SHADOW OF DEATH
"Even though I walk through the valley of the shadow of death......." Psalm 23:4, Old Testament.
Kim Leadbeater’s Terminally Ill Adults (End of Life) Bill passed its second reading on 29 November by a wider than expected margin, 330–275 and is seen as "bringing safe and compassionate choice at the end of life" according to those in favour.
The sun was high and harsh creating shadows as people gathered outside the Houses of Parliament waiting for the result of the MPs vote on The Assisted Dying Bill.
Death is big business, if we look at the ads everywhere especially this time of year after the indulgences over the holiday period. Many of us aim to get fit in order to prolong our lives whether it's gym memberships, books, food diets, vitamins, vaccines, insurances or just buying household goods such as smoothie makers - the list is endless and if we look at the cost of dying: treatments, caring and indeed funerals - its just costs we can't consider so let's not even go there! until we need to or we have no choice. We as a culture seem scared to talk about death, considered mobid or as if the mere mention of it may strike us or a loved one down. We can't cope with death and people generally don't have a clue how to organise a funeral until they have to or deal with the aftermath because we're too busy with life before that happens and then of course the whole process is overwhelming. We don't even talk about making a will because thats something that we put off until we actually have something to consider. I believe the Assisted Dying bill is another topic that many families will not be able to talk about, for all kinds of reasons until its too late. I'm from a family of 8 siblings, I'm unsure whom will have the 'power of attorney' for a sick or dying relative, but I cannot imagine all of us agreeing on it - as we can't agree at the best of times! My concerns: where will this will be carried out and as with everything else, where is this funding coming from? Ultimately this begs the question : could that money be put into a better pallative care scheme instead to ease the suffering and of course 'the burden' that many people dying feel?
It was during Covid Lockdowns that the never ending NHS waiting lists grew longer, and the diseases that were once treatable (if caught in time) became terminal and the UK health and welfare system that was once the envy of the rest of world became broken. Sadly during this period and ever since, there has been even more suffering physically and mentally, leaving sick people and carers unable to access the system that was set up and mostly paid into by them. The bottom line seems to be that the NHS can no longer sustain the cost of our aging population.
Suicide is defined as the act of intentionally ending one's own life. Before the Suicide Act 1961, it was a crime to die by suicide and anyone who attempted and survived could be prosecuted and imprisoned, while the families of those who died could also potentially be prosecuted. Today as the UK voted in favour for this bill it's aim is to take that burden away from those that are planning to do so and we will follow other countries that already have a system in place (since 2015) including Canada, Australia, New Zealand, Spain and Austria – some allowing assisted death for those who are not terminally ill.
During the protest outside Parliament before the results were announced, I listened to the views of the people on both sides FOR and AGAINST should this become law. It was the people's passion that was compelling, they had come from far and wide to share their concerns. A large proportion of the crowd were disabled, wheelchair users whom were sitting in the cold with their banners - commendable that they would take on such a journey (as our transport system is another point of concern for disabled users, as often the difficulty of simply getting from A to B as a wheelchair user is a huge task with lifts not working or available in some stations). And yet in stark contrast, there is of course the general malaise and apathy from passers by and those not interested in general - because it's an issue that doesnt concern them YET. I'm not sure how we as a nation are not up in arms at a govenment that doesn't seem to be looking after it's most vulnerable population after the pandemic. From axing the winter fuel allowance this year, taxing pensions, energy crisis and the general living crisis, this along with making it nigh on impossible to see a doctor unless you know the online system to get an appointment.
This bill needs to be discussed by everyone in their schools, universities, homes and workplace whether we agree or disagree. If this is to become a reality we need to think long and hard because what would you do if faced with this for yourself or a loved one? and how would we deal with this if we have no one looking out for us.
“ Yet the Assisted Dying Bill takes no account of the possibility of complications in the suicide procedure. Doctors would not be allowed to intervene by administering further lethal medication even if severe oxygen deprivation and brain damage resulted from a botched suicide attempt. How long before direct medical killing is seen as an acceptable response when assisted suicide goes wrong? ” John Wyatt, CARE.
