As someone who has always been captivated by the intricacies of the royal family, I have witnessed how the tabloid media often spins tales around them — particularly the speculation and sometimes malicious reporting surrounding the late Princess Diana.

Seeing the relentless pursuit to monetise the vulnerabilities, pain and challenges of primary members of the royal family has been disheartening to see for this dedicated royal follower.

Indeed, the strength and existence of the royal family are intricately linked to the media attention and coverage they receive. As public figures whose expenses are partially covered by taxpayers, there is a natural curiosity and interest in their lives. However, there comes the point when this interest can become disruptive and even dangerous for the people who are idolised by the nation.

The constant scrutiny and invasion of privacy can have detrimental effects on their mental health and well-being, blurring the line between public duty and personal life. Society must acknowledge the boundaries and respect people’s private spheres, including those in the royal family, to ensure their safety and emotional stability.

In today’s digital age, social media, especially platform X, has become a treacherous landscape for public figures like Kate, the Duchess of Cambridge, who face a barrage of conspiracy theories and unwarranted scrutiny.

I was taken aback when I stumbled upon Kate’s heartfelt revelation about her cancer battle. Her words provided a glimpse into the rollercoaster of emotions she endured, from the nerve-wracking wait for test results to the life-altering moment of receiving a diagnosis, as well as the difficult choices surrounding how and when to disclose this information to those closest to her.

One particular phrase from Kate’s disclosure struck a chord within me: “The uncertainty is terrifying, but the courage to confront it head-on is liberating.”

Receiving news of a life-threatening from a loved one is a profoundly emotional and significant moment that requires a delicate touch and a compassionate heart. I was transported back to the time when my own mother bravely disclosed her battle with cancer to me when I was just 26 years old.

It was a time filled with conflicting emotions as she revealed this challenging news amid the chaos of my responsibilities as an executive producer for SAFM during the provincial elections. She chose to wait until the hustle and bustle of the elections had subsided before beckoning me home for a crucial meeting.

I vividly remember the mix of vulnerability and resilience in her eyes, igniting a profound contemplation on how young children like Princess Kate’s could possibly comprehend the weight of it all.

Her decision to postpone the conversation reflected her profound care for both the gravity of my work and the need to grapple with her own array of emotions, thoughts, and needs. In that poignant meeting, we found a safe haven to openly share our fears, concerns, and uncertainties, enveloped in a cocoon of mutual understanding and unwavering support.

This shared moment of vulnerability and strength etched a lasting imprint on my soul, showcasing the beauty of empathy and resilience in the face of adversity.

Navigating a life-threatening illness amid the relentless scrutiny of the media must be an unimaginable ordeal for a mother of three. The juxtaposition of personal struggles against the spotlight of public perception underscores the resilience required to endure such challenges with grace and dignity.

As we embrace empathy and understanding in society, it’s essential to remember that behind every headline lies a human story of strength and hope.

Trigger warning: This article contains graphic depictions of the death of a colon cancer patient and is not suitable for sensitive readers. 

On this 2024 Human Rights Day, so close to our marking 30 years of democracy, I have been listening to the radio while picking up family who arrived to spend the school holidays with us.

This special occasion has generated both celebration and activism.

Arts Alive has organised a four-day programme at Constitution Hill. This morning began with one thousand drums drumming for Palestine. There is a compelling lineup: a film festival, poetry, theatre, music, exhibitions, a market, a book fair, and a programme of children’s activities.

There is such national pride in what we can celebrate: equality, freedom of belief, freedom of expression, freedom of association, freedom of assembly, among many others.

Speaking in Sharpeville, President Cyril Ramaphosa saluted those who lost their lives in the bitter fight to end centuries of inequality. He noted the need to protect hard-won gains, including the rights of those who identify as Lesbian, Gay, Bisexual, Transgender and Queer. He called out those he described as reactionary for lobbying to cancel LGBTQI+ rights as reactionary. Sadly, such a reactionary stance prevails in several African countries.

As I pack groceries for a weekend away, the radio host asks the listeners: “Which of your human rights feel secure to you and which do you feel are at risk?”

A caller, Karabo, says his right to feel safe and secure is not fulfilled. As a father, he cannot allow his son to play outside in the street unsupervised, so he takes out his camping chair and sits watching. He hopes that this will no longer be his family’s reality in five years.

ALSO READ | Changing the ‘what ifs’ of sudden death to ‘even ifs’

A woman, who chooses to remain anonymous, says once winter sets in and the days get shorter, she will have to give up on running. The route she runs, in the heart of affluent Sandton, has streetlights that seldom work. As a woman, exercising her right to exercise freely will become simply too dangerous.

