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.  

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Article
Care
Culture
Mental Health
3 min read

Separating mind and body still stigmatises mental health

Our minds and bodies are meant to be inseparable.

Rachael is an author and theology of mental health specialist. 

 

 

Two bird sit on wires facing in opposite directions.
Eduardo Soares on Unsplash.

I recently had a somewhat surreal experience whilst trying to get two consultants to agree to some treatment I needed to have.  

One was a cardiologist, the other a psychiatrist - both consultants, working in the same geographical area - and I found, to my surprise, that there was no recourse for my physical health records to be viewed by the psychiatrist and vice versa.  

And as I went through the process of trying to mediate between these two professionals, it made me reflect that whilst in theory there is agreement that our minds and our bodies are one and that they cannot be treated wholly separately, the reality is something rather different.  

Mental and physical health problems are, in fact, treated as entirely separate entities, with different trusts and funding models in place to deliver care and treatment for mental illness and physical illness.  

Now, there is probably a bureaucratic reason for this, but I believe it uncovers a perhaps unconscious belief that our minds and bodies are distant relatives at best, and not only that, but our mental health is still the poorer relation - best ignored unless it’s particularly bothersome.  

I think this separation sits at the heart of the stigma that mental health problems still face - a stigma that persists even in the mental health system. It has ancient roots. Go back to ancient Greece and its philosophers. They held to a  doctrine where the body and soul were completely separate - our bodies are simply houses for our souls. In a way, the stigma that exists about mental health is the inverse of this- that our minds are less important than our physical bodies and that caring for mental health always comes second to caring for physical health. 

Yet, also in those ancient times, the Bible's treatment of humanity shows that we are creations of mind, body, and soul—all equal, beloved, and cared for by God. In Mark’s gospel, we read that the command to love God and one another is multi-faceted: “Love the Lord your God with all your heart and with all your soul and with all your mind and with all your strength.’ The second is this: ‘Love your neighbour as yourself.’ There is no commandment greater than these.” To love one another, then, means we need to care for one another’s mental health as well as physical health and strength, as we love with our minds and bodies. 

In truth, we cannot care well for ourselves or one another without considering both our mental and physical health. To ignore the mental strain of physical illnesses like cancer, and ignore the physical pains that mental illnesses cause, such as their effects on digestion and blood pressure, is to ignore significant parts of people's suffering.  

In the Old Testament of the Bible there is the story of Elijah, one of the great prophets who flees from a murderous ruler and, whilst spiritually and physically exhausted, begs God for death. “I have had enough, LORD,” he said. “Take my life; I am no better than my ancestors.” 

These are words of desperation that echo those who struggle with their mental health, and God’s reply to Elijah’s pain is to meet him with an encounter with an angel who urges him to sleep and eat, comforting him with the words “the journey is too much for you”. There is no reprimand for Elijah’s suffering, simply comfort for a tortured mind and provision for an exhausted body. 

The answer, then, is to treat ourselves and others as the embodied creations we are, with mind and body inseparable and interconnected in ways that even science cannot quite explain or articulate.  

The answer is to trust in the embodied hope of Christ, who chose to save us through not only his bodily crucifixion and resurrection, but through experiencing the breadth and depth of human emotions so that we may never again feel alone in them. 

Both our bodies and our minds matter to God, and we need to see that reflected in society, where we care not just for single ailments, but the whole person. We need not just an awareness of our minds, but an understanding of what it means to be mentally healthy, as well as a recognition of the horrors of mental illness. Only then, I believe, can we see a society which cares and serves those most in need not simply as isolated symptoms, but as valuable creations.