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GEORGE CAREY: Why I've changed my mind on assisted dying

GEORGE CAREY: Why I've changed my mind on assisted dying

By George Carey, Former Archbishop Of Canterbury
DAILY MAIL
http://www.dailymail.co.uk/debate/article-2689511/Why-Ive-changed-mind-assisted-dying.html
July 11, 2014

Anyone who has had to watch a loved one go through the final agonies of a painful terminal illness is bound to ask deep philosophical questions about the nature of life and death.

I remember Dorothy, one of my congregation many years ago, at the beginning of my career, when I was a parish priest in Durham. An intelligent and faithful Christian lady, she had been an outstanding head teacher.

In retirement, she found out that she had cancer in an advanced form.

I visited her regularly in hospital. I saw the ravages of the illness on her body as she was given huge doses of morphine to try to keep the excruciating pain at bay.

Talking about her discomfort one day as she lay with tubes dripping fluids in and taking fluids away, Dorothy questioned whether she could go on, whether life was worth living. ‘It is quality of life that counts,’ she whispered, ‘not number of days.’

When I visited her again, I must have looked very miserable because she looked up at me and said: ‘Why are you so sad, Vicar? I’m only dying, you know!’

I saw in that reply the depth of her faith. There was something else, too. Life was precious when it was worth living. Tired and in pain, she feared nothing from its end. Indeed, she died the next day.

Even the most devout believers will find their faith tested by the sight of a dying person in torment — especially when modern medicine could swiftly bring the torment to a merciful end.

Indeed, this rapid advance of medical technology has brought us to a crucial ethical turning point.

For, while drugs might be able to hasten the end more quickly and painlessly, sophisticated medical science also offers people the chance to be kept alive far beyond anything that would have been possible only a few years ago.

Yet our laws have not caught up with the science.

While medicine progresses at a remarkable pace, our outdated statutory framework remains trapped in the past, badly out of kilter with the real needs of our society.

For years we have had a basic, comprehensive law to prevent any person killing another.
Under the terms of the Suicide Act (1961), assisted suicide is illegal and punishable by up to 14 years’ imprisonment. Depending on the circumstances, it is regarded as either manslaughter or murder.

But now, in some cases, that law risks undermining the efforts of families and doctors to care for and ease the pain and misery of people reaching the end of their lives.

This is worrying, for I believe that such compassion and concern should be at the very heart of our society.

As a result of this growing gap between the existing law and the need for compassion, pressure is growing for change. There is now a powerful campaign to legalise assisted dying for terminally ill patients.

Professor John Ashton, president of the UK’s Faculty Of Public Health, has urged that doctors be allowed to give dying patients a legal dose of lethal drugs if they ask for help to end their life, without any fear of prosecution. The NHS, he said, should ‘stop keeping people going at any price’.

His call was echoed by an editorial in the British Medical Journal which stated that ‘people should be able to exercise choice over their lives, which should include how and when they die, when death is imminent’.

These demands follow a recent high-profile case in the Supreme Court in which a man called Paul Lamb, who had been paralysed in a car crash, eloquently argued that the refusal to allow him the right to die was a breach of his human rights.

It was impossible not to be moved by his argument, especially when he described the horrific pain he has to endure every day.

He was supported in this legal action by Jane Nicklinson, whose late husband suffered from the terrible locked-in syndrome after he suffered a stroke.

A previously active, sports-loving family man, Tony Nicklinson had been rendered absolutely powerless, vulnerable and isolated, an experience he found intolerable.

Although sympathetic, the Supreme Court judges could not directly support Paul Lamb’s case, maintaining that it was for Parliament — not the judiciary — to change the law.

But they sent a powerful signal that politicians had a duty to look again at this issue.

Next week there will be the perfect opportunity to do so, when MPs and peers are due to debate a Bill on the right to die which has been introduced by the former Lord Chancellor, Lord Falconer.

The proposed new law would enable doctors to prescribe lethal doses of drugs to terminally ill patients who have stated a clearly expressed intention to end their lives.

Until recently, I would have fiercely opposed Lord Falconer’s Bill. My background in the Christian Church could hardly allow me to do otherwise.

I would have used the time-honoured argument that we should be devoting ourselves to care, not killing. I would have paraded all the usual concerns about the risks of ‘slippery slopes’ and ‘state-sponsored euthanasia’.

But those arguments that persuaded me in the past seem to lack power and authority now when confronted with the experiences of those suffering a painful death.

Dorothy’s words — ‘It is quality of life that counts, not number of days’ — ring in my ears.

The current law fails to address the fundamental question of why we should force terminally ill patients to go on in unbearable pain and with little quality of life.

It is the magnitude of their suffering that has been preying on my mind as the discussion over the right to die has intensified.

The fact is that I have changed my mind. The old philosophical certainties have collapsed in the face of the reality of needless suffering.

It was the case of Tony Nicklinson that exerted the deepest influence on me. Here was a dignified man making a simple appeal for mercy, begging that the law allow him to die in peace, supported by his family.

His distress made me question my motives in previous debates. Had I been putting doctrine before compassion, dogma before human dignity?

