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Assisted dying
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9 min read

Assisted dying's language points to all our futures

Translating ‘lethal injection’ from Dutch releases the strange power of words.
A vial and syringe lie on a blue backdrop.
Markus Spiske on Unsplash.

In the coming weeks and months, MPs at Westminster will debate a draft bill which proposes a change in the law with regards to assisted dying in the UK. They will scrutinise every word of that bill. Language matters. 

Reading the coverage, with a particular interest in how such changes to the law have been operationalised in other countries, I was struck to discover that the term in Dutch for dying by means of a fatal injection of drugs is “de verlossende injectie.” This, when put through the rather clunky hands of Google translate, comes out literally as either “the redeeming injection” or “the releasing injection.” Of course, in English the term in more common parlance is “lethal injection”, which at first glance seems to carry neither of the possible Dutch meanings. But read on, and you will find out (as I did) that sometimes our words mean much more than we realise.   

Writing for Seen & Unseen readers, I explained a quirk of the brain that tricked them into thinking that the word car meant bicycle. Such is the mysterious world of neuroplasticity, but such also is the mysterious world of spoken language, where certain combinations of orally produced ‘sounds’ are designated to be ‘words’ which are assumed to be indicators of ‘meaning’. Such meanings are slippery things.  

This slipperiness has long been a preoccupation for philosophers of language. How do words come to indicate or delineate particular things? How come words can change their meanings? How is it that, if a friend tells you that they got hammered on Friday night, you instinctively know it had nothing to do with street violence or DIY? Why is it that in the eighteenth century it was a compliment to be called ‘silly’, but now it is an insult?  

Some words are so pregnant with possible meaning, they almost cease to have a meaning. What does “God” mean when you hear someone shout “Oh my God!”? Probably nothing at all, or very little. It is just a sound, surely? And yet no other sound has ever succeeded in fully replacing it. We are using the term “God”, as theologian Rowan Williams points out in his book The Edge of Words, as a “one-word folk poem” to refer to whatever we feel is out of our control.     

Both of these first two interpretations look at death, in some sense, ‘from the other side’ – evaluating the end of someone’s life in terms of speculation over what will happen next. 

This idea of an injection being verlossende seems to me to be the opposite. I find myself hearing it in four different (and not mutually exclusive) ways, each to do with taking control of this very uncertain question of dying. The first, releasing, sounds to me like an echo of the neo-platonic ideas that still infuse public consciousness about what it means to be dead. As we slimily carve our pumpkins for Halloween and the children clamour to cut eyeholes into perfectly good bedsheets, we see a demonstration of society’s latent belief that humans are made up of body and soul, and that at death the soul somehow leaves the body and floats into some unknown realm (or else remains, disembodied yet haunting). If we translate verlossende as releasing then we capture that idea – that of the soul, which longs to be at peace, trapped inside suffering, mortal flesh. 

Google’s second suggestion for verlossende was redeeming. This could be heard theologically. Christians believe in eternal life, that the death of this earthly body is only the start of something new – a life where there will be no crying or pain, and people will live forever in the glorious presence of God. In the bible, the apostle Paul encourages those who follow Christ to trust that they have been marked with a ‘seal’, meaning that they are like goods which have been purchased for a price, and that God will ‘redeem’ this purchase at the appointed time. Death, therefore, is not a fearful entering into the unknown, but a faithful entering into God’s promises.  

Both of these first two interpretations look at death, in some sense, ‘from the other side’ – evaluating the end of someone’s life in terms of speculation over what will happen next. But there is the view from this ‘side’ also. We do not need to speculate about what death means for some of those who experience acute suffering due to terminal illness, and who wish to hasten the end of their lives because of it. They too might want to speak of a releasing injection or a redeeming injection – given that both terms hint at the metaphor of life as a prison sentence. To be in prison is to have one’s rights and freedoms severely limited or entirely taken away. It is not uncommon to hear a sufferer refer to incapacitating illness as being ‘like a prison sentence’, and one can empathise with the desire to have the release date set, back within the sufferer’s control.  

