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J Med Ethics. 2007 November; 33(11): 639–642.
PMCID: PMC2598103

Ordering suicide: media reporting of family assisted suicide in Britain

Abstract

Objective

To explore the relationship between the presentation of suffering and support for euthanasia in the British news media.

Method

Data was retrieved by searching the British newspaper database LexisNexis from 1996 to 2000. Twenty‐nine articles covering three cases of family assisted suicide (FAS) were found. Presentations of suffering were analysed employing Heidegger's distinction between technological ordering and poetic revealing.

Findings

With few exceptions, the press constructed the complex terrain of FAS as an orderly or orderable performance. This was enabled by containing the contradictions of FAS through a number of journalistic strategies: treating degenerative dying as an aberrant condition, smoothing over botched attempts, locating the object of ethical evaluation in persons, not contexts, abbreviating the decision making process, constructing community consensus and marginalising opposing views.

Conclusion

The findings of this study support the view that news reporting of FAS is not neutral or inconsequential. In particular, those reports presenting FAS as an orderly, rational performance were biased in favor of technical solutions by way of the legalisation of euthanasia and/or the involvement of medical professionals. In contrast, while news reports sensitive to contradiction did not necessarily oppose euthanasia, they were less inclined to overtly support technical solutions, recognising the importance of a trial to address the complexity of FAS.

Keywords: assisted suicide, suffering, bioethical issues, media, UK

The news media play a crucial role in the emergence and development of public debates.1 The media's impact on public debates is especially salient around issues such as euthanasia and assisted suicide, with which the public has little or no direct experience.2,3 Studies of news reports have found a consistent bias in favour of euthanasia,4,5,6,7,8,9 a pattern of concern to those troubled by the possible ethical and social consequences of “mercy” killing.2

Some scholars suggest that this bias follows from journalists' liberal inclinations, which favour individual autonomy and shun governments' infringement on personal liberties.6 Others suggest it may be due to journalists' preference for personalised narratives that tend to exclude the abstract social and ethical concerns upon which opposition to euthanasia is frequently based.5 Media support for euthanasia may also be due to synergies between euthanasia as an act of self‐determination and the ideal of the entrepreneurial individual central to prevailing neo‐liberal rationalities.9

This study explores the media's support for euthanasia in relation to the construction of suffering in the press. The analysis offered is guided by Heidegger's writing on technology.10 Heidegger understood technology to be not merely humanly produced artefacts but an orientation—a way of revealing the world such that it appears “orderly” or orderable. Such orderly presentations, Heidegger argued, opened the world to instrumental responses. In contrast to orderly modes of revealing, Heidegger juxtaposed “poetic” revealing, which presents the world in its complexity and chaos. Poetic revealing discourages instrumental action in favour of more contemplative responses.

Heidegger's work suggests that the presentation of suffering as either orderly or poetic may have profound consequences for what is done about it.11 In particular, we would expect that orderly presentations of suffering would open up a terrain for technical interventions—such as the administration of a fatal overdose—as a rational and ethical response to end‐of‐life suffering. In contrast, revealing suffering poetically might favour non‐technological interventions such as contemplation, dialogue or artistic responses. A poetic revealing would certainly be expected to trouble any assumption that there could be a straightforward technical fix to terminal suffering.

This study examines the reporting of three highly publicised cases of assisted suicide in Britain and pays particular attention to the media's construction of suffering. Findings are discussed in terms of the avenues for action around end‐of‐life suffering that are opened up or foreclosed by media presentations.

Methods

This study focuses on a particular class of assisted suicide, family assisted suicide. The decision to focus on family assisted suicide (FAS) emanated from the assumption that the convergence of close family ties with the killing of a first degree relative intensified emotional distress and the blurring of moral boundaries. As such, FAS would serve as an intriguing site to explore how the media might handle such sensitive tensions, and to what extent they would be constructed as “orderable” or, on the other hand, acknowledged “poetically”—that is, beyond concerns for resolution.

