John MacLeod writes:
It was just after New Year 2019 and, in a central-Scotland city, Donald — seventy-eight, a clergyman, theologian, author and journalist — suddenly felt dreadfully unwell.
The alert Lewisman had always been vigorous and strong and rarely bothered doctors. His GP that day felt uneasy, and promptly directed Donald to the Brutalist pile of a certain local hospital.
That was Thursday. On Friday, hours apart, Donald was put through two emergency abdominal operations. On Saturday morning, the consultant — who had not even bothered first to summon wife and family — calmly told him he had aggressive, end-stage cancer of the colon.
He had, he learned, but weeks to live and might never even be able to leave hospital. “We were shocked by what we saw,” the assistant surgeon breathed later that day as we reeled from the news.
For, dear reader, Donald was my father.
Had the Assisted Dying for Terminally Ill Adults (Scotland) Act been on the statute-book — MSPs face the final vote on Orkney MSP Liam McArthur’s Bill today; it passed first-reading last May by seventy votes to fifty-six — the learned physicians could have pressed Daddy to consider euthanasia.
There are, gratifyingly, signs that McArthur’s Bill is already in serious trouble — as Kim Leadbeater’s similar proposals seem now to be foundering at Westminster.
Three MSPs who backed the measure in principle last May — including, last Monday, the political weathercock that is Russell Findlay, leader of the Scottish Conservatives — have now reversed their position. If four more flip their vote, McArthur’s Bill is sunk.
They are increasingly anxious about coercion, be it by covetous offspring or abusive and controlling husbands.
The penny, too, has finally dropped that very few adults truly grasp the finality of death until about the age of twenty-five — it takes that long for the prefrontal cortex of the brain to hardwire — and that it is most unlikely, left in the hands of Providence, you will die in racked anguish.
My own position, as a very poor Christian, is that the triune God is the author of life, that my times are in His hands and — be it soon or distant — I quietly leave my eventual demise, its cause and circumstances and timing, to His gracious decree.
But this is not, these days, an outlook on life widely held. And, in January 2019, my loathing of euthanasia became far more personal than that.
With difficulty, ten days after the surgery, I took my father home to die. Not that he was allowed to leave the Soviet bloc, to which said infirmary spiritually belongs, without signing a “red letter” — the timid agreement that, should his heart conk out, he was not to be resuscitated.
Something began to feel a bit off. Far from fading away, my father began ever so slowly to rally. He ate a little more each day, struggled out of bed and tried to dress smartly. One morning I clipped his toenails — an interesting new experience; but he was still too sore to bend — and, one evening, he even finished most of the Southern fried chicken, crispy French fries and gravy I had tenderly concocted for him.
Then, like a thunderclap — tissue-samples had been sent away for biopsy — the histology came back.
The consultant had made a mistake. Daddy did not have cancer of the colon at all. He had in fact a very rare cancer of the appendix — pseudomyxoma peritonei — and in unusually unhurried form.
It might, I suppose, have caught up with him when he was about a hundred and ten. For now, he rapidly mended and made a slow but complete recovery. By a sunny Saturday late in March he was out in the garden planting potatoes.
He went on to enjoy arguably the best four years of his life, wrote several books, had several holidays on his native island, kept up his Stornoway Gazette column and preached and lectured.
As late as October 2022, my father was still carrying 25-kg sacks of compost through his townhouse to the back-garden. Presiding at the dinner-table and still throwing his decisive weight around: on occasion, especially in the house-arrest months of Covid, we had epic rows.
After some enjoyable grousing, we forgave that hapless consultant. Cancer of the bowel is one of the commonest and chief killers in Scotland. And often presents uncommonly.
Pseudomyxoma peritonei is extraordinarily rare: few doctors ever see a case in their entire career. The same consultant did us one great service: months later, he quietly dissuaded my father from undergoing an epic operation in Basingstoke — the “Sugarbaker Process” — for what doctors jocularly term the jelly-belly cancer.
It takes hours and hours, it is not without risk, and, given Daddy’s regained and high quality of life, it made scant sense. There was, too, the concern that the eagerness of Basingstoke consultants to do it might have owed something to academic, The Lancet derring-do.
I read once that men typically think about sex nineteen times a day. The trouble with euthanasia is that, by contrast, we are very reluctant to think about death at any time — those eyes of fire that search out all.
Opinion-polling on assisted dying always shows enthusiastic support for a question like “Do you agree you should have a right to die with dignity and without unbearable suffering?”
But deeper polling, digging down and with some enlargement on the facts, soon unearths profound unease.
There are lazy and widely-held assumptions in the pro-euthanasia case. This, I personally believe, is largely driven by hatred, conscious or otherwise, of any Judeo-Christian restraints on our passions. So much opposition to it, honked brain surgeon Dr Henry Marsh to The Sunday Times in 2017, “is all bloody Christians”:
They argue that grannies will be made to commit suicide. Even if a few grannies get bullied into it, isn’t that a price worth paying for all the people who could die with dignity?
We tend to think that doctors never make mistakes. That it’s a breeze to kill with a prescribed injection or swallow. In fact, from the Netherlands to Canada, it often goes horribly wrong.
