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There's menace behind the mercy of assisted suicide
Death destroys a man, but the idea of death saves him, as EM Forster wrote - the idea of physical immortality is appalling. I do not suppose he had the idea of being helped to kill yourself in mind, but I have always thought that the possibility of an easy escape into death must be, or at least would be, a great comfort to people facing extreme suffering.
It would make life tolerable, and tolerable for longer, in that sense of making life worthwhile. Unfortunately, it isn't a comforting thought available to most people in this country.
Unless you have doctors or friends brave enough to kill you discreetly, or you are skilful enough and well enough to kill yourself, you will be condemned to life without the option. In this country it is illegal for others to help you into death under any circumstances.
Put like that, it seems wrong. Most people, I imagine, felt sympathy last week for Reginald Crew, Britain's first suicide tourist, who had to travel to Switzerland to get help to put himself out of his misery. The accounts of his relief were very touching, as was the account of another man, aged 81, who had died contentedly some time before on the same bed.
One could only feel glad that Crew did not suffer for as long as the heroic Diane Pretty, who also had advanced motor neurone disease and who fought a long battle through the courts for the right to get help in killing herself. She lost, and met her death in frustration and fear and, in her own mind at least, without dignity.
Anyone who saw television interviews with Pretty and her family must have been deeply shocked by their suffering.
Motor neurone disease brings a particularly terrible, drawn-out living death, but there are plenty of others.
It seems entirely wrong that people cannot decide for themselves when to die, if life seems unbearable, simply because they can no longer hold a pill or swallow without help.
The irony was that Pretty was - if I understood correctly a television interview with one of her doctors - effectively killed by someone else anyway. Hospital staff gave her palliative drugs which gradually ended her life and more quickly than if she had been given nothing.
So because it happened in hospital and was only a side-effect of appropriate drugs, responsibly administered, and not done on purpose, so to speak, that was not a killing.
It was in fact a killing, I believe, and does great credit to the humanity of the doctors and nurses. Fortunately, this humanity is not uncommon in Britain's better hospitals. I have many friends and acquaintances who have told me with enormous gratitude that their fathers and mothers have died peacefully because of the compassion of the medical team.
Other stories I have heard take us into murkier waters. The mother, say, is in great pain, drifting in and out of consciousness and likely to die before long, though nobody can say how long. The doctor consults the family and tactfully tries to understand what the patient and they would prefer. Phrases such as "letting her go" are spoken. If the doctor trusts the family, he may indeed let her go, without putting her relations through the ordeal of asking him to kill her or knowing the moment.
This takes great courage and compassion. I imagine it is, strictly speaking, illegal. At any rate it is a deliberate killing, although one can argue all day about the intentions. But put like that, it doesn't seem wrong.
Sometimes it seems that as a society we are excessively cautious, perhaps even squeamish, about death. After all, as my eccentric (and irreligious) mother-in-law always used to say: "Death isn't the end of the world." Besides, there are, as the cliche puts it, many fates worse than death, and you can see them in nursing homes up and down the land.
Visiting a nursing home full of confused, sick and fearful old people makes one feel that oblivion would be infinitely better than this death in life. Because of the advances of modern medicine there are tens of thousands of people who survive for years, more or less demented, subsisting in meaningless anguish with ulcerated sores, useless limbs and uncontrolled bowels, just because death is not an option. Some people say, and mean, that they would rather die than go into such a place or would die once they get there. But legally they do not have the choice.
We do recognise that killing in some circumstances may be morally right, or at least not wrong. We also feel strongly that not to kill in some circumstances may even be morally wrong. The classic example is withholding antibiotics from distressed geriatric patients.
I know of a woman, a heroine of my childhood, who has lived in unspeakable misery with dementia and other serious chronic illnesses. Yet nursing staff insist on saving her life again and again by giving her antibiotics. That is wrong. And from here it's a short step to thinking that something ought to be done in law about such matters. The law ought to be modified, people feel, as it was with suicide; killing yourself has been legal for decades.
Yet, all the same, there was something very troubling in the demands last week for a legal right to assisted death.
I hate the language of human rights anyway; it is confused and confusing and it is used almost routinely to justify ever more state intrusion into our lives. And, philosophically, the idea of human rights seems to me to be full of holes. Who is to grant them? Who is to uphold them? What if they clash, as they frequently do? It seems much more useful to me to think of human wrongs; it is usually much simpler, too.
