Assisted Dying- Can You Be Bothered?

If you are looking to gain a deeper understanding of the issues surrounding the assisted suicide bill which will be debated in the Lords today, you could do worse than read Greg Daly's blog for Catholic Voices which I reproduce in full below. Greg picks up on comments made by Poly Toynbee in the Guardian on Tuesday which put the two sides of the argument in stark relief for me. Madeleine Teahan has also address Toynbee's chilling comments in the Catholic Herald.

Mgr Keith Newton, head of the Ordinariate of Our Lady of Walsingham, has also issued the following statement:

The Assisted Dying Bill

The Assisted Dying Bill has its Second Reading in the House of Lords on Friday 18 July. If it became law it would make incitement to suicide routine in our society, thereby putting pressure on the most vulnerable to see themselves as a burden to society. The Church’s teaching is clear: that human life, from conception to natural death, is a gift from God. Christ calls us to offer those facing serious illness care and hope, not despair and killing. The emergence of the hospice movement, which has enabled great progress in palliative care, is one of the fruits of this Christian calling common to Catholics, Anglicans and other Christians. The Assisted Dying Bill is a rejection of this Christian inheritance, and instead promotes what Pope St John Paul II called a ‘culture of death’.
Information on lobbying Peers can be found here:
www.catholicchurch.org.uk/Home/Featured/Assisted-Dying-Bill/Contact-a-Peer
This conflict against the culture of death is first of all a spiritual one, and therefore I invite members of the Ordinariate and others to dedicate some time today (Thursday) or tomorrow (Friday) to pray - if possible before Our Lord in the Blessed Sacrament - for the upholding of the sanctity of human life.

It is good to see all the religious leaders of our country come together to condemn this. Ruth Dudley Edwards makes the essential point in The Telegraph:

The sentimentalists, the populists and the lazy-minded are in the ascendant, with showmen like Archbishops Carey and Tutu taking up populist positions. Whatever your views on assisted suicide, surely as a society we need to engage properly with the issue, before we go down a dangerous and irreversible path because we couldn’t be bothered to think about it properly?

With this in mind, have a read of Greg's blog below and then pray, and lobby!

Assisted suicide: the red flags from abroad

by catholicvoicesmedia

It is hardly surprising that in dismissing the reality of how some slopes truly are slippery, Polly Toynbee this week in the Guardian looked to the U.S. state of Oregon’s experience of assisted suicide to prove her point, asking skeptically, “How often will it be used? After 17 years of Oregon’s Death with Dignity Act 80 people out of 30,000 deaths used it last year.”

Oregon is  the jurisdiction where the legalisation of assisted suicide appears to have been least detrimental, making it the poster example for campaigners for a change in Britain’s law. Yet cultural, demographic, and geographic similarities mean that Britain’s near neighbours Netherlands and Belgium offer far more natural comparisons than distant, rural, thinly populated Oregon.

But even if Oregon were the comparison, it still offers a powerful warning of what happens once the law changes, as Lord Falconer proposes, to allow doctors to help people to take their lives. Since 1998, the first full year in which the Death with Dignity Act was in force, the annual rate of deaths from physician-assisted suicide has increased fivefold. Eighty deaths a year might not sound like a lot to Polly Toynbee, but barely four million people live in Oregon; such a death rate, if applied proportionately to England and Wales, would lead to more than 1100 annual deaths from physician-assisted suicide.

Consider, too, what happens in practice. Lord Falconer’s bill, as noted yesterday, leaves it to doctors to decide how public safety should be enforced, neither detailing criteria nor imposing safeguards for assessing patients’ eligibility for physician-assisted suicide. In Oregon between 1998 and 2009 the typical doctor-patient relationship for those who died through physician-assisted suicide was just ten weeks, and was often much shorter. It is hard to see how a doctor, however well-intentioned – and we will come on to this – could reliably assess a patient’s mental state and intention in so brief a period.

The brevity of so many doctor-patient relationships seems to be closely linked to the phenomenon known as “doctor shopping”: many doctors in Oregon, as in Britain, are strongly opposed to physician-assisted suicide, which means that those wanting a doctor to help take their lives have recourse to a small number of doctors. In 2013, for instance, following a similar pattern to 2012, a mere 62 doctors wrote 122 prescriptions for lethal drugs to enable patients to take their own lives. At least one of these doctors, as in the previous year, wrote ten prescriptions. These are doctors, naturally, who are very supportive of the idea of physician-assisted suicide.

‘Doctor shopping’, in this context, leads to patients seeking doctors who will give them the answers they want, which may not be in their best interests, as though ‘choice’ is the greatest good in medical care. It is hard to avoid comparisons with press stories these past years about British doctors who, rather than building relationships with their patients, were instead found to have signed abortion forms without even meeting the women for whom they ought to be caring.

Given Oregon’s experience, it is hardly surprising that the British Medical Association is concerned about how the introduction of physician-assisted suicide to the UK could undermine medical ethics, as well as endangering vulnerable individuals and – as Alice Maynard of Scope points out – undermining society’s attitudes to the weak. Similar views have been expressed by the Royal College of Surgeons, which recognises no circumstances in which physician-assisted suicide should be introduced, noting that a change in UK law would

fundamentally alter the role of the doctor and their relationship with their patient. Medical attendants should be present to preserve and improve life – if they are involved in the taking of life, this creates a conflict that is potentially very damaging.

