• Assisted Dying – Why I’ve changed my mind

    The time has come to admit it. I’ve changed my mind about assisted dying.

    As a priest, the presumption is generally made that I’m against it for religious reasons. Recent aggressive campaigning by those in favour of allowing doctors to help people to end their lives has been relentlessly dismissive of religious reasons for being against it. As though religious people have no consciences worth respecting, no bodies of their own, no pain and no right to be heard.

    The truth is, though I am very obviously religious, I do not have any religious reasons for objecting to the proposed law in principle but the longer that I’ve spent time with those who are actually dying the more I find myself unable to support a change in the law. My concerns are not religious but practical.

    For a long time I was fairly uncommitted in this debate. My tendency would be to think that the alleviation of pain was the ultimate goal for anyone at the end of life and to take the view that preventing pain might well be a justification for allowing someone to end their life early.

    More recently though experience has suggested to me that the question is a good deal more complicated than that. And so I find that I’ve changed my mind. From being moderately supportive of a change in the law, I now find myself fully opposed to the new legislation.

    I remember the day when I changed my mind very well too. I had been called to the deathbed of someone whom I did not know. Before I could get into the room with the dying person, their family met me in the corridor. They asked me whether I could help them as things were very difficult.

    “We were just wondering whether you could ask the doctors to speed things up a bit.”

    I replied that I couldn’t as the law wouldn’t allow such a thing. And I asked why. What was it? Did they need me to help them to speak to the doctors about trying to get some better pain regulation?

    “No” came the answer, “No – the thing is we’ve a skiing holiday booked and we leave on Monday – we just need this to be over so we can get away”.

    That was the moment that I realised that not everyone dies with people close to them who have their best interests at heart.

    Those who are dying are some of the most vulnerable people in our society. They are losing their power to make independent choices. They are vulnerable to the attitudes of everyone they encounter. And almost everyone whom they encounter may have a financial or other interest not only in their death but in its timing.

    Spending time with the dying, I’ve also realised that those at the end of life are particularly vulnerable to societal assumptions about being a burden and causing a fuss.

    Increasingly, funeral directors are making good money from ghoulishly promoting Direct Cremations – the disposing of bodies without ceremony or the presence of loved ones. To do so, they repeat again and again in their advertising, suggests that it is better to face death without causing a fuss.

    Yet everyone who grieves knows that death in itself is disruptive. Death and grief change lives. They are not to be dismissed. No amount of trying not to cause a fuss changes that.

    It has all made me realise that when I die, I want everyone to know that I want plenty of fuss. Fuss is how we show one another that we love them.

    The desire to cause others no fuss at all though is one of the greatest pressures that the dying feel.

    If it were the case that all people had access to the finest palliative care at the end of their lives and were all surrounded by those who had their best interests at heart in institutions where there is no financial pressure on managers and medics then I might be able to get to a position where I might support the assisted dying proposals.

    However, we don’t live or die in that world. And until then, the best way to assist people to die is by investing in those studying pain management, better funding hospitals and hospices and by listening to the stories of those who sit alongside those who are dying.

    I’ve sat in those rooms many times.

    All of us should be in the presence of those who love and care for us when we die. Not all of us will be. The law, as it stands, is the best way to protect the interests of all of us when we die. For these reasons, I hope that our parliamentarians have the courage to vote no when the final vote is taken on this bill. It is legislation that would fundamentally change the relationship between the individual and the state.

    The principle of alleviating pain is a godly one but the reality is that the devil is in all manner of practical detail.

7 responses to “Assisted Dying – Why I’ve changed my mind”

  1. BobS Avatar
    BobS

    You lucidly illustrated an example of a family seeking to pressurise someone to influence the process of death. But what was possibly missing was the voice of the person nearing death. Where was their perspective, their reasoning? Assisted Dying starts and driven by the person dying. They are the ones who, with mental capacity, take those steps, if necessary, to expedite death at that final stage. They, together with medical experts, make those decisions.
    The examples cited refer to a family desperate for a skiing holiday and your concern of funeral directors making money through direct cremations.
    I fully agree with your desire for a better palliative care system. Having witnessed their work it is amazing. But that is another argument. To conflate the two dismisses the voice of those seeking assisted dying.
    Your concern over assisted dying seems to be interwoven by a call for improved palliative care and a demise in direct cremations.

