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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Review
Art
Care
Culture
Mental Health
5 min read

Mental health: the art that move us from ostracism to empathy

Four current London exhibitions show the move towards compassion.

Susan is a writer specialising in visual arts and contributes to Art Quarterly, The Tablet, Church Times and Discover Britain.

A painting of a haunted looking old man dressed in an imagined military uniform.
A Man Suffering from Delusion of Military Rank.
Théodore Géricault, Public domain, via Wikimedia Commons.

Portrayals of mental health were revolutionised from the nineteenth century onwards. While previous generations had focused on the ostracism of those suffering mental illness, and the fear their condition aroused in others, modern artists began to focus on the dignity and humanity of sufferers. Four current London exhibitions show this move towards compassion. 

On display at the Courtauld’s Goya to Impressionism, Theodore Gericault’s A Man Suffering from Delusion of Military Rank, c.1819 -22, shows the artist’s sensitive response to ‘monomania’, the term coined in the early 1800s for people living with a single delusional obsession. It is thought this painting is part of a series of portraits on fixations including A Child Snatcher, A Kleptomaniac, A Woman Addicted to Gambling and A Woman Suffering from Obsessive Envy, the face of the last rendered in an unsettling green tinge. 

The circumstances surrounding the painting of the series remain mysterious. The timing coincides with Romantic painter Gericault completing his most famous work, the monumental The Raft of the Medusa, 1818-19, depicting 15 survivors of a shipwreck, who had been adrift on a makeshift raft, originally containing 147 passengers, from the French frigate Meduse. Gericault’s preparation for the canvas included visiting morgues to check on the colour of decomposing flesh and building a model of the doomed raft. His difficulties in completing the huge work, over 23 feet long, and the possibility some of his close family may have suffered from mental illness, have supported the belief Gericault painted A Man Suffering from Delusion of Military Rank, and related portraits for personal reasons, possibly out of gratitude to the physician who cared for his family. But there is now doubt if Dr Etienne-Jean Georget commissioned the painting, and whether he was chief physician at Saltpetriere asylum in Paris. 

Even if a biographical motivation for the series falls down, and there is no way of knowing if the subjects of the portraits were individuals living with mental health conditions, these portraits remain unique in early nineteenth century painting. People deemed at the very margins of society are portrayed in the same manner as the most powerful, in half-length portraits emphasising their dignity and humanity, over their social estrangement and health challenges. 

The Raft of the Medusa, Louvre, Paris. 

A painting shows a wreck of a rafter holding survivors and corpses.

Van Gogh’s mutilation of his own ear is interwoven into his biography and his art. In The Ward in the Hospital at Arles and The Courtyard of the Hospital at Arles, both 1889, the artist depicted the interior and exterior of the institution where nuns cared for him, during his mental health crisis. The paintings’ significance to his recovery is shown by Van Gogh taking them with him when he moved to another psychiatric facility 25 kilometres away at Saint-Remy-de-Provence. 

Blue is the dominant colour of The Ward, permeating the walls, the beamed ceiling, the crucifix and the door underneath it, and several patients. wear dark blue clothing, including the two nursing Sisters at the centre of the scene, whose Order of St Augustine black and white habits, have been realised in darkest blue. Van Gogh described the long ward as ‘the room of those suffering from fever’, most probably referring to patients with mental illness. The painting was reworked during the artist’s admittance at Saint-Remy-de-Provence, with the symbolic empty chair used in other works to represent him and his housemate Paul Gauguin added to the foreground, together figures gathered around a stove. The return to the painting was prompted by reading Dostoevsky’s The House of the Dead, a fictionalised account of the author’s spell in a Siberian prison, and the book’s characters may have provided the inspiration for the huddled men. 

The Courtyard of the Hospital at Arles captures the grace of the hospital’s Renaissance building, by depicting the inner courtyard from the vantage point of the first-floor gallery. From this aerial angled viewpoint, the garden’s bright flora, radiating from a central pond, spreads out in all directions. Van Gogh’s description of the scene to his sister Willemien, hints at their Bible reading, clergy childhood: ‘It is therefore a painting full of flowers and springtime greenery. Three dark and sad tree trunks however run through it like snakes…’ 

Van Gogh’s images of healing were from memory rather than life, and document his own mental health recovery:  

‘I can assure you that a few days in hospital were very interesting and one perhaps learns how to live from the sick.’ 

The Ward, Vincent van Gogh, Public domain, via Wikimedia Commons.

Van Gogh's painting of a mental ward in a hospital

Edvard Munch's Portraits, Evening 1888, shows the artist’s sister Laura, who had been hospitalised for mental illness, on and off, since adolescence. Although Laura is lost in her own world, staring fixedly ahead against a coastal landscape, the affection of the artist for the subject is palpable. Fashionably dressed in straw hat and summer dress, Laura’s dignity anchors the composition. Munch documented his own breakdown after alcohol poisoning in a portrait of Daniel Jacobson. His full-length portrayal of the doctor, arms akimbo, drew the reaction: ‘just look at the picture he has painted of me, it’s stark raving mad.’ Munch’s fascination with the doctor-patient relationship is evident in Lucien Dedichen and Jappe Nilssen, 1925-6, where Dedichen’s looming, purple presence, overshadows the diminutive, seated patient. 

Portrait, Evening. Museo Nacional Thyssen-Bornemisza, Madrid.

A painting of a  pensive young woman sitting and staring across a lawn.

Mental health and delusion form the wellspring of Grayson Perry’s Delusion’s of Grandeur. The artist responds to the Wallace’s flamboyant rococo collection in the persona of Shirley Smith, a character believing she is the rightful heir of the Wallace Collection. Eighteenth century style ceramics are decorated with outline figures resembling the Simpsons. Perry creates a family tree for Shirley from the Wallace’s miniatures, A Tree in the Landscape where every member has a condition from the American psychiatric guide Diagnostic and Statistical Manual of Mental Disorders. 

Grayson Perry, Untitled Drawing, Courtesy the artist and Victoria Miro. 

A image of a woman against a detailed red background.

In Alison Watt: From Light at Pitzhanger Manor, the artist’s still lifes of roses, fabrics and death masks responds to the collection of Regency architect Sir John Soane, and the ever-present fragility and complexity of human life and psychological flourishing. “With a rose it is impossible not to be aware of human intervention. Roses are bred, altered outside of nature and given names. In the history of painting the rose can be read as a symbol of beauty, innocence and transience, but also of decline and decay, echoing Soane’s preoccupation with themes of death and memorialisaton.” 

With the scientific and medical advances of the nineteenth century, life in all its psychological complexity, could supplant death as artists’ inexhaustible fount of inspiration. 

Le Ciel, Alison Watt.

A diseased rose.

Find out more.

Celebrate our 2nd birthday!

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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?

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