The view from across the pond: An update from the U.K.

Dr. David Amies brings an update on the status of physician assisted dying in the United Kingdom, where religious leaders and politicians "continue to defy the wishes of a large majority of the population on matters of this sort, indefinitely."

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The Roman Catholic archbishop of Westminster, has condemned a recent private member's bill defeated in the House of Commons (above) as legalizing “assisted killing” which would “gravely undermine” the value of human life.

As I mentioned in my last piece for this blog, a private member’s bill, recently introduced in the House of Commons at Westminster, in favour of physician assisted dying (PAD), was overturned by a two-to-one majority. Consequently, the move towards PAD has been effectively quashed for the time being in the United Kingdom. Two previous attempts to change British law on the matter were blocked in the House of Lords or allowed to lapse on the order paper for procedural reasons.

Much of the opposition to the motion has been marshalled by various faith groups and it looks as if politicians have been unduly influenced by them, although the United Kingdom is one of the most secular nations on Earth and can now be described as merely culturally Christian. The Church of England (CoE), the established or official church, is in decline. Church attendances have decreased greatly while its remaining congregations are ageing. However, the CoE still holds a privileged position in England. The Queen is its titular head; twenty-six of its senior bishops have seats in the Upper House, the House of Lords, where they enjoy full voting privileges. It controls many schools and ensures that daily, formal acts of worship take place in them all. It requires that official proceedings in Parliament and city and town councils are opened with devotions. The Church of England is jocularly termed the Tory party at prayer. It is hugely wealthy and is, probably, the largest landlord in the country. In spite of these advantages, it is becoming less and less relevant to the general population but retains influence grossly out of proportion to the number of its adherents. It is resolutely opposed to assisted dying.

The Roman Catholic Church has recently enjoyed a boost in membership due to a large number of Polish migrants attracted by positive economic conditions but it remains very much a minority religion. It regards PAD as a sin. Briefly, the Roman Church teaches that humans are made in God’s image and that life is a gift from God and only He can determine its duration. Islam is said to be the fastest growing religion in the U.K., due to the very large influx of adherents to that faith from the Middle East, Pakistan and parts of Africa. The Muslim point of view on PAD reflects that of the Roman Church. It proclaims that he who kills another, kills the whole human race. Muslim scripture offers the following, "O Muslims, seek cure, since God has not created any illness without creating a cure." (That leads me to ask why God created diseases in the first place? Are such questions sacrilegious, even mischievous!)

Medical establishment divided

The views of the U.K. medical establishment on PAD are divided. Current policy of the British Medical Association opposes all forms of assisted suicide while admitting that there is wide spectrum of opinion about it in the profession. One survey found that roughly two thirds of doctors were against and one third in favour. Another put the numbers as half being against and two fifths being in favour. 

The Campaign for Dying in Dignity, the British sister organization of Dying with Dignity Canada, has found that four out of five people in the United Kingdom favour assisted suicide legislation. That number was reflected among the disabled as well as the religious communities.

“We want terminally ill people to have the choice of assisted dying should their suffering become unbearable to them during the last few days or weeks of their life,”they say.

Just before the important vote in Parliament, there was a flurry of letters in the major, national newspapers. One, from senior members of the medical profession, claimed that the proposed legislation would help ensure that safeguards would be in place for a practice that already goes on behind closed doors and would let patients choose the time of their deaths. It went on to say:  

“As healthcare professionals we believe that the current law prohibiting assisted dying is dangerous, cruel and in direct conflict with our duty to care for our patients. Forcing people to travel abroad to die or to end their own lives in this country in distressing circumstances is not consistent with patient-centred care.” 

Its signatories included Sir Muir Gray, the NHS’s chief knowledge officer; Henry Marsh, a prominent neurosurgeon; and Dr. Sheila Adam, a former deputy chief medical officer, as well as seven past presidents of some of the medical royal colleges, two ex-presidents of the British Medical Association and a former chief nursing officer for England.

The views of the medical brass paled in significance when Church luminaries such as the Bishop Newcombe of Carlisle, the lead bishop in the House of Lords on health matters, wrote:  

“Terminally ill people deserve to be surrounded with love, compassion and care; not called to make a choice between dying prematurely and being a burden. The only effective safeguard against this pressure is to keep the law as it is and that high profile endorsements of the Assisted Dying Bill and snap opinion polls ought not to replace careful analysis of this complex life-and-death issue.” 

The leaders of the country’s Christian, Jewish, Muslim and Sikh communities wrote a joint letter urging rejection of the bill. Justin Welby, the archbishop of Canterbury, warned that Britain would cross a “legal and ethical rubicon”if it embraced doctor-assisted suicide. Cardinal Vincent Nichols, the Roman Catholic archbishop of Westminster, has condemned the bill as legalizing “assisted killing ”which would “gravely undermine”the value of human life.

PM's views at odds with majority of Britons'

David Cameron, the prime minister, said that he opposes euthanasia because of fears he has about undue pressure being put on vulnerable people. 

So, you see that the United Kingdom is highly conflicted over this issue. Just about four fifths of the population (able-bodied, disabled, religious, among others) want assisted dying legislation introduced, accompanied by suitable safeguards. Around one third of the medical profession is in favour of it. Parliament has just turned down a bill by a two-to-one margin. Religious institutions are resolutely opposed. 

It is not difficult to understand the stance of the medical profession. Until now, doctors have been trained to prolong life at just about any cost. As students they are taught to regard death as a failure and to wage war on disease. Many doctors claim that the Hippocratic oath enjoins them to do no harm. (As an aside, I have never met a single physician who has actually taken that oath!) It is also possible to have a nice argument whether keeping someone alive at all costs is harmful or beneficial. 

Legislators, who, in theory, are elected by the people to carry out their will, do not wish to alter the status quo. It does seem that faith organizations and their representatives have had more influence than the voters. I find this position curious. The British have more or less abandoned religion and yet their parliamentarians continue to defer to bishops, rabbis and mullahs. I can only assume that there remains a definite propensity to afford undue respect to men of the cloth, titles, position and uniforms that persists even now, especially among the English portion of the population. 

However, I am confident that this issue will be revisited before too long and that the outcome will be very different. It is hard to see how the people’s representatives can continue to defy the wishes of a large majority of the population on matters of this sort, indefinitely.

Dr. David Amies is a retired doctor in Lethbridge, Alta., and a member of DWD Canada's Physicians Advisory Council.


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