Living and Dying Well – three reflections on assisted dying

Church in the Public Square John Wyatt Baroness Finlay of Llandaff Robert Preston Stafford CarsonThere is increasing debate in legislatures and civil society around end-of-life issues, terminal illness and euthanasia. While Northern Ireland is behind the curve in discussing the issues, moves in Edinburgh and Westminster are likely to eventually stimulate local debate.

Union Theological College, in co-operation with The Church and Society Committee of the Presbyterian Church in Ireland along with Union Theological College hosted the third of their series of Church in the Public Square conferences.

On Thursday 22 January the topic was Living and Dying Well.

Does medically-assisted death have a place within healthcare? Is medically-assisted death just another end-of-life choice that some people have to make? Would a change in the current legislation put pressure on vulnerable people to consider assisted dying because they were making demands on their carers?

Stafford Carson, principal of the college introduced the event and suggested that the agenda “raised major theological and ethical issues which cause much concern for individuals who are directly affected, as well as for legislators and those in the legal, medical and caring professions”.

You can listen back to the three guest speakers …

Church in the Public Square Robert PrestonRobert Preston is director of the Living and Dying Well think-tank having worked in Whitehall for 30 years and served as clerk the House of Lords select committee which examined Lord Joffe’s Private Member’s Bill “Assisted Dying for the Terminally Ill” back in 2004/5.

He asked whether we would “seriously consider licensing other criminal acts for certain groups of people and in specified circumstances?”

Church in the Public Square Baroness Finlay of LlandaffBaroness Finlay of Llandaff chairs the All-Party Parliamentary Group on Dying Well and is a professor of palliative medicine at Cardiff University and currently President of the British Medical Association.

She made the distinction between “withdrawing treatment when death is inevitable” and “foreshortening life”.

Church in the Public Square John WyattJohn Wyatt is Emeritus Professor of Ethics and Perinatology at University College London a specialist in the medical care of newborn infants for more than 20 years, and author of Matters of Life and Death: Human dilemmas in the light of the Christian faith.

He disagreed with recent statements of support from prominent Christian leaders that “assistance of suicide can be an expression of compassion” and suggested that society’s trend towards “robust individualism needs to be balanced by a recognition of our mutual dependence and inter-relatedness”.

Three complementary yet distinctive contributions which were significantly more nuanced that some attendees expected and which may be of interest to Slugger readers.

Photo credit: Jamie Trimble

Alan Meban. Normally to be found blogging over at Alan in Belfast where you’ll find an irregular set of postings, weaving an intricate pattern around a diverse set of subjects. Comment on cinema, books, technology and the occasional rant about life. On Slugger, the posts will mainly be about political events and processes. Tweets as @alaninbelfast.

  • notimetoshine

    Just out of interest, would assisted dying in NI be something decided at stormont or Westminster?

  • Seems to fall under devolved health, so it would be NI – there’s a bill going through Scottish Parliament and discussions at Westminster. Personally I can’t see NI following any move in Scotland, England or Wales very quickly. Like abortion, I suspect NI politicians will be reluctant to change. However, legislation in GB together might change public sentiment …

  • Belfast Barman(ager)

    With all due deference to the many other issues in our society that require legislature attention, with a liberal nod to the #mybodymyrights campaign and the SSM lobby…I think assisted dying is the most sensitive subject up for discussion these days. I think in that situation every single member of society would wish there was some method of easing the suffering in the final days or those occasions when science and medicine is exhausted, but I just can’t imagine any form of law that A: meets the needs required and B: isn’t liable to be exploited. Without meaning to cop out…it’s a toughie

  • kalista63

    I’m in an odd position. Having spent just over 20 years working I spinal injuries, I’m also a tetra/quadriplegic now. I’ve seen the death that awaits me and I’ve seen the total nonsense that is called living, in the run up to it.

