Article
Assisted dying
Care
Comment
Easter
5 min read

I know who will be most affected by legalising assisted dying

Contemplating lent revives hard memories and raises fresh fears.

Ryan is an ordained Priest in the Church of England, currently serving in south London. 

A close up of a forehead bearing an ash cross marked on it.
Ahna Ziegler on Unsplash.

“What’s that - a face tattoo?” 

These were the words of one person as I walked past them on the streets on a recent Wednesday, with the ashes of last year’s burnt palm-branches placed across my forehead in the shape of the cross.  

The cross has been a symbol of hope for over two millennia; that even in the most painful of circumstances, darkness does not have the final say, including in death.  

As a society, we don’t really talk about death that much. Margot Robbie’s Barbie was the quintessential party-pooper when she pondered: 

 “do you guys ever think about dying?”. 

It’s no fun to dwell on death and dying, and for many of us, we put it off as long as we can. That all changed last year with the introduction of the assisted dying bill into the Houses of Parliament. Our national attention was, for a rare moment, captured by death.  

As a parish priest, I’ve seen the finality of burying someone into the ground. I’ve seen the sadness in the eyes of those trying to grieve. 

The words of Ash Wednesday, which remind us that we are ‘but dust, and to dust we shall return’ are echoed in the famous words that the priest recites in those last moments of burial, ‘ashes to ashes, dust to dust’. In that moment, amongst the bereaved, there is no escaping the inevitability of death. It is the ultimate statistic, 1 in 1 die. 

Whilst death is of course universal and will affect us all, the impact of this assisted dying bill could have consequences for some of the most vulnerable in society.  

As I reflect on my time as a Priest in East London, this is not abstract theory, but something I lived with each day. I served amongst a hugely diverse, vibrant, community in one of the poorest parts of the city. As I try to picture some the people I’ve walked alongside, I know it is these lives that will be most affected.  

One of the reasons I have concerns about the bill is the prospect of these people being coerced into ending their own lives prematurely, by a world that has already told them their lives are of little value. There are already huge disparities in access to the current provision of palliative care at the end of life, particularly amongst people of colour, the disabled and the poor.  

Of the 500,000 people who die each year, 100,000 do not access the care they need. This number is skewed towards ethnic minorities and those who come from poorer backgrounds.  

There is much confusion and misinformation about what end-of-life care even is. Research conducted by Marie Curie shows that 1 in 5 people from an ethnic minority background believe Palliative Care is actually Euthanasia.  

We only need to look at what has happened around the world when the ‘right to die’ becomes a duty to die. Even with the best of intentions, other jurisdictions show us that safeguards rapidly deteriorate and those who are already vulnerable become even more so.  

I worry that the way in which this bill is being handled - rushed through, little time being given to properly chew over the profound consequences it may have - reflects the wider way we view death. 

By trying to provide a ‘choice’ for a certain group of people, the consequence will be taking away real choice from those who already have little. 

Yet we know that for those who do access it, palliative care can be hugely effective in improving their quality of life, and for some, they can even outlive their prognosis. During Ash Wednesday’s service, I met an elderly gentleman who was diagnosed with stage four pancreatic cancer in 2019. He was told he had five months to live. He described every day of his six-year survival since as a ‘miracle’, his eyes filled with evident joy.  

Such a blessing stands in stark contrast to the lonely final days of my 96-year-old great grandmother. She was suddenly taken ill during the Covid-19 pandemic and was frantically rushed to a hospital. Amidst the chaos, exasperated by the restrictions against seeing family that were in place at the time, I distinctly remember confused conversations about placing her in a care home for her final days. It was clear she needed a lot of specialist attention, more than our family could provide ourselves.  As she was discharged to stay with our aunt, she never did reach that care home, as she died at home. She was buried in our local cemetery, with our family watching on Zoom.  

My final memory of my great-grandmother will be the FaceTime call we shared when she was taken to hospital, with the poor data connection and shaky picture. I am so grateful for the few family members who were able to be by her side when she died, but I’ve often wondered whether she fully received the care she actually needed during those final days, in the way she needed it.  

