Article
Assisted dying
Death & life
4 min read

Behind the data: the social messages physician assisted suicide sends to the autistic

If intense suffering caused by society drives autistic people to seek assisted death, then society has failed.
A hand rest gently on another outstretched hand.
Alexander Grey on Unsplash.

Statistically speaking, autistic people are far more likely to die by suicide than non-autistic people. They are also, statistically speaking, far more likely to die by physician assisted suicide than non-autistic people, in countries where this is allowed.  

For example, in a study of 927 people who sought physician assisted suicide in the Netherlands (where this is legal) 39 of them were autistic. That’s about four per cent, but the prevalence of diagnosed autism in the Netherlands is only one to two per cent. The researchers go on to note that 21 per cent of these 39 people cite autism or intellectual disability as the “sole cause of suffering” that had prompted them to request assistance to die.  

I don’t like speaking statistically. For a start, 21 per cent of 39 people is 8.19 people, which raises obvious questions. A little digging reveals that what the researchers mean really is eight people. Eight people with eight unique stories that include an account of autistic suffering so intense that they asked for help to end their lives.  

But we do not have those stories, not really. Included in the report are carefully anonymised excerpts from the physicians’ notes, and this is the nearest that we can get.  

‘The patient suffered from his inability to participate in society [ … ] [He] was not able to live among people, because he was easily overstimulated. This made him isolated’ (2019 (22), male, 70s, ASD) 

‘The patient had felt unhappy since childhood and was persistently bullied because he was just a bit different from others [ … ] [He] longed for social contacts but was unable to connect with others. This reinforced his sense of loneliness. The consequences of his autism were unbearable for him [ … ] The prospect of having to live on in this way for years was an abomination to him and he could not bear it’ (2021 (26), male, 20s, ASD) 

The debate about legalising physician assisted suicide in the UK is ongoing, and the British Medical Association have provided a helpful guidance document which sets out the main arguments, both for and against, without making a recommendation either way. In the document, they observe that the reasons people ask for assisted suicide are predominantly personal and social, not clinical, and also that “laws send social messages.” I agree that laws do that, and I also think that those seeking assisted suicide send social messages too.  

For example, even just from these two tiny excerpts, I hear that a life worth living is one where people can participate in society and have social contacts, even if they are a “just a bit different from others.” It would be good to hear more. It would be good to sit down over a cup of coffee with each of these two men and ask them all my questions about their lived wisdom when it comes to autism.  

I could ask “2019 (22), male, 70s, ASD”: 

What causes the overstimulation - are there places where you don’t feel that?  

Can we create more such places for autistic people to socialise?  

And I could ask “2021 (26), male, 20s, ASD”:  

What makes you feel different?  

What kind of social contacts and connections do you think that you are looking for?  

But of course, I can’t do that, because these two men have been assisted to die.   

The word ‘welcome’ is striking to me here. What does it mean to welcome someone, not to merely include or tolerate, but to really welcome someone. 

When approached for comment, autistic theologian Claire Williams said:  

‘There is something of a personal and social tragedy reflected in these cases. If we understand that much of the difficulty that autistic people suffer is caused by society – as per the neurodiversity paradigm – then it is the case that these two nameless men were failed by society. They felt that their lives could not find a place in an unwelcoming world. It is, of course, their choice to end their lives but I do also think that God chose to start their lives and finds them to be infinitely valuable. They were both made in God’s image and reflect something of it. That they felt there isn’t a place for them that is suitable is a tragedy because society should do better to welcome them.’ 

The word ‘welcome’ is striking to me here. What does it mean to welcome someone, not to merely include or tolerate, but to really welcome someone, even if they seem ‘a little bit different from others’? Dr Léon van Ommen, another theologian who writes about autism, suggests that it is a matter of making oneself and one’s resources fully available to that person, to the point where they feel that you belong to them. This is not to promote relationships with unhealthy power dynamics, but to highlight that when a person feels truly welcomed by another, they feel the opposite of owing a debt or being a burden – they feel they are of value, that you would be lacking something without them.  

I feel we are lacking something without you, “2019 (22), male, 70s, ASD”. And I feel we are lacking something without you, “2021 (26), male, 20s, ASD”. Not to forget the 37 others who are a little like you. We can pause to reflect on the social messages that you have sent, what you are teaching all of us about what it means to live a “good” life. But I am sorry that you have all died now and we cannot hear more.   

Whether people in the UK should be able to choose physician assisted suicide, I, personally, am not yet sure. Like the BMA, I see and respect the very good arguments both for and against. But eight people have chosen physician assisted suicide due to autism or intellectual disability, and when it comes to the social messages that sends, I feel compelled to sit down and listen.  

Review
Culture
Death & life
Film & TV
Trauma
5 min read

Bridget Jones: a brilliant mess of a movie

A fresh expression of lost, stolen, love.
A couple sit on outdoor seats, her resting her head on his shoulder.
Working Title Films.