Mapi and I are unapologetic advocates for “life-affirming conversations about mortality”. We would have added a layer to the question if we had called in.

For us, it is not about what human rights we consider at risk; instead, it is about a human right that has not yet been fulfilled. The right to dignity – not only in life, but also in death.

During the week, I interviewed the former chief operating officer (COO) of a chain of hospitals. He spoke of how fragile patients’ rights are in our country – that, in his experience, doctors act with an assumed authority that their instructions about treatment should prevail – and that any patient who has the temerity to voice dissent is regarded as being difficult and the family is bullied into submitting. There are those who – when given the patient’s Do Not Resuscitate order (DNR) – refuse to respect it.

In South Africa, your DNR does not have legal standing – although some doctors will honour patients’ rights and fulfil your wishes.

The COO advised Mapi and me that we should collaborate with progressive lawyers and set up a legal service to intercede on patients’ behalf. He noted that people who do our course, Live By Design – Finish Strong, have done a great deal of thinking about their end-of-life wishes, and they deserve support to ensure these wishes are honoured.

The COO also spoke to me about the hospital patients he has seen who have been sent home to die. One such patient was his mother-in-law, Mariella. She’d had colon cancer for two years.

If “nature had taken its course”, she would have been dead within months, but medical advances gave Mariella blessed extra time, and she was able to celebrate family milestones. The removal of the cancerous colon left her unable to process food. Doctors declared there was nothing more to be done. She must go home and die there.

It took Mariella 21 more days to die. The effects of dehydration and starvation were awful to witness, the COO told me.

He has seen suffering in hospitals – but said that, when it is your relative, it’s much harder. First, there were headaches, confusion, and a dry mouth. Her dry skin was inelastic, and her eyes sunk inwards. At a later stage, she was delirious. Then, her kidneys began to fail.

She was a mere 26 kilos when she died – around the weight of a six-year-old child.

It does not need to be this way. If Mariella had the good fortune to have been a citizen of the Netherlands, Belgium, Colombia, Luxembourg, Canada, Switzerland, Guernsey, Japan, Albania, or lived in the USA states of Washington, Oregon, New Mexico, Montana or California, she and her family could have requested and qualified for the dignity of Medical Assistance in Dying (MAID).

Quebec introduces bill allowing advanced consent for assisted dying

Our country is a strange mix of political courage and cowardice.

When it comes to LGBTQI+ rights, there is courage. When it comes to a progressive policy, such as MAID, to support the human right of dignity, politicians talk about what they say is the will of God. Others are pragmatic.

Passing a law to support dignity in dying may be unpopular, and they do not want to lose voters.

Medical advances have long ensured that we continue to live when, decades ago, that very same illness would have led to death. But medicine can also prolong suffering.

Canadian politicians in Quebec, which is majority Catholic, assumed the Quebecois would not support MAID. However, they held a provincial-wide series of town hall consultations where people shared their stories of witnessing end-of-life suffering. Many wept. There was unexpected popular support for MAID, and the Canadian government changed the laws.

As South Africans, we take justifiable pride in our progressive Bill of Rights. It’s time for our progressiveness to include medically assisted dying in certain circumstances.

Our Bill of Rights mentions dignity as a right. Surely, this cannot be limited to dignity in our everyday lives. The Bill of Rights must also secure the legal right to dignity in our final days.

We need the possibility that the indignity of prolonged suffering can be foreshortened.

For the past 21 years, 24 February has been a day etched in my heart — a day dedicated to celebrating my mother’s birthday, honouring her memory, and connecting with her friends.

It was a ritual of remembrance, a tradition of love that I held onto dearly. However, this year, something unexpected happened. For the first time since her passing, I forgot her birthday.

The realisation crept up on me slowly, like a gentle whisper amid life’s usual hustle and bustle. There were no alarm bells, no pangs of guilt — just a subtle shift in the rhythm of my existence. At first, I was taken aback by my forgetfulness. How could I, who had always been so diligent in commemorating this day, let it slip by unnoticed?

But as the days passed, a sense of calm descended upon me. It was a feeling of liberation, of release from the weight of expectations and obligations that had accompanied this day for so long. Forgetting my mother’s birthday was not an act of disrespect or neglect; instead, it was a sign of healing, a symbol of the passage of time and the evolution of grief.

Amid this emotional journey, I impulsively booked a ticket to Durban, eager to be surrounded by family and retrace the footsteps of my mother’s life. I wanted to share this milestone with her friends, to confide in them that I had finally let go of the need to mark this day in a certain way. I wanted them to know that it was OK, that I was OK.

