End of Life (aka Death)

I was pleased this week that the vote in the Scottish Parliament to change the law on so-called assisted dying didn’t manage to make any further progress. Parliamentarians have now had a number of chances to think about this and vote on it and it still failed comprehensively to get anywhere near a majority of parliamentarians supporting it.

Yet in survey after survey we are told that people support it.

What’s going on?

It seems to me that any of us would be frightened of finding ourselves in a situation where we were left alone and in pain. People do die bad deaths alone and in pain in Scotland. Somehow many people then manage to make a jump in their heads to saying that the law should be changed to allow people to request help to end their lives.

I can’t make that jump myself. The current situation seems to me to be the right one. I have no problem with the idea that a doctor might give a treatment that improved the quality of someone’s life whilst knowing that the life itself might be shortened by doing so. I do have a problem with a drug being given or withheld where the very purpose is to hasten life.

To put it bluntly, if people are frightened of the idea of individuals dying alone and in pain then there are things we can do about that that fall a long way short of killing people off.

I don’t want to see the law changed but I do want to see a lot of things surrounding death to be changed.

I want hospices to be better funded.
I want more palliative care consultants to be trained.
I want money to be put into pain clinics.
I want more research to be put into pain relief.
And I want us to talk a bit more honestly about who should be with the dying if we don’t want dying people to die alone. Who would actually benefit from lives being shortened at will? The patient is not the only person affected by a death, nor the only possible person to derive any “benefit” from life being cut short.

These are so sensitive things to talk about and there are far more issues involved in decisions about end of life care than could ever be resolved in a bill in parliament.

It is good that people are talking about this more. The “death cafe” movement seems to me to be a good thing. Allowing people who are living to talk about the business of dying has to be positive. Sometimes we get into those kind of issues when I’m doing my “Plan your own funeral” workshop – which I’ve just been asked to do in other parts of the diocese too.

I recently conducted the funeral of someone who had had that kind of conversation about his funeral just a couple of weeks before he actually died. It was the most profound thing to have happened, and in the end one of the most profound and beautiful funerals that left me completely in awe of the person who had died and the plans he had made.

Parliamentarians have difficult decisions to make here. We all do. But the priority must be to protect the vulnerable. My judgement is different to the judgement of many and even maybe the majority. I don’t think the vulnerable would be best served by changing the law.

Doctors need to be able to make informed decisions and help others to make informed decisions but we are in an area where sometimes decisions will be tested hard. I’m not alone in thinking that things have become harder for many doctors since Harold Shipman’s crimes were revealed. No doctor wants to be accused to acting too swiftly. No health authority wants to risk harbouring someone who simply wants to kill. But we must be wary of restrictions on care that might prevent doctors taking action which relieves pain where that might be possible.

If I were dying and in terrible pain, would I not want my life to be ended more quickly and more intentionally and more humanely? Well maybe I would. But I’m not the only person in the world and that description of someone dying doesn’t come close to the complexity of what really happens when someone’s life is drawing to a close. There are far more people to think about – not just relatives but those who will die after we do.

So yes, I want pain to be relieved. Yes, I can imagine situations where I’d prefer to die than to live. But no, for the good of those who are vulnerable, for the good of those whose deaths would be a relief to others, for the good of those who are vulnerable and often least able to make autonomous choices, for all their sakes, I don’t think that the law should be changed.