The Belgian Paralympian Marieke Vervoort made headlines earlier this month when she said she was glad that euthanasia had been legalised in Belgium. “It gives a feeling of rest to people,” she said, “I know when it’s enough for me, I have those papers.” Vervoort said that, if she had not had the security of “those papers”, then she would probably already have ended her life. She therefore hoped that other countries would embrace euthanasia and was highly critical of those who characterised euthanasia as “murder”.
These comments were widely reported in Belgium where Vervoort is a well-known and popular figure, a Paralympic medallist. They were also widely reported internationally, not least because they were spoken by someone directly affected by the legislation she spoke about, a sportsperson with a progressive illness. Her words were also newsworthy because they seemed in such stark contrast to the perceived message of the Paralympics, which is “spirit in motion”, elite achievement in sport in spite of adversity. The possibility that, once the Games were over, an athlete might seek euthanasia, sits uneasily with this theme.
Vervoort’s comments can be contrasted with those of the British Paralympian Tanni Grey Thompson. During the debate in 2015 over proposals to legalise assisted suicide in the United Kingdom, Thompson repeatedly warned about the dangers she thought such a change would represent. In an opinion piece in the Guardian newspaper she stated that this law would bring a “seismic shift” in the way people with disabilities were viewed and cared for and would “introduce discrimination” into the national approach to suicide prevention. There would be one rule for the young and physically healthy, another for those with disabilities or progressive illnesses.
Two countries, two attitudes: Britain
Thompson and Vervoort both speak from experience and speak of the kind of society they would like to see. They also speak out of the society they know. Vervoort finds the possibility of euthanasia consoling. Thompson finds it threatening. Vervoort regards it as a testimony to her nation that Belgium has legalised euthanasia. Thompson regards it as a testimony to her country that her fellow Britons continue to resist calls for such legalisation.
Perceptions are shaped by social practices to which we have become accustomed. In general, and on average, people are more likely to defend the customs of their own land. There are, nevertheless, some ways we can judge between personal perceptions. In relation to the Paralympics, it is possible to ask, for example, how deeply that movement has shaped, and has been shaped by, each country.
Britons are rightly proud of the role their country played in the origins of the Paralympic movement, especially the precursor event held at Stoke Mandeville Hospital to coincide with the London Olympics in 1948. This attitude is also reflected in the television coverage of the Paralympic Games in the United Kingdom. The tone was set by the London Games of 2012 and the advert commissioned by Channel 4 ‘Meet the Superhumans’. This title might have been condescending and it runs completely contrary to the IPC media guidelines. However, the advert itself was unapologetic, aggressive, and uncompromising. It portrayed the athletes as brooding, dangerous, formidable, with imagery taken from the X-Men. The production values were of the highest quality and it was aired simultaneously on 78 television channels, reaching 50 percent of the total television audience. The advert won popular acclaim and many awards. It raised awareness and helped boost audiences. When Channel 4 became official broadcaster of the Paralympics 2012, just 14 percent of the population said they were looking forward to the event. By the time it closed, 64 percent of the population agreed that the Paralympics had been as good as the Olympics – a figure that rose to 79 percent among those who had watched Channel 4’s Paralympics coverage.
Coverage of the Rio Paralympics 2016 was heralded by a new advert that shifted the focus from elite athletes to a much wider range of people with disabilities. The theme ‘Yes I can’ was upbeat with a deliberate attempt to inspire disabled people in all walks of life. The musicians featured as much as the Paralympians. It has become one of the most shared Olympic adverts of all time. This advert set the tone for coverage that totalled 120 hours of Paralympic sport with 700 hours of broadcasts available online! While audiences for the Paralympics still lag behind those for the Olympics, the opportunities given to viewers to see the Games were completely on a par. This aspiration for parity is also evident in the successful London 2012 bid which was for the event to become “one festival of sport, with an integrated Olympic and Paralympic Games, underpinned by a single budget”.
This growing public engagement in the United Kingdom, and the use of Lottery funding to support both Paralympic and Olympic athletes, has borne fruit in sporting success. In the home games in London 2012, 288 British Paralympians won 124 medals, while at Rio in 2016, 264 athletes amassed a total of 147 medals.
For Belgian Paralympians, less encouragement and reward
Belgium is, of course, a smaller nation, of only 11 million people, that is, roughly one sixth the size of the United Kingdom. Nevertheless, it has a comparable per capita GDP and a similar welfare system and a democratic form of government. There is no reason it could not achieve similar success per capita to the United Kingdom in the Paralympics. However, in London 2012 Belgium’s 40 Paralympian athletes won only 7 medals, while in Rio 29 athletes won 11 medals. This is one medal per million population, which is less than half the equivalent figure for Team GB. Belgians have rightly celebrated the sporting achievements of Marieke Vervoort, but there has been no equivalent to the massive advertising campaigns mounted by Channel 4 in the United Kingdom. There has been no attempt to provide equal coverage to the Olympics and Paralympics. There has been no parity and no evidence of an aspiration to parity.