As I sat among her friends, sharing stories and laughter, I felt a sense of peace wash over me. The act of forgetting had not diminished my love for my mother or the memories we shared; instead, it had allowed me to embrace a new chapter in my journey of healing. It was a reminder that grief is not static; it ebbs and flows like the tides of the ocean, shaping and reshaping our relationships with those we have lost.

So here I am, 21 years later, learning to navigate the waters of grief with a lighter heart and a clearer mind. I am also eternally grateful for my mother’s last gift she bestowed on us as a family – her conversation for clarity about her wishes – which she then wrote down.

My mother’s friends are in their 80s, and I am curious about their clarity and whether they have their affairs in order. One of my mother’s friends has been in and out of the hospital over the past few months, dealing with one ailment after another. Her daughter’s unfortunate situation with job searching has meant she is the 24/7 caregiver.

I asked if the crucial conversations had taken place. With tears in her eyes, she said that only the finances around her burial are settled, and everything else is unresolved, which means she and her brother expect to be at loggerheads, potentially requiring a law enforcement intervention.

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I visited my mother’s 88-year-old friend. It is always a bittersweet experience. She holds a special place in my heart. I arrive bearing gifts that may not be advisable for someone of her age and health status, but knowing that these indulgences were shared favourites of my mother and her, I cannot refrain from bringing them along.

Our gatherings wouldn’t feel complete without their cherished foods. She greeted me with a solemn declaration that these are her final days, and she is prepared to reunite with her maker. Our conversations drifted towards her unwavering belief that my mother awaits her in the afterlife, eager to catch up on the past 21 years.

Wanting to steer our dialogue towards practical matters, I inquired about her arrangements and whether her children and grandchildren were mentally prepared for her imminent departure. Will her passing strengthen their familial bonds? Her response was stoic yet profound – she expressed confidence in the values she has instilled in them. She believes they are equipped to navigate life without her guidance.

The conversation omitted the unspoken fears and concerns, and I couldn’t shake the worry about her legacy and the impact of her absence on their lives. How will they simply “adult up and leave their best lives” if certain conversations have not happened? What about a will to guide them on how to divide her assets? But she insists that her time is up, and she is only left with the energy to die rather than to think about the fate of her children, whose youngest is 48.

I hear her words, and the weight of the unresolved now lingers in the air, leaving me to ponder the intricate layers of love, loss, and the enduring legacies we leave behind.

“It’s always too soon – and then it’s too late,” I recall these words of Ellen Goodman, American feminist Pulitzer prize-winning journalist, who was left to manage the consequences of conversations that hadn’t happened. Ellen’s suffering prompted her to co-found Boston-based The Conversation Project – a not-for-profit dedicated to supporting ordinary people to have end-of-life conversations EARLY ENOUGH.

See www.theconversationproject.com for a series of conversation guides about dementia, your doctor, a dying child, or how to choose someone to speak for you if you can’t speak for yourself.

For my mother’s friend, it’s too late – she’s clearly telling me her life force is in decline. Talking with her makes me sad that while I run LoveLegacyDignity programmes, undertake public speaking engagements and write this column, I’ve somehow missed the opportunity, closer to home, to sit earlier with my mother’s old-old friend to support her to have these critical conversations.

This is the time of year with many family gatherings and time for conversation. The 30 days of Ramadan have started, Easter is a few days away, and Pesach follows just a couple of weeks later. I urge you to have no regrets. Create opportunities to have life-affirming conversations about mortality.

What rites of passage have you chosen to observe in your life? How might you do things differently if you could turn back the clock and make other decisions?

At the end of last month, I turned 70. Questions arose – whether to celebrate or not to celebrate? Party? Dinner? Or to quietly enter the next decade without a fuss? Maybe it is the echoes of the biblical phrase, “three score years and ten.”

I decided that, indeed, the culmination of seven decades felt significant.

I follow the work of a US organisation called School of Lost Borders, whose focus is strengthening the practice of rites of passage in a modernising world where communities disperse, and traditions are not pursued – casually so – without genuinely considering the value of what is being lost.

There are different rites of passage in our lives: our arrival, our passage of puberty into adulthood, from adulthood to elderhood, and finally, from elderhood to death.

Yes, there are other ceremonies, such as betrothal weddings and religious ceremonies, but the five above are linked to the linear physicality of our ageing.

Our arrival: Naming ceremonies are common throughout the world.

People speak of them as providing a celebration of life, a family occasion, carrying the weight of a formal ritual, and an opportunity to pass down cultural values and beliefs to the next generation.

The Catholic baptism ceremony also allows for naming the “godparents,” trusted faithful adults who formally make the promise to help the child’s parent in their duty as Christian parents.

