Doctors should avoid supporting a status quo that leads to great suffering, says Lord George Carey
When I first spoke out in support of assisted dying in 2014 many people were surprised. They had assumed I subscribed to the view that to help shorten life in any way, even at the voluntary request of a dying person, was morally wrong.
I did believe that but, through experience and frank discussions about assisted dying with distinguished palliative care and pain specialists, my views changed. I began to see that while medicine can do remarkable things for most dying people, there is an unfortunate minority who are forced to suffer unimaginable pain and misery, without any expectation of a return to health.
It is, of course, profoundly Christian to do all we can to ensure nobody suffers against their wishes. Some people believe they will find meaning in their own suffering in their final months and weeks of life. I respect that, but it cannot be justified to expect others to share that belief. Correspondingly any proposed assisted dying law must protect the rights of doctors and others with a conscientious objection, so they do not have to participate.
I am puzzled that some people oppose a change in the law that aims to relieve the experience of excruciating pain as well as enable suffering people to end their lives with dignity. Autonomy is a key element in medical care—why do we set it aside for those who refuse to prolong their own painful deaths?
Whether believers or not, most of us recognise the power of faith, the values and traditions of which should never be underestimated. But an unexamined faith, which does not rise to the challenges posed by modern medicine, can create tensions. As a former archbishop I am painfully aware that I am out of step with other Christian leaders although, ironically, in step with the vast number of Christians who see the need for change (82% according to the largest UK poll conducted on the issue [1]).
I was sad to see that the National Secular Society felt the need to write to the BMA to seek reassurances that the BMA’s treatment of assisted dying would be protected from undue religious influence.[2] However, I would love to see more religious leaders look more closely at the reasons why so many in their congregations are reconsidering this matter. It is not because they hold life to be unimportant, but because they understand that the demands of compassion lie with a change in the law.
Three arguments sit at the heart of any case constructed to oppose change: concern that legislation may have unintended consequences; misunderstanding about how assisted dying works in practice in places like the United States and Australia; and an unwillingness to recognise how much harm is inflicted by the UK’s existing laws.
I will not repeat the “for” and “against” arguments here. Instead, I ask you to consider why more assisted dying laws are being passed around the world, rather than existing ones repealed? Why have religious leaders in jurisdictions such as Oregon told me their societies have not descended into the dystopias once predicted by those who campaigned to block legislation? We should not shy away from these questions.
Nor should we protect ourselves from the reality of what is happening at present in the UK: immense suffering in spite of access to the best care [3]; people travelling to Switzerland to die if they can afford it [4]; others opting for lonely DIY suicides [5]; grieving relatives being charged with murder [6]; and in one case a pioneering doctor feeling he had no option but to starve and dehydrate himself to death. [7]
Some people claim that by legalising assisted dying we would be crossing the Rubicon, yet I consider this a crude attempt to mask the ethical and legal difficulties we have already stumbled into.
Laws do indeed send powerful social messages. I want to send the message that we live in a compassionate society that has the courage to confront complexity, not one that bases its rules on fear or misunderstanding.
I have observed a shift in pace in this debate in recent years. I meet far more people of faith who share my views. In parliament there is growing acceptance that change is needed.
History will no doubt conduct a forensic examination of how the assisted dying debate unfolded. I would not wish to see doctors criticised for being the last group defending a status quo many now recognise is leading to great suffering.
Lord George Carey, Former Archbishop of Canterbury.
Competing interests: None declared
References:
[1] https://www.populus.co.uk/poll/dignity-in-dying-2/
[2] https://twitter.com/Stephenmevans1/status/1215295376556797952
[3] https://www.dignityindying.org.uk/wp-content/uploads/DiD_Inescapable_Truth_WEB.pdf
[4] https://www.theguardian.com/lifeandstyle/2020/jan/25/a-letter-to-dignitas
[5] https://www.bbc.co.uk/news/uk-england-south-yorkshire-48875301
[6] https://www.bbc.co.uk/news/uk-england-stoke-staffordshire-49743727
[7] https://www.bmj.com/content/362/bmj.k2894.full
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