I cannot overstate how low my expectations were going into this film. I love the first Bridget Jones, a classic of the (specifically British) romcom genre. The two sequels were tedious retreads, and the idea of number four in the series elicited the opposite of delight. I went to see Bridget Jones: Mad About the Boy out of parochial duty – many of the film’s beautiful exterior shots were filmed in my parish, at the church school and the surrounding streets. I wanted to ‘represent the parish’ and show some local pride. I wasn’t alone; I saw many faces I recognised from the school gates, and I ended up sitting next to a parishioner. Thank goodness cinemas are dark!  

You’ll understand by the end of the review. 

The film opens on Bridget, rather disorganised and dishevelled in just the manner we’ve grown to love, getting ready for a night out while also preparing dinner for her children. She and Mark Darcy now have two children, and the house looks like a cyclone has passed through. She calls Daniel Cleaver, who engages in some raunchy chat, and then insists he’s on his way. Oh no! Have she and Darcy divorced? Has that bounder and cad Cleaver wormed his way back in?  

Cleaver arrives at her home…to babysit!?  

Bridget hurries off to her dinner, and as she approaches her host’s front door she smiles. Darcy is walking towards her from the other end of the street. They meet at the door and lovingly complement each other’s appearance. They ring the bell. The door opens. Bridget in standing there. Alone. 

Bridget is a widow and a single mother. Her children are adorable, but hard work. She hasn’t worked properly since Mark died. She is both overwhelmed and yet also numb. She has no life or purpose outside of the chaos of her home. Her friends – especially her gynaecologist – encourage her to re-invent and re-emerge. Go back to work, go back to socialising, go back to dating. 

This is the first five/ten minutes of the film and sets the scene.  

To begin with the positive. The script is very funny. The direction is competent and even throws in a few unexpected and moving tableaux. The cast are on fire! Renée Zellweger could sleepwalk this role, scrunching her eyes in that endearing way on command. Leo Woodall is smouldering and hunky as the young lover, and Chiwetel Ejiofor is pure charisma and chemistry as the new science teacher Mr. Wallaker. Emma Thompson chews the scenery and delivers the best jokes as Bridget’s gynaecologist. The standout is Hugh Grant, who has immeasurable fun turning the roguish lothario Cleaver into the wittiest silver-fox we’ve seen on screen for many a year. He is at the peak of his career, and it is a joy to watch. 

But… 

None of it really hangs together. There is no real plot; there are little comedy sketches and episodes that jump from one to the other – never entirely unrelated, but never entirely coherent. 

This is a film of many subplots. The subplot of Bridget and the mums at the school gate. The subplot of Bridget getting back to work. The subplot of Bridget smoothing the rough edges off Mr Wallaker (who uses a whistle like a weapon). The subplot of Daniel, of her friends from the first film, of her parents, and so on and so on.  

There is the subplot of Bridget developing a new, modern, Tinder romance with a hunky Hampstead Heath ‘ranger’ (the ‘boy’ of the title). It could be argued this is the main subplot: Bridget finding new confidence and a new lease of life via a summer romance with a handsome younger stranger. It is also the most forgettable. It’s shallow, and is really only an excuse to make updated references to the original film. 

The film is a mess. 

And yet… 

I cried. I cried more than once, and proper tears. Thank goodness cinemas are dark, because no priest wants their parishioners to see them blubbing, especially while watching a Bridget Jones sequel! This mess of a film has a single strand that runs through it, gives shape to its episodic nature, and turns it from an ‘okay’ film into a brilliant film.  

Grief. 

Bridget is grieving Darcy. Her children are grieving their father. Cleaver is grieving the life he could have had – so committed to debauchery was he, that he has no one permanent in his life (except Bridget) and he hasn’t spoken to his son for nearly two decades. She and her friends are grieving the passing of the years, and the reality that they are 25 years older. Through the raunch, and crude jokes, and slapstick set-pieces, this film surprised me by being a slow-burn meditation on grief. I won’t say too much more about the film because – and I can’t believe I’m saying this about a Bridget Jones film – this film really does need to be experienced fresh.  

This is a welcome supplement and corrective to the Valentine season: an exploration of love that is lost or stolen away, and is sorely missed. It is a life-affirming bit of cinema, that takes you through the stages of grief (there is even a scene where her friends debate just how many stages there are) and the various methods we have for dealing with them. It even includes a clumsy little science/faith debate, and yet manages to conclude by encompassing all views. 

The film has a truly pastoral message. Grief cannot be avoided. Grief is a sign that love was real, and also that love cannot be snuffed out…even by death. Bridget intermittently has visions of Mark, and by the end of the film she has managed to make peace with those visions. They won’t leave her – her love for Mark won’t leave her – even as she experiences new love. Bridget ends the film recognising that her grief won’t leave her…and she can still live the fullest and happiest life possible. 

Go see it. It’s good to have a cry sometimes. 

4.5 stars 

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