Jewish tradition for boys also requires them to be circumcised on the eighth day of life (or when they reach five pounds in certain medical circumstances), perhaps drawing on the ancient practices of the Egyptians and Ethiopians.

Maasai elders name a baby very soon after birth, whereas the Wodaabe of Niger will not name a child until it reaches twelve years of age so that the death spirit may not identify the child.

There is such diversity, but the consistency is that it is not ignored.

Puberty as entry to adulthood: There seems to be more awareness of ceremonies for boys rather than girls. Circumcision is so often considered the rite of passage for boys becoming men irrespective of religious orientation – excepting the Jewish faith, requiring circumcision a few days after birth.

When I listen to the ceremonies associated with girls’ menstruation, that is when I am most saddened by what we have lost culturally for many urban young girls around the world.

The Ghanian tradition, “Dipo”, creates a weeklong retreat with bathing rituals, a special drink and older women sharing their life lessons about sex, womanhood, and well-being. The week ends with a community ceremony, which includes skin decoration and a dance called the “klama.” Certain North American Indigenous people have a similar four-day retreat.

In Sri Lanka, the Yamil puberty celebration involves a retreat and then a celebratory gathering with gifts of new clothes and jewellery.

Jewish tradition has a Bat Mitzvah for girls once they have turned twelve. Boys have their Bar Mitzvah after their thirteenth birthday per the Talmud, Numbers 6:2, which indicates age 13 as the age of manhood.

Adulthood to Elderhood: I could not find societal celebratory ceremonies for elderhood. I learnt that the USA sub-divides its older adult population into three life-stage subgroups: The young-old (approximately 65-74 years old), the middle-old (ages 75 to 84 years old) and the old-old (over the age of eighty-five). I learned that there are pockets of people and groups creating opportunities for rites of passage.

For example, I could fly to Los Cabos in México for two nights during the spring solstice and spend R30 000 to participate in “Celebrating the Crone and the Senex”.

The hosts offer “rites of passage for women and men ready to embrace their embodiments of Age, Wisdom and Power.” I discovered a magazine publication called “Third Act.”

I found an organisation called the Centre for Conscious Aging. I guess I am relatively new to elderhood, and now that I’m curious, I’ll find my peops.

What is missing for me so far is any formal societal embrace – say, for example, I always notice Chinese elderly doing Tai Chi and their presence in kindergarten photos as assistants.

Elderhood to Ancestry: Including an honourable death.

This is where Mapi and I are trying to consciously write on topics to support all of us, irrespective of our spiritual orientation, to design our lives to secure a dignified departure.

Again, I don’t find community examples that lay out a pathway.

Returning to the question, “What rites of passage have you chosen to observe in your life? How might you do things differently if you were able to turn back the clock and make other decisions?”

My early motherhood years were spent in an exile community that did not recognise the importance of and/or make time for ritual. I am sorry that my girls did not have celebratory naming ceremonies.

Menstruation was a “practical” happening, and while I hope they felt enough concern, care, and empathy, I feel my girls missed out on a much richer deeper emotional and spiritual experience of coming of age. I now know of women in my age cohort – more conscious than I of the importance of rites of passage who designed puberty ceremonies for their daughters. Lucky girls!

I cannot turn back the clock. I cannot undo what’s done. But, Mapi and I, in our Live By Design – Finish Strong advocacy, hope that through our reflections, we can provoke your reflections and make a difference as to how you choose to live in this world.

Somewhere out there, a family is grieving the sudden and tragic loss of a loved one.

From unexpected deaths like car accidents or violence to medical emergencies like heart attacks, every loss is unique and deeply painful.

One family I know is mourning the passing of their 30-year-old daughter after she suffered from an epileptic attack while sleeping alone in her room.

This is how her mother described her death:

“She had lived and managed the disease since she was 10 years old. This week, [she] had an unexpected attack while visiting her grandmother who lives nearby. The attack was different; it happened at night, and nobody heard anything.

They discovered her in the morning. Doctors who declared her death said she had multiple attacks in her sleep, which caused her to die. It is hard, sad, painful. However, there is an element of relief. The family and her brothers loved her but wished she had a healthier life. In the past two years, her memory was getting worse. She forgot people’s names and anything that she was told.”

Her mother is shattered by the loss, grappling with feelings of guilt and sorrow as she wonders about what could have been done differently and if her daughter’s suffering could have been prevented.

There are many ‘what ifs’.

Her struggle with severe epilepsy impacted her entire life, from childhood to adulthood. As a mother, she prioritised her well-being and showered her with unconditional love.

There is a temptation from her friends to change her ‘what ifs’ to ‘even ifs’. But how do you tell someone who is overwhelmed by complex emotions that there is a better way to feel and process their pain?

