I am not against euthanasia for "religious reasons". I do not think it is enough to say "life is sacred" and believe that the debate stops there. If my faith influences my position on euthanasia, it is mainly because it urges me to speak out to protect the most vulnerable and encourages me to face truths that will set me free. My opposition to euthanasia come mainly from eleven years experience working as a medic in the NHS - including spells as a palliative care doctor and a psychiatrist. I have neither time nor energy to write an in-depth blog on every reason I have for opposing legalized euthanasia: some notes will have to do. The notes may seem a little disjointed, but I hope together they paint a picture of what I find troubling about the right to die debate:
Effective palliative care has not be found wanting - it has not been tried. All of us will die and most of us will have some warning of that death. Death is a very common ailment! Yet the medical speciality which supports "good dying" has been chronically underresourced (much of it funded by public donations and not the NHS budget), and palliative care training for all health care professionals is seen as something optional rather than a core skill. I grieve for Debbie Purdy and remember her as a remarkable woman, but I think the many less-celebrated people with life-limiting illness who raise money for their local hospice or Macmillan nurses have done more to ease the suffering of those with incurable disease. I also wish more was done for the millions of people worldwide who will die in unnecessary agony because of ignorance and cultural suspicions about effective palliative pain relief. So if you are concerned about suffering associated with terminal illness, don't write to your MP to get them to support Lord Falconer - write to your MP and ask what they are doing to help resource effective palliative care in the UK and abroad.
Most people in the UK do not know what normal dying looks like. The vast majority of deaths occur in some form of institution, and have done for three generations. As a doctor, I did not find it unusual to walk into a room where someone was leaving this life in a beautifully gentle way, and be accosted by distraught relations begging me to hasten the end and "stop them suffering". Losing someone you love is an intensely painful experience - sadly we all know that - and distressed relatives, ridden with very normal feelings of guilt and anxiety, do not always respond rationally to what is before them. In the right to die debate, doctors are often accused of over-treating dying patients and denying them a dignified, peaceful end. While I do not suggest for one moment that some of my former colleagues could not have benefitted from palliative care training to help them know when to draw back on treatments and interventions that were no longer helpful (see my first point!), many front-line staff are pressured by relatives to continue treatments, food and fluids when best and kindest practice would be to stop. There is a great need for education amongst the general public as well as amongst the professionals.
A left-field one, this one. The baby boomer generation are beginning to die. This generation - for those interested in generational theory -are an interesting bunch. They succeeded the wartime generation, who were depleted and defeated by what they had endured, and took control of post-war Britain from their early twenties. They pretty much stayed in control for the next forty years, and now in active retirement remain influential in many spheres of common life. They have not relinquished control easily to susequent generations, struggling to anticipate a world they were not controlling. Have you noticed a common theme? But death is the one thing you cannot really control is it? For an entire generation this is a huge anxiety, and I am not surprised that despite euthanasia being discussed for centuries, it is now the debate is gaining momentum.
Back on central ground, again. Lord Falconers bill will not help the majority of the heartbreaking cases we see portrayed in the media. We have heard many stories of people with incurable and incapacitating illnesses which cause them distress and indiginity, but few of them are in a recognisable terminal phase of a illness. So, there is no comfortable solution - if we are determined not to have some sort of free-for-all in terms of ending life, we will have to accept that some hard cases and some suffering will always lie out with the law. Also, the safeguards most recently discussed are unlikely to be responsive enough for terminal patients with acute symptomatic distress, so those tales you hear of "Grandma was in pain at the end" will still occur under this bill. The question we have to ask is what Lord Falconer's bill solves. It would not have ended Debbie Purdy's suffering. It would not have ended your neighbour's Gran's suffering. (Better access to excellent palliative care may have - see point one again) Is Lord Falconer's bill the best solution to the problem of terminal suffering? If not, what sort of problem is it trying to solve? Perhaps the generational anxiety I mentioned in point 3?
Finally, I have seen a lot of death compared to your average UK citizen. And even with the ignorance and under-resourcing mentioned above, I have seen very few expected deaths which ultimately did not have some peace and diginity. In the flurry of the euthanasia debate, you could be forgiven for believing that horrendous deaths were the norm, but that is not my experience. So, please don't be afraid. If you do have to wait with someone in the final days and hours of their lives, you can do a good thing. You can love them and care for them and ask for help for them and send them gently on their way. Love and do not be afraid x
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