JAMES KEOGH

PhD candidate, Department of Sociology & Philosophy, University College Cork, Ireland

Month: October, 2015

Care home director with motor neurone disease ends life at Swiss clinic

Monday 19 October 2015…http://www.theguardian.com/society/2015/oct/19/care-home-director-with-motor-neurone-disease-ends-life-at-swiss-clinic

A care home director with motor neurone disease has ended his life at a Swiss assisted-dying clinic, it was reported today.

Simon Binner, a 57-year-old Cambridge graduate, had previously announced on social media that he would take his own life.

In a posting on his LinkedIn page which emerged last week, he wrote: “I died in Switzerland with Eternal Spirit on 19 Oct 2015 and my funeral was 13 Nov 2015 … I don’t recommend MND. Better to have one massive fatal stroke or be killed instantly by a drunk driver! There is nothing I can say that is positive about MND.”

Eternal Spirit is a clinic in Basel where people end their lives. The Daily Mail reported that he travelled there over the weekend with his wife Debbie. In recent weeks Binner had been working with the British HumanistAssociation (BHA) and Bindmans solicitors.

They posted a video in which Debbie explained: “He doesn’t want to go to Switzerland and he doesn’t want to go into a hospital. He wants to be at home as much as possible with his friends and family. And I think the most important thing to say is that Simon believes if that was available in the UK he may well want to stay alive longer.”

A spokeswoman for the BHA could not confirm the death, but said in a statement: “Simon Binner’s battle with motor neurone disease may now be at an end, but many others like him continue to suffer without access to the dignified death that they want for themselves.

“All these people want, like Simon, is for the law to treat them with compassion and respect them as fully autonomous human beings. Most Britons agree with this position – around 80% of us.

“But parliament has let the people of Britain down, and now the fight for the right to die‬ must return to the courts. Our thoughts remain with the Binner family at this difficult time.”

In September MPs rejected the assisted dying bill to allow terminally ill patients to be supplied with a lethal dose of drugs.

Desmond Tutu: I approve of assisted dying

Sunday 13 July 2014 10:03…http://www.independent.co.uk/news/uk/home-news/desmond-tutu-i-approve-of-assisted-dying-9602619.html#commentsDiv

Desmond Tutu has spoken out in favour of assisted dying for the terminally ill, days before the controversial subject is set to be debated in the House of Lords.

The retired Anglican archbishop said that he reveres the sanctity of life, “but not at any cost”, adding that he now wants to apply his mind “to the issue of dignity for the dying”.

The 82-year-old said the treatment of his friend Neslon Mandela, who endured a long and difficult illness in which was hospitalised a number of times to keep him alive, was “disgraceful”.

Writing in the Observer, Tutu cited an incident when Mandela was required to appear with political leaders shortly before his death, stating that it was clear that Mandela “was not fully there”, was “an affront to Madiba’s dignity”.

Tutu has made it clear that he does not want his life to be prolonged: “I don’t want people to do their damnedest to keep me alive,” he said.

“Yes, I think a lot of people would be upset if I said I wanted assisted dying. I would say I wouldn’t mind, actually,” he added.

The religious leader’s comments come days before a pivotal debate in the House of Lords. On Friday, Lord Falconer’s assisted dying bill will be debated by a record number of peers, with 110 already registered to speak.

The bill proposes that doctors should be able to legally assist “competent, terminally ill” patients in their wish to die by handing over lethal medication, if it is believed the patient has less than six months to live.

Lord Carey, the former archbishop of Canterbury, shocked the church by his dramatic change in position on the proposed law, stating: “The fact is that I have changed my mind.” He dropped his opposition of the bill “in the face of the reality of needless suffering”, he said.

But the Anglican Church remains in opposition to the bill and has called for an inquiry into assisted dying, with the current Archbishop of Canterbury Justin Welby calling it “mistaken and dangerous”, warning that elderly and severely disabled people would face pressure to end their lives if the bill were passed.

The Church of England is circulating a letter written by a dying clergyman to every member of the House of Lords in a bid to stop the law being passed.

The letter is written by Rev Christopher Jones, a former chaplain of St Peter’s College, Oxford, and advisor to the Archbishop’s Council, while he was dying of cancer.

Jones, who died in 2012, wrote in the letter that while he experienced “extreme stress and a sense of hopelessness” when he knew his condition was terminal, and that he would have been open to assisted dying, were it an option.