    1. Rev Owain Jones Avatar

      Respectfully, Bob S, I think you’re overlooking the one thing that struck me very forcefully from this incident. I’ve always felt profoundly uneasy at the likelihood – I’d say ‘moral certainty’ – that the voice of the dying will in some cases be influenced, even swayed, by the dying person’s assumptions, inferences or intuitions (correct or not) about the needs of those closest to them, and even their desires. These desires might not be articulated, or even correctly guessed – but they might, and as soon as the dying person is subject to them, they are, by definition, influenced in their decision. At that point, Assisted Dying can no longer be said “to start and driven by the person dying.” I’ve been there for a long time – but what I suddenly realized reading Kelvin Holdsworth’s post, was that there’s a much darker issue here, and it relates to a fundamental principle to which I’ve always adhered. Please bear with me, and entertain for a moment an analogy which you might consider to be extreme, and which I’d be appalled to hear deployed by the religiously fanatical opponents of Assisted Dying. It’s this. I have always been opposed to the death penalty for a number of reasons, but very prominent among them is that it takes to an extreme the testing of a fundamental principle of justice (which I know I’m modifyng here to make the analogy a better fit, and of course, you’re free to take issue with that): “It is better that a hundred guilty men go free than that one innocent person be punished unjustly.” I’m aware that there’s a very significant separation between that and this, but I don’t believe it amounts to ‘clear blue water’. Let me try and articulate my conviction in a reasonable way, for you to consider, even if you reject it. I think that there’s a huge danger inscribed in legislation which will, of a moral certainty, permit circumstances in which unwilling dying individuals give assent under pressure to the active premature termination of their lives. This holds true even if a hundred times as many individuals assent freely, and even actively seek, such termination. One of the things that always made me uneasy about the Vulcans was the assertion that “The needs of the many outweigh the needs of the few”. There seems to me to be no way in any legislation to protect the needs and rights of the few in this issue. At the very least, I think that needs to be acknowledged openly by proponents of Assisted Dying. If we’re about to be taken across a Rubicon, I believe that everyone, on both sides of the decision, need to acknowledge that. (Incidentally, I completely agree with Kevin Holdsworth’s horror (I hope I’m expressing that fairly) at ‘Direct Cremations’ and the way they’re advertised. They seem to me to be open profiteering from the death-phobic culture in which we’re immersed. I fear that the impulses behind Assisted Dying as currently advocated may be a good-faith manifestation of the inability of society to look at the full actuality of human mortality and the relationship between life and death. I may be deluding myself, but I think I’d say that even if I were an atheist.

    2. Val Dobson Avatar
      Val Dobson

      You are wrong to connect funeral companies’ promotion of Direct Cremation with the push for assisted dying. Nowadays, many families simply cannot afford a “proper” funeral / cremation, and funeral grants come nowhere to covering the the costs. The funeral companies are simply responding to customer needs.

      1. Kelvin Avatar

        I’m happy to speak out about funerals being too expensive. However, it is manifestly not the case taht funeral companies are simply responding to customer needs. If they did they would promote these as being about price. They don’t – they promote them as being about not causing a fuss, which is the point I’m making here.

  2. Nigel Kenny Avatar
    Nigel Kenny

    Thank you for your wise and persuasive words – may they influence MSPs to vote against the Bill.

  3. Chriatine McIntosh Avatar
    Chriatine McIntosh

    Thanks for this, Kelvin – I’ve been thinking more about this as contemporaries begin to vanish from this life.

  4. Helen Leslie Avatar
    Helen Leslie

    Thank you Kelvin. I am someone who has spent the majority of my working life caring for people at the end of their lives. You said exactly what I would want to.

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