Comments: Religious leaders call for end to 'legal euthanasia'

The distinguished signatories to this letter, including the ABC, mention the tremendous work of the Hospice movement in the UK as being one of the most important ways of dealing with terminal illness. Whatever one's personal thoughts about the availability of any 'assisted suicide' provision at law, one cannot discount the obvious advantages of the palliative care programme offered by the Hospice Movement.

The real question here is: Is there sufficient availability of such provision for all who might need it? And does the government, in debating this amendment to the Bill, intend to offer the increase of financial support that would be necessary to support the palliative initiative?

Posted by Father Ron Smith at Monday, 29 June 2009 at 7:25pm BST

It is the same old "We know best" approach.

If I needed to end my own life or support a loved one, I certainly should not let the quibbles of Williams and Nicholls detain me very long at all.

I do have more respect for Sacks, but at the end of the day, we must all decide for ouselves, if ever in the difficult position of contemplating suicide assisted or otherwise.

Fr Ron's point about funding is well made.

I see the Free Church voice is not represented here....

Posted by Rev L Roberts at Monday, 29 June 2009 at 11:05pm BST

"The real question here is: Is there sufficient availability of such provision for all who might need it? And does the government, in debating this amendment to the Bill, intend to offer the increase of financial support that would be necessary to support the palliative initiative?"

The Hospice movement is indeed an invaluable gift. I have friends who are Hospice volunteers, and know many people whom Hospice has touched with blessing.

In the US, Hospice is a voluntary service, available in many places, but by no means everywhere.

What a blessed gift. Thank you.

Posted by Cynthia Gilliatt at Tuesday, 30 June 2009 at 4:16am BST

My parents lived in an Oregon (USA) retirement center. Oregon voted twice for the assisted suicide law. This center was big enough to be its own precinct. This center voted overwhelmingly "yes" in both cases. Many people seem to want to have some control. It may be fear of pain or losing control of their life, but they want that reassurance that they have the choice. In Oregon, many of the people who request the drugs, never use them. Oregon, also has a strong Hospice presence. Both of my parents were under Hospice care when they died.

Posted by Elizabeth Young at Tuesday, 30 June 2009 at 6:23am BST

I hope we all applaud the hospice movement and the work it does. But it does point up a philosophical problem with this letter. It is generally accepted that 'palliative care' often involves increasing the amount of pain relief, as slowly as possible, and leaving as much consciousness as possible, and maintaining quality of life, up to the point where the drugs relieving the pain become the cause of death. Like it or not, this is a form of euthanasia. All this letter does is reveal the usual muddled thinking, dishonesty and fudge that we have come to expect from Lambeth Palace. There is a serious debate to be had about whether we extend the legal basis of euthanasia, and the conditions which prevail, but that debate will not be helped by misrepresenting what already goes on and the degree to which it is already accepted.

Posted by toby forward at Tuesday, 30 June 2009 at 8:35am BST

"Like it or not, this is a form of euthanasia."

That doesn't seem to be the case. In the situation you describe, relieving pain is the goal, not killing the patient.

Posted by BillyD at Tuesday, 30 June 2009 at 10:07am BST

Once again, the Church is wrong, and the inadequacies of the hospice movement, unable to control pain, are all too obvious. I would not go near one of those sanctimonious , hypocritical institutions.

Posted by Merseymike at Tuesday, 30 June 2009 at 12:02pm BST

"It is the same old "We know best" approach."

But what is it that "we know best"? We "know best", from our perspective, that life is a gift from God, that, given that gift ourselves by God, we do not have the right to take it away. We "know best" that human life is valuable because of that, that humans are all made in the image and likeness of God, are all equally valuable in His sight. We "know best" that we are called to relieve suffering, and have responsibility to do so. Why is it that we choose an end to life as the best way of relieving suffering? Be careful when the conservatives accuse you of "throwing away the inconvenient", which they will surely do, that this does not actually contain a modicum of truth, at least in some quarters.