However, he later experienced a renewed “energy and vitality” that he described as being “recalled to life” when his cancer went into remission, and experience that he would have been denied, had he chosen to end his life earlier.

Right to die: MPs reject assisted dying law

2:59PM BST 11 Sep 2015….http://www.telegraph.co.uk/news/uknews/assisted-dying/11857940/Assisted-dying-vote-in-House-of-Commons.html

MPs have overwhelmingly rejected the legalisation of assisted dying in England and Wales after an impassioned four-and-a-half hour debate in which party lines were set aside.

Members voted by three to one against giving second reading to a bill tabled by the Labour backbencher Rob Marris, to allow terminally ill patients to be supplied with a lethal dose of drugs

It was the first ever serious attempt to change Britain’s assisted suicide laws through the House of Commons and saw calls for the issue to be put to a referendum amid polling suggesting public support running at around 80 per cent.

MPs on both sides lined up to give moving personal accounts of the loss of loved ones arguing both in favour and against.

But they were swayed by a series of warnings, including from fellow MPs qualified as doctors, that a change in the law would fundamentally alter the relationship between doctor and patient.

The bill, based on a system already in place in the US State of Oregon, would have enabled anyone thought to have no more than six months to live in the opinion of two doctors to be given heolp to end their life.

A High Court judge would also have had to rule that the person had voluntarily expressed a clear, settled intention to die.

Assisting a suicide is a crime in the UK punishable by up to 14 years in jail, but guidelines drawn up by the former Director of Public Prosecutions Sir Keir Starmer mean that those who help loved-ones travel abroad to die are unlikely to be charged if they are acting out of compassion.

Dr Peter Saunders, campaign director of the Care Not Killing campaign said the vote was an “unequivocal rejection” of a “dangerous piece of legislation”.

“The current law exists to protect those who are sick, elderly, depressed, or disabled from feeling under pressure to end their lives,” he said.

“It protects those who have no voice against exploitation and coercion, it acts as a powerful deterrent to would-be abusers and does not need changing.

“We hope Parliament will now turn its attention to the real issues facing our country of ensuring that everybody can access the very best care, regardless of whether they are disabled or terminally ill and that we fund this adequately.”

The Roman Catholic Archbishop of Southwark, the Most Rev Peter Smith, said the bill had posed “grave risks” to the most vulnerable people in society.

“There is much excellent practice in palliative care which we need to celebrate and promote, and I hope now the debate on assisted suicide is behind us, that this will become a focus for political action,” he said.

Speaking for the Church of England, the Bishop of Carlisle the Rt Rev James Newcome, said: “The vote in the House of Commons sends a strong signal that the right approach towards supporting the terminally ill is to offer compassion and support through better palliative care. We believe that all of us need to redouble our efforts on that front.”

But Sarah Wootton, chief executive of Dignity in Dying, said: “The vote only goes to show just how ridiculously out of touch MPs are with the British public on the issue.

“By rejecting the Bill Parliament has in effect decided to condone terminally ill people ending their own lives but refused to provide them the adequate protection they need,” she added.

“Suffering will continue as long as MPs turn a blind eye to dying people’s wishes. Dying people deserve better.”

Rabbi Dr Jonathan Romain, one of a group of faith leaders supporting assisted dying said: “We are saddened that it failed to progress, as it dashes the hopes of those who wish to avoid ending their days in pain or incapacity.

“We hope MPs will revisit the issue at a future debate, although it will be too late for those who face dying in distress right now.”

Among MPs who spoke from their own experience in the medical profession, Dr Philippa Whitford, the SNP MP and breast cancer surgeon, gave an impassioned speech urging MPs to allow terminally ill people a “beautiful death” rather than helping them die.

But there were many moving contributions from supporters of the change. Paul Flynn, the Labour MP, read out a heart-rending letter from an elderly man who had sat with his wife as she starved herself to death for three weeks after she begged him to help her die.

“Every day of her life she said prayers for other people but when she pleaded ‘please God help take me now’ for once in that long life she prayed for herself but there was no-one to answer,” the man wrote.

Mr Marris told MPs that the current system amounts to “protection for the dead when it is too late” rather than proper safeguards and choice for those facing the end of their lives.

“The current law does not meet the needs of the terminally ill,” he said. “It does not meet the needs of their loved ones and, to some extent, it does not meet the needs of the medical profession.

“We have amateur suicides going on. We have what would be technically illegal assistance going on and we have those who have means going off to Dignitas in Switzerland and the Supreme Court in the Tony Nicklinson case recognised that there is a problem.”

