Dignity, broadly, is a concept protected in our Constitution and is regarded as tantamount to our constitutional and democratic dispensation. The South African courts have gone on to hold particularly in the S v Makwanyane decision that the “recognition and protection of human dignity is the touchstone of the new political order and is fundamental to the new Constitution”.

Human dignity may be the so-called “touchstone” of our democracy but many South Africans are still not able to fully live and express that fundamental right. Judge Fabricius of the Pretoria High Court in his judgment earlier this year dealing with assisted suicide or euthanasia (in the matter of Mr Stransham-Ford) remarked that “one must proceed with courage and fortitude no matter what”.

My grandmother, who grew up in Apartheid South Africa and was burdened with continuous blows of oppression throughout her life, has always believed, convictions that I share, the system must work for the people.

My grandmother abides by the idea that we are all duty-bound to participate in our democracy and that extends beyond simply voting. She has a greater awareness of what is going on in South Africa, and the world, than many of our younger compatriots. It is for those reasons that she still believed that the public healthcare system would best serve her interests when she got sick or needed help.

About two years ago, my maternal grandmother was unwell with a plummeting haemoglobin count and spiking sugar levels with a general state of uneasiness. However, that public healthcare system did basic observations and checks whereafter they advised her that she was simply “old and should go home”.

The subtext of that diagnosis was broadly that Mrs Gasnolar did not require any help and should simply go home to die. This is not what human dignity is about nor is it how a healthcare system should function. Yet, for many people, this is exactly what it is.

My grandmother, after much protestation, allowed her family to ‘contract her out’ of the public healthcare system and migrate her into private healthcare. However, dignity is not automatically guaranteed in this parallel and alternative world but rather it must continuously be fought for.

We cannot simply take these values as being part of the normative culture, even when we are paying for it, but rather we must strive to make these values part of our social fabric.

There are opportunities for some South Africans to simply ‘contract out’ of the system by hiring their own security services, buying their own medical services or procuring their own private education.

These tendencies are often understandable but often there is an unspoken side effect that they those who ‘contract out’ also check out of the system. South Africa requires us to actively participate, to question, to do more than simply vote. We must actively engage and continuously strive “with courage and fortitude no matter what”.

Growing old is not for the fainthearted; it is a difficult and treacherous road and often made more difficult by the socio-economic conditions. My paternal grandmother has lived a good and full life but is terminally ill and medicine cannot save her except to make her comfortable and to manage the pain.

However, she, like many other older persons, will be confronted by the reality that often death is brutal especially on the body and to those around you. In those moments, the person you knew and loved is slowly taken away from you until you cannot even recognise them anymore.

Former Constitutional Justice, O’Regan in the S v Makwanyane decision remarked that “the rights to human dignity and life are entwined. The right to life is more than existence – it is a right to be treated as a human being with dignity: without dignity, human life is substantially diminished”.

We dare not embark upon redefining issues in the next decade of our democracy and beyond without being mindful that the erosion of dignity makes human life substantially less. Importantly, the values of dignity must be relied on more in the wake of the Marikana massacre and the possible future crises that we will be required to confront.

The area of assisted suicide or euthanasia is not a simple or confined issue that has one answer. Rather the issue is such that it puts someone in the unenviable position of determining if the particular circumstances dictate whether it should be authorised.

There is a risk though that again those who can afford to ‘contract out’ of the system will be able to access this option while those, who because of their socioeconomic conditions, a mere accident of birth and in part designed and perpetuated by the dynamics of privilege, will be unable to die with dignity.

The words of former Justice O’Regan are a stark reminder that “without dignity, human life is substantially diminished” and we collectively need to ensure that our healthcare system and society is able to deal respectfully with a growing cohort of elders.

Our legal system and politicians will not be enough to ensure that the entwined space of human life and dignity are safeguarded. Surely, despite the difficulties and emotions of death, let alone the sectional, moral and religious issues, we must ensure that human dignity are preserved, protected and cherished instead of being available for a select few.

No matter what, more of us should return to the fold, with “courage and fortitude”, to meaningfully participate in our country and truly make dignity the “touchstone” of our democracy especially on issues of life and death. DM