, for example. It may have been his condition shortly after his stroke, but it is not now.

Another untruth is that he is incapable of taking his own life himself. As a disabled person whose tweets I have been reading pointed out, anyone capable of operating a power-chair, which Tony Nicklinson is, has access to a number of methods of achieving that aim without getting anyone else’s hands dirty. Probably the same method he could use to operate a power-chair could be used to operate a communication device more effectively than using eye-gaze — I have seen videos of a woman using the same chin joystick to both move her power-chair and operate a computer mouse, and by the look of things it could do other things as well.

The problem is that Nicklinson, asked by the same disabled person why he did not get himself a power-chair, replied that he did not need one as he never went out. He seems to spend his entire life in the same room, watching TV and surfing the Internet and pretty much waiting to die. Various disabled people have tried to persuade him to avail himself of various aids so that he can make something of his life because they suspect he is depressed and agoraphobic, but he insists that he is not, and thus gets no help with them. Clair Lewis, AKA Miss Dennis Queen, who is also disabled, has an even harsher judgement on him:

Know what it isn’t easy for some of us crips. To sympathise, I mean - Tony’s attitude is quite offensive.

I am tired of the pitiful debates. I am exasperated with this dishonest man who admits denying himself a better life but blames it on his body. I agree Tony needs to see his doctor - not for a lethal injection, for some anti depression support and a kick up the proverbial about how life can get much better if he puts down his fear and self loathing and lets it.

Come on Tony! Give life a go - almost all of the rest of us manage without suicide. Try living before you throw your life away dude!

I was listening to the discussion about this case on the BBC London morning show last Friday, and heard his situation compared unfavourably to Prof. Stephen Hawking’s, and described as a “life sentence”. While I accept that Nicklinson won’t be writing any long tomes on theoretical physics any time soon, his communication situation is actually much better than Hawking’s: Hawking has deteriorated significantly over the years and is able to communicate using only his cheek, producing around one word per minute. It is also a strange “life sentence” that can be served in one’s own home in the company of one’s wife and children, if one has any: Stephen Downing and the Guildford Four did not get that privilege.

In this country, assisting a suicide remains illegal. Those advocating the abolition of this law claim that it attracts sentences of up to 14 years. In practice, people who assist the suicide of someone with extreme or terminal illness when it is clear that the deceased gave their full consent and did the final act (e.g. drinking or injecting the lethal substance) themselves are almost never imprisoned, something that has been the case for more than 20 years at least. The law also makes it illegal to encourage suicide, so the ghouls who shout “jump” when police are trying to coax someone away from the edge of a bridge are committing a crime by this law as well; someone who encourages a vulnerable or mentally-ill person to kill themselves would get a much stiffer penalty than someone like Kay Gilderdale, who got a conditional discharge in 2010 for assisting the suicide in 2008 of her daughter Lynn, who was several orders of magnitude more ill and disabled than Nicklinson and had been for more than 16 years, since age 14.

I think the Gilderdale case actually demonstrates that we have got the balance about right with assisted dying for the terminally and long-term ill: there is some leniency and compassion for those who break the law in extreme circumstances, but there must always be an investigation and the disapproval remains, and must do because it protects the vulnerable both from themselves (feeling suicidal when dealing with a new or worsened state of disability or ill-health, for example) and from others (and the pressure can be subtle or even unintentional, such as constant complaints about the expense of time and money in caring for them and remarks about how wretched their condition is), and offers some protection to carers facing pressure to end someone’s life by allowing them to say they will not break the law and risk going to prison. It also protects vulnerable people from those who think they know what is best, as in the case of Frances Inglis who killed her son with a heroin overdose, convinced that he was in pain and would not recover (his doctors did not agree), and was jailed for his murder. Those who advocate assisted dying always say they can think of safeguards so that nobody can be railroaded into assisted dying when they do not really want it, but much the same can be said about the death penalty and the fact remains in both cases that once someone is dead, there is no bringing them back.

It may sound harsh but someone needs to tell Tony Nicklinson and others like him to sort their ideas out and find something to do with their lives, rather than idling away while waiting to die. He is not Lynn Gilderdale; he could get out if he wanted to and is fairly healthy even if severely disabled, and could do more than sit in front of the TV all day — indeed does, but for an utterly futile endeavour which is entirely unnecessary in his case. That energy could have been expended for some benefit to himself or to wider society — and the resulting sense of achievement might have given him something to live for.

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