What my great-grandmother didn’t have a lot of at the end of her life was time.  

That’s also true for this bill. Concerns have been raised that only five hours of debate were given to this Bill in the chamber, comparatively short for a change in the law of this magnitude.  

I worry that the way in which this bill is being handled- rushed through, little time being given to properly chew over the profound consequences it may have- reflects the wider way we view death.  

Do we view death - and indeed the dying- as something to be shoved to one side, not spoken about in the hopes we can avoid its impact? Or do we view death as an important moment to review who and what matters most in life?  

Perhaps for some, the fact that Christians devote a period of 40 days to dwell on death may be one of the mysteries of faith. However, perhaps it’s not such a bad idea after all.  Death may bring with it fear, grief and pain and so we tend to avoid it. But do we risk missing out on much more? As we head into Easter, the cross still serves as a powerful reminder that, especially in death, Hope can be found, that Good has triumphed over evil, and Light shines even in the darkest of places.  

Celebrate our 2nd birthday!

Since March 2023, our readers have enjoyed over 1,000 articles. All for free. This is made possible through the generosity of our amazing community of supporters.
If you enjoy Seen & Unseen, would you consider making a gift towards our work?
Do so by joining Behind The Seen. Alongside other benefits, you’ll receive an extra fortnightly email from me sharing my reading and reflections on the ideas that are shaping our times.
Graham Tomlin
Editor-in-Chief

Explainer
Comment
Holidays/vacations
Mental Health
Psychology
Time
7 min read

How to get the best time out of your downtime

The joys and perils of taking time out for summer holidays.
A pair of sunglasses beside a swimming pool.
Jakob Owens on Unsplash.

For the first few days of any summer holiday there seems to be something wrong with my brain. Having looked forward for months to the moment when I can finally down tools and get some rest, having yearned for weeks to be free of the relentless schedule of emails and meetings, the moment finally arrives and I, well… hate it. I’ve wanted to stop for ages and then when I get the chance, I don’t want to. The flywheel momentum of the to-do list somehow carries over into the holiday and turns the first few days into an obsessive nightmare of drivenness. 

This usually manifests in the agitation of wanting to rest while being unable to do so. My schedule says stop but my mind hasn’t got the memo. Instead of gently sculling across the pool, I’m swimming time trials through an obstacle course of inflatable beds and dayglo sea creatures. My family is quick to remind me that the languid currents of the pool were designed for relaxation, not for achieving a personal best. ‘It’s called the lazy river, Dad, not Verstappen at the Nürburgring.’ It makes me laugh, but it doesn’t make me stop. Nor does it stop them shouting things like ‘He’s taking the apex’, and ‘Dad’s got DRS’ from their sun loungers every time I sluice past.  

In the old days, psychiatrists used to call it the Sunday Neurosis, the mild state of agitated low mood that afflicted people on their day off. The inescapable feeling that we should be doing something on days when there is nothing to do. The realisation that we’re not quite sure who we are when we are freed from the daily demands we can easily resent. I don’t know what you have planned for the summer- a beach party in the Bahamas or an Airbnb in Bridlington or the classic post-Covid staycation- but if you’re planning to take a break of any kind there are a few things you should perhaps keep in mind to make the best of it.

If we must work full throttle to the final hour – we may have to accept that we’ll spend the first few days on holiday getting used to being on holiday.

First. Slow down slowly.  

We have a tendency to think that life can change at the speed of thought. Just because our diaries say holiday, doesn’t mean that our bodies are working to the same schedule. The autonomic nervous system that governs our state of physiological arousal largely operates automatically. It isn’t synched to our Outlook calendar and can’t deliver relaxation on demand, no matter how much we would like it to. Psychotherapist Deb Dana likens changing our state of physiological arousal to taking a lift down a few floors. It takes time to move from a highly active state, to a more relaxed and connected way of being. It doesn’t happen at the flick of a switch and we only agitate ourselves more thinking it should. She says we should befriend our nervous system. Instead of impatiently asking ourselves why we aren’t more relaxed, we should simply ask whether we need to be this agitated right now. And if we don’t, accept that it may take us some time to adapt to a less demanding environment.  