Their daughter’s death has shaken them to their core. But, by acknowledging and processing their emotions, seeking support from others, and actively working to find meaning in the loss, they are beginning to move through the grief and find a way to honour her memory.

Sudden death is a traumatic event that can leave loved ones reeling with shock and disbelief. The common reactions to sudden death include feelings of disbelief, anger, sadness, and confusion. The sudden loss of a loved one can shatter our sense of security and stability, leaving us struggling to make sense of what has happened.

However, finding a different meaning in the tragedy can be a powerful way to help those grieving cope with the loss. By shifting our perspective and looking for lessons or silver linings amid the pain, we can begin to heal and find some semblance of peace in the wake of a sudden death. One example of someone who found solace in helping others after experiencing a sudden loss is David Kessler.

After the untimely death of his son, Kessler channelled his grief into a mission to support and comfort others who were going through similar experiences.

By using his own pain as a catalyst for helping others, Kessler was able to find purpose and meaning amid his profound loss. The reaction to sudden deaths can vary depending on the circumstances surrounding the loss.

Tragic deaths, such as those resulting from shootings or car accidents, may elicit intense feelings of shock and horror. The sudden and violent nature of these deaths can leave survivors grappling with overwhelming emotions and struggling to come to terms with the senselessness of the loss.

In contrast, deaths due to natural causes, like heart attacks or unexpected events, such as someone not waking up from sleep, can also prompt a range of emotional responses. While these types of deaths may lack the traumatic and violent elements of other sudden losses, they can still be profoundly shocking and disorienting for those left behind.

Finding meaning in the face of sudden death can be a challenging and deeply personal process. It requires us to confront our grief head-on and search for ways to honour the memory of our loved ones while also finding a path forward in our own lives.

Like David Kessler, we have the power to transform our pain into purpose and use our experiences to bring comfort and understanding to others who are walking a similar path.

Have you ever “buried” a blood relative while they are still alive? Do you know of situations where the rift in the family is such that a son says to a father, “You are dead to me,” or vice versa?

How do you support a person going through this grief and psychological loss of a primary relationship? And then, what can be expected when the long “dead-to-you” relative actually dies physically?

A colleague informed me of his father’s passing and his need to take time off work. My initial response was to show empathy and support for his loss. I shared the news with other coworkers, and we all expressed our condolences and discussed how we could be there for him during this difficult time.

I haven’t been close to this colleague. I am aware that not everyone has a positive relationship with their parents, filled with happy memories and love, but I still tend to assume a deep sense of sadness and grief when someone loses a parent.

I wrote the following message to my grieving colleague:

“I am truly sorry to hear about the loss of your father. I can only imagine the depth of your grief. Please know that my thoughts are with you during this difficult time. May you find comfort in the cherished memories you shared with him and know that he will always hold a special place in your heart. If there is anything I can do to support you, please do not hesitate to reach out.”

My message, as it turned out, was way off the mark. Less than an hour after I sent this message, someone commented about his Facebook status. This is what he wrote—the block capitals for emphasis are his.

“I WAS NOT SAD WHEN MY FATHER DIED. I did not mourn his death. In fact, I had a sense of ecstasy once the funeral ceremony was concluded. I know it sounds absurd and frankly callous of a boy child not to feel pain when his father dies, but I was not and still would not, even if given a second chance. In fact, I will not feel any pain anytime soon if I can help it.

“The truth is I killed my father. Yes, I had to kill my father to survive the Mncube’s malady, i.e., mental illnesses. My psychologist helped me commit the ultimate crime. My father was murdered in what we described with my psychologist as a mercy killing.

“The idea of killing my father emerged whilst I was sitting comfortably on the Freudian couch with my psychologist. She was talking non-stop, trying to console me. I was weeping uncontrollably. (Extract from The Love Diary of a Zulu Boy).

Yesterday afternoon, my father took his last breath. He died a second time. I didn’t cry, but I wanted to. Rest in peace, Mzilakatha. We all have to deal with our demons at some stage. Hopefully, your demons will disappear into the ground like your body.”

My colleague had already gone through what Litsa Williams calls ambiguous grief, which is grieving someone who is still alive. Today, he is grieving while navigating the delicate balance of honouring the deceased while supporting loved ones who may have had differing relationships with them.

Mourning the death of someone you have already buried long ago, metaphorically speaking, can be a complex and emotional process. It may involve feelings of relief, guilt, sadness, anger, and confusion.

In writing about his experience, my colleague acknowledged the conflicting emotions from his decision to “murder” his father. He mourned the loss, while also feeling a sense of freedom from his father’s toxic behaviour. As he mourns the second time, he will reflect on the impact his father had on his life, both positive and negative, and explore how his second death has affected him.