'The introduction of the Assisted Dying Bill shines an uncomfortable spotlight on the inadequate levels of care that is provided for many people in the UK as they approach the end of their lives. It is tragically true that many people in our society die in distress, frightened, in pain and without adequate support and skilled care. It’s genuine compassion that drives many people to campaign for assisted suicide to stop this horrific prospect. But helping people to kill themselves is not the answer. The medical and professional knowledge to allow people to die in peace and with dignity is available, but scandalously there is little emphasis on training and resourcing health professionals across the NHS in palliative care. But this is the best way of genuinely “assisting the dying”.
As a society we put far more focus on and invest far greater resources in demanding and obtaining highly expensive and sophisticated treatments for cancer which may only extend life by a few weeks or months. The current focus on Assisted Dying Bill gives an opportunity for us as a society to invest in excellent quality palliative care for every dying person. Only then will we discover the truth behind the words of Cicely Saunders, “You don’t have to kill the patient in order to kill the pain”.
https://care.org.uk/cause/assisted-suicide/whats-wrong-with-the-assisted-dying-bill
But critics fear the bill’s guardrails are not stringent enough, and suggest patients could feel pressured to opt for an assisted death only to avoid becoming a burden on their families. Others have concerns that the bill has been sprung on MPs – hundreds of whom are in their first few months in the job following July’s election – without a thorough impact assessment or time to consider the proposal.
And Maskell told CNN that Britain’s creaking National Health Service (NHS) wasn’t in a fit enough state to offer assisted deaths.
“I really believe that Labour got elected because the NHS is such a mess. … We’ve got to sort the NHS out before we go down this route,” she said. “Pressing ahead now is ignoring the imperative we’ve got to address the woefully underfunded palliative system.”
The proposed bill is broadly in line with the Oregon model, and does not go as far as Switzerland, the Netherlands and Canada, which allow assisted death in cases of suffering, not just for terminally ill people. It differs from euthanasia, the process in which another person deliberately ends someone’s life to relieve suffering.
It is currently a crime to help somebody die in England and Wales, punishable by up to 14 years in prison. Performing euthanasia on a person, meanwhile, is considered murder or manslaughter.
And Maskell told CNN that Britain’s creaking National Health Service (NHS) wasn’t in a fit enough state to offer assisted deaths.
“I really believe that Labour got elected because the NHS is such a mess. … We’ve got to sort the NHS out before we go down this route,” she said. “Pressing ahead now is ignoring the imperative we’ve got to address the woefully underfunded palliative system.”
The proposed bill is broadly in line with the Oregon model, and does not go as far as Switzerland, the Netherlands and Canada, which allow assisted death in cases of suffering, not just for terminally ill people. It differs from euthanasia, the process in which another person deliberately ends someone’s life to relieve suffering.
It is currently a crime to help somebody die in England and Wales, punishable by up to 14 years in prison. Performing euthanasia on a person, meanwhile, is considered murder or manslaughter.
https://www.bma.org.uk/media/4394/bma-arguments-for-and-against-pad-aug-2021.pdf
Key arguments used in the debate on
physician-assisted dying
There are many strongly held views on both sides of the debate on physician-assisted dying, and a huge
range of materials and literature has been published on the topic. Here we outline some of the key
arguments used by those who support and oppose physician-assisted dying. These are not intended
to be comprehensive but to provide an overview of the range of views and opinions expressed in the
debate. Some people may disagree with some of these arguments or have different reasons to support
their position.
Additionally, we set out some of the arguments used by those who support the BMA adopting a neutral
position on physician-assisted dying, and those who oppose it. Again, these are not intended to be
comprehensive, and individuals may have other reasons for their views.
Key arguments for and against physician-assisted dying
Those who oppose physician-assisted dying often use the following arguments.
1. Laws send social messages. An assisted dying law, however well intended, would alter
society’s attitude towards the elderly, seriously ill and disabled, and send the subliminal
message that assisted dying is an option they ‘ought’ to consider.
2. So-called ‘safeguards’ are simply statements of what should happen in an ideal world.
They do not reflect the real-world stresses of clinical practice, terminal illness and family
dynamics. It is impossible to ensure that decisions are truly voluntary, and that any coercion
or family pressure is detected.
3. For most patients, high-quality palliative care can effectively alleviate distressing symptoms
associated with the dying process. We should be calling for universal access to high quality
generalist and specialist palliative care, rather than legalising physician-assisted dying.
4. Licensing doctors to provide lethal drugs to patients is fundamentally different from
withdrawing ineffective life-sustaining treatment, and crosses a Rubicon in medicine. The
role of doctors is to support patients to live as well, and as comfortably, as possible until they
die, not to deliberately bring about their deaths.