I am a physician, once practiced clinical medicine, including some experience in elder care. I have had to deal with this issue personally. In my training when I had much responsibility but little authority, I have stood at a bedside thinking that I was involved in prolonging suffering in a way that people were executed for doing to people in the Second World War. Often, the issue was not what I judged the quality of a person's life to be, but that we as physicians were doing such an awful job of relieving suffering, both physical and emotional, and that people wouldn't be nearly so desparate if they believed they wouldn't suffer. There is an aspect to this, whether liberals want to face it or not, that comes from our society's inability to acknowledge the dark side of life, things like illness, helplessness, and death. We can't even say the word 'death', for God's sake! People don't die any more, they "pass", we "lose" them, they "leave us". A corpse isn't allowed to look like a corpse any more. (How many of you just recoiled at that word?) I once witnessed an embalming. At the end of it, the undertaker said "There now, she looks like she's asleep." He didn't know how to answer me when I said, "But she isn't asleep, she's dead. What's wrong with looking like you're dead when you ARE, in fact, dead?" That attitude also informs our attitudes on euthanasia.

We can also ask, do we Christians really "know best" that what believe has to apply to all? Do we have the right to say to nonChristians that they may not practice euthanasia because we think it's wrong? Our answer to that question will be transferrable to a whole number of other issues, and it is a question we must ask. My answer, BTW, is 'no'. But seeing Church opposition to euthanasia as nothing more than an attempt to control people misses the issue, I think.

Posted by Ford Elms at Tuesday, 30 June 2009 at 2:32pm BST

People now fear more than death the possibility of spending months or years in a nightmare situation produced by interventive medicine. The brouhaha about Terry Schiavo shows how far life-defenders will go to shore up their dogmas at the expense of basic decency.

Posted by Spirit of Vatican II at Tuesday, 30 June 2009 at 4:35pm BST

Btw 'Euthanasia' literally means 'to die well'. Let us never forget there are different ways of dying well, in varying situations and for different individuals' values, feelings, aspirations and needs, which may also change over time.

Of course we need the hospice ideal and actual hospices, but we also need clinics in UK like those in Europe. Maybe 'hospice' could become wider concept, as times and needs change and ethical ideals develop ?

Posted by Rev L Roberts at Tuesday, 30 June 2009 at 6:29pm BST

'Church opposition to euthanasia' ? Opinion is divided as usual. People will as I said above, decide for themselves / ourselves. Thank you very much.

The Church is not its ministers -- not even high ranking ones -- it is all of us. Most of us unknown and private.

Btw We won't be dictated to by the 'We know best' element with the medical profession either!

We will have our own death ...

Posted by Rev L Roberts at Wednesday, 1 July 2009 at 12:41am BST

"Religious leaders call for end to 'legal euthanasia'"

Doesn't this headline really say it all?

Putting an end to to "legal euthanasia"---as with safe&legal abortion---will only drive it underground to the illegal side, won't it?

It's one thing for people of faith to try to PERSUADE others of their beliefs...

...but getting the state involved (w/ making currently-desired practices illegal) works out for precisely NO ONE.

Lord have mercy!

Posted by JCF at Wednesday, 1 July 2009 at 3:10am BST

Ford
"We can also ask, do we Christians really "know best" that what believe has to apply to all? Do we have the right to say to nonChristians that they may not practice euthanasia because we think it's wrong?"

Can this sentiment please extend to other Christians too?

I can see why the church as a whole takes the stance it does, but actually, it has no right to interfere in my life.

It's not as simple as saying that we relieve suffering, therefore the dying should not be desperate. Often, it's our modern medicine that's responsible for them still being alive in the first place, and it then sounds a bit odd to say that we insist on the right to prolong your life against nature but God doesn't allow us to let anyone help you to die when you've had enough of our treatment.

If and when I ever feel that I really do not want to continue to live, I will take full responsibility for my death before God. Neither you nor anyone else in the church has the duty or the right to interfere on what they perceive to be the truth, and neither you nor anyone else in the church has the right to say that all I need is a bit more pain management.

I fully support hospices, they are truly wonderful places. They have their rightful place in the whole range of caring for the dying, and they should be available to many more people. But they are not the final answer for everyone.

As you rightly say, dying is a part of life. Christians hope that it is not the end, some of us believe it with a very real certainty.
I could almost turn your argument on its head and say that it is only our desperate fear that death is truly the end of everything that makes us so terrified to allow people to move on when they’re ready.

Posted by Erika Baker at Wednesday, 1 July 2009 at 7:10am BST

The British Medical Association conference has voted this morning against a motion which calls for doctors who help people to die to be immune from prosecution, and for assisted dying to be an option for NHS patients. Their official position is opposition to euthanasia.

Posted by David Keen at Wednesday, 1 July 2009 at 12:03pm BST

"If and when I ever feel that I really do not want to continue to live, I will take full responsibility for my death before God."