This lack of aspiration is shown perhaps most vividly by the prize money awarded to athletes. In the United Kingdom neither Olympic nor Paralympic athletes receive prize money for winning a medal. Their reward, in addition to the achievement itself (and, for some, the possibility of an honour from the Queen), is the increased likelihood of funding for their training. This is true of Olympians and Paralympians. In other countries there is prize money for individual athletes, which is frequently given on an equal basis for Olympic and Paralympic medallists.
In Belgium, while prize money is given to both, a Paralympian gold medallist gets only one fifth of the winnings given to an Olympic gold medallist (10,000 Euros over and against 50,000 Euros). These figures are set by the national Olympic and Paralympic committees. The Chair of the Belgian Paralympic Committee, Ozek Kazimirowski, explained that “if the rates of pay are different, it’s because we don’t have the same sponsors, the same public support or the same visibility in the media.” However, this response puts the cart before the horse. It is up to national committees what opportunities they give to sponsors and to audiences and how the allocate the funds they generate. If India can provide parity for Olympic and Paralympic athletes in prize money then so can Belgium. By remaining satisfied with such a clear example of double standards between Olympians and Paralympians the Belgian national committees perpetuate this double standard and communicate that expectation to sponsors and to audiences.
Vervoort deserves great credit for mentioning the danger that suicide poses for someone with a disability, even someone who is internationally successful in her sporting career. So often media attention on suicide is focused exclusively on the deaths of young people who are physically healthy. Without minimising the tragedy of these deaths, the threat to people who are older or disabled or physically ill is no less, and the human loss no less. Every single life lost to suicide is one too many.
Vervoort says that she feels that having “those [euthanasia] papers” helps her cope and has helped her to avoid suicide. This may be true of others in Belgium. However, there is no evidence that, overall and over time, legalising euthanasia helps prevent suicide. Belgium in fact has the highest rate of suicide in Western Europe, more than twice the suicide rate in the United Kingdom. There has been no direct research on the impact of euthanasia on suicide rates in Belgium. However, analysis of data from the United States, taking into account economic, social and legal differences between States, shows no positive effect on suicide from legalising “assisted dying”. The rate of unassisted suicide remains just as high, or even higher, while the total number taking their own lives increases significantly. Assisting suicide promotes suicide.
These comparisons with Belgium do not imply that the United Kingdom is immune from systematic disability discrimination. Even while celebrating the achievement of British Paralympians at the London Games, the coalition government were proposing changes to the Disability Living Allowance that would see hundreds of thousands of disabled people worse off. The spirit of the Paralympics was not evident in the attitude of the UK government, but it was present in the resistance to such proposals by groups such as Disabled People Against Cuts.
Disability rights activism makes a difference
It is noteworthy that the campaign group Disabled People Against Cuts was also vocal in resisting a change in the law on euthanasia. This proposal was regarded as an expression of fear or of pity for people with disabilities but it posed a direct threat to disability equality. People with disabilities do not need encouragement or assistance with suicide but need support to live. The support that exists has been won by struggle and struggle is very much still needed.
In November 2013, Kevin Fitzpatrick, a philosopher and disability rights activist in the United Kingdom, travelled to Brussels for a debate on euthanasia. At that event he witnessed Professor Etienne Vermeersch, an advisor to the Belgian government, declare that it was “obvious” that “a man with no arms and no legs” might want to die for that reason. The advisor claimed that it was his life’s work to make euthanasia available for “any disabled person”. These comments were witnessed by other people at the event but provoked no interest from the Belgian media. It was not thought scandalous in that country and at that time that “a man with no arms or legs” should be thought a candidate for euthanasia.
Belgium was not the only country to underperform in the Paralympics nor the only country to limit its television coverage. The United States relegated most coverage of the Paralympics to a cable channel, and, while the USA convincingly topped the Olympic medal list, it came a poor fourth in the Paralympics, below the Ukraine. In the case of the United States, this disparity reflects the dependence of sports funding on the private sector, and the tendency of the market to reinforce social inequality.
In contrast, in Belgium, funding and social support is ostensibly provided by central government but there remains a problem of double standards. This problem should be placed in the wider context of “lack of effective access to social and medical assistance, social services and housing” for people with disabilities in Belgium. This frequently leads to “a violation of the right to independence, social integration and participation in the life of the community; a lack of social, legal and economic protection against poverty and social exclusion; and discrimination.”
The law on assisted suicide or euthanasia is debated within every country and community, in the United Kingdom and in Belgium, among disabled and able-bodied people, and no one person represents a whole community. Nevertheless, it is clear that the disability rights movement in the United Kingdom, which has close links with the Paralympic movement, has been a source of spirited opposition to euthanasia. In contrast Belgium, which has embraced legal euthanasia, has a much less active disabled rights community and this is reflected across many areas of society not least in the scandalous disparity in the remuneration of Olympic and Paralympic athletes. Marieke Vervoort is an admirable advocate but her country is not worthy of such impressive endorsement. In such cases one can appreciate the singer but not the song.
Dr David Albert Jones is the Director of The Anscombe Bioethics Centre in Oxford, England.