He went on: “This bill provides protection for the living, what we have at the moment is protection for the dead when it is too late.

“Because it is only after people die in questionable circumstances that an investigation is made by police and the prosecuting authorities and then a decision is made on whether a decision would be in the public interest.

“I make no criticism whatsoever of the prosecuting authorities or the police, they are doing the job that we in Parliament have asked them to do but they are doing it after the fact.

“And the fact is that in many of these cases there are only two witnesses to what happened when that person died and one of those witnesses is dead. There are safeguards in this bill for the living the, the two doctors and the judge.

“In Oregon there is not one documented case of abuse or misuse, there a many rumours and urban myths … no one there has ever been changed with a crime.”

Pointing to the need for the former Director of Public Prosecutions to draw up detailed guidelines, he said: “It is time Parliament grasped this issue and social attitudes have changed.

He was challenged about concerns from doctors who oppose assisted suicide but might feel force d to step in in extreme cases, such as where a patient chokes.

“I appreciate that the medical profession in England and Wales is divided on this bill and that probably a majority are against,” he said.

“However, as far as we can tell, there is a significant minority who are in favour of this bill some of them I suspect because they would themselves like to have the option if they were terminally ill.

“There is no contradiction between this bill and having high quality palliative care – it is not a case of one or the other. “Some patients’ needs cannot be met by palliative care and they remain suffering.”

Amid a debate filled with powerful and at times emotional contributions from both sides of the argument, several MPs who worked as doctors spoke of their experiences.

Dr Whitford, the MP for Central Ayrshire, recounted how seeing one terminally ill woman go from fear to experiencing a “beautiful death” had made her decide to dedicate her career to working with cancer patients.

She spoke of being involved in journey with patients whose cancer comes back.

“That journey can lead to a beautiful death,” she said. “The biggest impact on me as a junior doctor was the death of a lady that I had looked after for many months. When I came onto the ward that night the nurses said I think Lizzie is going.

“She was curled up in her bed obviously quite upset, she said she was frightened, she didn’t know what to do. I said you don’t have to do anything, you just have to relax, you just have to let go.

“We had the family in. The West of Scotland male is not good on emotion or openness so I took her son in and I spoke to her again about what was happening to the point where he could tell her that he loved her, how much he was going to miss her.

“I went for a tea and came back and she was sitting up holding court and I thought Oh no we’ve called it wrong. But she was gone in an hour. And it was beautiful.”

Detailing the transformation in the approach to death within her career, she said: “I think we should support letting people live every day of their lives until the end and recognise that as legislators we provide the means for them to live and die with dignity and comfort not to say when you can’t [bear] it take the black capsule. I think we should vote for life and dignity and not death.”

Ben Howlett, the Conservative MP for Bath, said he had come to the Chamber planning to vote in favour but had been persuaded to change his mind by Dr Whitford’s words.

Among those welcoming the vote, the Roman Catholic Archbishop of Southwark, the Most Rev Peter Smith, said the bill posed “grave risks” to the most vulnerable people in society.

“There is much excellent practice in palliative care which we need to celebrate and promote, and I hope now the debate on assisted suicide is behind us, that this will become a focus for political action,” he said.

“We hope MPs will revisit the issue at a future debate, although it will be too late for those who face dying in distress right now.”

A similar Bill, introduced by Lord Falconer, was granted a second reading by the House of Lords following a marathon and impassioned debate last year. It was subject to two days of detailed committee stage debate but failed to make progress before the election.

Sir Keir, who is now a Labour MP, detailed how he had drawn up the guidelines allowing leeway for relatives and loved-ones to offer help but not medical professionals.

He said he now believed there was an “injustice trapped” in the guidelines – that those who wish to end their lives can in practice receive amateur assistance from loved-ones but not professional help unless they have the ability and the means to travel abroad.

But Nadine Dorries, the Conservative MP and former nurse, said thousands of people with no close relatives who effectively count the state as their only next of kin would find themselves in a unenviable position if the law sanctioned assisted dying.

“That sends a shiver down my spine,” she said.

Dr Liam Fox, the former Defence Secretary gave an impassioned speech against a change in the law which he said would force doctors and nurses into an “ethical trap” in the most difficult circumstances.

Recalling his time as a young doctor in Glasgow Royal Infirmary, he said: “I very often would be sitting with a dying patient and there is a very strong temptation to end their suffering.