5. Currently, seriously ill patients can raise their fears, secure in the knowledge that their doctor
will not participate in bringing about their death. If doctors were to have the power to provide
lethal drugs to patients to end their lives, this would undermine trust in the doctor-patient
relationship. Some patients (particularly those who are elderly, disabled or see themselves
as ‘a burden’) already feel that their lives are undervalued and would fear that health
professionals will simply ‘give up’ their efforts to relieve distress, seeing death
as an easy solution.
6. Once the principle of assisted dying has been accepted, the process becomes normalised
and it becomes easier to accept wider eligibility criteria or to widen eligibility through the use
of anti-discrimination legislation.
7. In modern clinical practice many doctors know little of patients‘ lives beyond what the busy
doctor may gather in the consulting room or hospital ward. Yet the factors behind a request
for assisted dying are predominantly personal or social rather than clinical. Assisted dying is
not a role for hard-pressed doctors.
Key arguments used in the debate on
physician-assisted dying
There are many strongly held views on both sides of the debate on physician-assisted dying, and a huge
range of materials and literature has been published on the topic. Here we outline some of the key
arguments used by those who support and oppose physician-assisted dying. These are not intended
to be comprehensive but to provide an overview of the range of views and opinions expressed in the
debate. Some people may disagree with some of these arguments or have different reasons to support
their position.
Additionally, we set out some of the arguments used by those who support the BMA adopting a neutral
position on physician-assisted dying, and those who oppose it. Again, these are not intended to be
comprehensive, and individuals may have other reasons for their views.
Key arguments for and against physician-assisted dying
Those who oppose physician-assisted dying often use the following arguments.
1. Laws send social messages. An assisted dying law, however well intended, would alter
society’s attitude towards the elderly, seriously ill and disabled, and send the subliminal
message that assisted dying is an option they ‘ought’ to consider.
2. So-called ‘safeguards’ are simply statements of what should happen in an ideal world.
They do not reflect the real-world stresses of clinical practice, terminal illness and family
dynamics. It is impossible to ensure that decisions are truly voluntary, and that any coercion
or family pressure is detected.
3. For most patients, high-quality palliative care can effectively alleviate distressing symptoms
associated with the dying process. We should be calling for universal access to high quality
generalist and specialist palliative care, rather than legalising physician-assisted dying.
4. Licensing doctors to provide lethal drugs to patients is fundamentally different from
withdrawing ineffective life-sustaining treatment, and crosses a Rubicon in medicine. The
role of doctors is to support patients to live as well, and as comfortably, as possible until they
die, not to deliberately bring about their deaths.
5. Currently, seriously ill patients can raise their fears, secure in the knowledge that their doctor
will not participate in bringing about their death. If doctors were to have the power to provide
lethal drugs to patients to end their lives, this would undermine trust in the doctor-patient
relationship. Some patients (particularly those who are elderly, disabled or see themselves
as ‘a burden’) already feel that their lives are undervalued and would fear that health
professionals will simply ‘give up’ their efforts to relieve distress, seeing death
as an easy solution.
6. Once the principle of assisted dying has been accepted, the process becomes normalised
and it becomes easier to accept wider eligibility criteria or to widen eligibility through the use
of anti-discrimination legislation.
7. In modern clinical practice many doctors know little of patients‘ lives beyond what the busy
doctor may gather in the consulting room or hospital ward. Yet the factors behind a request
for assisted dying are predominantly personal or social rather than clinical. Assisted dying is
not a role for hard-pressed doctors.
For more information on physician-assisted
dying go to bma.org.uk/pad'
dying go to bma.org.uk/pad'
References
1. https://bills.parliament.uk/bi...
2.https://www.thetimes.co.uk/art...
3. https://www.justice.gc.ca/eng/...
4.https://www.oregon.gov/oha/PH/...
5. https://www.apa.org/monitor/20...
6. https://www.nejm.org/doi/full/...
7. https://www.springer.com/gp/bo...
8.https://humanism.org.uk/wp-con...
https://edition.cnn.com/2024/11/29/uk/uk-assisted-dying-vote-debate-gbr-intl/index.html
What Happens Now?
https://www.instituteforgovernment.org.uk/explainer/kim-leadbeaters-assisted-dying-bill