When it comes to holidays, this suggests we should allow ourselves some time to acclimatise. Our bodies don’t automatically relax the moment they hit the beach, or hike the mountains, or lie under canvas - they need some time. We can do this before the holiday starts, by slowly decelerating as time off approaches. Like a car approaching a junction, if we want to stop smoothly, we might want to hit the brakes long before we reach the stop sign. And if we can’t do that – if we must work full throttle to the final hour – we may have to accept that we’ll spend the first few days on holiday getting used to being on holiday. It may not make us a pleasure to be with, but we can at least understand that it’s just how our bodies work. We are not droids, there isn’t an off switch on the back of our heads.

On holiday, we can take time to savour the experience of living- to be in our bodies, not just use them.

Second, get into your body (and out of your mind).  

There’s a reason people spend so much time on holiday exercising their bodies: surfing, climbing, walking, riding. And weird stuff too, that you’d never dream of doing at home. One time in Normandy we booked a hand-pumped locomotive and huffed/puffed our way up and down a railway line for an afternoon. If I didn’t have the blisters to prove it, I’d think I’d dreamed that. Why do we do these things? Because it feels good to be aware of our bodies. Even my laps around the lazy river had a certain logic to them.  

Many of us spend most of our time in disembodied thought. We can sometimes feel like the involuntary participants in a workplace time and motion study, in which worth is measured by output. It doesn’t matter where you work – home, school, office, a boat, the woods – sooner or later a spreadsheet will find you. You can run, but you cannot hide your data. And the impact this has on us is that we tend to be more aware of whether we have hit our targets than we are of the toll these targets take on our bodily wellbeing. Just recently I was asked to support a management team going through a stressful restructuring. One guy claimed he didn’t feel the stress of it- he just got on with the job. But when I sympathetically suggested he might be paying for it with his body, the litany of physical ailments he produced sounded like the list of side effects in a 1980s pharmaceutical commercial. He didn’t think he was stressed, but his body kept the score. 

Let’s face it, going on holiday itself is stressful. It’s ranked 42 on the Holmes-Rahe Life Stress Inventory, just above ‘minor violations of the law’. Apparently packing for Marbella is more stressful than being pulled over by the cops. But it’s worth it if it creates a space in which we can de-stress, a space in which we can remember that we have a body, a body that needs to be looked after. Of all the benefits of bodily awareness – the positive sense of how our body feels, not the crippling consciousness of how it looks – perhaps the greatest is its capacity to turn off the hyperactive judgement of our minds. On holiday, we can take time to savour the experience of living- to be in our bodies, not just use them. 

If we are defined by our output, who do we become when our output drops to zero?

Third. Make time to connect.  

What happens when we slow down and learn to live in our bodies again? We become open to connection: socially, emotionally, even spiritually. Back to Deb Dana. She notes that when we take that slow elevator down from the souped-up state of busyness to a more relaxed and open state of mind, we activate the ventral vagal nervous system. She calls it our ‘home away from home’- which seems especially apt for being on holiday. In this state we are happier to be seen by others and therefore to be in relationship with them. Whether it’s a conversation while walking, or an evening card-game, or a meal together, all of them offer a chance for us to dwell in our home away from home in connection with others. 

One of the things that can keep us so obsessively busy, is that we are not always sure who we would be if we stopped. We’re not certain we have a right to exist when we’re not being productive.  If we are defined by our output, who do we become when our output drops to zero? This is why for thousands of years the practice of rest has been enshrined in spiritual practices. Without space to detach ourselves from the hectic pace of life we will inevitably confuse who we are with what we do. The Judeo-Christian tradition called it sabbath, not just a day of rest, but a way of being in which there is nothing left to prove. Holidays can offer us that opportunity, if we are willing to take it. Because after all what do we call someone who becomes more relaxed and embodied and connected? I think: more human.