“I believe anything that increases this pressure on doctors is an ethical trap which I do not want to see.”

He said the principle of “double effect” – in which strong medication given to reduce pain also hastens a patient’s death – was widely accepted.

“That is very, very different ethically and morally from giving a patient something that is primarily designed to kill them,” he said.

Norman lamb, the Liberal Democrat MP and former care minister, said he had changed his mind to back assisted dying after speaking to terminally ill patients.

“When I think would I want that right I am very clear in my mind that I would want it,” he said. “I don’t know whether I would exercise it but if I would want it for myself how can I deny it to someone else.”

Among them Paul Flynn, the Labour MP, said that the use of double effect was nothing more than a “mind game of self-deception” by doctors and the church and potentially “far more dangerous” than the proposals for assisted dying.

He urged the UK to have a referendum on the issue as had happened in Oregon.

He read the House a moving letter from an elderly man who had sat with his wife as she starved herself to death for three weeks, feeling powerless at not being able to help her die as she had asked.

“Every day of her life she said prayers for other people but when she pleaded ‘please God help take me now’ for once in that long life she prayed for herself but there was no-one to answer,” the man wrote.

He went on to describe how she had become increasingly emaciated and had reached the stage where “the shame and humiliation were no longer an embarrassment”.

“I held her close on the days when I could no longer understand her mumbled words, I could only reply hoping she would hear when I said ‘I love you darling, I understand’.

“I hope she knew that I was there with her. I held her when her eyes no longer opened and when she could no longer see I knew she could hear my words when a tear dropped from the corner of an eye.

“I held her until she had no touch, no sight possibly no hearing and I still said ‘I know darling I love you I understand’. I watched her beautiful face become a skeleton and held her when this poor love finally die.

“I hope she knew I was there but I doubt it. And now for the rest of my life I will remember her poor wrecked body and once so beautiful face become a hallow mask.”

Arguments against

  • Faith groups have led the argument against assisted dying, insisting that it would have serious impacts for the most vulnerable in society.
  • The Church of England believes a change in the law would lead to people either feeling pressured to, or putting pressure on themselves to, end their lives prematurely.
  • The Archbishop of Canterbury described the issue of assisted dying as one of the “biggest dilemmas of our time” but said legalising the act would give rise to a “slippery slope” which could lead to further difficulties.
  • Justin Welby stressed his belief that the current law is working and allows for compassion but society must accept that some situations will never be “neat and clear cut”.
  • His concern was recently echoed by UK faith leaders Dr Shuja Shafi, secretary general of the Muslim Council of Britain, Ephraim Mirvis, chief rabbi of the United Hebrew Congregations of the Commonwealth and Lord Singh of Wimbledon, director of the Network of Sikh Organisations UK in a joint open letter to MPs.
  • Together they warned that the UK would cross a “legal and ethical Rubicon” if Parliament votes to let terminally ill patients end their lives.
  • They are supported by David Cameron, who has made his own opinion on the ethically fraught issue clear. A Downing Street spokesman said the Prime Minister is not in favour of an approach that would “take us closer to euthanasia”.

Arguments for

  • However, an alliance of bishops, priests and rabbis, including former archbishop of Canterbury George Carey, have broken ranks to voice an opposing view.
  • In stark opposition to Archbishop Welby, Lord Carey instead believes allowing doctors to help terminally ill people to die is a “profoundly Christian and moral thing” to do.
  • Proper legal safeguards could be devised to ensure vulnerable people are not pressurised into ending their lives by greedy relatives, he argued.
  • Dr Jonathan Romain, Rabbi of Maidenhead Synagogue and chairman of the group Inter-Faith leaders for Dignity in Dying, was among those who signed an open letter published in the Daily Telegraph which urged: “There is nothing sacred about suffering, nothing holy about agony, and individuals should not be obliged to endure it.”
  • Former director of public prosecutions Keir Starmer said the law needs to be changed to “deal with the problem of people wanting to end their lives in this country, medically assisted, rather than traipse off to Switzerland”.
  • He said the debate is not about legalising euthanasia but addressing in-built limitations in the current guidelines, which mean that there can be “injustice in a number of cases”.
  • Campaign charity Dignity In Dying believes it is time the UK “puts an end to unnecessary suffering and gives dying adults the choice of an assisted death”.

