“If God is dead, somebody is going to have to take his place. It will be megalomania or erotomania, the drive for power or the drive for pleasure, the clenched fist or the phallus, Hitler or Hugh Hefner.” –Malcolm Muggeridge (1903-1990)
A judge in the UK allowed a 50-year-old woman to die, as per her request, by refusing her doctor’s insistence that she undergo kidney dialysis. “Clare” (not her real name) wanted to die because she did not want to grow old and ugly.
Barbara Davies reports for Daily Mail, Dec. 4, 2015, that last year Clare was 49 years old and “in her prime” — an “effervescent blonde” who had been married 4 times, with 3 children and a new grandchild, although she did not look old enough to be a grandmother.
Clare seemingly had the perfect life: she owned a “cosy boutique hotel” in the south of England where “she loved to entertain guests with delicious home cooking and endless chat.” She reveled “in a bustling social life, which included polo matches and horse-racing,” and Mediterranean beach holidays with her husband where she showed off her girlish figure in colorful bikinis.
Then she was diagnosed with breast cancer in late 2014 and her life began unraveling. Clare refused to undergo chemotherapy, fearing that would affect her appearance. Instead, she underwent surgery in January (when she turned 50) and radiotherapy in March of this year, but refused to take other medication in case it made her fat. By the time summer arrived, the stress of her illness had caused her marriage to fall apart and her business to collapse.
In September, in a botched suicide attempt, Clare overdosed by taking 60 paracetamol tablets with a bottle of Veuve Clicquot champagne — not quite enough to kill her, but enough to seriously damage her liver and kidneys. She was admitted to King’s College Hospital in London for specialist care and initially agreed to undergo kidney dialysis to treat the overdose. Doctors reassured her that her prognosis was good.
But Clare eventually refused the dialysis. Insisting she was fully aware of the consequences, she said she wanted to die not because she had no hope of getting better, but because she didn’t want to “live in a council flat, be poor or be ugly”. (A “council flat” in the UK is low-income housing.) She told one of her doctors:
“I know that I could get better. I know that I could live without a health problem. But I don’t want it. I’ve lost my home. I’d lost everything I’d worked for. I’ve had a good innings. It’s what I have achieved. Everything is ifs and ands and pots and pans. My quality of life won’t be what I want.“
King’s College Hospital NHS Foundation Trust sent three psychiatrists to examine Clare to determine her mental fitness.
On November 5, 2015, one psychiatrist recorded a conversation with Clare, noting that: “C states that she remains adamant that she does not wish to continue with dialysis treatment… She states she knows she will die as a result of not having it. She believes herself to have the capacity to make this decision.” Another psychiatrist concluded that Clare was suffering from the “narcissistic personality disorder which constituted an impairment or disturbance in the functioning of her mind”. The third psychiatrist said that in his view she was suffering from “an underlying histrionic personality disorder”. All three doctors observed that Clare was frustrated that her recovery was taking so long and had become “petulant”.
So her doctors tried to force her to accept the dialysis that would save her life and restore her health, arguing that she was psychologically impaired to make rational decisions.
It became a court case.
The Royal Courts of Justice in London was told Clare had refused medical help and wanted to die, not because she had no hope of getting better, but because she didn’t want to “live in a council flat, be poor or be ugly”. At the heart of the evidence heard by Justice MacDonald was whether or not Clare had the “mental capacity” to refuse treatment.
In court, Clare was described as a shallow hedonist — a reckless spender, an excessive drinker, a “reluctant” and “completely indifferent mother” who led a life of “impulsive and self-centered decision-making without guilt or regret”. When she saw how her “life of fun and possessions” slipped from her grasp, the whole edifice quickly crumbled.
Her first husband, whom Clare married when she was in her 20s and with whom she had her first two children, said, “She wasn’t very good with money. I never had any money. She would spend money we hadn’t got. It was mainly things like trying to put the girls through private school. By the time we lived together it was a negative equity thing, where the mortgage rate was 15 per cent. I was getting paid £1,000 a month and the mortgage was £940. So I’ve got £60 — it was as tight as that. And she was off seeing private schools for the girls.”
When Clare’s second marriage failed, her daughters remained living with their stepfather (Clare’s second husband) while Clare moved on with her next lover. This likely led to the descriptions in court of her being an “indifferent” mother. Her first husband admits that Clare’s relationship with her daughters at that point broke down: “The girls didn’t like her and didn’t speak to her for years.”
Clare and her daughters eventually reconciled. A friend said, “She had a better relationship with her children in recent years.”
Justice MacDonald “reluctantly” ruled in Clare’s favor, maintaining that Clare had weighed up all the facts in her case and reached a “clear and reasoned decision” and that the decision to die was hers to make, citing John Stuart Mill’s 1859 treatise On Liberty: “Over his or her own body and mind, the individual is sovereign.” In so doing, MacDonald admitted that his judgment “will alarm and possibly horrify many”.
Strangely, Clare’s oldest daughter, a mother-of-one in her 20s, actually supported Clare’s refusal of the dialysis, effectively committing suicide. The daughter told the court:
“My mother would never have wanted to live at all costs. Put bluntly, her life has always revolved around her looks, men, material possessions and ‘living the high life’. She understands that other people have failed relationships, feel sad and continue living, but for her, as she has said, she doesn’t want to ‘live in a council flat, be poor or be ugly’, which she equates with being old.“
Clare had told her husband and daughters that she wanted to “go out with a bang” before old age would spoil things for her.