There is something much more universal about our understanding of wrong than of right. In any dilemma it is much easier to sense what you should not do; somehow our moral perceptions work better in the negative.
That's why, I think with reluctance, new legal rights in this area are bound to lead to new wrongs. Killing is usually wrong; one cannot make a law which tries to anticipate all those complex and various situations in which it might be right without letting in all kinds of cases in which it would still be wrong. That's what underlies the adage that hard cases make bad law.
Last week I couldn't help thinking of the story told to me by a friend whose mother helped someone else to die. The mother had nothing to gain. She acted out of compassion, as she understood it, but she ended up in prison. A middle-aged acquaintance who was determined to commit suicide had asked this mother to sit with her and keep her company until the pills worked. Convinced of this woman's determination, the mother agreed.
However, the pills did not work properly and, when the woman had been unconscious for many hours without dying, the mother suffocated her. She was perfectly open about what she had done but she was sent to jail.
This sad story makes the point. It is probably better that a few well-meaning people are punished for killings that may be right, than that many bad and perverted people are able to go free after killings that are wrong.
The Sunday Times | Sunday, January 26, 2003 | Comments (0)
People so alien that perhaps only ghettoes can hold them
Soundbites are so much better in Latin. A very well-known ancient Roman one came back to me last week as I looked at the front-page pictures of sad, ageing celebrities driven off by the police under suspicion of child porn offences: Homo sum; humani nil a me alienum puto - "I am a man and I think nothing human alien to me." Except paedophilia, I thought. Paedophilia is incomprehensibly alien.
I believe most of us can imagine committing most serious crimes; certainly I can easily imagine murdering, stealing and even torturing, at least if my children were threatened. I feel some understanding, too, along with revulsion, of men who drunkenly get carried away and assault women.
I don't feel those things are entirely alien to me, wrong though they are. But I simply cannot begin to understand why men - and it is almost always men - get pleasure from buggering babies and raping toddlers or letting animals abuse little children, or watching it done. That is beyond the pale of humanity.
The difficulty is that it is very important to understand paedophilia, alien though it is, in order to be able to deal with it. Yet my strong impression is that despite lots of research and statistics, nobody really does understand it, or what to do about it.
Experts and research disagree constantly. We are united only in a general hysteria, which leads to absurdities. Not long ago a paediatrician was menaced by an angry mob that did not understand the difference between paediatrician and paedophile. The newsreader Julia Somerville took entirely innocent bathtime family photographs to be developed, only to find herself in trouble with the police (though not for long, fortunately).
A newer hysteria is beginning to develop about what you may or may not see on the internet.
I don't mean visiting child porn sites, which is clearly very wrong; I mean innocently giving clues to the people who watch the internet that you might have paedophile inclinations, for example by using certain phrases. While trying to do some research about paedophilia I was genuinely slightly anxious about typing that word and others like it into my internet search engine, lest I stumbled on an illegal site or became of interest to the watchers. I am sure that all internet traffic is watched by Big Brother, for this and many other reasons.
What matters in all this, beyond hysteria and the feelings of the lynch mob, is to understand what paedophilia is and what can be done about it. Yet there seems to be little agreement among experts about either. For every theory put forward, there is another to the contrary.
Perhaps we can agree that there is a very great difference between types of child abuse. Most schoolchildren know there are a few teachers who are a bit funny, a bit too interested in them. Usually it goes no further. And as a distinguished editor of a famous daily paper once humorously suggested in an editorial, teaching can be so dreadful that only people with a slightly unnatural interest in children would take it on. We have all had a teacher like that; mine was one of the most inspiring people in my life and fostered, among other things, my interest in Latin quotations.
Two old friends of mine, who went to a well-known West Country prep school years ago, told me that one of the best and most interesting masters used to sit on their beds at night and fondle their genitals, briefly, under the sheets; both have told me it caused them no anguish whatsoever, either then or later. Of course it was very wrong, and that man would be in prison today. But his crime was a much lesser offence than those of hardened paedophiles who deliberately violate children, who enjoy it and who help other deviants to do or to watch these things for pleasure.
It seems to me that little is really understood about these alien beings - and there isn't much agreement either. Nobody seems to have a clear idea of why they are driven to do what they do. Some, possibly many, have personality disorders that are not treatable; some offenders cannot even be persuaded that what they have done is wrong; while others refuse treatment altogether and most are extremely devious and manipulative.