The articles selected all centered on court cases in which a family member had been charged with assisting a terminally ill, first degree relative to put an end to his or her life. Data was retrieved by searching the British newspaper database LexisNexis from 1996 to 2000. According to our search, the three most reported cases were those of Peter Pitman, who aided his mother, Janet Pitman, to kill herself; Paul Brady, who assisted the suicide of his brother, Jim Brady; and Gillian Jennison, who helped her mother, Annie Wilks, to commit suicide. Twenty‐nine articles were retrieved: eight concerning Peter Pitman, nine concerning Paul Brady and 12 concerning Gillian Jennison. These press reports were from the news section of reputable papers (eg, The Times, Guardian).

Data was analysed by attending to the textual devices used to construct end‐of‐life suffering. We paid particular attention to whether suffering was represented, following Heidegger, as orderly or was acknowledged poetically. We further inquired into the textual devices that were used to produce such orderly or poetic presentations. While not exhaustive, the main textual devices that we attended to in our analysis included the selection of sources, themes, key points and metaphors; the use of labels, images, stereotypes, analogies and anecdotes; and the amount of space allotted to various perspectives, as well as their position in the article.

Findings

The reports appeared extremely homogeneous. Journalists constituted the complex terrain of FAS as an orderly, rational performance whose unresolved horrors could be further managed through technical means, primarily through the involvement of medical professionals or changes to the legal status of euthanasia. In what follows, we illustrate the ways an orderable world was construed through the consistent emphasis of several motifs. We also consider the exceptions.

Degenerative dying as aberrant

Though the reports dealt with issues of disease and death, they took the autonomous, healthy individual as the norm. This image was projected onto the deceased persons, who were portrayed as passionate and strong‐willed. Jim Brady was described as an engineer, who “fought like a demon against the illness”;12 Janet Pitman was a “a strong‐minded, determined woman”;13 and Annie Wilks was a “decent,” “dignified,” “strong,” “self‐reliant” and “vibrant” career woman.18 Juxtaposed against such images, debilitating dying revealed itself as an aberration, a violation of one's dignity, reducing mature individuals to a dependent, infant‐like state. Jim Brady

… could do nothing for himself. His family dressed his skeletal frame, took him to the lavatory, minced his food and held his baby beaker to his lips. His body racked by violent spasms, Huntington's disease had left him with little more than breath itself.14

We regard the stark contrast between the autonomous person and the dependent, dying individual as a product of selection, suggesting drastic transformation rather than gradual degeneration from one state to the other. This dichotomous imagery (mind/body, health/disease, autonomy/dependence) occasioned suffering as an exceptional state rather than part of the human condition. From such a perspective, suicide occurred as a means of ordering—bringing physical death in line with personal and social death.

Contracting the decision to assist

The decision to help a family member die, undoubtedly a challenging and emotionally laden process, was presented in the press in highly contracted form. Three words described the decision to accede to Jim's request: “Paul gave in.”14 Similarly, describing his decision to kill his mother, Peter explained: “I just had to do it.”15 While readers were told about Brady's sister's refusal to kill her brother, little was said except to note she lacked “the nerve”.16

Difficult decisions might be expected to leave individuals torn. In these cases, the media reported no second thoughts or any form of regret: “I [Jennison] don't regret what I have done. I'd never have forgiven myself for letting her be in this living death”17; and “the family's only regret is that they let Jim suffer for so long.”14 “Peter [Pitman] was eventually convicted of aiding and abetting a suicide. He received a nine‐month jail sentence suspended for 2 years. But he has no regrets.”15

Though the cases most likely affected a broader network of relatives, there was no suggestion of family dissent or even discussion. The family dynamic was framed as consensual and caring. The moment of death thus appeared as the culmination of harmonious family togetherness:

In each other's arms they lay, the loving daughter and her suicidal mother, talking about old times. Annie swallowed her pills—two at a time—sipped her sherry and slipped slowly into the big sleep.18

The sense of consensus was further affirmed through consistent reports of the public's unequivocal support. The following sentence was typical: “…family members and villagers had supported Pitman throughout his time on remand.”19 While euthanasia and assisted suicide are hotly contested in Britain,20 opposing voices were absent or marginalised. When present, they consisted of little more than a single sentence, placed at the conclusion of the report. Given the supportive tenor of the news reports, they seemed incongruous:

The Voluntary Euthanasia Society last night welcomed the decision and called for the law to be changed. But a spokesman for the Roman Catholic Church in Scotland voiced concern at the case.12

