Assisted Suicide The Musical and The Final Brexit

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In the context of Liz Carr’s touring show, supported by Unlimited, Anne Teahan looks at the arguments on both sides of the electric fence that divides pro and anti Assisted Dying campaigners.

Performer Liz Carr sits in a golden wheelchair on a red carpet with a male and a female actor posing beside her.

Assisted Suicide the Musical is written by and stars Liz Carr

Liz Carr’s vibrant musical is complex. At the premier of Assisted Suicide The Musical at the Southbank Centre Unlimited showcase she not only entertained a full house, but analysed and satirised received wisdom. The show presents her research involving a tour of countries where euthanasia or suicide is legal for the sick, old and disabled, examining the idea of ‘choice’ and what it might mean in practice. Carr found the thin end of the wedge and peered over it to show us what she could see.

Themes of life, death and disability, enough to keep a panel of philosophers and psychologists arguing into the night were woven together with songs, jokes and dance routines… many of which involved a swinging hoist.

There were moments in this live event when I wished I could press pause, to think about the implications of a single song or theme or even a word. Her chilling story about attending a conference of enthusiastic ‘assisted suicide’, medics might make a full length play all by itself.

Seeing Assisted Suicide The Musical (4 years in the development) was also a kind of relief for the disability aware audience because it offers a vital challenge to the majority view. Dignitas has campaigned hard to get the medical profession and state to offer a package of choice, compassion – and death. Mainstream drama has not challenged the predominant view. So at last, Liz Carr was asking some critical questions: What does ‘choice’ and ‘compassion’ really mean? And who is framing the debate?

So the show was the hot ticket in disability circles and had sold out long before the premier. But this brings up a persistent theme for me that disability culture and concepts, and mainstream culture and attitudes are not only distinct but mutually exclusive in their worldviews. Assisted Suicide The Musical has a huge task ahead. It has to address complex issues in ways that both sides of a big divide can understand. It has to engage punters who know nothing about the social model.

The extent of the divide is illustrated by two cartoons. Dignitas on its website, describes the issue of assisted suicide as a simple choice. The cartoon shows two campaigners holding placards. One says: “I support a dignified death.” The other says: “I support the right to needlessly suffer”. In their worldview, anyone who disagrees with their aims must by definition be cruel and sadistic.

Cartoon by Crippen, entitled Grim Reaper

Grim Reaper by Crippen, courtesy of the artist.

Alternatively, Crippen’s cartoon on DAO is defiant. Death is hovering by a hospital bed, and requires an assertive response.

To put it another way, in disability culture, ‘assisted suicide’ is seen as a dangerous social and political development, which ultimately threatens everyone. The real battle for choice is a political one aimed at equality and autonomy in life. And choices for independent living, inclusion, and Access to Work and shrinking NHS services are hard-won.

In contrast, Dignitas are driving a determined libertarian campaign by representing assisted suicide as a simple choice between individual freedom or a painful death. A poll, referenced in numerous media articles, alleges that 82% of the British public are in favour of the Assisted Dying bill. This was taken further with a call for a referendum.

When the Assisted Dying bill was defeated in parliament, there was relief from disability groups, but libertarians felt that parliament and experts like the BMA had gone against majority public opinion. If a vote on assisted suicide were allowed the public would return a resounding ‘yes’. Despite two failed referendum attempts the assumption is that it is only a matter of time before parliament will have to catch up with the will of the people expressed in a yes-no poll.

Not only does this echo the old Daily Mail type declarations on capital punishment, it also raises thoughts about Brexit.

An important difference between these two approaches is that one sees complexity where the other sees simplicity. And here the recent Brexit referendum becomes a cautionary tale. The public have already translated the baffling complexities of leaving Europe into a simple yes, or no ‘binary’ vote. The decision cannot be reversed yet no-one really knows for sure what ‘yes’ means and it may take years to find out.

Furthermore, one person’s ‘yes’ meant political independence, while another person’s ‘yes’ meant immigration fears. The issues are far more complex and multi-layered than the question.

It is an individual pot of ice cream, with the words 'Dignitas - Ice Cream with Dignity. With our special, secret ingredient.' On the lid it says: 'Rocky Road'.

Assisted Suicide Ice Cream

Like Brexit, Dignitas’ proposition is presented as a simple binary choice: are you in favour of assisted suicide, ‘yes’ or ‘no’?