Fine. Why the need for clinics, then? It's not as if suicide were such a delicate operation that it needs the expertise of professionals: plenty of people have figured out how to kill themselves throughout history without their doctor's help; in these days of the instant communication the information necessary for a painless end is more available than ever before.

To me, the answer seems to be in part precisely because people do not want to take full responsibility for their death, before God or society. They want the aura of respectability that comes from the association of people in white coats. "See, it's not as if I were killing myself - it's a *medical* procedure."

Getting medical personnel involved in killing ourselves is a bad idea. Not only is it likely to result on pressure from society and families for the aged and disabled to "do the right thing," but it will insert a measure of suspicion into the doctor-patient relationship.

http://disweb.org/cda/issues/pas/golden1.html

Posted by BillyD at Wednesday, 1 July 2009 at 1:26pm BST

BillyD

I'm pretty sure that if we absolutely wanted to we would be able to ensure that people who do not wish to die are not pressurised into it. Slippery slope arguments are never a good argument against the substance of the main topic - see the lgbt debate.
They merely serve to close the conversation down and always always work against change.

What I would like to see is fewer people feeling pressurised into committing suicide while they're still physically capable of doing so, but before they're ready to die, simply because it is illegal for anyone to help them with a dignified death when they're truly wanting it.

I would like to see fewer lonely suicides because people are afraid to have family present in case they are then likely to be investigaged by the police.

I would like to see people who don't know how to commit suicide, or who are physically incapable of doing so (say after a sudden accident followed by paralysis)to have an alternative way out when they feel they truly would prefer not to live any longer.

There have been a number in recent years going through the courts demanding that right for themselves - clearly, they were very willing to take that responsibility for their own deaths.
I don't think we have the right to deny them that autonomy.

Posted by Erika Baker at Wednesday, 1 July 2009 at 7:07pm BST

"I'm pretty sure that if we absolutely wanted to we would be able to ensure that people who do not wish to die are not pressurised into it"

But there's evidence that this is happening already. Did you read the material at the link I provided? How would you prevent it? By severing the ties between the patient and their family? Good luck with that.

You still have not made a case for giving medical personnel the responsibility for being our agents in suicide.

Posted by BillyD at Wednesday, 1 July 2009 at 11:45pm BST

BillyD
Yes, there is evidence that it is already happening. So clearly, the current system isn't preventing it.
Changing the system, making it more transparent, more subject to rigorous checks and assessments can possibly help to alleviate this problem.


I'm not wanting to make medical personnel responsible for being our agents in suicide. That makes it sound as though I wanted to compell them to do something against their conscience and something that absolves us from our own personal responsibility.

I merely want assisted suicide to be decriminalised, so that those who are willing to take this responsibility are allowed to do so.

Posted by Erika Baker at Thursday, 2 July 2009 at 8:16am BST

"Yes, there is evidence that it is already happening. So clearly, the current system isn't preventing it."

Um, it's happening in places where physician-assisted suicide is legal. Are you *sure* you read the material at the link I provided?

"I'm not wanting to make medical personnel responsible for being our agents in suicide. That makes it sound as though I wanted to compell them to do something against their conscience and something that absolves us from our own personal responsibility."

I think you're reading this into it, because there's nothing in there that suggests making medical personnel kill us against their wishes.

"I merely want assisted suicide to be decriminalised, so that those who are willing to take this responsibility are allowed to do so."

Which does not necessitate either the participation of medical personnel, or the setting up of the "clinics" that you advocate.

Frankly, the arguments for disguising suicide as a medical procedure seem to have an awful lot in common with the way that the United States has tried to sanitize capital punishment by instituting the practice of "lethal injection." They seem to be ways to disguise the harsh reality of what's really happening.

Posted by BillyD at Thursday, 2 July 2009 at 2:22pm BST


Billy said,

'Fine. Why the need for clinics, then? It's not as if suicide were such a delicate operation that it needs the expertise of professionals: plenty of people have figured out how to kill themselves throughout history without their doctor's help; in these days of the instant communication the information necessary for a painless end is more available than ever before.'

This is callous. Sending people away to experiement on how to end their lives without technical assistance and personal-emotional support ? Also the tone is dismissive, as if you don't care about the people involved in these agonising dilemmas, Billy.

Erica's voice speaks my mind too. And with a touch of loving clarity and sensitivity.


' I would like to see fewer lonely suicides because people are afraid to have family present in case they are then likely to be investigaged by the police.