Disturbing though the reality of Oregon’s physician-assisted suicide laws is, matters are decidedly worse in our densely-populated neighbors, Belgium and the Netherlands. They show just how laws on assisted suicide tend to be elastic: once we decide that it is in some people’s best interests to no longer be alive, we establish the principle that some lives are not worth living; once people get used to this notion, they naturally become willing to expand the range of people who can avail of physician-assisted suicide.

In Belgium, for instance, the number of deaths from physician-assisted euthanasia rose from 235 in 2003 to 1133 in 2011. And in February this year, despite public opposition from doctors including a group of 160 paediatricians, Belgium’s parliament voted to allow euthanasia for terminally ill children who request it and have parental support. Some slopes actually do slip.

Theo Boer, a Dutch former supporter of physician-assisted suicide, has spoken out against Lord Falconer’s bill based on the Dutch experience. He knows what he is talking about: he is a member of one of the Netherlands’ five regional review committees charged with assessing whether instances of euthanasia were conducted in accordance with the law,

Noting how assisted deaths have increased in number by about 15 per cent every year since 2006, such that physician-assisted euthanasia is now “on the way to being a default mode of dying for cancer patients“, Boer has noted that whereas the Netherlands’ law continues to see assisted suicide and euthanasia as exceptions, “public opinion is shifting towards considering them rights”, with corresponding duties on doctors to act. The parallels with Britain’s abortion law are, again, startling.

The law in the Netherlands presupposes an established doctor-patient relationship, but does not demand this, and this ambiguity has led to the Dutch Right to Die Society having founded a network of travelling doctors who typically see a patient just three times before administering drugs to end their life.

Boer has expressed concern about this development and about how the type of patients who are being ‘helped to die’.  Numbers of euthanised patients with dementia or psychiatric illnesses are now sharply on the rise, and there have been cases where a large part of the suffering of those given euthanasia or assisted suicide consisted in being aged, lonely or bereaved. These people could, with proper care and support, have lived for years if not decades.

Horrified by these developments, Boer’s warning to Britain is stark:

I used to be a supporter of legislation. But now, with twelve years of experience, I take a different view. At the very least, wait for an honest and intellectually satisfying analysis of the reasons behind the explosive increase in the numbers. Is it because the law should have had better safeguards? Or is it because the mere existence of such a law is an invitation to see assisted suicide and euthanasia as a normality instead of a last resort? Before those questions are answered, don’t go there. Once the genie is out of the bottle, it is not likely to ever go back in again.

[Greg Daly]

Father Simon Henry has written on this as well here, which led me to this moving, personal account from Matthew Schellhorn:

When my mum was diagnosed with late-stage cancer she turned to me and said, ‘We will get through it.’ At the time, I did not know what that could possibly mean.

Looking after my mum disrupted my normal life. Being her carer took away my time. It made me lose interest in music and endangered professional opportunities. It also dragged my pregnant wife and young son into a world of commodes, hoists, medication and round-the-clock worry.

But amidst the difficulties we all built our motivation on one solid belief, that life was something precious, something to be celebrated, cherished and affirmed. As mum’s health declined and the opportunities for ‘normal life’ decreased, the possibilities expanded. We lived the paradox that when there are limits to life the freedom is greater. Mum also knew that positive experiences would sustain the bereaved left behind: that further altruism also gave her life some meaning.
I am so glad I did not have to discuss the Assisted Dying Bill with my terminally ill mother. I think that if my mum had lived to know about this Bill it might well have destroyed all our happy experiences. I think she would have been terrified to know that the same doctors so keen to see her enjoying life, even in a limited way, might be perfectly willing to help her to end her life, should she have so chosen. It would have destroyed the relationship of trust to know that there were no boundaries between healthcare professionals and patients. And it would have demoralised her carers, who together worked towards making life comfortable, to think that their efforts might be considered futile.

It would also have increased my mother’s vulnerability. As she lay in bed for 23 hours a day in our living room I knew she was already self-conscious about the enormous strain put on us. Numerous times she took decisions about routine and food that she presumed would alleviate any difficulties in our family life. The sanctioning of that inclination, the condoning of any despair, might well tip the balance in favour of a fatal outcome ahead of further positive experiences. As I tried enormously hard to remove all suggestion that her presence was an unwelcome burden, there could have been an altogether more powerful tacit force undermining me.

Although it has made for uncomfortable reading, I have considered the arguments in favour of this Bill. Lord Carey and Desmond Tutu have given their reasons why it is ‘compassionate’ to provide an exit door to the terminally ill ahead of their natural demise. The Care Minister, Norman Lamb, thinks people should be able ‘to make their own decision about their life’.

These ways of thinking contradict established medical ethics and fly in the face of all logic. The life of a physically sick person is worth as much as a physically healthy person. Importantly, the person in question gains happiness from experiencing that truth. Now that the dust has settled, I see we ‘got through’ terminal illness, each in our own way. That is why I oppose this Bill.