By Fr. Francis Marsden
(Reproduced with the permission of the author)
Death is on the Parliamentary menu once again. On Friday 11th September the House of Commons is due to debate and vote on a Private Member’s Bill to legalize assisted suicide.
Rob Marris MP (Labour) has introduced what is essentially the same Bill as that introduced by Lord Falconer last year, which ran out of time before the General Election. Mr Marris’ constituency is Wolverhampton South West, a marginal; his majority was only 801 last May. Wolverhampton Catholics please take note!
The assisted dying (AD) bill would allow doctors to prescribe a lethal dose to terminally ill patients judged to have six months or less to live and who request it. A patient is supposed to be assessed to ensure that they have a “clear and settled intention” to terminate their life. The lethal prescription has to be approved by two doctors and a high court judge.
Most of us are afraid of death and of the dying process. We do not like pain. Toothache or headache and we reach for the paracetamol or ibuprofen, whatever our theology. We are afraid of dying in agony, of suffering uncontrollable acute pain that cannot be relieved.
While we know that sooner or later our last day upon this earth will come, we do not want our life to be prolonged artificially to no purpose, in great pain and discomfort. There comes a time when it is better to let Nature take its course and to say farewell to this world.
For many people, it is this fear of a prolonged, lingering dying, made worse by excessive attempts at medical treatment, which generates the support for euthanasia of one sort or another.
This prolongation of the dying process is known as disthanasia. It also is opposed to Catholic medical ethics.
We need to be clear what euthanasia is not. Euthanasia is defined as: ‘the intentional killing by act or omission of a person whose life is felt to be not worth living’.
So it is not euthanasia to stop a medically futile treatment where the burden of that treatment outweighs the benefits. So-called extraordinary treatment – excessively painful, burdensome or costly, without proportionate benefit to the patient – is never obligatory.
It is not euthanasia to give pain relief even if there is some risk that the treatment may foreshorten life (often it prolongs it slightly by removing stress and anguish). The condition is that the doctor does not intend to shorten life.
It is not euthanasia when a mentally competent person refuses treatment. This is a legal right. Medical staff cannot force a person to undergo treatment against his will. If the patient then dies it is not euthanasia. Bear in mind, however, that we have a responsibility to preserve our own life, and normally we should accept ordinary medical treatment.
For years the pro-euthanasiasts have been campaigning to swing public opinion round to their way of thinking, with the support of the BBC and other mass media. A key element in their campaign has been “compassion” for people with slowly progressive terminal illnesses – multiple sclerosis, Parkinson’s and motor neurone disease in particular.
Some 25 British citizens per year make the sad one-way trip to the Dignitas house in Zurich, sandwiched between two factories and a football pitch, to commit suicide with barbiturates. The “Freitod” (“free death”) treatment doesn’t come free at 5900 euros, maybe €10,000 if they include your cremation etc.
21% of Dignitas victims have no terminal illness, but are simply “weary of life.”
The second pro-euthanasia argument revolves around unlimited autonomy: the notion that I have the right to do whatever I want with my life. On the contrary. As well as rights we also have duties, in particular the duty of human solidarity, that is, of showing that life is worthwhile living, of not giving up in despair, of living bravely and cheerfully despite suffering. A dignified death is never a death by one’s own hand. That is the worst sort of death.
Moreover, suicide can leave families and loved ones with a terrible burden of guilt or unanswered questions. Why didn’t he say something? Why did he do this? What did we fail to spot? In over thirty years as a priest, the most traumatic funerals I have officiated at or attended have always been the suicides.
It is reckoned that in 80% of cases, the person who commits suicide is suffering from mental imbalance or dreadful depression. The fact that priests usually now permits a funeral for these poor individuals, does not mean that the Church condones their act. The Mass is a prayer for Divine Mercy.
The advocates of euthanasia claim that it will be carefully surrounded with safeguards and controlled - in the AD case by two doctors and a judge. However the experience of Holland and Belgium shows that it is impossible to control any sort of euthanasia once it reaches the statue book.