'I would like to see people who don't know how to commit suicide, or who are physically incapable of doing so (say after a sudden accident followed by paralysis)to have an alternative way out when they feel they truly would prefer not to live any longer.

'There have been a number in recent years going through the courts demanding that right for themselves - clearly, they were very willing to take that responsibility for their own deaths.
I don't think we have the right to deny them that autonomy.

Posted by: Erika Baker on Wednesday, 1 July 2009 at 7:07pm BST

Posted by Rev L Roberts at Thursday, 2 July 2009 at 3:05pm BST

"This is callous. Sending people away to experiement on how to end their lives without technical assistance and personal-emotional support ? Also the tone is dismissive, as if you don't care about the people involved in these agonising dilemmas, Billy."

I don't intend to get into a pissing contest over who cares more about potential suicides, L. However, if my refusal to cloak my side of the discussion in euphemism is startling, I'm not altogether dismayed. I deplore euphemistic discussions about death and dying.

Posted by BillyD at Thursday, 2 July 2009 at 3:51pm BST

BillyD

OK, so we need to find even better ways of protecting the vulnerable. Agreed.

I'm not sure where you get the idea that I necessarily support the setting up of clinics.

Physician assisted suicide means simply that. Doctors who find themselves in a position where they can compassionately, medically competent and as sensitively as possible help someone to die, and who are willing to do this, should be allowed to.

I don't know enough about suicide to judge whether medical assistance is always helpful. I admit, I'm a little naive, and I'm imagining relatives bringing potentially dodgy drugs and equipment bought anonymously from the Internet into a hospital as one possible alternative to proper professional and skilled help.

Like Laurence, I'm a little astonished at your seemingly cold hearted disregard for the people wishing to die.
Would it just be more convenient if they suffered in silence, out of sight and without creating a fuss?
Why should your views about their life and the morals of their doctors matter, and those of the actual participants in these cases be disregarded?

Or is suicide just a bit yucky to those not in that place and can therefore be treated with contempt?
Now, in which debate have I come across that approach before!


Posted by Erika Baker at Thursday, 2 July 2009 at 4:05pm BST

"I can see why the church as a whole takes the stance it does, but actually, it has no right to interfere in my life."

What do you think the Church is, and the purpose of the Church? No snottiness there, no tone of "who do you think you are". I just think this shows a major difference between us, because I just can't get my head around that statement at all. I simply cannot say that the Church has no right to "interfere" in my life. I can't even see it as "interefernce" in my life, in most cases. It is my choice to be a Christian, and to practice that form of Christianity that I believe is nearest the Truth, or at least that speaks to me. That means I am accepting a Tradition that goes back 2000 years, and that has developed under the guidance of people far more versed in spiritual matters than I am. It is also guided by people, fallible though they might be, who are leaders either because God told us to make them our leaders, or we thought they showed good leadership skills and knowledge of the faith. Your attitude on this may vary. I cannot see their helpful advice or explanations of the faith as "interference" in my life, any more than I would go to a footie workshop given by David Beckham and say that his suggestions as to how to better my game were "interference" in my life. It's like saying that my university professors were "interfering" in my life when they tried to teach me something. I really can't relate to that attitude at all.

Posted by Ford Elms at Thursday, 2 July 2009 at 4:34pm BST

"I'm not sure where you get the idea that I necessarily support the setting up of clinics."

I think it was the part where you wrote, "...we also need clinics in UK like those in Europe."

"Like Laurence, I'm a little astonished at your seemingly cold hearted disregard for the people wishing to die."

Erika, you do not know me, or my circumstances, or my history well enough to know how I feel about people who want to commit suicide. All you know is that I don't write in the same hand-wringing, anodyne euphemisms that some people prefer, and that I am against medical personnel killing patients on purpose.

Posted by BillyD at Thursday, 2 July 2009 at 7:15pm BST

Ford
What I mean is that where Christians disagree, it is likely that it is possible to be of different opinions, and to live by those opinions with integrity.

That the majority of Christians may decide for themselves that assisted suicide is not for them is fine.
But that does not give them the right to tell me that my understanding of my faith must be precisely like theirs and that I must follow their discernment, not mine.

Helpful advice and explanations, as you put it, is absolutely fine. Actively stopping me from living differently is not.

Posted by Erika Baker at Thursday, 2 July 2009 at 9:51pm BST

BillyD
Absolutely, I don't know how you feel. That's why we're having this conversation, to work out how each other thinks and feels and why. It's a bit like a new listening process for a new topic, no?