This is the strange power and pregnancy of words – verlossende is able to carry all these meanings or none of them. Until I began researching this article, I had always assumed that the English term, lethal injection, simply meant an injection of some substance that is deadly. This is how the term is commonly understood, therefore, in a sense, this is its meaning. Yet, when I came to consider the possible origins of the word, I realised its likely etymology is from the Greek word lēthē, meaning ‘to forget’. In the Middle Ages, if something was lethal it caused not just death, but spiritual death, placing one beyond the prospect of everlasting life. By contrast, something could be fatal, meaning only that it brought one to one’s destiny or fate.  

With this in mind, as we try to speak clearly in the assisted dying debate, the term fatal injection might be a more precise way to describe this pathway to death that is in want of a name. After all, whether you believe in an afterlife or not, dying is everybody’s fate, and I can see that choosing to take control of one’s fate is, for anyone, an act of faith with regards to what comes next.  

  

This article was part-inspired by Theo Boer’s original article Euthanasia of young psychiatric patients cannot be carried out carefully enough, in Dutch newspaper Nederlands Dagblad.  Theo is a professor of health ethics at the Protestant Theology University, Utrecht. 

Read the original article in Dutch or an English translation below. Reproduced by permission.

 

 

Euthanasia of young psychiatric patients cannot be carried out carefully enough 

Theo Boer 

How is it possible to determine that patients who have suffered from psychiatric disorders for five or ten years and who are between the ages of 17 and 30 have ‘completed their treatment options’, wonders Theo Boer. It also conflicts with perhaps the most important task of psychiatrists: ‘offering hope.’  

The patients we are talking about now are not physically ill and therefore do not have the ‘comfort’ of an impending natural death. 

A letter was recently leaked in which leading psychiatrists ask the Public Prosecution Service to investigate the course of events surrounding euthanasia of young psychiatric patients.  

One death mentioned by name concerns seventeen-year-old Milou Verhoof, who received the redeeming injection from psychiatrist Menno Oosterhoff at the end of 2023. It will not have escaped many people's attention how much publicity the topic has received in the past year or so. Together with a colleague and a patient (who later also received euthanasia), Oosterhoff wrote the book Let me go.  

The tenor was: it is good that euthanasia is possible for this group of patients, the taboo must be removed, their suffering is often terrible, they have already had to undergo countless 'therapies' without effect - can one time be enough?  

Or would we rather have these patients end their lives in a gruesome way? And who really thinks that psychiatrists make hasty decisions when they decide to comply with a euthanasia request?  

To be clear: we are talking about something completely different than what has been called 'traditional euthanasia' for years: euthanasia for physically ill patients with a life expectancy of weeks or months. Given the excellent palliative care that has become available, such euthanasia will actually be less and less necessary in 2024.  

Panic  

No, the patients we are talking about now are panicky, anxious, confused, depressed, lonely, often unemployed, poorly housed, without prospects. But they are not physically ill and therefore do not have the 'comfort' of an impending natural death.  

I have heard several of them say: if only I were terminal, then euthanasia would not be necessary. The fact that there is now attention for this group of patients, with whom we in our hurried and solution-oriented society know so little how to deal, is a gain. At the same time, I am happy with the leaked letter. You can criticize Oosterhoff's procedural approach ('why not an ethical discussion instead of a legal one?'), the lack of collegiality, this perhaps underhanded action ('why did you go straight to the Public Prosecution Service?'). But in my opinion, the letter writers are definitely hitting the mark with this crooked stick. Firstly: how is it possible to determine that patients who have suffered from psychiatric disorders for five or ten years and who are between the ages of 17 and 30 have ‘completed their treatment options’ (a criterion from the Euthanasia Act)?  

Review Committee  

Nobody disputes that their suffering is unbearable. At the same time, I know from my time on a Regional Euthanasia Review Committee that an illness becomes unbearable when all hope is gone.  