But we all know that answers to polls depend on how questions are framed. Like Brexit, among the 82%, there might well be a hard and soft version of what ‘yes’ might mean. One person’s ‘yes’ might be a vote for a dignified, pain-free and gentle death – in line with the aims of the hospice movement (who do not support assisted suicide); another person’s ‘yes’ might mean something more coercive.

Matthew Parris expressed what could be described as a ‘hard exit’ view in his article on the Spectator website. In his ‘Darwinian’ argument, he writes about people who find themselves ‘no longer useful’. He merges the disabled, old, and terminally ill into a single category, under the umbrella term of ‘the enfeebled’. He recommends that they should make the ultimate sacrifice for the sake of the tribe. He says that if he found himself ‘enfeebled’ he would volunteer to die.

He does not pretend that his view represents ‘compassion-with-safeguards’. He wants the weakest to respond to the coercion of the state and to self-define as a burden and take the ‘exit’.

He is honest… he may be saying what many people feel but will not openly admit to. In terms of simplicity and complexity, he has flattened it all out. Some people are strong and should live – others are weak and should die. And he is convinced that this outcome is inevitable.

It seems to me that there is a kind of race going on between two opposing tendencies. A determined Libertarian campaign is becoming increasingly populist in character. They have the marketing, the branding, the t-shirts and the celebrities to keep a clear focus on a simple yes or no message.

On the other side through ‘Assisted Suicide The Musical’ and the work of artists like Liz Crow and Ju Gosling, the consensus is being challenged by a deeper and sharper critique of the underlying assumptions.

Parliament has favoured detailed scrutiny and debate, but at the moment – in polling terms – the libertarian, populist view is allegedly winning. So how do disabled artists and activists bridge the gap and reach the great British public? What can be done to stop their rigorous critique of the status quo from remaining marginalised?

In other words, why should an average punter, without any knowledge of the social model – want to come and hear a disability perspective at all?

An image of 4 paintings of Liz Carr talking into a microphone

Anne Teahan series of portraits of Liz Carr.

A friend asked me recently in relation to assisted suicide why disabled people’s concerns should have special relevance to his freedom of choice?

In thinking about his question, it seems to me that disabled people have a particular expertise in the territory where social and medical definitions of life interact. Yet when it comes to this specialist knowledge, and its potentially universal value, it is a well-kept secret.

As Penny Pepper wrote in the Guardian ‘we are the canaries in the mine’. Disabled people know about the space where social policy meets medicine and where the language of ‘caring’ and ‘compassion’ can be used to sound one way but mean something quite different.

The critique of the concept of choice embedded in Liz Carr’s show is a prime example. Disabled people have achieved a degree of choice, in employment and access, and with the Independent Living scheme, but it has been hard won and requires vigilant, constant defence in the face of cuts and social prejudice.

So when ‘soft exit’ people, argue in favour of choice, but add kindly that they would have safeguards to protect the old-and-disabled-and-vulnerable – it sounds simplistic and naive. As though unconsciously they believe in the Darwinian view, but are too dishonest to admit to it.

Take depression, for example. Many disabled people have a real and raw understanding of what it takes to sink or swim. In Liz Carr’s research in Oregon the fear of being perceived as a burden was rated more highly among those who chose assisted suicide than the fear of physical pain associated with illness.

Disabled people know that in some circumstances the offer of choice sits between a rock and a hard place. It is easy to imagine how a depressed person might accept a medical solution to what is essentially a social problem as there is no such medical condition as ‘being a burden’. Deconstructing the language of this debate has to be in everyone’s interests.

Liz Carr’s musical has also left me wondering what an alternative musical based on Parris’s Darwinian arguments would look like? It would certainly start in a minor key, the old and fragile and depressed and disabled would voluntarily shuffle off together into the sunset against a grim soundtrack – leaving the physically strong and energetic to run things. Wagner in the background. Leni Reivenstall-inspired sets? Or a romantic lush violin solo as the volunteers vote for sacrifice.

Certainly not much humour – no singing, or sharing, – no wisecracks about the essentially unsatisfactory nature of life, with or without disability. There aren’t any jokes in a Survival of the Fittest worldview.

Assisted Suicide, The Musical will feature at DaDaFest International 2016 from 17-18 November at the Unity Theatre, Liverpool. See the DAO listings for details.