Arguments alone can never be enough with something as big as this. Unless we learn to understand why people think and feel as we do, we simply try to use cold logic to trump each other. Not helpful.

But to get back to a more objective conversation, what do you mean by euphemisms?
People helping others to die is pretty clear. People needing help to kill themselves is also pretty clear.
How would you put it?

Posted by Erika Baker at Friday, 3 July 2009 at 8:01am BST

"...we also need clinics in UK like those in Europe."

I wrote this, not Erika.

*******************************

It is clear to me that there is little point in trying to have a discussion. I had no idea that it was both essential to know people's histories and subjectivity to continue this ; and at the same time, unknown and never to be disclosed--apparently.

Fortunately we don't have to go cap inhand to clergy or medics most of the time in Britain.

Norshould we have to.


Posted by Rev L Roberts at Friday, 3 July 2009 at 2:54pm BST

"I wrote this, not Erika."

My bad. I apologize, Erika, for the mistake.

"It is clear to me that there is little point in trying to have a discussion. I had no idea that it was both essential to know people's histories and subjectivity to continue this..."

You don't, if you keep yourself to the topic and what's actually written. When you want to do internet aura readings of how people feel about the subject, then yes - personal knowledge might be helpful.

Posted by BillyD at Friday, 3 July 2009 at 8:34pm BST

"Arguments alone can never be enough with something as big as this. Unless we learn to understand why people think and feel as we do, we simply try to use cold logic to trump each other. Not helpful."

No, I don't think I agree at all with this, Erika. I'm more interested in what people think about a subject, not necessarily how they feel about it. And I certainly don't think that feelings are as important than ideas when it comes to framing new law.

"But to get back to a more objective conversation, what do you mean by euphemisms?"

"Death with dignity," "right to die," "self-deliverance," "patient-directed dying," "auto-euthanasia," "hastened death," "choice in dying," "self-determination, "managed death" - these are some of the euphemisms used to refer to suicide, besides all the other ones used for dying in general: "passing away," "passed on," "gone to a better place," and all the rest.

"People helping others to die is pretty clear. People needing help to kill themselves is also pretty clear."

Well, the second is clearer than the first. Besides sounding more passive, it seems that it could also apply to circumstances where life-support - respirators, feeding tubes, and the like - are discontinued to let someone die, as opposed to actively killing someone with drugs, etc.

Posted by BillyD at Friday, 3 July 2009 at 9:03pm BST

BillyD
You only have to look at the lgbt debate to see that conversations about "thinking" don't get anyone anywhere. It's only a genuine opening up to the other that has any chance of bridging what appears to be unbridgeable divides.

I don't understand why death with dignity is a euphemism? It seems to me to be more dignified to die in clean, comfortable rooms surrounded by your family, than it does to hide away in the garage and rig your exhaust up so it suffocates you while no-one is looking.

Right do die is the same thing. When I've absolutely had enough, I have the right to die, without anyone else telling me I mustn't and that people mustn't help me with it.

Hastened death seems pretty clear - without intervention I would still be alive, but I'm hastening the natural process.

I agree about passing away, gone to a better place and all that. It doesn't describe what's happening at all and only serves to stop us thinking about it.

But you're not actually just objecting to the terminology, are you? You seem to be objecting to the whole idea that people might be allowed to do something you personally don't approve of.

Posted by Erika Baker at Saturday, 4 July 2009 at 8:39am BST

"You only have to look at the lgbt debate to see that conversations about "thinking" don't get anyone anywhere. It's only a genuine opening up to the other that has any chance of bridging what appears to be unbridgeable divides."

You *are* kidding, aren't you? I don't see that we've bridged that particular divide yet. Emoting, on either side of it, certainly doesn't seem to have helped.

"But you're not actually just objecting to the terminology, are you? You seem to be objecting to the whole idea that people might be allowed to do something you personally don't approve of."

No, that's what you "feel" I'm doing. And it's incorrect.

I am opposed to clouding the doctor-patient relationship by associating it with suicide. Suicide is not a medical procedure. And medicine is not about killing the patient.

About "death with dignity." As the material I tried to point you towards shows, the "death with dignity" concept isn't primarily about the mode of death, as in your scenario. People have reached the point where disability and dependence are more objectionable than death. It fosters a devaluing of people with disabilities. There's nothing undignified about disability, or needing help. The debate over assisted suicide seems to open with the fear of intractable pain, but is buoyed up by pandering to prejudice about disability.