A psychiatrist who gives euthanasia to a young adult is also undeniably sending the signal that, like his patient, he has given up all hope of improvement. That is actually risky, because even patients who have suffered for years sometimes recover and, moreover, our brains are not fully developed until we are 25. But it also conflicts with perhaps the most important task of psychiatrists: offering hope. In their training, the risk of transference-counter-transference is consistently pointed out: a patient takes his therapist with him into despair, the psychiatrist transfers those feelings to this and other patients: ‘this kind of suffering is untreatable and cannot be lived with’.  

In the recent NPO television documentary A Good Death we see an embrace between a psychiatrist and her emotional patient. In doing so, this psychiatrist offers a unique form of involvement. But does she provide sufficient resistance to the cynicism, despair and negative vision of the future that is also widespread outside psychiatry?  

Sensible decisions?  

That brings me to a second objection: is it sufficiently recognised how much a psychiatric illness can affect someone’s ability to make sensible decisions? The hallmark of many psychiatric illnesses is a deep desire to die and an inability to think about it in a relative way. As a result, many are unable to think in terms of a ‘possibly successful therapy’.  

Boudewijn Chabot 

The main character in the book Zelf heeft by Boudewijn Chabot, Netty Boomsma, responds to Chabot's suggestion that there might be a life after depression: 'Yes, but then I won't be it anymore.' She wants to go down with her depression. I know differences. The people with a death wish who remark about a possible therapy: ‘I hope it is not effective, because then I will have to go through it again.’ 

 Another hurdle 

If a second psychiatrist is consulted and, for example, suggests trying one or two more therapies, many patients see this as yet another hurdle on the road to euthanasia. They do not see it as a serious opportunity to be able to cope with life again. There are no easy answers here. Nor are pillories appropriate. But let euthanasia remain complicated here, and let us continue to look for hope. 

 

Reproduced by kind permission

Article
Character
Comment
Friendship
Virtues
6 min read

Guiding’s new badges don’t deserve this media criticism

Encouraging interests builds character now and for tomorrow

Paula Duncan is a PhD candidate at the University of Aberdeen, researching OCD and faith.

Two Brownies point out their badges.
Girl Guiding.

As a Brownie leader, what I love about Girlguiding is the perfect blend of tradition and modernity. Lots of people will have memories of belonging to Brownies or Guides. In conversation, it’s often the uniforms that people mention first – for ex-Brownies it’s always the brown dresses, or the iconic yellow sweatshirt which has now been relaunched for adults as a retro range. I will admit to buying one almost immediately and have loved wearing my tribute to the Jeff Banks design era of uniform that I loved so much as a child.  

For those unfamiliar with the organisation, Girlguiding began in 1909 with a small group of girls who joined a Scout rally and bravely asked that there be ‘something for the girls’ too. Today, Girlguiding has four youth sections: Rainbows (aged 4-7), Brownies (7-10), Guides (10-14), and Rangers (14-18).  

I’m particularly excited to go back to our weekly meetings after the school holidays because a new range of interest badges have just been launched for all sections – 78 in total! These badges are designed so that girls can choose which activities they’d like to pursue – either a new skill or hobby or learning something new. Each badge fits into one of our six distinct programme areas: Be Well, Express Myself, Skills for My Future, Take Action, Know Myself, and Have Adventures.  

A lot of the publicity surrounding the badges has been really positive – praising the organisation for representing the interests of young people. The badges were designed, after all, with the input of members and with extensive testing by groups across the UK, and feedback from 11,000 girls about the new badge offerings. My Brownie unit enjoyed being part of the testing pool for the ‘Passions’ badge, which encouraged them to think more deeply about the hobbies they have and try some new pursuits. Reading the final version of the badge when it was released was brilliant because I could really see the impact of the Brownies’ feedback.  

I’ve been disappointed to see the organisation’s new badges be subject to some heavy media criticism and that headlines have been tailored to mock, rather than share the relevant and interesting content that the badges actually offer. The Telegraph used the current tensions around gender identity to create a clickbait title: “Girlguiding ‘hostess’ badge gets gender-neutral makeover” which, inevitably, caused a flurry of (largely unpleasant) Facebook comments about identity politics. While the article itself does well to describe some of the new badge offerings, leading with a controversial heading detracts from the truth that the previous ‘hostess’ badge was discontinued as part of the programme refresh and that member feedback brought about a return of a similar offering.  

