assisted dying IS on its way in the UK

The Assisted Dying Bill, discussed in the Lords in July, probably won’t become law this time – but that paradigm changing moment in UK culture around death is definitely on the cards now.

More Peers requested to speak on this bill than any other bill ever.  There were 120 speeches in the ten hour debate on Friday 18 July.  The bill passed its first major hurdle, its Second Reading, with no vote and no wrecking amendment either.  The last time Lord Falconer’s Assisted Dying Bill was debated, in 2006, it was defeated by a wrecking amendment which secured 148 votes to 100.  That probably didn’t happen this time as opponents of the bill weren’t confident they had enough support in the House of Lords to do that.

In the week preceding the debate some major figures announced their surprising support for the bill.  Lord (George) Carey, the former Archbishop of Canterbury, was an unlikely convert. Carey said his thoughts now focused on the suffering of the person and that alleviating that was now a higher priority for him than a doctrinal position.  I thought that was quite an admission!  Good old Desmond Tutu also waded in with his support, breaking the silence on how Nelson Mandela was kept alive/died and highlighting the importance of dignity in death.

There are still a lot of Bishops in the Lords, in far greater proportion there than they are amongst the public – 80% of who support this bill.  Most of the bill’s opponents in the Lords are against it for reasons of Christian doctrine ie that the decision when we die is God’s and God’s only, in his own good time, though other reasons will mostly be cited instead of that.

The most common is the infamous ‘slippery slope’ – that this will lead to the forced extermination of all imperfect (ie the disabled) or inconvenient (older, dependent relatives) people.  To me the ‘slippery slope’ argument betrays a lack of faith in the law, which is a tad ironic coming from law makers.  (If you want to get to grips with all the details of the ‘slippery slope’ arguments, I recommend the superb last chapter in the recent book ‘Assisted Dying’ published by Dignity in Dying.)

The strength and humanity of this bill is that it aims to give the person dying the choice, not their doctor, nor ‘God’.  It’s up to them, and no one else, whether to exercise that option.  Who knows how often that option will be used.  After 17 years of Oregon’s Death with Dignity Act, 80 people out of 30,000 deaths used it last year.

And the safeguards in Falconer’s Bill are solid.  Two doctors, acting independently, must confirm a patient is likely to die within six months, is of sound mind, has decided without pressure, is told of palliative options, and is able to take the medication themselves, after a cooling-off period of reflection.  A sunset clause means the law is repealed in ten years, requiring parliament to vote it in again.  This bill slips down no slopes and…. that it’s now been allowed to progress into Committee stage means all the details will get a thorough working over (again).

 

It’s unlikely to become law this time because the General Election in early May 2015 means the Parliamentary year will be shortened and there won’t be enough time for the bill to complete the process of becoming law.  But the 18 July debate will be remembered as the tipping point methinks.  The majority of speakers recognised something has to be done to change this out of touch law and out of date law.

A change in the law is inevitable – not least because the Supreme Court warned in the Spring that if Parliament doesn’t make this Bill law, the courts will soon be forced to decree it legal.  There’s been a campaign to change British law in this direction since the 1920′s.  Parliament usually trails behind the public on so-called ‘moral’ issues.

One of the best results of the Bill was the increase in public discussion about the detailed realities of dying – and this in the summertime too!  Another argument sed by opponents of the bill is that the right to die is a dangerous substitute for good care.  ’Care Not Kill’, the placards read.  Who could disagree with that?  But it’s a disingenous argument.

For all the marvels that morphine pumps display, they are not all powerful.  Studies show that pain control is complete in 60-70% of cases only.  There are neurological pains and bone pains when people are dying that are hard to relieve.  Several tragic and poignant stories of this kind had the chance to be heard in July reminding us, to quote Ann Munro who works with the dying in a large NHS hospital, that “It’s a lottery.  You never really know what it’s going to be like.”

The hospice movement provides exemplary palliative end-of-life care to those fortunate enough to receive it. These days hospice teams help people die in their own homes too.  But few people without a cancer diagnosis get palliative care – only 20% in Scotland according to research.  When I read that I gave heartfelt thanks that my mother, dying from pneumonia in February, slipped in to the exemplary Alexandria (palliative) Unit in Dumfries Royal Infirmary (for people with cancer) for the last four days of her life.  Every hospital should have a Unit like this, I thought , for all.

Most people want to die at home, or in a hospice.  Most people die in hospital.   Help the Hospices are aware of this and have recently boldly announced a campaign to increase the numbers of people who can take up their services.  At the same time the Government has recently announced cuts in its already limited funding of hospices!  Why am I bringing that up here?  Because all these issues are linked up.  Let’s keep the detailed realities of dying in the realm of public discussion – keep talking about it, with our friends, family and in our community.  It’s the main way that change will happen, that suffering will be lessened.  Let’s make dying in the 21st Century an issue in the General Election campaign.  There’s 64 million people in the UK  and they are all going to die…

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