Particularisation

The dilemmas associated with killing were further allayed by locating them within the individual. Rather than situating ethical relations more broadly between individuals and society, journalists remained within the confines of the particular case at hand. Reporters went to great lengths to establish the assisting relative's moral integrity—for example, their respectable professions, the dedicated care they had provided, their honesty in confessing. Though relying primarily on the family members' own declarations without external validation, the praise for the individuals' moral integrity was given official affirmation through quotes from judges:

Judge praises the honesty of “devoted” daughter who helped her distressed mother to end her life … the circumstances … showed plainly that she was a caring and loving daughter.21

By establishing that the relatives acted with benevolent motives, the killing was both morally and legally absolved, all within the clear boundaries of the specific case: “Releasing Brady, Lord MacFadyen said he was satisfied he had acted out of compassion rather than malice.”16

Particularisation was also effected by journalists' reiteration of juridical claims that these cases were “exceptional”. In the Jennison trial, for instance, Mrs Justice Smith was quoted as saying that she viewed assisted suicide a serious offence but that “the circumstances were exceptional”.21 Such comments were included in each of the cases we examined. While it is not clear when a case of FAS would not be exceptional, it is notable that even the Crown prosecutor was quoted as sharing a similar view:

The Crown is not in any way condoning actions such as this by relatives or those who care for the elderly. It is the appropriate course in the somewhat exceptional circumstances of this case.22

We understand both the moral goodness of the assisting relative and the emphasis on exceptionality as vehicles of particularisation, functioning to keep broader ethical and political concerns at bay—thereby rendering FAS a tragic, though ultimately practical matter.

Smoothing over botched attempts

Two of the three assisted suicides involved botched first attempts. Both attempts with drugs failed and the assisting family member resorted to smothering. Euthanasia how‐to manuals warn that suicide with drugs is easier said than done: failed attempts may have disturbing consequences, with persons vomiting up pills, choking, gasping or slipping into a brain‐damaging coma.23 A recent study has also shown that complications may occur even when physicians administer the drugs.24 Among the reports examined, only one registered the trauma of a botched attempt:

Gillian left the room. When she retuned a little later, she got a terrible shock. Her mother was still alive. “There was this horrible rasping noise coming from Mum's throat,” she recalls. “I didn't know what to do. I was so frightened that I'd let her down. So I took a pillow and placed it gently on her face until there was no sound.”18

In all other reports, neither the ethical or clinical challenges nor the emotional hardship that follow a botched suicide were reported. Indeed, the botched attempts appeared planned, as if the suicide was intended to evolve that way, with the death following quickly, cleanly and efficiently: “When she fell unconscious Jennison held the pillow to her face for a ‘couple of minutes' until she stopped breathing;”25 “Paul…gave [Jim Brady] alcohol and extra medication before smothering him with a pillow.”17

Technical resolutions: the law and medicine

Given reports wherein physical degeneration is presented as manageable through suicide, where consensus prevails and the event, while undoubtedly sad, is necessarily and efficiently undertaken, the only remaining problem was represented as legal.

Unless the law is changed, loving relatives such as Paul Brady will remain criminals even if the courts are sympathetic … Jim's death was not horrible … It was what he wanted. It needs to be stripped of the legal horrors that have been attached to it.14

This legal disorder emerged as readily manageable. Indeed, bringing the law into line with public opinion was a common theme that ran through the coverage and at times was presented as the certain, inevitable march of things:

… the pressure for change to the strict illegality of euthanasia is growing, with calls for more formal guidance on what doctors can and cannot do. The law is inexorably being drawn into the debate.26

Surprisingly, this wholehearted statement in support of euthanasia legalisation directly followed an anecdote of a woman who recovered from coma after the denial of her husband's request to end her life. The cautionary tale was effectively negated. Perhaps more striking was a report wherein the journalist expressed concern for the discrimination against those who do not have a family member ready to help them die and wondered whether it was fair to make such a request of friends. In all cases, the ethical dilemma was presented as a technical problem, one that, in principle, could be resolved through the involvement of medical professionals: “we must get on with legislation to allow doctors—and half of all British doctors have said they would go along with it—actively to take life.”27

Exceptions: addressing complexity

While the majority of news reports were characterised by a technological orientation, revealing FAS as an unfortunate but potentially orderable event, a minority stood out for the complexity of issues addressed, especially attending to the emotional dimensions of FAS.18,22,28 Since these reports concerned Gillian Jennison's trial, there may be a gender dimension meriting further research.