Most experts agree there is no "cure" because paedophilia is not a medical condition and the deviant desire is never going to go away. It can only be controlled - or not, as the case may be. Yet most experts have faith in treatment of some sort. Other experts rage against the "medicalisation" of the condition, oddly enough. But nobody seems to agree what causes it.
There seems to be little agreement and little clear evidence about whether any of this works and stops people assaulting yet more children. In one authoritative review of recent international literature on recidivism, which included material from Britain, it emerged from one study that up to 50% of child sex abusers reoffended, and from another that 61% of all child molesters reoffend. A BBC report on the closing of the only residential treatment centre for paedophiles in England quoted 90% as the general reoffending rate among them. It is actually quite difficult to get the figures for Britain, since sex offences are not broken down in Home Office reports.
If this weren't depressing enough, in some studies it has emerged that treated sex offenders actually reoffend more than the untreated; some therapies can make things worse. Treatment is abused by cunning offenders who learn the therapeutic lingo of remorse and exploit it to get back on the loose - hence a recent suggestion to use truth tests on offenders.
Then there is the fact (generally agreed on) that paedophiles reoffend over a much longer period than other groups. And there is the "dark figure" of sexual offences; many victims do not come forward, for obvious reasons, while interviews with convicted child molesters show that the great majority admit to offences that had never come to light. It is also clear from this survey that predicting the risk of reoffending is both difficult and contentious.
Given all this uncertainty, and given the horror of the crime, I wonder whether it is right to spend so much time and money on people whose chance of reform is so very doubtful.
In the end it hardly matters why these wretched people - and I mean the very worst offenders - are as they are. One day, perhaps, we will know what abnormalities of the brain are responsible for their terrible behaviour. One day there may be real treatment. Meanwhile there are many other and better candidates for help and encouragement, with a much better prognosis - starting with most other offenders.
I once watched an American documentary about a group of safe ghettoes for convicted paedophiles; they believed they could not change and knew they were likely to be lynched wherever their names came out. So they agreed to live in a locked community, out of harm's way. This is a harsh solution and it is putting them beyond the pale of civilisation - but I am not sure that it is inhumane.
The Sunday Times | Sunday, January 19, 2003 | Comments (0)
Phoney crime figures hide the success of prisons
Imagine a very large and important British public company announcing that its profits for the year ending September 2002 rose by more than 9%, that in the same period they rose by only 2% and furthermore that they fell by 7%; imagine they announced at the same time that the profits of a high-profile subsidiary had both gone up by 5% and (simultaneously) fallen by 7%.
Such an astonishing announcement would provoke public outrage. Yet the Home Office made just such announcement yesterday when it revealed new crime figures. Substitute Home Office for the "important public company", substitute crime for "profits" and domestic burglary for the "high-profile subsidiary" and the parallel is exact.
The British have an unhealthy relationship with statistics. We feel we ought to be confused by them. It's part of our way of life. But this is confusion worse confounded. Of course, there are all sorts of explanations for the Home Office figures; there are new, improved recording methods, new calculation methods, different adjustments and so on - all the props of a Dickensian Ministry of Obfuscation. But who is going to go into all those details and make carefully adjusted comparisons? How many of us are capable of it, given that we are rapidly becoming a nation of innumerates and that one in four of our maths teachers is unqualified?
Crimes with firearms up 35%? Crimes with handguns up 46%? Burglary up 5%? Robbery up 13%? Overall crime up 2%. Ah yes, well, but if-and-but. And so on. Who can say anything much with any confidence? With all these ifs and buts, who can point the accusing finger of an angry electorate? Confusion is a very useful public relations tool, especially for politicians in a tight corner or public servants with entrenched ideas.
My own struggle with statistics last week had to do not with crime in general but with crimes committed after punishment, known as recidivism. It seems to have become an article of public faith that prison doesn't work, which is handy for the government since the chancellor of the exchequer refuses to spend more money on building jails.
But it isn't true. Prison does work. Liberals recoil in horror if you say so, but all the Home Office statistics I have show that prison is just as effective as community penalties (as we now call them). The rate of reoffending within two years is pretty much the same for both, and by pretty much I mean an overall average in both cases of about 56%. That is from figures published by the Home Office in 1999, but earlier official figures consistently tell the same story.
