What do you make of Esther?

A campaigner’s call to change an assisted dying law got family calling MND sufferer Michael Wenham. Here he shares why such legalisation will increase people’s fear of dying.

Michael Wenham

Michael Wenham lives with a motor neurone disorder, Primary Lateral Sclerosis. He blogs at My Donkey Body.

Today Programme post about Esther Rantzen's comments.

BBC.

"What do you make of Esther Rantzen?" asked my brother.

I knew what he was talking about, as no doubt all listeners of Radio 4's Today Programme would have done. Clearly the advocates of assisted dying, or specifically suicide, have launched the next round of their campaign, even enlisting the late Diana Rigg, whose resemblance to my wife was once commented on by an old welsh policemen, as a witness. The Today Programme devoted a great deal of airtime to the subject over a number of days.

My reply to my brother was that I thought it was a good thing if we were more open about the subject of death and dying. After all they are events everyone without exception will come in contact with at some point or another. So, the sooner we stop treating it as a taboo subject the better. However, the dangers of legalising assisted suicide, are proved by places like Canada and Belgium.

I don’t see any way to protect us from such coercion, internal or external, except to demonstrate through legislation that every life, however tenuous, is equally important.

In January this year I made a submission to the Parliamentary Health and Social Care Committee consultation on assisted dying/assisted suicide. Here’s some of that submission.

“I am writing as an individual who was diagnosed with a rare form of Motor Neurone Disease (MND) twenty-two years ago and who has experienced the condition’s relentless deterioration since then. There are a number of my contemporaries who have survived that long. That, and witnessing the ravages of the disease on friends in our local MNDA branch plus an Ethics qualification from Oxford, is the extent of my expertise.”

“My first observation is how positively my contemporaries, with short or longer prognoses, with the disease seize hold of life. Clearly there are some who, like Rob Burrows, devote themselves to fund-raising and creating awareness; while others enjoy the opportunities of life that come their way. What might have seemed a death sentence has proved a challenge to live.

"Secondly, I have recently discovered myself how expert professional care can enhance what is often portrayed as undignified dependence. Good caring can in fact add to quality of life. The sad thing however is that it is not something which the state will normally provide. Along with terminal palliative care, domestic social care must surely be a spending priority for any government that cares about the well-being of all its citizens. I’m fortunate to live an area of excellent MND provision and good, though not abundant, palliative care. But I understand that this is not equally spread through the country. If it were, I suspect it would reduce the fear of dying which must be a major motivator for assistance to ending one’s life.

"Ironically, in MND, according to the Association’s information sheet, How will I die?, those fears are greatly exaggerated:

In reality, most people with MND have a peaceful death. The final stages of MND will usually involve gradual weakening of the breathing muscles and increasing sleepiness. This is usually the cause of death, either because of an infection or because the muscles stop working.

Specialist palliative care supports quality of life through symptom control. practical help, medication to ease symptoms and emotional support for you and your family.

When breathing becomes weaker, you may feel breathless and this can be distressing. However, your health care professionals can provide support to reduce anxiety.

You can also receive medication to ease symptoms throughout the course of the disease, not just in the later stages. If you have any concerns about the way medication will affect you, ask the professionals who are supporting you for guidance.

Further weakening of the muscles involved in breathing will cause tiredness and increasing sleepiness. Over a period of time, which can be hours, days or weeks, your breathing is likely to become shallower. This usually leads to reduced consciousness, so that death comes peacefully as breathing slowly reduces and eventually stops.

"So, this is a third and subtle danger of legalising assisted dying/suicide. It would increase people’s fear of the inevitable fact of death and dying. I think this can be one factor in explaining why, in jurisdictions which have introduced it, we see it being extended beyond the first strict limits. It is held out as an answer to this fearful fact, death, whereas in fact death and dying should be talked about in realistic terms, as normal, as concisely outlined by Dr Kathryn Mannix. As she says, normally dying isn’t as bad as we think.

If the government should be doing anything, the first thing it might well do, is to promote informed education about dying of the sort exemplified by specialists such as Dr Mannix, as well as adequately funding her former specialism of palliative care. It should start with schools’ curricula. After all every child will have encountered death at some stage.

Finally, the dangers of coercion, in my experience, are not so much external as internal. It’s often rightly observed that prolonged pain is worse for the engaged spectator than for the sufferer. If you care for someone, seeing them struggling is barely tolerable. You may wish to see their struggle over, but underlying that wish is your own desire to be spared more of your own horror show. The person who is ‘suffering’ however has that strong survival instinct, common to all humans, and is more concentrated on living than dying. Having said that, when you are depressed, as might be natural, that instinct gets temporarily eclipsed. Then you need protection from your own dark sky. It is at such times that your other inner demons emerge: your sense of being a burden - to your family, to your friends (if you have any), to the NHS and to the state purse; your fear of losing your savings and of leaving nothing to your loved ones; your fear of pain and of dying (exaggerated by popular mythology), and your sense of suffering, heightened by your depression.

"For most of us with long incurable diseases, it’s these internal perceptions that are most coercive, although they can be easily compounded or even exploited from outside. I don’t see any way to protect us from such coercion, internal or external, except to demonstrate through legislation that every life, however tenuous, is equally important to our society and worth caring for. ‘Any man’s death diminishes me...’ and so we will value it to the end."

I'm grateful that when I received my 'motor neurone disorder' diagnosis, which was initially frightening, I couldn't be tempted to opt for an early death. Instead of one Christmas with my family (as I warned them), I've enjoyed 22 more Christmases. That was the law against suicide fulfilling its safeguarding function, protecting the vulnerable, as I was then. Contrary to my preconceptions, my form of MND (PLS) is very gradual and I've been able to live a full if increasingly limited life, thanks to my wife, Jane, who cares for me 100 per cent. 24 hours a day, seven days a week.