There is no legal basis for normalising suicide

1:40PM BST 10 Sep 2015….http://www.telegraph.co.uk/news/uknews/assisted-dying/11855862/There-is-no-legal-basis-for-normalising-suicide.html

Should Parliament legalise assisted suicide? Rob Marris, whose Assisted Dying Bill has its Second Reading debate in the House of Commons, believes we should.

It is important to understand what is being proposed: that doctors should be licensed to prescribe lethal drugs to terminally ill people so they can use them to take their own lives. Many doctors do not want to do this. A recent survey of GPs revealed that only one in seven would be willing to consider a request for assisted suicide.

A change in the law would be exploited by the ruthless who see personal advantage in the death of a relative or person over whom they have influence

This is a major change to the criminal law and to the “do no harm” principle that underpins medical ethics and practice. If Parliament is to go down that road, it needs convincing evidence that there is something seriously amiss with the law as it stands. I have seen no such evidence.

We have laws to criminalise acts that are not acceptable to us. One such act is encouraging or assisting someone to commit suicide. Society’s view of suicide is consistent and clear. Individuals who attempt to end their own lives should be treated with compassion and understanding and given help; but suicide itself is not something to be encouraged, much less assisted. This is why we have prevention strategies and suicide watches. Licensing assistance with suicide in certain circumstances flies in the face of such values, undermining them.

Laws are more than just regulatory instruments. They convey important ethical messages. When something is legalised by Parliament, it helps it acquire a stamp of social approval. An “assisted dying” law sends the message that, if you are terminally ill, taking your own life is something for you to consider and something that can be legitimately encouraged.

We can all think of exceptional circumstances where helping someone to end their life might not be morally reprehensible. But the law already has the discretion to deal with such cases sensitively and to ensure that charges are not brought where it is clear that there is no public interest in doing so. This is underpinned by guidelines to ensure consistency.

Under the present law, assisting suicide is rare. Fewer than 20 cases a year cross the desk of the Director of Public Prosecutions. If we had an assisted suicide law like Oregon’s – the model for Mr Marris’s Bill – then the evidence based on our different population sizes is that we will be looking at around 1,500 cases every year. And Oregon’s death rate from legalised assisted suicide is still rising. Enabling laws tend to encourage and promote the acts they enable.

There is also every reason to be concerned that the boundaries of an “assisted dying” law will not remain intact. The criteria proposed are entirely arbitrary. They do not rest on any rational logic, and for that reason they invite pressure to extend them.

We are already seeing the first attempts to relax the terms of Oregon’s law – to extend the six-months-to-live limit to 12-months-to-live. It’s hardly surprising. Criteria such as “terminal illness” and “six months to live” are arbitrary and uncertain. If compassion demands that we legalise assisted suicide for people who are expected to die shortly of natural causes, on what grounds can it be resisted for others who have longer-lasting conditions, such as MS or Parkinson’s, which they may have to cope with for many years?

By contrast, the law that we have now rests on the rational and widely-accepted principle that we do not involve ourselves in bringing about the deaths of other people. Once we start making exceptions based on loose criteria such as “terminal illness”, then the boundary becomes just a line in the sand, easily crossed and hard to hold. It will also be exploited by the ruthless who see personal advantage in the death of a relative or person over whom they have influence.

The present law and its application like all human constructs cannot be perfect. No law can be. But it fulfils the role that was intended for it – it deters malicious assistance with suicide while showing understanding and clemency in compassionate cases. It exists, not to give options and choices to some, but to provide protection for all, especially the most vulnerable. We tinker with it at our peril.

Dominic Grieve QC is MP for Beaconsfield and the former Conservative Attorney General

The Assisted Dying Bill is an ethical muddle

6:42PM BST 06 Sep 2015….http://www.telegraph.co.uk/news/uknews/assisted-dying/11847817/The-Assisted-Dying-Bill-is-an-ethical-muddle.html

On Friday, the Assisted Dying Bill will get its second reading in the House of Commons. If it passes, people can be helped to kill themselves, by law. Nothing like this has ever happened before in this country, which until now has based all medicine and law on the protection of innocent life. If one reads the Bill, the whole subject comes into clearer focus. Here are some points that arise:

1. In order to make people feel safe, the Bill requires the consent of the High Court (Family Division) for an assisted death to take place; the diagnosis of terminal illness by the “attending doctor” and by another “independent” doctor; a signed declaration of the patient’s desire to kill himself, witnessed by someone other than the doctors or a relation; and someone, not necessarily the “attending doctor”, to prepare and deliver the death-dealing medicines, and stay with the potential suicide until he is either dead or has changed his mind.

