Tomorrow, 11th September, M.Ps. will debate the Assisted Dying (No.2) Bill in the House of Commons.This bill allows doctors to administer drugs to end the lives of terminally ill people who have been given less than six months to live.This could only be carried out when two independent doctors and a high court judge have agreed that the patient had made an informed choice.
This piece of proposed legislation is very controversial and very emotive. Whilst on the surface it might appear to affect only a few individuals and promise alleviation of unbearable suffering, in reality it threatens to change the medical and moral culture of the United Kingdom.
Whatever protections and qualifications its proponents claim are built into this bill, it takes us in a whole new direction as a society, a direction that will ultimately replace support for many who are suffering with an unspoken pressure to end their lives.
I believe that there are many reasons to resist this new direction that some within our society want to take us in.
Of course, as a Christian, I believe that one reason is sufficient in itself. It is simply that such legislation contravenes the sixth commandment: “You shall not murder” (Exodus 20.13). To take life in this way is to grant to human beings the power to make decisions which belong to God.
However, I recognise that many will not share such a stark analysis of assisted dying. Therefore, I want to offer additional reasons, both social and personal, why this proposed law takes us in a wrong direction.
Firstly, this legislation undermines the integrity of the medical culture in our nation. Based soundly on the Hippocratic Oath, along with Judaeo-Christian convictions about the sanctity of human life, those in the medical profession have practised with a view to care and healing. Such will no longer be the case if this bill becomes law. There will be an expectation on doctors that, given a particular set of circumstances, they should administer drugs that will end a patient’s life.
No doubt doctors will be able to turn down such a request on the basis of conscience. That does not, however, compensate for the creation of a new climate in which ending life as well as preserving life is entailed in the practice of a doctor.
Secondly, a corollary of this change in medical culture is the change in relationship between patient and doctor. At present, one can undergo treatment in any hospital in this country, safe in the knowledge that, however ill one is, the medical staff are committed to caring and preserving life. One can also be sure that they will do everything in their power to alleviate suffering. And, however ill the patient is, he or she can be sure that there will be no pressure from medical practitioners to end his or her life.
If this bill becomes law, those assurances no longer exist. The trust between patient and doctor becomes strained. Suspicion replaces that trust, because even if the doctor does not articulate the option of ending the patient’s life, the possibility that that expectation might be there must be entertained by a terminally ill patient.
The BMA has recognised this alteration in the patient / doctor relationship if assisted dying becomes law:
‘The BMA’s view is that the unique relationship between doctors and patients risks being undermined, and trust lost, if doctors were permitted to play a role in ending patients’ lives’
The BMA has expressed its opposition to all forms of assisted dying in very strong terms.
Thirdly, it should also be recognised that legislation of this kind would also create expectations and pressures for doctors with respect to how they should advise patients or their families. Doctors, of course, face, daily, tough questions and emotive decisions as to what constitutes the best interests of those who are suffering and or coming towards the end of their lives. Once again, however, this bill places further responsibility on the shoulders of doctors: in some cases they would be expected not only to rule on whether treatment should be continued, but on whether life should be ended by the administration of drugs.
Fourthly, the pressure on relatives of those who are terminally ill should be considered. At a time when a loved one is suffering, families do not need the additional pressure of whether their loved should choose to bring their life to an end.
There are all sorts of dimensions to this kind of choice. Are families going to feel guilt in the aftermath of such final decisions that somehow they contributed to their loved one choosing to end his or her life? Perhaps. Perhaps not. But what is certain is that the choice to have one’s life ended is not made in an emotional vacuum. It is not a clinical decision made in isolation from those to whom one is closest. It impacts on all connected to the patient.
Fifthly, as indicated above, there is the wider social impact of such legislation to consider.
What message does this send out to those in our society who have serious health struggles? Or to those who are disabled? I will leave you to reflect on that.
This bill is being presented as a humane attempt to alleviate suffering. Undoubtedly its supporters are sincere in their motives. Sincerity, however, has no control over how legislation enacted for genuinely humane reasons, can end up having an impact that was never intended.
Our abortion laws are a case in point. One of the arguments advanced in favour of the 1967 Abortion Act was that it would stop back street abortions. Nearly half a century later, abortion has become an additional method of contraception. Of the almost two hundred thousand abortions in the UK every year, 98% are performed on the basis of mental health.This was never the intention of Lord Steel who is considered the father of the Abortion Act.
We cannot always accurately predict the consequences of a given law, but the trajectory of Lord Steel’s legislation should at least give us pause for thought.
Statistics from Oregon (scroll to page 7 on this report), where assisted dying has been legal since 1994, indicate that of those who ended there life in this way, 59% in 2014 stated “burden on family, friends / caregivers” as an “end of life concern”. For the previous year the figure was 61%.
Legislation that starts out granting the right to die has all the potential for creating a climate in which those who have the right to die feel a duty to die. I cannot for one moment believe that this is a direction in which a nation that considers itself an enlightened Western democracy should wish to travel. Whatever way you look at this legislation it supports taking life rather than preserving it.
Although many would dismiss it as alarmist, I believe that we are in danger of promoting a culture of death in our society. And legislation such as this catalyses the growth of that culture.
I have written to my M.P. asking her to vote against this bill. Please write to your M.P.. It is not too late. This link will show you how you can contact your M.P. by email.