Victoria Richards writes in The Independent that: ‘Girlguiding is […] modernising the way it interacts with young people. Speaking their language. After all, what use is an organisation for girls if nobody wants to join it?’  

This does not seem to be the opinion of Lucy Mangan who writes a particularly scathing indictment of the movement in general and in a large part advocates for teaching children how to use a gun and cut down trees. Obviously unfamiliar with the Girlguiding programme, she misses that our new interest badges are just that – part of a programme that encourages girls to pursue their own interests and often to try something new! “Interest” simply means that we allow girls to choose for themselves what they are interested in learning more about. We remain dedicated to teaching core life skills (things like first aid, I’d argue, rather than using a gun) as part of the Skills Builder set of badges that progress through each section.  

An opinion piece in The Express says: ‘The new Girl Guide badges are so easy, it’s like awarding a gold star for blinking’… This simply isn’t true; even the youngest members are encouraged to try something new or improve on a skill. It’s strange that none of these critical articles come from current members or leaders. Sometimes we do offer badges for participation at an event or marking on occasion but part of the joy of those is collecting them. I love looking for a badge patch when I’m on holiday and adding them to my camp blanket. There are some fantastic blankets out there – with badges from people’s travels, awards they’ve earned, and badges they’ve swapped with others they’ve met at events.  

Why shouldn’t we be encouraging our youngest members to have courage?

Most articles – including the BBC – have chosen to lead articles with the range of badges that fall under ‘Be Well’ or ‘Know Myself’ and are therefore designed to help young people learn valuable skills in self-care and identifying the things that are important to them. They are, by nature, designed to help young people learn more about themselves and how they interact with the world.  

This leads readers to believe that all badges are ‘self-centred’ as critics like Mangan have written. Why shouldn’t we be encouraging our youngest members to have courage? Girlguiding’s research has shown that 50 per cent of girls surveyed felt anxious about their future in 2024. Showing girls how to manage feelings of worry from a young age can only be a good thing. Our Rainbows are encouraged to “share the laughter with someone else.” Brownie Guides are working on their friendship badge are asked to “spend time with a new or old friend”.  

Dig a little further and look to the other interest badges and there can be no doubt that the programme Girlguiding offers is important and helps young people to challenge themselves and build new skills. The activities offered are relevant to the concerns of young people and the betterment of their communities. Rangers are supported to learn more about voting and how to ensure their voice is heard. In a world with fast fashion and markets like Temu dominating digital spaces, Guides can find out how to make informed decisions as part of their Conscious Consumer badge. 

Brownies can learn new languages or work towards their Mechanic badge. Even the youngest girls have the chance to learn about key principles of architecture in their Construction badge – the full syllabus of which is online. For critics who say that traditional skills like knot tying, sewing, or semaphore are forgotten by Girlguiding, all of these can be found in our Skills Builders and unit meeting activities. It can be so easy to be critical of something new or something that is changing without doing any further research to find out whether the headlines are accurate. Clickbait headlines are designed to drive up traffic and revenue, but something of the truth is lost in the process.  

I am incredibly proud to be part of an organisation that offers a rich, varied programme to young people. It has helped me grow from an anxious primary school child to a leader who can recognise the value of teaching life skills that are relevant to our time and place. Right now, girls need to have the resources and support to thrive in both the tangible world, and in an increasingly digital world.  

For those disheartened by the reception of the new badges, it’s worth looking to smaller news outlets. Those who have taken the time to garner responses from members and young people are much more encouraging and help to celebrate an exciting new step in our programme. I hope that those who can see the value of the programme offered to girls through Girlguiding can use this opportunity to find out more. If anything in this article has resonated with you, please do check out volunteer opportunities. 

From someone who likes to incorporate things like Star Trek into my academic work, why shouldn’t we be able to offer a badge about Fandoms? Why shouldn’t we celebrate the things that we enjoy? There really is something for every girl, even if the loudest voices in Facebook comment sections don’t make that clear. I’m incredibly proud to be part of an organisation that brings out the best in young people (and in me as an adult leader!).  

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