We fool ourselves that offspring or relatives would never, but never, press for Grandma’s swift, convenient slide into eternity because they seek fast inheritance for that little place in the south of France.
We fear that dying is a dreadful, wracking, painful experience. I have sat by several death-beds, seen a lot of dead bodies, decreed an embalming, screwed shut a few coffins, filled in many graves and even helped dig the odd one.
Please do not be frightened: I have no idea where you live. But having witnessed last days, last hours and last gasps, I have never seen anyone who wanted to die or who passed away in terror and agony. Daddy, in nearly sixty years of pastoral ministry, never saw one either.
We all used to know this. Until well after the Second World War, most in Britain died at home, not in hospital. Every grandmother knew the natural processes involved. Folk were not afraid of it: every housewife, just within living memory, was expected to know how to “lay out” her dead.
My late MacLeod grandmother, born in 1912, was so good at this task — certain aspects are not for the squeamish — she was frequently summoned by neighbours when bereavement struck.
Now so few of us even see — far less handle — a cold corpse that imagination has wrought its worst and all reason is out the door.
Few have seen so many people die as Dr Christopher Kerr, of New York state and one of the world’s foremost experts in palliative care. He is adamant. “It’s actually quite hard to die in a sufferable state. Because, to die, you need to be able to sleep, and to sleep you need to be comfortable.
“Pain is overstated as an issue — way overstated. Confusional states, agitation, psychogenic distress, disturbed sleep, or changing sleep architecture — these are much more likely to be issues we treat.”
About 10 per cent of deaths, Dr Kerr says, are acute. “The rest are essentially forecastable. It’s seldom a falling off the cliff — it’s a slow slide. I ask, ‘Well, what were they like two months ago, four months ago, six months ago?’ And it’s that trajectory that’s going to take them to the end.”
As for the moment of death itself? “It’s remarkable how undramatic it is — how anticlimactic.” Indeed, when Dr Douglas Glass slipped into the Queen’s Balmoral chamber on 8th September 2022, no one in the little bedside vigil had even noticed Her Majesty had stopped breathing.
I find the phrase “assisted dying” truly offensive. We have been helping our loved ones to die for millennia. Holding their hand, fetching and carrying, washing and sterilising things, hushing concerns and fear, prayer and praise by the bedside. Making sure, at every moment, they are clean, they are safe and they are comfortable.
For the new, terrifying moral order we might shortly tumble into, take a look across the pond.
In 2016, Canada passed “Medical Assistance In Dying” legislation that granted, on supposedly strict terms, euthanasia.
It was only, declared the Government, for people with terminal illness. Then, in 2021, the law was broadened by Bill C-7: MAID would now be available to people with non-terminal conditions.
The Parliamentary Budget Officer, Yves Giroux, even crowed about the cost savings it would create: whereas the old MAID regime saved $86.9 million per year — a “net cost reduction”, in his sterile words — Bill C-7 would create additional net savings of $62 million per year.
Healthcare, particularly for those suffering from chronic conditions, is expensive; but assisted suicide only costs the taxpayer $2,327 “per case,” Giroux enthused.
And we might do well to ask ourselves who has long funded those slick social-media campaigns in this land for assisted suicide. Can we be confident it is not, for instance, private health insurers keen to save a few bob?
MAID will change again next year. People with mental illness will also be eligible for euthanasia. And some Canadians already talk about making it available to children: since 2017, the number of Canadians annually put down like a tired old tabby-cat has quadrupled.
My father outran his cancer, but he could not outrun the weight of years. Hospitalised briefly with aspirate pneumonia, late in October 2022, he was never well again.
By New Year he was already eating less and less, leaving the house less and less, withdrawing emotionally, and (critically) sleeping more and more — as we ran up and down stairs, attending to the latest summons, measuring out pills, leaving two pint-glasses of cold water by his bedside every night.
And, at his express decree, only drawn from the kitchen-tap. Dr Kerr’s slow slide…
Somehow, by immense effort of will, my father stayed on his feet into May 2023. Then he collapsed. Daily Marie-Curie hospice carers became our new friends and family. Beyond the odd yip of frustration, there was no suffering.
On the final Wednesday — I later learned this is a phenomenon known as “terminal elation” — he was unexpectedly bright enough to sit up in bed, call for the paper, check his emails, phone his siblings for a chat, and inquire as to the sprouting progress of the potatoes he had planted weeks earlier.
He even ate some mussels for his supper and braved a spoonful of chocolate-mousse from my hand. “Ah, John,” he chuckled, “don’t be coming at me now with new things.”
Increasingly he “visioned,” murmuring serenely to people and spirits we could not see. His late parents, possibly, his beloved grandfather or long-gone schoolfellows — death-divided friends at last who met to part no more.
Daddy died peacefully, with a faint half-smile, on the Sabbath evening after long hours of unconsciousness. In his own home and his own room. We were all with him. His body had simply worn out, wound down and stopped.
The following day, in the sort of death certificate conversation you never want to have, his GP and I agreed he had died of old age.
We buried my father a week later, by the shore of the Butt of Lewis township where he had been born in November 1940. A peerless day of Hebridean summer. I began the shovelling myself as, high overhead, a joyous skylark praised her God.
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