Dealing with death at Christmas

On the darkest December day, a grim anniversary is recalled.

Jean Kabasomi

Jean Kabasomi works in financial services in London. She also writes and broadcasts.

A moody sky overshadows a shingle beach on which a lone empty deckchair stands. A pier with funfair is in the middle distance.

Brighton Pier.

Nick Fewings, via Unsplash.

Thursday 17th December 2020 - a day I won’t forget.

Christmas 2020 was already proving to be a little strange. The UK was in this weird place of tiered restrictions, a sort of semi-lockdown approach. In London and the southeast, we had a bit more flexibility than folks in the north of the country, but people were not really out and about. Most people were saving their interactions for Christmas Day, so the streets were mostly quiet.

Like virtually everyone working in the financial services, I was working from home. The night before, my older brother had left the house after an argument and not come home. My younger brother and sister were concerned about his whereabouts. His phone kept going to voicemail. They were worried. There wasn’t much to do or anyone to see because everyone was regulating their behaviour and saving themselves for Christmas. I, on the other hand, was more nonchalant about his ‘disappearance’. My view was that he was an adult and had a habit of doing ‘immature things’ to get our attention. I thought, ‘He would come back home when he needed to.’ Little did I know how wrong I would be.

At about 4:50pm, as I was winding up and about to log off at work, I saw a police car in our street. My room is on the second floor of our house and my desk is positioned so that I can look directly out of the window onto the street in front of our house. The police car stopped in front of our house. The officers got out and opened our gate. I remember I went downstairs and said, ‘The police are here.’, just before the doorbell rang. I was slightly annoyed, I remember thinking, ‘What silly thing has my brother done now?’

My Mum invited them in. But they wouldn’t speak to her. They were looking for my sister. This seemed really weird at the time. Mum kept asking them what they wanted. But they wouldn’t reply. They just kept saying that they needed to speak to my sister. They wouldn’t speak to my sister in front of all the family, so they led my sister outside into the garden. It was dark outside. We couldn’t hear what they were saying because the back door was shut but we could see my sister’s reaction. She was deeply distressed. My Mum was beginning to get upset too, because she could see my sister through the window. They came back into the house. The police remained silent. It was just strange. My sister kept saying that we all needed to sit down in the living room. Mum kept asking the police what was going on but they remained silent. My younger brother and I were also frustrated and wanted to know. ‘Just tell us what is happening’, I remember saying. But my sister kept saying that we needed to sit down and go to the living room.

We finally all sat down and then one of the officers began to speak. I don’t remember his exact words but it was something to the effect of ‘A body was found this morning at Brighton Pier. From the belongings found on the body, we have identified that it is the body of your brother.’

At this point, I don’t think any of us really understood what he was saying. Someone must have asked, ‘Does that mean he is dead? Are you saying he is dead?’ ‘Yes.’, was the response. ‘How did he die?’, was the next question. Again, more weirdness. It seemed that they didn’t really want to use the word suicide, but that’s what it was. We kept asking for more details. What time? How did it happen? Was there anyone with him? But nothing was forthcoming. It all felt like a cover-up. And then it was over. They left and it was just us left to process it. It all seemed so surreal.

That evening is all a bit of a blur. I am quite a practical person - I knew I was leading a bible study meeting that evening. So, I messaged, the pastor in charge to say I wouldn’t be able to lead it that night. After that, the next feeling, I remember is annoyance towards my brother. I felt it was selfish on so many different levels. Why did he have to do this? How does it solve anything? Why is he always looking for attention? Why would anyone do something like this just before Christmas? I remember feeling he had destroyed Christmas for us forever. Why didn’t he just say something to us? We had just started playing tennis on weekday mornings before I logged into work, why didn’t he mention he was upset then? My younger brother and sister were deeply disturbed and didn’t know what to say or do. Both were blaming themselves. Mum was totally shocked. I kept thinking and saying that he didn’t mean to do it. It was just a mistake that he couldn’t undo. If we weren’t in this quasi-lockdown situation, maybe someone would have noticed him in the water sooner and he would have been rescued? Maybe someone would have been walking along the Pier that night, seen him in the water, jumped in and pulled him out? We didn’t need a hero, maybe someone would have seen him in the water and just called 999? Maybe someone would have noticed him pacing up and down, and tried to speak to him before he went over the edge?