    Already, my diaphragm is fek’d, which means I already spend hours in a rather disgusting routine. I’ve fucking tourists on my back 24/7 asking me questions I spend 24/7 trying to ignore and I’m nowhere in the serious league.

    I’d a C2/3 patient who could do nothing of any value, hooked up to tubes a la lChritsipher Reeve, who asked to co e off his ‘happy meds’. He talked to me about how he misses solitude, just solitude. Imagine never being able to have simple time alone. Anyway, he decided that he wanted to go. Soon as he said that, the consultant said he was depressed (no shit) and put him back on the happy pills, sod all that he could do to stop her.

    If he had the same injuries just a few years earlier, he could not have been saved. Is that progress?

  • Korhomme

    I don’t fear death, it’s inevitable. But I do fear a long, drawn out process of dying. I’ve seen far too many people die, far too many people dying before their time. There’s a time when one can accept that death is inevitable, when it’s time to go, and I want to go then. I see no value in prolonging my existence, there is nothing but bleak suffering beyond that time, nothing but pain not just for me but for any family. There is no common humanity in suffering, in prolonging any suffering. There is no morality in prolonging my life beyond any point that I have chosen. To do otherwise, to think otherwise is an insult to my integrity, an insult to me.

    And I don’t much care what the “law” says. The law is here to help us and society as a whole; but the law has no right to determine, on a theoretical and highly abstract basis what I may and what I may not do with my life, or on what I may request or not request of my carers or my family. The law is an artefact of mankind, the servant of mankind and not the master.

    I am the master of my fate, the captain of my soul.

    If I don’t die in my sleep, as so many of us wish, if I am condemned to a protracted period of suffering, of decline, loosing my abilities but maintaining my faculties, then I wish to go to a civilised place, to the Dignitas Klinik in Zürich, and being fully cognisant of what will happen, to make a final and irrevocable decision, which will be mine and mine only.

  • notimetoshine

    So one could assume maybe that there is a reasonable chance of some form of assisted dying being legislated for in GB over the course of say the next parliament?

    I wonder how that would work assuming that equivalent legislation isn’t passed here?

    Could you go to England Scotland to die? And if so would the person helping you (presuming you couldn’t travel alone) be liable for prosecution in NI jurisdiction?

    Potentially messy. Seems like the sort of thing that would have to be agreed on a UK wide basis to avoid messy scenarios like the one I outlined above.

  • notimetoshine

    On a side note to what you talked about in terms of aging, we still have a care system for the elderly which is built around what I think are outdated ideas of longevity in older age. Where once a care home was the last year or two of ones life, it now becomes 5 maybe 10 years in a place that realistically is not conducive to ones quality of life or a natural human environment. I am my grans primary carer and physically she may live with relative health for some time, but require increasing amounts of care. And your point on shrinking of your space is entirely right. Her life has shrunk from international to national to local to the doors of her own home. And it will only continue to shrink. The care systems in place for people like her are I feel based on the assumption of a few years of quite poor health, which can and does ignore the psychological aspects as secondary, which with longer lives is more and more important. I don’t know what the answer is but with an aging population a change in the ethos and concept of care is required.

  • notimetoshine

    Of course and how do you legislate for such a subjective point. One persons breaking point may not be another’s. But I wholeheartedly agree with your analysis except for the younger people thing. Fundamental reform is needed in how we deal with the older population and that includes more money, but it needs to be a long term plan not short termism which gives rise to the ‘intergenerational conflict’. If we are only legislating and planning now for the increased longevity of the baby boomers well its already too late. We should be planning now for the care of the millennial generations.

  • No law is foolproof or perfect, and never will be, but all the evidence from Oregon and Zurich is that there has – so far – not been any attempted abuse. Of course that doesn’t guarantee there never will be, but it calls into question denying choice to people now. Sure it needs careful handling, and strong supervision. But to hold back for un unquantifiable potential problem is condemning many to a horrible – and unnecessarily horrible end.