Dutch criminologists estimate that only 10% of Dutch euthanasia deaths are freely and competently chosen. Many are carried out by doctors on comatose or incompetent patients without consent. Very often a sick patient is depressed, and ends up euthanased within a few days. Palliative care in Holland is poorly developed. It is easier to kill than to care.
The fourth, but unstated argument for euthanasia is the economic one. This appeals to the Treasury and the accountants. With increasing numbers of elderly patients, hospital bed shortages, and an NHS at financial breaking point, the mandarins of Whitehall know that one way to save money is to dispose more quickly of those of us who are appraoching the natural end of our lives.
The euthanasiasts want us to believe it is kinder to kill than to care. It is certainly cheaper to kill than to care.
There is a sinister side to the AD legislation. It would make judges and doctors complicit in the killing of patients. We have already seen the dreadful results when doctors develop a liking for the power of life and death over their patients: the Harold Shipman case.
We took away from judges the power over life and death when capital punishment was ended. Are we now to give it back to them?
One voice worth listening to is that of Robert G. Twycross, a pioneer in hospice care. In the 1970’s he worked with Dame Cicely Saunders at St Christopher’s Hospice in London. He did specialist work on palliative care with diamorphine, morphine and other derivatives. He served as Director of the World Health Organization's Collaborating Centre for Palliative Care from 1988–2005.
In an article on the website of “Not Dead Yet” – an organisation of handicapped people against euthanasia – he explains that palliative care does not leave people to suffer uncontrollably. In extreme situations, increasing the dose of sedatives is already permissible.
The best response to the horror stories of long drawn-out deaths, is improving the quality of palliative care. 90% of palliative care specialists are against any change in the law.
The AD debate centres upon this question: Can a law be devised which would allow terminally ill people to end their lives (should they wish to) without endangering others (who do not want to)?
The answer is No. Already some patients refuse palliative care because they fear “being done away with.” They then suffer pain needlessly. If AD became lawful, it would enhance the perception of doctors and nurses as potential killers, and seriously undermine trust between patients and physicians.
The promoters of AD claim to be motivated by compassion. Palliative care and AD are mutually exclusive approaches. Palliative care is based on the belief that life has meaning and purpose right up to natural death. AD is nihilistic, believing that such a life has no purpose and the person is better off dead. One cannot expect health professionals to “face in two directions simultaneously.”
I might add that if AD were legalised, it would be preferable to have a separate group of “executioners”, totally apart from normal medical staff, whose job was killing.
Dr Twycross continues:
“The common denominator in patients who desire to hasten death is despair – a sense of hopelessness, helplessness and lack of control – related to actual or anticipated severe pain or other distressing symptom, loss of independence, and becoming a burden. The wish to hasten death is generally not constant unless the patient has a depressive illness, which normally responds to treatment.
In practice, almost all patients change their minds when in receipt of high-quality palliative care. In fact, an expressed wish by a terminally ill person to hasten death does not mean they want AD; they want to be heard, to express their frustrations and fears, to be understood.
Prognosis, when more than a few weeks, can be wildly inaccurate. Some patients live much longer than estimated, sometimes 10–20 years.”
There is also the danger of coercion. As one Dutch doctor remarked: ‘In the past, if I suggested euthanasia (a lethal injection), nine times out of ten the patient would choose euthanasia; now when I suggest palliative care, they choose palliative care’.
Families may also urge the doctor towards medical killing, or persuade their relatives that they are outstaying their welcome – especially if the nursing home fees are coming out of the inheritance. An elderly, confused, sick patient is extremely vulnerable. Once they have been euthanased, they can give no court evidence of how they were coerced into it.
Several of the high profile AD campaigners have actually died natural deaths with palliative care. That too tells us something! Permitting AD would be the foot in the door that the euthanasia lobby wants. Please write to your local MP and newspaper, if you have not already done so.
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