The run-up to Christmas that year was extremely difficult. The government announced a full lockdown again and my family had to travel to the morgue in Brighton to formally identify my brother. I chose not to go with them, I felt at the time, that I wasn’t ready to see my brother’s body. We also had a tree in our garden whose roots had ruptured the sewer pipe, causing our bathroom to flood. It was all one big mess.

I am in charge of the Christmas shopping operation in our house. Christmas is my favourite time of the year. I love the carols, the weather, the darkness, the cosiness, the services at church, the Christmas TV schedule, the food and the opportunity to rest, pause and reflect. I love everything about Christmas. But now it felt weird celebrating Christmas. The delivery came. On Christmas day, I cooked, my sister baked. But it was all just so sad. We sat in silence through a lot of it just eating. Sometimes we spoke about the days leading up to my brother’s death. At different points throughout the day, one or all of us would be struggling to hold back our tears or silently sob. That period was one of the most difficult periods of my life.

I do not have to be in a state of constant mourning throughout the Christmas period. Neither do I need to pretend or ignore that I haven’t experienced death at Christmas.

Three years later, Christmas is still my favourite time of the year. Why? Despite everything, I still believe in the hope that came into the world at Christmas through Jesus Christ. It is that hope that helped me pull through that time. I held on to the comforting words I found in the Bible. I found people who supported me and worked through my grief on the Bereavement Journey. On this course, I discovered that it was okay to be angry, guilty, disappointed and sad about death. It was all part of the process. It was okay to grieve differently from my siblings and my Mum. I didn’t have to force them to feel like me, nor make myself feel like they did. As we began to piece together my brother’s final days, I slowly understood that he had his own mental struggles and sadly was unable to find the help he needed.

I learnt that grief involves the whole person – the body, soul and mind. I understood why I sometimes felt exhausted and at other times I was wide awake. It all made sense when I suddenly felt sad on my way home from my first time at Wimbledon. The body has a weird way of remembering things even when you think you are okay mentally, so I wasn’t surprised when I got a severe migraine exactly three years to the day that my brother didn’t come home. My faith does not mean that I understand everything about my experience neither does it mean that I can’t lament, question or be unhappy about the way things unfolded.

For me, Christmas is still a time to celebrate the birth of Jesus Christ, the birth of Hope. But it is also a time of solemnity, even of grief. As the years go by, this will get easier but probably won’t go away. The two feelings are not mutually exclusive. I do not have to be in a state of constant mourning throughout the Christmas period. Neither do I need to pretend or ignore that I haven’t experienced death at Christmas. Rather, the most honest thing I can do is to acknowledge both feelings and take each day as it comes.

Article

Assisted dying

Comment

Justice

15 October 2024

5 min read

Will clinicians and carers objecting to assisted death be treated as nuisances?

The risk and mental cost of forcing someone to act against their conscience.

Henna Cundill

Henna is a researcher with the Centre for Autism and Theology at the University of Aberdeen.

A tired-looking doctor sits at a desk dealing with paperwork.

Francisco Venâncio on Unsplash.

After a formal introduction to the House of Commons next Wednesday, MP’s will debate a draft Bill to change UK legislation on Assisted Dying. Previously, a draft Bill was introduced in the Scottish Parliament in March 2024, and is currently at committee stage. Meanwhile, in the House of Lords, a Private Member’s Bill was introduced by Lord Falconer in July and currently awaits its second reading. These draft Bills, though likely to be dropped and superseded by the Commons Bill in the fullness of time, give an early indication of what provision might be made on behalf of clinicians and other healthcare workers who wish to recuse themselves from carrying out a patient’s end of life wishes on grounds of Conscientious Objection.

There are various reasons why someone might want to conscientiously object. The most commonly cited are faith or religious commitments. This is not to say that all people of faith are against a change in the law – there are some high-profile religious advocates for the legalisation of Assisted Dying, including both Rabbi Dr Jonathan Romain and Lord Carey, the former Archbishop of Canterbury. Even so, there will be many adherents to various faith traditions who find themselves unable to take part in hastening the end of someone’s life because they feel it conflicts with their views on God and what it means to be human.