This whole process is in the charge of the Secretary of State for Health. Section 5 of the Bill provides for conscientious objection, so no one can be compelled to do any of the above. It is hard to imagine, however, that declining to take part would not damage the career of a politician (the Secretary of State), a High Court judge, a doctor or a nurse. Professionals who refuse to operate the law are always considered bores and weirdosand so are surreptitiously punished.

Millionaire hotelier Peter Smedley named as man whose assisted suicide was filmed by BBCThe Dignitas Clinic in Switzerland Photo: AFP  Photo: AFP

2. The people preparing and delivering the fatal drugs and helping the would-be suicide “ingest” them must, however, make sure “the final act of doing so must be undertaken by the person for whom the medicine has been prepared”. The person administering is not permitted to “have the intention of causing [the would-be suicide’s] death”.

This seems an ethically confused position. If, as the supporters of the Bill believe, it is good for a suffering patient to choose to die, why not – if that really is what he wants – kill him? Why not spare him the physical difficulty and mental anguish (he may be in a poor state, no matter how firm his decision) and do it yourself?

Here comes the well-known slippery slope: after a few years of watching people kill themselves, often with distressing incompetence, the argument for getting the professionals to do it direct will be presented as irresistible.

3. When the “assisting health professional” has delivered the drugs, he must then hang around until the person is either dead or has changed his mind and wishes to live. The definition of remaining with the would-be suicide can include “being in close proximity to, but not in the same room as, the person”.

How vividly one can imagine the scene: the nurse assisting ingestion, then leaving the bedroom to avoid the last convulsions, then re-entering after 10 minutes from the bathroom to check that all is “well”. Most people will surely find this etiquette for suicide-enablers macabre and the mind-bending demands it makes on the professionals cruel.

right to dieThe law is there to protect the dying  Photo: Alamy

4. Since the terminal patients wanting to kill themselves must be adults of sound mind and settled will, there is no place, in law, for the next of kin. It could not be otherwise, of course, but it would have remarkable effects. It would be perfectly possible, for example, for the sick person to get the agreement of the court, the inspection and signature of the doctors, the delivery of the drugs and the presence of the assisting health professional, all against the will of his spouse and children. They could carry out the fatal procedure against the wishes of the people who love him most and who are in the house caring for him.

The force of law would be applied to extinguish life in the heart of the family which is struggling to maintain it. Is this a bearable idea in a legal order? Could a spouse be charged with impeding a suicide sanctioned by the state? If not, according to the Bill’s morality, why not?

5. Conversely, how easily could professionals discern the true will of the sick person if he is being bullied by his family? It is, sadly, not unknown for people to want their relations to die. If such people can achieve their end under the cloak of law, some will be ready to do so. This could be a particular factor when the passage of time is involved. Suppose a Jeremy Corbyn-led government had just decided to double death duties – would it be surprising if the assisted dying figures showed a spike in the months before the new rate came into force?

Assisted dying is slowly turning into a fashionable, liberal cause

12:12PM BST 24 Aug 2015….http://www.telegraph.co.uk/news/uknews/assisted-dying/11820483/Assisted-dying-is-slowly-turning-into-a-fashionable-liberal-cause.html

Britain is inching towards the legalisation of euthanasia. Next month the House of Commons will debate overturning the ban on assisted dying – with the stipulation that the patient must have no more than six months to live, be able to make a “clear and settled intention” and have the approval of two doctors. It sounds foolproof. It’s also backed by a growing number of high profile stories of people so ill, so desperate that it’s hard not to sympathise with their decision to circumvent UK law and go to Dignitas. In an age when the boundaries of personal liberty are being pushed ever further, this seems like a rational and humane reform.

Except that it’s neither. It’s a terrible idea to base law upon individual cases of extreme circumstances. And while liberal reformers plea that they simply want to make the law reflect the realities of human experience, they overlook those human experiences that contradict their argument. Nearly 80 doctors across the country have written to the Telegraph to warn that the proposal could “devalue the most vulnerable in society.” They say that they regularly encounter patients who: “are under pressure from within to remove themselves as a burden on their hard-pressed families.” Sometimes that pressure does not come from within: “We do from time to time come across cases where there are signs of subtle pressures being exerted.” Libertarian reformers are often reluctant to acknowledge the sadder facts of life and the necessity of legal protection for the vulnerable. But these doctors write from positions of experience. Their warning should be heeded.