Posted by BillyD at Saturday, 4 July 2009 at 1:13pm BST

The only places where the lgbt debate has resulted in a genuine understanding of the other's view and friendship across the divide, have been those where genuine conversations have taken place. Largely at grassroots level because shouting your own certainties and misrepresenting what the other says, as well as putting words and thoughts into their mouths is a feature of long distance conversations.

But have it your way.
Stick rigidly with what you KNOW to be right, don't engage, don't explain, ignore what everyone else might be saying, ignore the actual people who have tried to get the law changed because of their own suffering.

As for me - I never said anything about disability, I know there is nothing undignified about it (what makes you think I don't?), there is nothing undignified about needing help.

What IS undignified is treating sane adults as children who must be patronised because we do not accept what they're telling us loud and clear but pretend that we have a different, better solution to their problems.

What IS undignified is when anyone gets to a place where the only help they desperately want is denied to them by those who claim to know better.


Posted by Erika Baker at Saturday, 4 July 2009 at 2:20pm BST

"The only places where the lgbt debate has resulted in a genuine understanding of the other's view and friendship across the divide, have been those where genuine conversations have taken place."

You seem to be assuming here that the only "genuine conversations" are about emotion, instead of ideas. I don't think that's true. I think that emotions have the tendency to becloud clear thinking.

"Stick rigidly with what you KNOW to be right, don't engage, don't explain, ignore what everyone else might be saying, ignore the actual people who have tried to get the law changed because of their own suffering."

Wow, Erika. What exactly have I not explained or engaged you in? And how does disagreeing with them ignore "the actual people who have tried to get the law changed"? Does the fact that you disagree with the disability rights group whose opposing views I linked to mean that you are ignoring them? (You *did* read them, didn't you?)

"As for me - I never said anything about disability..."

No, Erika, you didn't. But I thought we were discussing the subject of physician-assisted suicide, and disability and dependance are certainly part of the debate on that subject. You asked me why I opposed the euphemism "death with dignity;" I told you, and referred to material to help explain my opinion. Why are you assuming that I'm talking about you, instead of the subject?

"What IS undignified is treating sane adults as children who must be patronised because we do not accept what they're telling us loud and clear but pretend that we have a different, better solution to their problems."

Are you saying that the only dignified response to someone telling us something "loud and clear"is accepting what's being said at face value? The only dignified response to a demand is acquiescence and compliance? That doesn't seem to make much sense at all.

Posted by BillyD at Saturday, 4 July 2009 at 6:02pm BST

BillD
OK, let's take emotion out of it.

I really really fail to see why we're disagreeing.
If individual people, disabled or not, do wish to have support to die, and if doctors are willing to help them, I do not see why any group who claims to speak for them should have the right to stop them - whether that's physicians, disabled rights groups, faith groups or whoever.

If individual people, disabled or not, do not wish to die but are happy to continue to live for as long as nature allows them, then no-one has the right to pressurise them into chosing suicide. In fact, I would almost say that was more akin to murder than suicide.

The only dignified response to a demand is an open conversation with the individual in question, and with the possibility that the demand may be met if that is where the conversation leads to.
If the conversation leads to the person in question changing their thinking, all the better.
But we do not have the right to demand that they do.

The large numbers of individuals going abroad to he helped to die speak loudly enough for people's will to determine their own fate.


Posted by Erika Baker at Saturday, 4 July 2009 at 7:42pm BST

"If individual people, disabled or not, do wish to have support to die, and if doctors are willing to help them, I do not see why any group who claims to speak for them should have the right to stop them - whether that's physicians, disabled rights groups, faith groups or whoever."

For my part, "support to die" is one of those euphemisms I'd avoid, but leave that aside.

It's not that professional organizations like the AMA or the BMA "claim to speak" for physicians - they do, in fact, speak for physicians, and are tasked in part with maintaining professional ethics. *That's* why they get to a say in what physicians do.

Similarly, the government has the right to stop us from doing certain things - well, you *know* why the government has that right, yes? It's all part of that social contract thingee.

"If individual people, disabled or not, do not wish to die but are happy to continue to live for as long as nature allows them, then no-one has the right to pressurise them into chosing suicide. In fact, I would almost say that was more akin to murder than suicide."

Agreed. This pressure is one of the unintended consequences of changing suicide laws that's been observed in the Netherlands, along with doctors overstepping the bounds of the law to euthanize people without their consent.

