The NHS is 76 years old – and crumbling. How can waiting lists be cut, and the whole system made more efficient? As someone who has been on a waiting list since January, I have more than just a theoretical interest in the question. Wouldn’t the whole thing be a lot more efficient if there were less people in the system? One shortcut to achieving that may turn out to be ‘assisted dying’. Liam McArthur MSP introduced such a bill here in March, which will be discussed soon. South of the border, Keir Starmer seems ready to fast-track a similar one through the Commons. It would give adults who are terminally ill, with a life expectancy of less than six months, an option to end their lives with medical assistance.
Starmer is ’personally committed’ to changing the law and voted to do so in 2015. Other key figures in his party are less sure. The justice secretary, Shabana Mahmood, has said it is a dangerous ideas which she couldn’t back. According to a 2020 British Medical Association survey, only 10 percent of palliative care doctors would prescribe drugs to assist suicide, while 76 percent would not. The 2,500-year-old Hippocratic Oath – long considered the gold standard of medical ethics – contains the pledge: ‘Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course’. It certainly seems ironic that, just a few years after the world shut down to protect the vulnerable, medics could be given authority to help end the lives of some of the same people.
It can’t be denied that the end of some lives causes intense distress both for the individual and their family. Change certainly seems to be in the air. The Royal College of Physicians ended its opposition to changing the law in 2019, with the British Medical Association following suit in 2021. The Royal College of Surgeons of England moved to a neutral position in 2023.
So what objection can there be to letting people end their suffering?
One obvious one is the pressure it would put on the vulnerable and unsure to end their own lives. There’s the danger of pressure from unscrupulous relatives or those who can’t bear the suffering of their loved one. The terminally ill patient may be frightened of becoming a burden on their family. A desire to ‘Protect the NHS’ may lead to the frail and elderly sacrificing themselves to the great national healthcare god. In Oregon, 50% of those who chose assisted suicide in 2019 cited ‘being a burden on family, friends or caregivers’. Significantly fewer – 33% - gave ‘Inadequate pain control’ as a reason to end their life. Writing in the Times, Matthew Parris suggest this is a good thing: ‘“Your time is up” will never be an order, but may one day be the kind of unspoken hint that everybody understands’.
Another objection is what has happened in other countries. In short there is no country that has gone down this road that has not either relaxed, or faced pressure to relax, its criteria. In Canada, Physician-Associated Euthanasia (PAE) has been legal since 2016. Initially it was for those over 18 with a ‘grievous and irremediable medical condition…with death reasonably foreseeable’. In 2019, the Superior Court of Quebec ruled that it was unconstitutional to restrict access only to those at the end of life. In 2027 it will be widened out to include anyone with a mental illness. Cancer patients are encouraged to go down the assisted dying route rather than have treatment that might prolong a good quality of life. In the Netherlands, euthanasia with parental consent is allowed for children with life threatening conditions over the age of 12 years and under the age of 1.
The biggest objection, however, is that life is not ours to take. An article in ‘The Bulletin of the Royal College of Surgeons of England’ states that ‘If a clinician did not create a life, it may be difficult for them to feel comfortable ending it’. Why is assisting suicide illegal in our country? Surely it stems from a belief that human beings are made in the image of God – or at least a sense that we are somehow different from animals. That doesn’t mean that Christians don’t pray at times for God to take them home to Heaven – but ultimately we do not give ourselves life and so have no right to take it. Our times are in his hands.
Published in the Stranraer & Wigtownshire Free Press, 3rd October 2024.