Millionaire hotelier Peter Smedley named as man whose assisted suicide was filmed by BBCThe Dignitas Clinic in Switzerland  Photo: AFP

Here are two scenarios that MPs should consider when voting on this bill. First, a man is told that he has cancer and it has spread throughout his body. He lives alone. He is frightened. He has never experienced surgery this invasive or pain this traumatic. He doesn’t appreciate that the pain may be controllable – he’s confused and depressed. There’s also no one around to tell him that doctors get things wrong all the time. In panic, he might reach the conclusion that he’s rather be spared months of suffering. He’d rather die.

This man’s choice is a desperate one shaped by pitiful circumstances. What if he had been told by someone who loves him that there’s always hope? What if he’d been made to understand that the pain isn’t always unbearable, that it can be lived with and that he could even be given some relative comfort? Is he really committing assisted suicide because of his physical illness or because of his mental condition?

The second scenario is alluded to in the GPs letter. A woman is told her cancer is getting worse and she might have months to live. Her family are financially overstretched. They’ve never been very fond of her. They are told that they could make adjustments to their house at great expense to keep her at home or they could put her in social care, where they likely won’t visit. The patient is scared. She doesn’t want to be any problem for her family. When she tries to raise the subject they give answers that seem like placating: “Of course we love you. Of course we’ll look after you.” She concludes that she can’t trust her family or else she doesn’t want her last months to be spent living with guilt at having cost them money. So she chooses to die.

This scenario reminds us of something libertarians too often forget: people do not make choices in isolation. That’s not how real human beings work. Their decisions are shaped by their material circumstances and by the attitudes of those around them. Finally, they are shaped by culture.

right to dieThe law is there to protect the dying  Photo: Alamy

Frankly, we run the risk of assisted dying becoming fashionable. That sounds glib, but it’s true. We are being bombarded with false statistics about over-population. We are told that social care is bad and under-funded (true in many cases but a good government could change this). The elderly are not valued but depicted as useless, costly. Wealthy liberals hail assisted suicide as a solution to the problem of pain, although pain is a tragic reality of life.

We aren’t encouraged to leave ourselves open to hope and love. But they are realities of life, too. A friend recently lost his mother. He told me that in the course of her illness, the doctors repeatedly said that it was time to “let nature run its course”. She repeatedly got worse only to recover and enjoy many more weeks with her family. He told me, emotionally, that he was so glad for that extra time. Isn’t it better to leave ourselves open to such wonderful possibilities than it is to choose death?

Assisted dying leaves vulnerable at risk, warns alliance of doctors

12:01AM BST 24 Aug 2015….http://www.telegraph.co.uk/news/uknews/assisted-dying/11819407/Assisted-dying-leaves-vulnerable-at-risk-warns-alliance-of-doctors.html

Allowing doctors to help terminally ill people to take their own lives would ‘devalue the most vulnerable’ in society, a group of physicians has warned.

Next month the House of Commons will debate whether to overturn the ban on assisted suicide.

But a group of nearly 80 doctors across the country has written an open letter to MPs warning that many elderly and disabled people already feel pressured to end their own lives because they think they are a burden to relatives.

“We believe such proposals devalue the most vulnerable in society,” they write in a letter in The Daily Telegraph

“We regularly come across patients who feel a burden to their relatives and to society due to their particular health and social care needs.

“They are under pressure from within to remove themselves as a burden on their hard-pressed families. With an ageing population and with many families today unable to devote themselves to full-time care of a seriously-ill relative, situations like this are not uncommon.”

They also warned that some families would use a change in the law to exert pressure on relatives.

“Most families are loving and caring, but some are not,” they argue.

“We do from time to time come across cases where there are signs of subtle pressures being exerted. These are difficult to prove but they can be very real, and we fear that, if Parliament were to legalise assisted suicide for terminally ill people, they would be given free rein.”

Assisted suicide remains a criminal offence in England and Wales, technically punishable by up to 14 years in prison. But polling has consistently suggested high levels of public support.

The Assisted Dying Bill was brought before the House of Lords by Lord Falconer but it ran out of time before the general election.

However Labour MP Rob Marris, adopted the draft regulations and they are expected to be debated in the House of Commons on September 11.

The new Bill would allow patients to end their lives if they have no more than six months to live and had demonstrated a “clear and settled intention.’ Two doctors must sign off the request and it is likely that a High Court judge will make the final decision under safeguards which were added when it was debated in the House of Lords.