My view is still that legalising assisted dying/suicide has more cons than pros. The better choice is to invest in hospice and palliative care, so that everyone may have access to pain and symptom care in the last years of their life.

Article

Comment

Education

Leading

26 July 2024

5 min read

Why I teach over my students’ heads

Successful teaching is a work of empathy that stretches the mind.

James K.A. Smith

James is a philosopher, cultural critic and author.

A blackboard covered in chalk writing and highlights.

James's chalkboard.

I’ve been teaching college students for almost 30 years now. As much as I grumble during grading season, it is a pretty incredible way to make a living. I remain grateful.

I am not the most creative pedagogue. My preference is still chalk, but I can live with a whiteboard (multiple colors of chalk or markers are a must). Over the course of 100 minutes, various worlds emerge that I couldn’t have anticipated before I walked into class that morning. (I take photos of what emerges so I can remember how to examine the students later.) I think there is something important about students seeing ideas—and their connections—unfold in “real time,” so to speak.

I’ve never created a PowerPoint slide for a class. I put few things on Moodle, and only because my university requires it. I’ve heard people who use “clickers” in class and I have no idea what they mean. I find myself skeptical whenever administrators talk about “high impact” teaching practices (listening to lectures produced the likes of Hegel and Hannah Arendt; what have our bright shiny pedagogical tricks produced?). I am old and curmudgeonly about such “progress.”

But I care deeply about teaching and learning. I still get butterflies before every single class. I think (hope!) that’s because I have a sense of what’s at stake in this vocation.

I am probably most myself in a classroom. As much as I love research, and imagine myself a writer, the exploratory work of teaching is a crucial laboratory for both. I love making ideas come alive for students—especially when students are awakened by such reflection and grappling with challenging texts. You see the gears grinding. You see the brow furrowing. Every once in a while, you sense the reticence and resistance to an insight that unsettles prior biases or assumptions; but the resistance is a sign of getting it. And then you see the light dawn. I’m a sucker for that spectacle.

This is how the hunger sets in. If you can invite a student to care about the questions, to grasp their import, and experience the unique joy of joining the conversation that is philosophy.

Successful teaching is, fundamentally, a work of empathy. As a teacher, you have to try to remember your way back into not knowing what you now take for granted. You have to re-enter a student’s puzzlement, or even apathy, to try to catalyze questions and curiosity. Because I teach philosophy, my aim is nothing less than existential engagement. I’m not trying to teach them how to write code or design a bridge; I’m trying to get them to envision a different way to live. But, for me, it’s impossible to separate the philosophical project from the history of philosophy: to do philosophy is to join the long conversation that is the history of philosophy. So we are always wresting with challenging, unfamiliar texts that arrive from other times that might as well be other planets for students in the twenty-first century.

So successful teaching requires a beginner’s mindset on the part of the teacher, a charitable capacity to remember what ignorance (in the technical sense) feels like. To do so without condescension is absolutely crucial if teaching is going to be an art of invitation rather than an act of alienation. (The latter, I fear, is more common than we might guess.)

Such empathy means meeting students where they are. But successful teaching is also about stretching students’ minds and imaginations into new territory and unfamiliar habits of mind. This is where I find myself especially skeptical of pedagogical developments that, to my eyes, run the risk of infantilizing college students. (I remember a workshop in which a “pedagogical expert” explained that the short attention span of students required changing the PowerPoint slide every 8 seconds. This does not sound like a recipe for making students more human, I confess.)

That’s why I am unapologetic about trying to teach over my students’ heads. I don’t mean, of course, that I’m satisfied with spouting lectures that elude their comprehension. That would violate the fundamental rule of empathy. But such empathy—meeting students where they are—is not mutually exclusive with also inviting them into intellectual worlds and conversations where they won’t comprehend everything.

This is how the hunger sets in. If you can invite a student to care about the questions, to grasp their import, and experience the unique joy of joining the conversation that is philosophy, then part of the thrill, I think, is being admitted into a world where you don’t “get” everything.

This gambit—every once in a while, talking about ideas and thinkers as if students should know them—is, I maintain, still an act of empathy.

When I’m teaching, I think of this in a couple of ways. At the same time that I am trying to make core ideas and concepts accessible and understandable, I don’t regret talking about attendant ideas and concepts that will, to this point, still elude students. For the sharpest students, this registers as something to learn, something to be curious about. Or sometimes when we’re focused on, say, Pascal or Hegel, I’ll plant little verbal footnotes—tiny digressions about how Hannah Arendt engaged their work in the 20th century, or how O.K. Bouwsma’s reading of Anselm is akin to something we’re talking about. The vast majority of students won’t be familiar with either, but it’s another indicator of how big and rich and complicated the intellectual cosmos of philosophy is. For some of these students (not all, certainly), this becomes tantalizing: they want to become the kind of people for whom a vast constellation of ideas and thinkers are as familiar and present as their friends and cousins. This becomes a hunger to belong to such a world, to join such a conversation.

This gambit—every once in a while, talking about ideas and thinkers as if students should know them—is, I maintain, still an act of empathy. To both meet students where they are and, at the same time, teach “over their heads,” is an invitation to stretch into new terrain and thereby swell the soul into the fullness for which it was made. The things that skitter just over their heads won’t be on the exam, of course; but I’m hoping they’ll chase some of them for a lifetime to come.

This article was originally published on James K A Smith’s Substack Quid Amo.