Legalising Assisted Dying would be a slippery slope

By Gordon Brown

  • Talking Points

In the Times on Thursday  21 October Gordon Brown writes that the prior question lawmakers have to consider before they contemplate a complete change in the laws of the land is whether, by enhancing existing forms of care, we can improve our treatment of the dying…… the bill to legalise assisted dying gets the balance wrong between individual autonomy and the sanctity of life.

I learnt a lot when writing about the life of Dame Cicely Saunders, whose pioneering and courageous work in hospice care has since led to one of the greatest developments in medicine in recent times: the dramatic rise of the specialty of palliative care, now firmly part of mainstream medicine taught in all our medical schools; and supported by evidence-based clinical standards and continuing research by clinical academics……….

When I think of the kind of care my wife, Sarah, and I saw at first hand when we did some voluntary work in our local hospice, and the compassionate way that sensitive doctoring and nursing responded to individual wishes without undermining the sanctity of life, I am sure that there is such a thing as a dignified death.

While there is more to do, not least to ensure that more people can have such care in their own homes, I believe that the first duty of government policy in this area is to minimize the fear of dying badly. Great progress has also been made to reduce the fear of over-treatment when interventions might be uncomfortable and unhelpful and serve only to prolong life without maintaining quality.

Although safeguards against improper pressure are needed here too, people can now make advance directives that give them the power to determine, when they are well and of sound mind, their treatment in changed circumstances.

A doctor friend of mine has reminded me of the advice of a senior doctor to his newly-appointed junior: “Heal the sick, comfort the dying — and don’t get them mixed up.”……

More than ten years ago, in a landmark declaration that was updated in 2014 to deal with the position of health professionals, Keir Starmer, then director of public prosecutions, clarified the considerations prosecutors will have in mind — and sensitivity needed — when there are allegations of encouraging or assisting suicide. These changes — advances in palliative care, directives against over-treatment and the Starmer ruling — have weakened the case for an abrupt change in the law. And I believe they make the Assisted Dying Bill less defensible.

If death were to become not just an option but something close to an entitlement through the bureaucratic processes that an act of parliament’s provisions impose, we would, in my view, be altering fundamentally the way we think about mortality.The risk of pressures, however subtle and indirect, on the frail and the vulnerable, who may feel their existence burdensome to others, cannot ever be entirely excluded. And the inevitable erosion of trust in the caring professions — if they were in a position to end life — would be to lose something very precious.

In the current bill there are what I consider cold, bureaucratic directives — like the time-limit assessment that death is likely within six months — which would change the way we see the medical profession.

If the guiding principle of the bill is enhancing the autonomy of the patient, then introducing a particular time constraint transgresses such a desire.

If the guiding principle is, instead, one of relief from intolerable suffering, is there a case for a time limit at all if we accept the obvious truth that the longer the suffering, the stronger the case for such relief grows?

My fear is that, despite its protections against abuse, an Assisted Dying Act could lead to a slippery slope, and that over time legislators — undoubtedly out of compassion and a desire to avoid suffering — would be unable to resist the erosion of the safeguards against the taking of life.

And while the end result may not be called assisted dying on demand, harm will be caused. Better to provide palliative care that we know is caring and loving and will make possible a good death.

Gordon Brown is former UK prime minister

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Please also see Michael Nazir-Ali.  Should we be Assisting Patients to Die? - Faith Movement