I’ve decided to validate his feelings and witness his grief without judgment because we can learn from his decision to prioritise his own mental and emotional well-being. He sought out support from a therapist when he realised his relationship with his father was not a happy one. He allowed himself to process his feelings in a healthy way.

My thoughts are with him and his family as he steps in to support his siblings and relatives who might have had different experiences to his. As a firstborn, he is tasked with giving his father a decent send-off.

I feel for his twice-over pain—his first grief when self-protectively he closed his father out of his life, and now his father’s actual physical death.

I have the deepest respect for his honouring of his mantle of traditional responsibility. His Facebook posting may have been shocking to some—personally, my heart tells me that empathy, not judgement is appropriate. Wounds can heal, or wounds can fester. Words can comfort or words can inflict hurt. I sincerely want my words of support to go towards the healing.

WARNING: This article includes themes of suicide and physician-assisted suicide which may be triggering to some readers.

Carol’s predicament

A few days ago, 63-year-old Carol de Swardt travelled to Pegasus clinic in Switzerland for an assisted death. She requested 31st January as her day to die. She will first have been given an antiemetic to prevent vomiting and later a sufficient dose of a fast-acting barbiturate such as pentobarbital, causing death within 15-30 minutes. The medical staff and any family or friends in attendance will not be treated as criminals. They are acting within the law.

Her cancer treatment resulted in a leg amputation after radiation treatment. After a lengthy legal battle, Carol was awarded R4 million in 2020, but the money is cold comfort to her in a situation of intractable physiological and psychological suffering.

She said: “I have lost my will to live,” that she has no quality of life, that she can no longer “do the things that I used to, that I love, but I am disabled. All these things were taken from me – fishing, swimming, working in my garden”.

In 2023, Carol decided she wanted agency and the autonomy to say “enough” to her treatments and suffering. However, assisted dying is currently a criminal offence in South Africa. She decided to apply to go to Switzerland using some of the funds awarded.

South Africa’s inhumanity towards the terminally ill

Carol, as a South African with a terminal illness, should not need to travel to a foreign country to be able to die sooner rather than later.

Earlier this year, we covered the story of Klaas de Jonge, Dutch anti-apartheid activist, residing in the Netherlands, which supports physician-assisted dying for those who qualify. Klaas set May 5th as his date to die.

In the weeks leading up to this date, friends travelled to his home to say goodbye, and he held several gatherings online. On May 5th, the physician arrived, and Klaas, surrounded by loving family, swallowed the barbiturate and died peacefully within a few minutes.

Carol has had to leave her home and get on an aeroplane to another country. She has not been at home for her last days; there have been no friends dropping in for a final farewell.

But Carol is one of the fortunate few – the financial compensation meant that she had the funds. It is estimated that the Switzerland exit option requires you to budget about a quarter of a million rand to cover travel, accommodation, medical expenses, cremation, and considerably more if you wish for your body to be repatriated to be buried at home.

And what about those terminally ill who cannot afford or do not want to travel?

People sometimes reach the point where suffering outweighs any joy in staying alive. They know the law and know they cannot be with loved ones – they do not want to implicate others.

Craig Schonegevel suffered from neurofibromatosis from the age of seven. It is a lifelong disease that can result in intractable suffering, as mapped out by Marianne Thamm in her biography, The Last Right – Craig Schoenegevel’s Struggle to Live and Die with Dignity.

In 2009, by the time he reached 28 years old, he had had enough of drugs and operations. He ended his life alone without the comfort of being with loved ones. Taking care to act alone and not to implicate his parents – one night, Craig swallowed several sleeping pills, covered his head with two plastic bags kept in place two elastic bands around his neck. His parents found him dead the next morning.

IFP MP Mario Oriani-Ambrosini campaigned for the approval of alternative cancer therapies, including medical marijuana. Unfortunately, palliative care treatments for the alleviation of suffering have limited impact – especially if retaining consciousness and the ability to think and talk is important to you. In 2014, IFP MP Oriani-Ambrosinini, then in the last stages of terminal lung cancer, decided he needed to bring an end to his suffering. Alone in his study, he shot himself – family members heard the firearm discharged.

Their stories could have a different, more humane and dignified ending if we had a law that supported physician-assisted dying.

Our constitutional supports dignity and autonomy

The status of the law is out of alignment with the South African constitution.

SS10 of the Constitution on Human Dignity:

“Everyone has inherent dignity and the right to have their dignity respected and protected.”

SS12 in Freedom and Security of the person:

“12(b) Every person has the right to freedom of the person which includes the right to security and control over their own body.”

