Suicide in old age is much in the news nowadays. At the moment the spotlight is on relieving the plight of old people who are in great pain from some dire or incurable condition; giving them the right to slip away, as the very best thing for them. And also to make it legal for others to help them do that, subject of course to obvious safeguards.
We have heard already of people who undertake the journey to the Dignitas Clinic in Switzerland, and make an end there. Not all of those coming to the clinic seek help in extreme old age: younger persons have wanted to die, too. Thus far, it's a journey not very many have taken, possibly because it is suicide, and that in itself makes it difficult to consider, on ethical or religious grounds. There is also the danger of prosecution for those who accompany the sufferer, a danger still not completely removed. It is in any case the resort for extreme cases just now. But suppose provision for auto-euthanasia becomes legal, completely standardised, and available in ordinary hospitals, or even on a do-it-yourself basis at home. What then? Will the attitude of the medical world, or of society generally, begin to change? I think it will.
I think it will indeed be true that the elderly, as the group most likely to find themselves in great distress from bodily pain and degeneration, will come under pressure to end their lives voluntarily - first as a normal thing one might consider doing, then, later on, as a moral requirement unless special let-outs apply. And it's all very well to think about this in the abstract, especially if you are yourself a long way from the likely end of your lifespan. But for those whose date of death is not so far off - this includes me - the developing trend to drop all opposition to suicide, and assisted suicide, is a very disturbing one.
A very long time ago I read a science-fiction novel by the late Isaac Asimov, called Pebble in the Sky. It was about Earth in the far distant future, an underpopulated radioactive Earth with few habitable areas left, a mainly agricultural place, not well-regarded, its inhabitants subject to curbs and controls. One of these controls was mandatory euthanasia, if injury or chronic illness made anyone unable to work. An extension of this was The Sixty. A law that required all persons reaching the age of sixty to be put down, with very, very few exceptions. The hero is a retired man from the Chicago of 1950, who accidentally walks through a time warp and finds himself 50,000 years in the future. He is already aged sixty-two. (Just like me now, in fact!)
In my teens, this story first brought it home to me that arbitrary laws could be imposed to take life away, even when there was so much living left to do. I thought it revolting that a blanket law could do this. I still feel this way. And 'ordinary social expectation' and 'accepted law' can be practical equivalents. The Sixty had become accepted as part of ordinary life on planet Earth. They kept tabs on you. They knew when you had run out of time. And They would punish anyone who tried to thwart the law and defend you.
I thought the story had a possible flaw: what able-bodied sixty year old was going to be killed off without a fight? Who would report tamely to some Killing Centre? Why wouldn't a fifty-nine year old be making plans to run away? But then, on Asimov's future Earth, there was no realistic chance of escape, nowhere to go. Any more than an English serf could escape from a feudal village in the years after 1066.
Suicide more generally
I have always ruled out suicide as a personal option. Very early on, certainly by the time I was fifteen or so, I had decided that life - any kind of existence really, on any basis - was very precious. Because so long as one remained alive, one had opportunities to select something different. Choosing to live, whatever the circumstances, meant that change for the better was always possible. But life was necessary to take advantage of it. If alive, one could make decisions, take action, and hopefully enjoy the results. If the endeavour failed, then a secret inner life was still an option, until the next favourable moment for action arose. It was the standard way to survive growing up in a communist or fascist state; or to survive the conviction that one was really very different from one's outward appearance.
But death - suicide - achieved nothing. It was no answer at all. It did not face up to the challenge. It was not heroic, or noble. It was a cop-out that just caused grief to others. And I was damned if I was going to give in to any adversity. (Do you doubt me? Well, I'm still here, alive and kicking)
I had already grasped that nothing stays the same for very long. All things must pass. That gave hope, and the will to endure.
There is constant pressure on the status quo. That applies everywhere. Even if - say - a strong (but misguided, or frankly malignant) government imposes a rigid framework to keep everything the same forever, it will eventually disintegrate. And then something new will take its place. It will crack apart because the people at the top can't avoid growing old and weak and irresolute, or they overreach themselves, but in any case eventually die. And then the next generation - not necessarily the obvious or appointed inheritors - will want its own self-expression. Or an overriding global event or trend might intervene.
Nothing lasts for a 'thousand years'. I am amazed that the current crop of totalitarian rulers scattered around the world do not see how futile their dreadful regimes are. Every such ruler is bound to see their creation fall apart, given time - and probably before they breathe their last. You know what typically happens: the squabbles of succession that begin as the ruler gets old, when the knives come out and the plotting begins in earnest. In my lifetime I have witnessed the rise and fall of many regimes, the brutal or dishonourable end of many a figure who thought themselves different from ordinary people. They were not. And whether they died like dogs or not, they have vanished unlamented. Present-day leaders should keep their downfall in mind, and be themselves humble and unselfish; and not do things that will find them out, and get them kicked into the dustbin of history. Ironically, though, the worse the regime, the more likely that counter-balancing pressures for change will build up, as if there is a fundamental law of physics working away in the background.