One report acknowledged the contradictory feelings that may emerge when caring for someone with Alzheimer's, using such terms as “bitterness”, “heartache” and feeling “wretched, frightened, and alone”.28 Another presented, as noted, the perpetrator's fear of a botched attempt: “I didn't know what to do. I was so frightened that I'd let her down.”18 The article further acknowledged decision‐making as a process rather than a clearly bound event. This article presented the only critical question encountered in all the news reports, though even this was couched in overt support: “I tell Gillian I think she did the right thing, but that I wasn't sure about her timing.” The journalist registered Gillian's doubt and uncertainty:

I know what you mean … gosh ... I don't know how to answer that one … Maybe I should have waited. But Mum only had two small sherries. Okay, yes, in her state of mind it was probably not the right time. But when would have been?

Another article registered opposition through a somewhat longer than usual quotation.22 Conveyed in the context of euthanasia‐related emotional distress, this oppositional stance read as a legitimate expression of disquiet rather than an incongruous remark. In this context, it is noteworthy that the few reports that registered contradictions and emotions did not advocate, as so many of the others did, the straightfoward legalisation of euthanasia. One report presented court trials as a necessary process to sort out situational contingencies and warned that changing the law would be extremely dangerous “because an older person might feel pressured to ask to die”.18

Discussion

Our investigation revealed that, with few exceptions, the press reports adopted a technological orientation, wherein the complex terrain of FAS was constructed as an orderly or orderable performance. Whatever disorder was reported was conveyed as manageable by the implementation of further technique. This ordered revealing was enabled by containing the complexities of FAS through a number of journalistic strategies, mainly treating degenerative dying as an aberrant condition, smoothing over botched attempts, locating the object of ethical judgment in persons rather than contexts and abbreviating the decision making process to near trivialisation, all in the context of complete conviction on the part of the assisting relative.

The dominance of a technological orientation brings up some concerns regarding the impact of the press on euthanasia debates. In particular, we question whether reports that omit doubt, contradictions and confusion and marginalise the ambiguity that inheres in such situations serve the public's understanding of complex end‐of‐life issues such as FAS. Even if one believes that euthanasia is morally justified in certain circumstances and that society should provide support for it, such press coverage limits pathways to technical fixes such as the involvement of physicians or the application of law. Certainly for those concerned about euthanasia, the findings of this study suggest that it may be wise to work in conjunction with journalists to ensure that media reporting facilitates rather than stifles debate.

It is notable that those articles more sensitive to contradiction and complexity were not necessarily opposed to euthanasia, but were hesitant to advocate the simple application of legal or medical fixes. Within this context, the court trial emerged as an important response to the complexities of FAS. While such a trial may seem unacceptable to euthanasia supporters, the point here is to note that the news reporting of euthanasia is not neutral, but opens up or forecloses potential responses to end‐of‐life suffering. Rather than a post‐event trial, it is possible to conceive of some form of prospective guidance. However, whether such an intervention is deemed necessary, important, and meaningful depends very much on how the process leading up to suicide is portrayed. It would therefore appear that the dominance of a technological orientation restricts pathways for action in problematic ways.

This study focused on media content and therefore did not examine audience reception nor the production of news. Further research exploring the production of news is especially important if we wish to distinguish between the biases inherent in journalists' construction of FAS from those of their informants. For instance, while there were no dissenting relatives noted in the press reports, further research is required to determine whether there were actually no dissenting relatives or their opinions were ignored or not sought out in the first place. Other important considerations to be investigated are the structural, cultural and motivational forces that favour a technological orientation. To what degree, for instance, might tight deadlines bias journalists towards narratives of order rather than disorder? If this is the case, are there metaphors, narratives or other textual devices that might facilitate the reporting of emotional complexity and contradiction? Given the importance of the media in euthanasia debates2 and the role of the media in agenda setting,29 future research exploring these questions is warranted.

Abbreviations

FAS - family assisted suicide

Footnotes

Competing interests: None

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