What discussion has there been in South Africa?

After the new democratic dispensation, Parliament passed the Termination of Pregnancy Act. It put in place a commission to study end-of-life. The commissions finding have gathered dust for 20+ years. After passing one controversial law – there was no appetite to engage on a second issue.

Why are some people not supportive of assisted dying?

  • People say they are afraid that a policy on assisted dying could, in practice, be abused – and that the elderly might be “euthanised” or other vulnerable groups.
  • Others cite their religious beliefs and say that dying is in the hands of God.

What do those in favour say?

  • That assisted dying is a human right, and that people should have not only the right to refuse treatment, but to choose to bring forward the date of their death.
  • That there is now 20 years’ experience from other countries and American states to draw on as to what safeguards can be instituted to ensure there is no abuse.
  • That medical advances now supersede the hands of God, that it is now possible for people to be on life support, even in a Permanent Vegetative state.

Public opinion and constitutional alignment

The late Arthur Chaskalson – President of the Constitutional Court 1994-2001 – spoke about unpopular issues.

“Public opinion may have some relevance – but, in itself, it is no substitute for the duty vested in the courts to interpret the constitution and uphold its provisions without fear of favour. If public opinion were to be decisive there would be no need for constitutional adjudication.”

NOW is the time for Parliament to catch up with what is progressive in the rest of the world. Politicians need to put aside personal opinions and respect human rights as enshrined in our constitution. A new law is needed to decriminalise assisted dying.

Forgiveness is essential to healing if we are to have peace in our hearts – that’s what’s on my mind this week. Ever the student, hungry for learning, I’m currently attending an online USA course, “Creating a Good Death” (CAGD). The focus of session three last Sunday, was forgiveness.

It’s there on the teacher’s menu for one of the nine classes because, in her experience as an end-of-life doula, she knows first-hand that a peaceful heart will support psychological well-being as the person dies.

The need for forgiveness surrounds us. The hurt being created in world conflicts will have an impact for decades to come. The consequences of Apartheid’s cruelties remain part of our lives, almost thirty years since our first non-racial democratic elections.

Many people try to find ways to contribute to societal healing, hoping their efforts will make a difference. What’s more accessible, more tangible, and perhaps harder is working at a personal level with the hurts we’ve experienced and the hurts we’ve inflicted.

Our teacher offers questions to prompt our reflections on from where we might have unfinished business in our lives. I found them useful to get my brain focused.

We were urged to consider:

  • People who have pissed you off royally?
  • People you’ve loved like crazy?
  • People you want to contact before you die?
  • People you should apologise to?
  • People who you wish would apologise to you?

Forgiveness can be so hard and take years. Recalling the hurt as part of finding a way forward with forgiving is often a sharp, painful experience. The CAGD teacher had a difficult childhood. Her parents divorced and her father married the babysitter who had done the aftercare for several years since she was six years old. Her world imploded.

Her telling us of her experience, showing a photo of herself as the twelve-year-old to whom she wrote this letter, brings back the painful memories and her expression clouds, and tears fall quietly down her face as she reads the letter.

Her story reminds me of Archbishop Tutu writing of how forgiveness is not easy and yet he advocates,  “I would like to share with you two simple truths: there is nothing that cannot be forgiven, and there is no-one undeserving of forgiveness. Until we can forgive, we remain locked in our pain and locked out of the possibility of experiencing healing and freedom, locked out of the possibility of being at peace. Until we can forgive the person who harmed us, that person will hold the keys to our happiness: that person will be our jailor. When we forgive, we take back control of our own fate and our feelings. We become our own liberators.”

The Arch, as he was fondly known, and his daughter, Mpho Tutu, created a wonderful resource, The Book of Forgiving.

They offer us the fourfold path:

Telling your story, your truth, is the first part of the fourfold path. State the facts and accept that as and how they happened cannot be undone. Share your story with someone you trust. Your process may or may not include confronting the person(s) who caused the hurt.

Naming the hurt is the second step. Acknowledge your feelings and name the emotions. Accept your vulnerability. Be kind to yourself. Don’t hurry. Move forward only when you are truly ready.

Granting forgiveness is the third part. It is our choice. It is not conditional. The other person who hurt you may refuse to recognise the injury they caused and may refuse to apologise. In granting unconditional forgiveness, you become the hero of your own story, the person emotionally strong enough to make this choice.

Renewing or releasing the relationship as the choice for the future brings to a close the fourfold path process. Do you want to let the relationship go? Or do you want to invest in renewal?

In running workshops, I’ve asked people to bring a broken ceramic item. The process of creating a mosaic with the pieces creates reflective time to decide what it is that you want in your future. This can be a hard decision, especially when the perpetrator is part of your family constellation.

