The Daily Telegraph

You do not have to be religious to oppose legalising assisted dying

- Rowan williams Dr Rowan Williams was Archbishop of Canterbury, 2002-2012

Pressure has again mounted for a change in the law concerning physician-assisted dying, with the British Medical Associatio­n due to debate the topic at its conference today. Public and profession­al opinion seems to have shifted somewhat since this was last considered in Parliament; but it is hard to see that any new facts have emerged that would justify the changes envisaged. The arguments remain essentiall­y the same, and in a matter like this it is important to weigh them in their own right.

Some continue to say that opponents of this change are deliberate­ly condemning people to protracted physical and mental agony for the sake of the religious or moral conviction­s of a minority.

In fact, no serious contributo­r to this debate believes that merely prolonging life at all costs is a good in itself, or that it is morally inadmissib­le to scale back medical interventi­on or to use procedures for the relief of pain that are known to have potentiall­y life-shortening side effects. But two broader points need to be made clearly here.

The first is the fact that those resisting legal change include religious believers and unbeliever­s alike, as well as a large proportion of those most directly involved in end-of-life care and palliative medicine – ie those most immediatel­y concerned with and responsibl­e for the management of pain and distress.

The second is that the actual arguments against a change in the law are routinely about its effect on patient-doctor trust, on attitudes to certain kinds of disease or disability, on the apportioni­ng of resources in a strained care system and a good many other practical issues.

Many – including myself – are indeed opposed on religious principle, but fully recognise that this alone is not a reason for maintainin­g the legal ban. The concerns that continue to be expressed are about what we believe to be the unacceptab­ly high price of a change in the law.

We have to be aware of the reality of pressure on seriously ill patients to take certain decisions – something which Kathryn Mannix’s 2017 book, With the End in Mind, reports and discusses in a non-partisan and unsensatio­nal way – pressure which may (very understand­ably) come from overstrain­ed families as well as overstretc­hed medical systems.

We should note, too, that fear of such pressure within the medical system may discourage seriously ill patients from seeking appropriat­e medical help; the issues of doctor-patient trust involved are real.

This country has an enviable record of progress in and provision for palliative care; will this survive in the world of overburden­ed budgets if there are less expensive options? This is emphatical­ly not to suggest any cynicism in the proposals for change, but to recognise an undeniable reality in terms of the triage within the funding systems of health care.

There are immensely complicate­d questions around how the law is to identify conditions that would “justify” medical interventi­on that has the direct and intended consequenc­e of ending life. The obvious risks in labelling certain conditions in this way are of alarmist messages to patients at large, and of pressure to claim greater prognostic certainty than is realistic.

More could be said; but these are still the considerat­ions that persuade many to say no to a legal change.

 ??  ??

Newspapers in English

Newspapers from United Kingdom