What is even more striking is that prison is hugely more effective for first offenders or, more precisely, for people with first convictions (no doubt many are already very experienced offenders, since the vast majority of criminals in Britain don't get caught). According to Home Office prison statistics for 1999, 30% of first-timers sentenced to community penalties committed another crime within two years. The figure for first-timers sent to jail was a mere 18%. It seems that jail deters beginners much better.
This is absolutely the opposite of received wisdom. What's more, this startling figure excludes the very important point that people in jail cannot commit crimes. Those on probation or serving a community service order can and certainly do - like most criminals they just don't get caught.
Prison clearly does work, up to a point. At least it protects us better than community penalties. And prison could work better still if there were many more, less-crowded jails where illiterate and neglected people could get real help from the prison department. So it was jaw-droppingly infuriating to hear Lord Woolf, the lord chief justice, and Lord Irvine, the lord chancellor, and even David Blunkett mouthing the old misguided cliches and telling us grandly that we the public don't really want to send burglars to jail. Having been burgled three times and having accosted a drugged-up burglar in my own house, I certainly do. And I certainly do not want him to be let off to write appalling poetry.
However, repressing my intense dislike of Irvine, I asked his office on what evidence it was that the wallpaper wallah claimed on Radio 4 that "prison is not good at preventing people from reconvicting. The evidence is that community sentences are better at preventing people from reconvicting". I was told that his statement was based mainly on a new Home Office report on Public Service Agreement No10, which lists reconviction rates.
According to this document, there does indeed appear to be a very striking new difference in the results of prison and community penalties: for 1997, 1998 and 1999, the figures for community penalties were about 10 percentage points better than for prison (with reconviction rates of about 45% as against 55%, on average). Could it be, suddenly, since 1997, that community penalties have begun to work better? Better than prison? Unfortunately, the answer is no. Once again we, and Irvine it seems, have been bamboozled by statistics. The Home Office later confirmed what I supposed: that this analysis makes allowances for "breach convictions" and "pseudo reconviction", and without these adjustments the community penalty figure would be much closer to the prison figure of 55.3%. In other words, there is no difference between prison and community sentencing if you do the sums as before and compare like with like. Lord Irvine is simply wrong, as well as being insufferable.
What is needed urgently is some simple open talk about crime and punishment, without prejudice and without sentimentality. Rebuilding a better society would be nice, but meanwhile we have one of the worst crime rates in Europe.
Even without any new convicts, we still need far more new prisons to relieve overcrowding and to help all those unfortunate people who end up in jail and who don't really belong there - victims of the state's so-called care, those with inadequate parents, the lost, the illiterate, the mentally ill and those with intellectual disabilities. Something could really be done for these people, perhaps for the first time in their lives, in the order and discipline of a humane prison. Several excellent such schemes already exist in prisons.
Instead of such careful, daily guidance, what most offenders get is either vile jails or the chaos of so-called community penalties.
The Home Office itself reported in 1999 that one in two criminals were ignoring community sentence appointments without being punished, while one in five consistently failed to turn up - too busy committing crimes, perhaps. Last year it emerged that 30 out of 42 probation services were falling short of government targets to cut dropout rates. Electronic surveillance has had abysmal results.
Nothing sensible can be done if the highest in the land, and the liberal intelligentsia, insist on chanting platitudes and ignoring the facts, while our civil service makes it difficult to learn the facts. A public company run along such lines would not last until the next election.
The Sunday Times | Sunday, January 12, 2003 | Comments (0)
Flexitime for all can make a woman's career go snap
When half-naked, pregnant women crawled on all fours, in chains, pulling trucks of coal in Britain's mines in the 19th century, it seemed only right that the government should intervene to protect them. It did. When men and women worked 18 hours a day in dangerous factories, and tied their children to the bedstead while they were away to keep them from harm, it seemed right that the government should pass laws to protect them. It did.
People did not then simply live to work; they survived, barely, to work. Ruthless employers had to be restrained and gradually they were. But today the pendulum has swung too far the other way. It is right that we should now work to live, rather than the other way round, but the work-life balance (in the government's jargon) is weighted much too heavily against the employer. That will be bad for workers if their employers go out of business.
Last week Patricia Hewitt, the trade secretary, announced that millions of parents will be given the right in new legislation to demand flexible working hours. Employees with a child under six, or those with a disabled child under 18, will be able to ask to work different hours, part-time, or from home.
