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Posted on Mon 21 October 2024

Don’t Open This Pandora’s Box - The Times October 2024

 Once again, we have a bill before Parliament to legalise assisted dying. Attempts to do this in the past have been widely opposed by those involved in Palliative Care, those at the ‘sharp end’ in the medical field, those with disabilities and people of different faiths.Parliament also has previously rejected such attempts and yet this many headed hydra keeps returning to the public arena.There seems now a well worn path in bio-ethical matters: the public is seen as opposed to a particular development. It is then worked on by well funded publicity campaigns, a suitable celebrity figure is identified and Lo! in a few years public opinion is presented as having changed( or is it that people are now simply too fearful of going against the flow of history?). In the present campaign, Dame Esther Rantzen( of That’s Life fame) has been recruited as the figurehead. For some time now, she has been saying that she has a terminal condition and wishes to end her life at a time of her choosing. As an admirer of her work, long may she continue to live but her case does show the elasticity of what ‘terminal’ means.

 Behind these campaigns, there is the false notion of autonomy: my life is my own and I can end it when and how I want to. In fact, life is not just our own. The Judaeo-Christian tradition, based on the Bible, has long taught that life is a gift from God in whose image every human being has been made. Thus we are related to the very source of our being. We develop as persons, furthermore, because of our relationships with our parents, siblings, spouses, relatives, friends and colleagues who also have varying degrees of claims on us. The inalienable dignity of every person derives from being made in God’s image and is basis for the prohibition on taking human life, except in tightly defined circumstances. We are not just ‘animals with large brains’ and assisted dying should not be compared, as it sometimes is, with the ‘putting down’ of pets’( apart from anything else animals cannot consent to the fate awaiting them at the vet!). 

 Our spouses, children and the wider family may wish to care for us with time and money rather than letting us take the ‘quick fix’ solution of assisted dying. The role of the medical profession, similarly, for thousands of years, has been to save, support and enhance human life not to use its expertise to intentionally bring it to an end. Even on the grounds of autonomy, suicide is not now a crime but assisted dying involves another party, whether that is a medical practitioner or a family member recruited, however reluctantly, to administer the lethal drug. It thus involves wider society in the fulfilment of our wishes. While most of those who tragically end their own lives are in a disturbed state of mind and so not wholly responsible for their actions, the proposed bill will require those who wish for an assisted death to be of sound mind. That is to say, responsible for their action before God, who gave them life, and those of their near and dear ones who wished to care for them.

 It is true, of course, that those with life threatening illness may be fearful of the suffering they will have to undergo and how long this may last. It is entirely right to recognise such fears and to provide assistance and comfort to those experiencing them. 

The Christian inspired Hospice movement, though shamefully underfunded, has provided just this reassurance of managing pain and providing an environment where those towards the end of their lives have an opportunity for reflection, the restoration of relationships and the putting of their affairs in order. I understand that pain can nearly always be relieved and that sometimes this can prolong life although, at other times, the use of pain killers may shorten or even bring life to an end. The question here is very much of intention. Is the intention to relieve pain or to kill? This we must leave to the regulation of palliative care and to the consciences of the medical personnel involved. It is, of course, for medical practitioners to discern when to withdraw treatment for an illness that is seen as ineffective or unnecessarily intrusive. The patient also can refuse treatment, if they so wish. The withdrawal of nutrition and hydration is, however, in a different category and, in my view, these should not be withdrawn unless providing them becomes too complicated and intrusive.

 One of the dangers in this proposed legislation is that the elderly or the seriously ill may feel they have a ‘duty to die’ to relieve their loved ones of the burden of care. However unjustifiably, they may also feel that they are a burden on the health service and the nation itself. This should never be allowed to happen.

 The ‘slippery slope’ is often mentioned in this connection and it is the case that in whichever jurisdiction assisted dying has been legalised its remit has become progressively widened to include not only the terminally ill but also those with painful illnesses that are not terminal and then those who may be mentally ill or depressed or just tired of life. This is the logical result of the radical autonomy argument: “it is my life and I can end it when and how I want to”. Rather than acceding to such wishes, we need to build a society of care and connection where people can feel they belong and are valued, where family and friendship is supported and encouraged, where there is inter generational communication and care between the young and the old, the differently abled, the well and the sick. 

 It is my sincere hope that this bill will not succeed but if, God forbid, it does then we must make sure that adequate provision is made for the exercise of conscience. I understand that this may be provided in the draft bill for doctors but what about nurses, para medics and others who will be expected to cooperate in the delivery of this dreadful programme? Many Christian and other faith organisations are involved in the provision of Care Homes for the elderly. Will they be expected to service a request for assisted dying or will they be exempt? As the remit of the provision expands, as it undoubtedly will, will those caring for the disabled or mentally ill find themselves involved in having to take part in this ritual of death, when they had thought they were helping people to live as full lives as possible?

 We must oppose this well intentioned but, ultimately, dangerous legislation before a Pandora’s box is opened which will be impossible, afterwards, to shut.

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