So I always thought that life was worth living for its own sake, to give one space for action, tranformation, achievement and satisfaction, even if it all seemed impossible in the here and now. 'While there's life, there's hope' might as well have been my own motto. Death had nothing to offer.
Suicide in special circumstances
At the present moment I remain convinced that there is no better time to be alive than now, and that staying alive to enjoy what else might come is the absolute priority. I can envisage dying. I can imagine myself as very old, with limited energy and mobility - but still alert to trends, still wanting to know about things. I can't yet imagine being so old and tired of life that I'd like to put an end to it.
Are there no circumstances in which I'd commit suicide? In the world as it is, none.
One can conjecture about living in a country where deviant citizens are stripped of their rights, hunted down, arrested, and done to death horribly. If I were a potential victim, I think I would plan an exit route in good time, if need be abandoning everything in order to get out while I could, and then stay alive somewhere else. If I weren't quick enough, and they rounded me up and interned me, it would be a lot more difficult to escape, but I would still try. I would not compliantly sign my own death warrant, nor go quietly to the killing-pit. I wouldn't be British about it, either. I would bludgeon a guard from behind, steal his gun, and make off. I would do this even if I were already eighty-two, and not just sixty-two. Life as a fugitive, as an outlaw, would be infinitely preferable to death. It would sharpen my wits better than playing Sudoku.
What about being caught in a natural disaster? Let's say I'm eighty-two, in a beach resort, and the tsunami is coming. It's arriving in ten minutes. Two hundred feet high. A complete wipe-out looming. There is time to board a waiting helicopter, if I pay the pilot an outrageous £20,000 in cash drawn on my credit card - which I can do, although it will wipe me out financially. That's his price. Yes or no. Do I agree and pay him? Or do I just say hey-ho, why bother; it's been a great life; let's just saunter over to the bar and join the other fatalists having a cheerful gin-and-tonic. Or join the praying throng packed into the nearby church, putting their trust in divine deliverance. But I am neither a fatalist nor a person of faith. I will walk over the the bank, and ask for the cash. If anyone is still there to serve me, they may well dispense with formalities and simply hand it over, money suddenly being of no importance whatever. Very likely I can just help myself. And then rendezvous with the pilot.
Whatever their urging, I wouldn't listen to the bons vivants at the bar, ordering their last drinks. Nor would I enter the church, whatever the entreaties. I'd step into the helicopter, and tell the pilot to lift off. No doubt I'd look down in fascinated horror as the tsunami swept over the resort, a vision that would stay with me forever after. But that's another issue. I value living over making a stylish end, or one contemplating a death consoled by the promise of a sweet afterlife.
A better life after death?
I appear to have wandered away from NHS hospitals offering death pills to elderly patients in their care. But I will come back to it.
What about this idea that there is an afterlife? Specifically that self-inflicted death will propel you towards it?
It's a matter of belief. It may be so, or it may not. The problem is that there is no evidence that one can examine on a day-to-day basis. Historical accounts and sacred texts are not personally verifiable. You take them on trust. I don't know about you, but I need to be able to check something out in person before I will accept it as true. What, you say: don't you accept the existence of black holes and subatomic particles? Because you can't personally check those out! Well, I can check the research, and the bona fides of the researchers, and do as much of it as I like. I don't have to take anything blind. Consistent, repeatable measurements and observations that can be rechecked at any time are a sound basis for accepting something as reliably true.
But the religions of the world throughout the ages have been radically inconsistent with each other. They can't all be right. You can't tell which should be believed. Some may make more sense than others, or to offer insights that seem true. But is it actually one's background, the culture one was born into, that makes them connect better with one's own daily life? Again, you can't tell. But all that variability and inconsistency stands in the way. If 'religion' were a single, coherent and provable body of thinking that anyone could test and retest for themselves, then it would be so much easier to take it on board. After all, wouldn't it be good to know for certain, without taking it on trust, that there is a force beyond ourselves, a power that can save and forgive, and a realm beyond this life that is worth dying for?
In the hospital bed
But if (some years from now) I have been admitted to hospital, perhaps after a fall at home, and the rule there is that any patient over a certain age should be 'advised of their options', I will be very worried. Especially if the ethos in this hospital includes the officially-approved thought that dying hastens one's entry to paradise, and should therefore be eagerly yearned for.
I would be at their mercy. No close family, you see. I'd have to have my wits about me. So absolutely no hints whatever that I might have spiritual beliefs. No hints whatever that I am tired of living. Whatever my true state, I'd have to make out that I had a vibrant life so full of important activities that I mustn't be detained a moment more than necessary. Yes, I'm fine! I don't need to be kept in! The bed can be free by lunchtime! Anything, any lie, to get away. And certainly not to spend a night there. Because, who knows, someone might decide in the night that I should be put down.
Would it be any better if I had some close family, a son or daughter, perhaps? But if they were getting pretty old themselves, and yet still working because retirement wasn't a realistic option for them, they might be wondering why I didn't let go. They might be think about selling my house for the oodles of money it would raise, so that they could give up work. Wouldn't they make sure I considered all my options, including the 'benefits' of something now called Easy Release?
How much pressure? And could I survive it?