I think it would probably be a good thing to decriminalize suicide, with any necessary corresponding change in the murder statutes to make pressuring someone to commit suicide the equivalent of murder. But I am absolutely opposed to the participation of medical personnel in assisted suicide. I think it's especially important to keep medical personnel out of the equation in systems that are run according to the principles of "managed care," because killing patients is always going to be cheaper than treating them.

Posted by BillyD at Saturday, 4 July 2009 at 10:57pm BST

BillyD
I know that professional organisations don't "claim" to speak for physicians.
This conversation is about what I personally would like to see, along with many many others including a fair number of physicians.

I'm not expecting to ride roughshod over everyone else, but like with the lgbt debate, I'm hoping that there will eventually be a change towards more self-determination.

What we haven't touched on is what is, to my mind, the real problem - that many people commit suicide earlier than they would want to, because they know their progressive illness will leave them incapable of doing it later.
Would you oppose help for these people too?

I like your idea of changing the law.
And I can definitely see the danger of killing people off because its more convenient/cheaper etc.

We would definitely have to think of ways of preventing that. I'm not saying I know how to do this at the moment. I'm merely talking about the principle of the thing.

Posted by Erika Baker at Sunday, 5 July 2009 at 9:36am BST

" that many people commit suicide earlier than they would want to, because they know their progressive illness will leave them incapable of doing it later."

Do you happen to have any numbers for this?

"Would you oppose help for these people too?"

I can't see that my objection to the participation of medical personnel in assisted suicide necessarily deprives these people of help. Here in the United States we forbid doctors from administering the lethal injections used in state executions; nevertheless, those executions continue to occur.

Posted by BillyD at Sunday, 5 July 2009 at 1:30pm BST

BillyD
This thread is getting a bit cold now so we'll probably stop talking here soon. If you really want to continue the conversation, Simon has my email address.

As it happens, I don't have numbers for people who commit suicide before their time. I could try to research them, but it would take me a fair while to assess all the different sources to judge how valid they are.

So we're no longer arguing about people's rights to help others to die, we're only saying that doctors shouldn't be involved?

I could understand you saying that those who are entrusted with keeping you alive should be above suspicion, and that allowing them to assist with suicides would potentially destroy the patient-doctor relationship for other patients.

What I'm not so sure about is that keeping doctors out of it would solve all the other problems you've highlighted. Families could still exert pressure, economic reasons could still exploit the system.

I suppose we (society) would first have to agree on what was possible, then to think long and hard about appropriate safeguards.

Posted by Erika Baker at Monday, 6 July 2009 at 8:43am BST

You're right, it's probably time to wrap this up.

It's funny that you should mention the idea that the pressure I'm concerned about would not necessarily be eliminated by taking doctors out of the picture - that thought came to me, too, last night.

It wasn't my intention to argue against giving people assistance in committing suicide if they need it, but against the participation of medical personnel in the process. I don't think that most people really need help killing themselves, but for those who absolutely do (people in the last stages of ALS, for example) I'm not against someone acting as their agent - as long as it's not a member of the medical professions.

I hope that if I'm ever faced with a situation that tempts me to commit suicide because of intractable pain or loss of personal dignity that I will resist it, because I don't believe that that choice legitimately belongs to me - I do believe that suicide is usually either the result of disturbed mental processes or a sin. But (a) I don't believe it's the unpardonable sin, or the worst thing one could do, and (b) I don't have a mandate to force everyone else in society to hew to what I think are Christian moral standards, where their choices harm only themselves. But I am opposed the participation of medical personnel in the process, for the reasons that we've discussed.

Posted by BillyD at Monday, 6 July 2009 at 11:57am BST

BillyD
Thanks. I've enjoyed that conversation. It's good to see that despite what seemed to be completely opposite views at first, we have found quite lot we agree on.

Posted by Erika Baker at Monday, 6 July 2009 at 1:02pm BST

Same here, Erika.

Posted by BillyD at Monday, 6 July 2009 at 7:11pm BST

"But that does not give them the right to tell me that my understanding of my faith must be precisely like theirs and that I must follow their discernment, not mine."

But what is so wrong, so damaging to you, in following the expertise of people better versed in these things than you are? I am a physician, used to work in clinical practice. I can advise you about your health issues, I have the training, the experience. While you do certainly have personal autonomy, if you do not take my advice, why do you bother coming to me? This isn't absolute, of course, it's the extreme physician who refuses care to someone just because they won't stop smoking, though I have known of it happening. But would you therefor tell physicians they have no right to lobby for smoking bans because, while they think smoking is unhealthy, they have no right to contradict your opinion, to tell you what to do, depsite your relative lack of knowledge in that area?