Although MPs discussed assisted dying in a backbench committee debate on the Director of Public Prosecution’s guidelines in 2012, it will be the first time in almost 20 years that the Commons has taken a vote on the topic.

Downing Street has concern that the proposed change in the law would leave vulnerable people feeling pressurised to end their lives but signalled that Conservative MPs would have a free vote on matter.

Earlier this month an alliance of bishops, priests and rabbis broke ranks with the religious establishment to voice support for plans to change the law.

In a letter to The Daily Telegraph, they argue that far from being a sin, helping terminally ill people to commit suicide should be viewed simply as enabling them to “gracefully hand back” their lives to God.

The former Archbishop of Canterbury Lord Carey has also said that assisted suicide was a “profoundly Christian and moral thing” to do.

However the Rev Dr Brendan McCarthy, the Church of England’s national adviser on medical ethics, claimed that dying people would “most certainly” be put at risk by a change in the law.

The campaign group Dignity in Dying, said the new Bill would make Britain a more compassionate country.

But Baroness Finlay of Llandaff, co-chair of the Campaign group Living and Dying Well, which opposes a change, said licensing assisted dying would ‘fly in the face’ of ongoing attempts to discourage suicide.

Bishop of Shrewsbury warns that assisted dying bill would be “law of despair”

31st July….http://www.telegraph.co.uk/news/uknews/assisted-dying/11775785/Bishop-of-Shrewsbury-warns-that-assisted-dying-bill-would-be-law-of-despair.html

A controversial bill that seeks to legalise assisted dying represents the “first step” towards euthanasia, the Roman Catholic Bishop of Shrewsbury has warned.

The Rt Rev Mark Davies said MPs would be introducing a “law of despair” if they voted in favour of proposals to allow doctors to prescribe lethal doses of medication to anyone with only six months to live who showed a “clear and settled intention” to end their life.

He warned that the right to die would quickly become a “duty to die” and that those who should be receiving the utmost care would instead consider themselves an unwanted burden on society.

The bill, introduced by Labour MP Rob Marris, will be granted its second reading on September 11, when a vote will be held. It is the first serious attempt to change the law on assisted suicide.

MPs have not voted on the issue since 1997, when a proposal to allow doctors to help the terminally ill commit suicide was voted down by 234 votes to 89.

But recent polling has consistently suggested high levels of public support for a change in the law to allow assisted dying.

Bishop Davies, speaking to around 800 pilgrims from the Shrewsbury Diocesan in Lourdes, warned that some of the most vulnerable in society would come under huge pressure to end their lives if assisted dying became “the mindset of British society”.

He said: “The proposed law for ‘Assisted Dying’ will remove legal protections for the lives of some of the most vulnerable in our land.

“It is the first step on the road to euthanasia: the medical killing of some of the weakest members of society.”

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He urged pilgrims to make their voices heard, warning that there were just a few weeks before MPs chose between whether “a culture of care or a culture of suicide and eventually of killing”.

“We have good reason to fear that the right to die will quickly become the duty to die,” he added.

“And those who should be most cherished and cared for will increasingly see themselves as an unwanted burden to society.

Pope Francis frequently reminds us how it is the weakest and most vulnerable who can teach us the most important lessons of life. And he warns us that many societies are in danger of discarding them.”

The bill is almost identical to that introduced into the House of Lords by the assisted suicide campaigner Lord Falconer last year.

The former Lord Chancellor took the bill through its initial legislative stages but ran out of parliamentary time ahead of the General Election.

It provoked a highly charged, ten-hour debate and peers unanimously backed amendments giving a High Court judge a role in any system of assisted suicide, an extra safeguard against pressure on vulnerable people.

The bill to be put before the Commons will include those amendments, a move likely to strengthen potential support.

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The bishop’s views echo concerns raised by David Cameron that the proposed change in the law would leave vulnerable people feeling “unfairly pressurised” into ending their lives.

The Prime Minister’s official spokesman said: “He has concern that legislation in this area might push people towards doing things that they don’t actually want for themselves.”

But he added: “It is an issue of individual conscience and a matter for Parliament to decide, rather than one for Government policy.”

Mr Marris, the MP for Wolverhampton South West, said that people who were suffering and facing imminent death should not be denied medical help to end their lives.

“Alongside the vast majority of the public, I am in favour of terminally ill people who are of sound mind having choice at the end of life,” he said.

The MP chose to put forward proposals on assisted dying after coming top of this year’s ballot for backbench legislation.