The employer will have to consider the request seriously - if it is turned down there will be a three-stage appeal system ending with an industrial tribunal as a last resort. In the same legislation, maternity leave will be increased from 18 to 26 weeks, with a woman's job being kept open for her for a year. Fathers will be entitled to two weeks' paternity pay and there will be other parent-friendly measures.
On one level much of this sounds reasonable. It is absolutely clear, and all the surveys show, that women (and men, too) prefer flexible working hours. They value this freedom more than extra pay and more than most other perks, such as a company car or membership of a gym. That is hardly surprising: we all have other responsibilities apart from our paid work.
There are not only children under six to consider; there are also older children, who often need even more attention, and elderly parents, or mentally ill adult children, and then there is the usual round of collecting the dry cleaning, visiting the dentist or waiting in for the plumber, all during normal working hours, not to mention everything that really matters in life.
Of course we would all prefer to work flexitime, and many of us do. According to Ruth Lea, of the Institute of Directors, Britain already has one of the most flexible workforces in the world, although we rarely get the credit for it. There can be great benefits for employers as well as for employees. Where flexitime does not present problems for employers, it can make for happier and more productive employees. The extra cost of the complications involved can often appear to be worth paying.
A report appeared last week, for example, of a small label factory near Chesterfield, which has 35 employees. It also has 35 different shifts, which have been designed around each individual worker. The managing director has instituted a scheme whereby employees' preferences, such as going to the gym or coming in late, are all accommodated. Over the past five years, and since workers have been able to design their own contracts, the factory's productivity has doubled. This is all very heart-warming; it feels like the moment in a Dickens story when philanthropy miraculously prevails. And surely work can often be that flexible.
People are prepared to pull together when they feel the advantage; job sharing can work well when people are highly motivated, although it is obviously more expensive for the employer. Self-employed and part-time workers can often work flexibly, too, although they may pay the penalities of insecurity and lower wages. However, the problem - which the government ignores - is that not all jobs can function like that.
In all the arguments about employment there are some important and awkward distinctions that are hardly ever made. The unpleasant truth is that there are jobs, on the one hand, and there are services and careers on the other. Perhaps this sounds a little brutal, but such is life.
In jobs, people are relatively interchangeable: one good person on the checkout till is much like another and more or less anyone can do it. One good dustman or bus driver or firefighter or squaddie or assembly line worker is much like another. But in both services and careers, people are much less interchangeable: it is often the personality, or the talent, or simply the continuous presence of the individual that matters. Another person, filling in flexibly, is not nearly as good. Clients and consumers don't like it and might be tempted to take their custom elsewhere. That alone puts the employer at a serious commercial disadvantage.
Imagine that you want to speak urgently to someone in a housing trust about a problem with a homeless client. You cannot get through to the senior manager who knows all about the case and has met the person, because she works at odd times which you yourself aren't aware of. Imagine that you need to see your consultant psychiatrist because your new pills are driving you crazy, but you find that he won't be available until after the weekend and his stand-in is someone you don't know or trust.
Imagine you call your chosen community midwife because you are about to give birth, only to be told she is at a parents' evening. Imagine your important advertising campaign is about to be undermined by a big news story, but the creative director is off every Wednesday. Imagine you call your personal style guru for urgent advice, only to find she is having a naked detoxing shower with someone else.
What if you need a Dimbleby-type figure to announce a national tragedy, only to find they are doing Christmas flexi-shopping off-message? Imagine you want to declare war, but the minister of defence is out discovering his inner child.
All businesses would lose, but smaller businesses are the most vulnerable, obviously. Yet small businesses will not be exempt from the new legislation. And that is before you consider the treacly swamp of existing employment legislation in which employers are trying desperately to keep afloat. Even the trade and industry department doesn't always seem to understand it when desperate employers telephone its hotline for advice.
It is simply wishful thinking on the part of government to imagine that the work-life balance can be adjusted by ever more legislation so that everyone is happy. It cannot. There are some problems that are insoluble and one is the conflict between a career and children. Something has to give.
The irony is that by rushing in to interfere with these imponderable problems, the government will probably achieve precisely the opposite of what it intends. Prudent employers will avoid hiring career women in their reproductive years.
In 1998 45% of employer members of the Institute of Directors said they would find such women less attractive to employ; by 2001 the number had gone up to 67%. Hardly surprising. Instead, the illegal and the infertile will begin to appeal. This may be good news for the black and grey economy, but it will not do much for women or for families.
The Sunday Times | Sunday, January 05, 2003 | Comments (0)