The Arch and his daughter Mpho remind us: “Forgiveness is not quick – it can take several journeys through the cycles of remembering and grief before one can truly forgive and be free.”

So far, we’ve considered forgiving others. But that’s just one side of the coin. What about when we are the ones whose actions have caused hurt? Will a compassionate letter to one’s younger self who knew no better be helpful? Might it be the first step in the process of asking to be forgiven? Another column for another week.

Meanwhile, Mapi and I hope this contribution will support any reflections you are ready to undertake for 2024 to be the year of repairing relationships.

This week, I was invited for supper by a journalist friend. “So, what’s our thinking on the elections and the new parties – what might be the outcome?” That was the substance of the first part of the evening.

My friend explored thoughts on, “if the results might be contested, and if so, would the contestation be peaceful? Or would there be violence? Would trucks burn on highways? Will South Africa’s security apparatus be more effective in their responses than in July 2021?”

I watched his partner’s face become worried. I thought she might begin to hyperventilate. She requested that we change the subject.

As the 2024 national elections approach, the anxiety surrounding this crucial event has become increasingly palpable, not only within our homes but in the media reports of what politicians are saying.

Last year, an interview with Herman Mashaba, leader of ActionSA, heightened concerns as he alluded to the possibility that this election could be the last opportunity for opposition parties to peacefully remove the governing ANC from power. The mention of such a scenario left me pondering the consequences if theparties were unsuccessful in their endeavour.

Adding to the tension, claims of a groundswell of support for former president Jacob Zuma’s newly formed party, the MK Party, have emerged. While the formation of this party could be seen as a positive step towards a more democratic society, the escalating rhetoric questioning the integrity of the upcoming election is undeniably unsettling.

It is within this climate of unease that Helena Dolny’s invitation to plan for our 2024 marathon year prompts me to delve into the unique challenge of living by design in an election year.

Electioneering in an election can have a significant impact on the national psychology of citizens. The intense competition, political rhetoric, and media coverage can create a sense of anxiety, division, and uncertainty among the population.

Individuals may feel overwhelmed and bombarded with sensational reporting about the hopeless state of their country and political manipulation. In her examination of the proximity and competitiveness of how national elections influence in-group favouritism, ethnic groups’ status anxieties, perceived discrimination, and trust in Sub-Saharan Africa, Elena Genova, Assistant Professor of Sociology at the University of Nottingham found that election cycles strongly influence group anxieties in plural societies where political competition is high.

Furthermore, being bombarded non-stop on how a nation is a failure tests your resilience.

In this column, we delved into the importance of self-care, fostering healthy conversation, and staying informed without becoming overwhelmed. We have the power to shape our own lives and make a positive difference in our society during this election year. So, how can we focus on intentional living while navigating our political climate?

1. Limit exposure to sensational reporting: While it is crucial to stay informed about political developments, constant exposure to sensational reporting can be overwhelming. Take regular breaks from news consumption and set boundaries on the amount of time spent engaging in political discussions on social media. More so this year, when artificial intelligence is bought to be used to manipulate the national narrative. Switch off screens at least one hour before going to sleep.

2. Seek diverse sources of information: Avoid relying solely on one news outlet or social media platform. Explore diverse sources that offer balanced perspectives and fact-checking. This can help individuals gain a more comprehensive understanding of the political landscape and reduce the influence of biased reporting.

3. Engage in critical thinking: Develop critical thinking skills to evaluate the information presented by political parties and candidates. Question the motives behind statements and promises made during election campaigns. This can help individuals navigate through political manipulation and make informed choices based on their own values and desires for the country.

4. Connect with like-minded individuals: Seek out communities and support networks that share similar concerns and values. Discussing and sharing experiences with others who understand the challenges of political contestation can provide a sense of solidarity and validation.

5. Take breaks from political discussions: It is essential to find balance and not let political discussions consume every aspect of life. Engage in activities that bring joy and relaxation, such as pursuing hobbies, spending time in nature, exercising, or practising mindfulness and meditation.

6. Focus on personal growth and contribution: Instead of dwelling solely on the political landscape, channel energy into personal growth and meaningful contributions. Take time to set personal goals, pursue education or skills development, and engage in activities that positively impact the community. This can provide a sense of fulfilment and empowerment beyond politics.

7. Celebrate achievements – small and big.

8. Cultivate a gratitude practice: Every day, create three minutes to enjoy thinking about what you are grateful for

9. Prioritise your self-care: Refer to last week’s column: eat well, sleep enough, take breaks, move your body, and take a daily pause for a few minutes to breathe deeply and relax.