However, there are also Conscientious Objectors who are not religious, or not formally so. Some people, perhaps many, simply feel unsure of the rights and wrongs of the matter. The coming debates will no doubt feature discussion of how changing the law for those who are terminally ill in the Netherlands and Canada has to lead to subsequent changes in the law to include those who are not terminally, but instead chronically ill. The widening of the eligibility criteria has reached a point where, in the Netherlands, one in every 20 people now ends their life by euthanasia. This troubling statistic includes many who are neurodivergent, who suffer from depression or are disabled. It is reasonable that, even if a Conscientious Objector does not adhere to a particular religion, they can be allowed to object if they feel uneasy about the social message that Assisted Dying seems to send to vulnerable people.

“You will often find that legislation that provides a right to conscientious objection is interpreted by judges these days in a way that seems to treat conscientious objectors as nuisances”

Mehmet Ciftci

Conscientious Objection clauses can themselves send a social message. A response to the Scottish Bill produced by the Law Society of Scotland notes concern over the wording of the Conscientious Objection clause, as it appears to be more prescriptive in the draft Bill than in previous Acts such as the Abortion Act of 1967. In the case of any legal proceedings that arise from a clinician’s refusal to cooperate, the current wording places the burden of proof onto the Conscientious Objector, stating (at 18.2):

In any legal proceedings the burden of proof of conscientious objection is to rest on the person claiming to rely on it.

The Bill provides no indication of what is admissible as ‘proof’. Evidence of membership of a Church, Synagogue, Mosque or similar might be the obvious starting point. But where does that leave those described above, who object on grounds of personal conscience alone? How does one meaningfully evidence an inner sense of unease?

The wording of the Private Member’s Bill, currently awaiting its second reading in the House of Lords, provides even less clarity, stating only (at 5.0):

A person is not under any duty (whether by contract or arising from any statutory or other legal requirement) to participate in anything authorised by this Act to which that person has a conscientious objection.

Whilst this indicates that there is no duty to participate in assisting someone to end their life, there remains a wider duty of care that healthcare professionals cannot ignore. Thus, a general feature in the interpretation of such conscience clauses in medicine is that that the conscientious objector is under an obligation to refer the case to a professional who does not share the same objection. This can be seen in practice looking at abortion law, where ideas around conscientious objection are more developed and have been tried in the courts. In the case of an abortion, a clinician can refuse to take part in the procedure, but they must still find an alternative clinician who is willing to perform their role, and they must still carry out ancillary care and related administrative tasks.

Placing such obligations onto clinicians could be seen as diminishing rather than respecting their objection. Dr Mehmet Ciftci, a Researcher at the McDonald Centre for Theology, Ethics and Public Life at the University of Oxford comments:

You will often find that legislation that provides a right to conscientious objection is interpreted by judges these days in a way that seems to treat conscientious objectors as nuisances who are just preventing the efficient delivery of services. They are forced to refer patients on to those who will perform whatever procedure they are objecting to, which involves a certain cooperation or facilitation with the act.

This touches everyone, even those who (if the Bill becomes law) will still choose to conscientiously object. Therefore, it is important to consider that the human conscience is a very real phenomenon, which means that facilitating an act that feels morally wrong can give rise to feelings of guilt or shame, even if one has not been a direct participant.

Psychologists observe that when feelings of guilt are not addressed, if they are treated dismissively or internalised, this can significantly erode self-confidence and increase the likelihood of depressive symptoms. But even before modern psychology could speak to the effects of guilt, biblical writers already had much to say on the painful consequences of living with a troubled conscience. In the Psalms, more than one ancient poet pours out their heart to God, saying that living with guilt has caused their bones to feel weak, or their heart to feel heavy, or their world to feel desolate and lonely.

If the Conscientious Objection clauses of the new Bill being proposed on Wednesday are not significantly more robust than those in the draft Bills proposed thus far, then perhaps that is something to which we should all conscientiously object? There is much to discuss about the potential rights and wrongs of legalising Assisted Dying, but there is much to discuss about the rights and wrongs of forcing people to act against their consciences too.