Posted by Ford Elms at Monday, 6 July 2009 at 8:05pm BST

Ford
I think your comment mixes two different things.
Of course physicians can lobby for a smoking ban. Every group in society can lobby for anything, and some will have better reasons than others.
I am not saying that I would break the law, or that I would deny anyone to lobby for what they want. I just happen to be supporting one side of the debate.

The other question is to what extent I will take your advice. And that again is a dual one.
In principle, I will take your advice to the extent that I trust your judgement. And so I will not take a psychiatrist's advice that he might cure my bisexuality, but I will take your advice that I should stop smoking.

But what BillyD and I have discussed here goes beyond a doctor saying I can cure you.
It's about being at that point in a progressive illness where there is no cure, and there are only different ways of managing the rest of life.
I know that your views will be influenced by your faith, I know that other physicians might disagree with you and base their different views on something else.
We're now way beyond the "stop smoking because it kills" medical knowledge but in the realm where we have reached the edge of science, and ethics plays as great a role as medicine.

But when we're talking ethics, you're no greater expert because of your medical training, and so I may choose to listen carefully to you and then decide to go my own way.

And theologians? I will no more take the consevo advice on homosexuality than I will take any theologians advice on euthanasia just because he claims to know best because he represents the tradition of the church.
I will listen to all the arguments, take advice, be guided – but then make up my own mind.

Posted by Erika Baker at Monday, 6 July 2009 at 9:24pm BST

"I will listen to all the arguments, take advice, be guided – but then make up my own mind."

I have no argument with the above, but I'm still not comfortable with it as an approach I can take. In thinking about this last night, Erika, I think I may be able to formulate our difference here. Correct me where ever I'm wrong. I suspect that for you, the Primary Relationship is between the believer and God. For me, the primary relationship is between the Church and God. My relationship with God is as a result of my relationship with other believers in the Body. Jesus is NOT my "personal Saviour", a term I find more and more objectionable the more I think about it. Now, what are the implications for this for my own personal autonomy? That's why I'm an Anglican and not a Roman Catholic. I believe in the "All can, none must, some should" approach. And my reference to smoking was that if it is appropriate for me, a physician, to lobby government to ban, or at least restrict, smoking, surely it's appropriate for the Church to lobby government to ban something it believes is equally damaging to the health of society. And notice, I am NOT talking about a single theologian or cabal of theologians, here, but about the collective voice of the ecclesia. That voice takes a very long time to be expressed, and longer to be heard, but it is there that the authority lies, not with me, not with you, not even with Scripture, and certainly not with a bunch of men who likely value their mitres more than they value the Gospel. I suspect you would take great exception to that, and would take upon yourself the final responsibility of "doing the right thing" so to speak, so it is your conscience and your individual relationship with God that, for you, has authority over your behaviour, not some external force like the Church. Am I right in that, or utterly off the mark?

Posted by Ford Elms at Tuesday, 7 July 2009 at 4:02pm BST

Ford
I think you're right in saying that I place a greater value on my own responsibility before God than on the church. The Roman Catholic view of "I was told to believe/do it" is an abbrogation of that freedom and responsibility that Christ brought us.

But even if your approach is right, I'm at a loss to see what that might mean in practice. There is no The Church that agrees on any single subject bar, possibly, the creeds. Church is a continuous process of discernment, and whenever we're faced with cutting edge issues we can be pretty sure that there will be no agreement in my lifetime.
So what am I to do - abandon all active choices and hope that my dilemmas will be answered in time for my grandchildren?

I cannot see any way round taking responsibility before God for myself.

Posted by Erika Baker at Tuesday, 7 July 2009 at 5:19pm BST

Ford
I'm not actually sure I quite understand what you're saying yet. If you believe that the church alone discerns God's will, and that we must not change our actions until the whole church agrees, how can you live in a partnered relationship, the only nod to the church being your opposition to SSBs? I'm not asking this critically, I genuinely do not understand, because according to your understanding of church and your place within it, are you not deliberately acting against God's discerned will?

Posted by Erika Baker at Tuesday, 7 July 2009 at 5:52pm BST

Erika, to explain it would take way more room than I can take here. I have got a rather long explanation prepared to send off list, it's just now in need of a bit of editing, for verbosity as much as anything else.

Posted by Ford Elms at Thursday, 9 July 2009 at 4:49pm BST
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