I began to reconsider how to interpret Christian theology on the subject. As I did so, I grew less and less certain of my opposition to the right to die.

It seemed to me that both the Bible and the character of God laid far more importance on open-hearted benevolence than on upholding this particular law.

As I reminded myself, one of the key themes of the gospels is love for our fellow human beings.

Indeed, Jesus’s mission was underpinned with compassion for those suffering from the most dreadful conditions, such as leprosy. To those people, rejected by society and condemned to live apart, he brought comfort, healing and a new sense of dignity.

It hardly needs saying that I am a minority voice within the clergy and do not represent the views of the current Church hierarchy. But I am driven by private conscience to urge a change in the law when the matter comes before Parliament next week.

Today we face a terrible paradox. In strictly observing accepted teaching about the sanctity of life, the Church could actually be sanctioning anguish and pain — the very opposite of the Christian message.

Indeed, there is nothing anti-Christian about embracing the reforms that Lord Falconer’s Bill offers.

After all, church leaders already understand that the use of pain medication such as morphine may occasionally have the effect of hastening death.

Why not extend this understanding further, so that the dying have a choice over how and when they wish their lives to end?

Many of us, whether practising Christians or not, have used the term ‘merciful release’. If we truly think death can be a form of mercy after suffering, should that thinking not be enshrined in law?

Some complain that new laws governing the right to die would allow doctors to ‘play God’. But that is an argument without substance.

Health professionals already have power over life and death in numerous ways — such as the remarkable way in which newborn babies are kept alive until they are old enough to survive outside an incubator, or through complex surgical transplants.

The Church must start to face up to the reality of the world as it is.

In any case, the truth is that assisted dying is already a reality for people in this country.
People in desperate pain and suffering from terminal illnesses make visits to the Dignitas clinic in Switzerland, which has among the most liberal euthanasia laws in the world.

Families who accompany their loved ones to the clinic are already protected from criminal charges by guidelines issued by the director of public prosecutions.

Yet this official policy of turning a blind eye to clients of Dignitas is hardly adequate or compassionate. What about those unable to travel, or unable to afford the clinic’s fees? They, too, may be serving out their final days in extreme pain and discomfort.

It is a shameful blot on our country’s great reputation for caring for others that we have not come up with a better alternative than the Zurich clinic.

Then there are all those cases conducted in the shadows, where doctors, friends or relatives privately carry out mercy killings with a high dose of drugs.

Though the risk of prosecution may be small for those genuinely acting on the wishes of the departed, the police are duty-bound to investigate any such incidents.

It would be far better if this practice were taken out of the legal twilight.

For I believe that the present approach not only fails to distinguish between assisted suicide and murder, but imposes an extra burden on families already in turmoil.

A proper, legal means of seeking assistance to die would be more compassionate to them as well as to their sick loved ones.

There must, of course, be safeguards against abuse of the so-called right to die. It would be outrageous if it were extended beyond the terminally ill to an ever-widening group of people, including the disabled and the depressed.

Such a step would impose terrible pressures on some of the most vulnerable people in our society. It also conjures up the nightmare image of official death-panels that could decide the fate of individuals, as the sinister ideological eugenicists of the early 20th century advocated.

The need for caution is also shown by the experience of Holland, where assisted suicide was legalised in 2002. As a result, there are not just a few isolated cases of such doctor-assisted dying, but thousands every year.

This week Dr Theo Boer, who was involved in overseeing Holland’s euthanasia law, warned of a surge in deaths in Britain if our Parliament lets doctors give deadly drugs to their patients.

There is even a movement for a further change in the law to allow all Dutch people over the age of 70 who feel tired of life to be given the right to end it with professional help.

Though this is certainly disturbing, it should be noted that the overwhelming majority of cases of assisted death in Holland involve terminally ill cancer patients.

Any step towards assisted dying in Britain must be accompanied not just by powerful safeguards, but by a great improvement in palliative and hospice care.

Although the Churches, the NHS and charities have done some fantastic work in supporting the hospice movement, the truth is that such care remains something of a lottery.

Those facing death should be offered the best in professional services, so they can genuinely have dignity in their final days.

I strongly believe that this should be enshrined in law, thereby ensuring that the Government cannot easily evade its responsibilities.

As the debate on Lord Falconer’s Bill approaches, the challenge for us all is to rise above traditional and entrenched divisions. Instead of warring against each other, the Church, medical profession and campaigners on both sides of the argument should get together to work out an effective plan for the future.

It should be one that addresses both religious concerns and the principle that those who are painfully dying should be allowed to choose the timing of their end if they want.

The words of Bronnie Ware, a palliative nurse who has witnessed many deaths, should, I believe, be at the heart of the Christian response.

She said: ‘There is no doubt that the physical suffering of a dying person is cruel and unnecessary . . . The old ways of society and the current approach are not working any more.’

Above all, our attitude to these difficult cases should be one not of judgment, but of compassion.

The outcome of the debate on the Assisted Dying Bill could hardly be more important.

For the sake of those suffering at the point of death, we must not waste this opportunity to change the current law that has let so many people down so badly.

END

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