Archbishop Peter Smith has asked us to place a notice in our Bulletins
this weekend encouraging us to write to the House of Lords and express our
views on the ‘Assisted Dying’ Bill. Having sat for a month by the bedside of my
mother following a subarachnoid bleed, and observing the care given and the
rationale behind the medical and nursing interventions, I shall be saying that
the dying person does not require killing (or assistance to take their own life)
but complete and dedicated care. We should not measure our care of the
terminally ill by how easy it is to bring about their death, but against the
criteria of “is this going to delay natural death (in which case it is
wrong) or sustain comfort while
moving towards a natural death?”
In the UK, Pathways for the dying routinely remove food and fluids while
increasing drugs which sedate the patient, achieving a calmness in the patient
that may prevent the dying person from being unaware they are thirsty, with the
family thinking their loved one’s death is simply ‘peaceful’ rather than
procured. In the situation with my mother, the physician said they were going
to remove mums subcutaneous infusion (500mls N/S per 24hrs) as it was
life-extending. I had to challenge this to have it noted as -at most- life-sustaining,
and certainly not life-extending. In that we all lose around 450mls per day
just by breathing, never mind the insensible loss (loss of which we are
generally unaware, as in sweating) and the sensible (obvious) loss in passing
urine, there seems no good reason for removing all fluids. Even in congestive heart failure, removing the infusion
may do little to relieve the pulmonary congestion since circulating fluid ‘seeps’
into the lungs whether fluids are given or not -and it is, after all, simply
replacing only one daily ‘insensible loss’. This is not to say there are no occasions
in which infusions can be removed in the last few hours of life, but whether
infusions are present or not, frequent mouth care by nurses and relatives must
be a priority intervention for reasons of comfort.
Many anxieties arise in those who are dying, mainly concerning pain and dignity
during the dying process. It is this pain
and distress that needs to be ended, not the patient, while their dignity and enjoyments
are to be retained. If the dying person can
retain their dignity (by respectful cleansing after passing urine or stools
etc); have their anxieties relieved (by
adequate but not excessive use of anxiolytics), their pain relieved (by such as morphine); any muscle spasm relieved (by such as Baclofen or Clonazepam); and if their enjoyments (TV programmes, reading or music etc) can be provided
along with comforting, human-touch therapies
(such as massage and aromatherapy), many who think they should end their life might
be happy to have more time with their loved ones. This kind of care requires more
and better funded hospices. We must strive to provide such care because the human
person alone walks the earth with a dignity that does not have a sliding scale based
upon whether one is rich or poor, black or white, male or female, sick or well.
We are not mere animals; we have a mind which produces concepts; a mind which
brings us to understand and master the world in ways that animals with their basic
instincts cannot. We may euthanize the arthritic dog, but people require other
than killing –they require compassionate caring and respect.
It is said that the Assisted Dying Bill will result in fewer dying adults
facing unnecessary suffering at the end of their lives and bring clarity to the
law, thus providing safety and security for the terminally ill and for medical
professionals. This is a poor argument,
since suffering can be relieved by medications and having pleasures retained as
I outlined above. Nor do we need a clarity in the law that brings physicians, nurses
and loved ones to become killers rather than carers; the clarity we need is on
the protection of human life and the provision of proper care.
It is said the Bill will not legalise voluntary euthanasia, or act as a
slippery slope to do so, only give dying adults peace of mind that the choice
of assisted dying is available if their suffering becomes too great for them to
handle. That the Bill would not legalise euthanasia
is nonsense; the procuring of death in the dying person is exactly that: euthanasia.
It is said that the Assisted Dying Bill would only apply to adults with ‘mental
capacity’ both at the time of their request and at the time of their death. This does not lessen the reality that this
Bill is seeking to procure death before one’s natural time. Further, the issue of consent is very problematic:
when given a long time in advance it cannot be relied upon since it is given
when the person cannot actually know how well they would cope if complete and expert
care were given. If consent is given in the immediate situation it is hampered
by fears, and if anxiolytics are given to relieve that fear then the consent is
given while under the influence of drugs. The Bill would certainly NOT protect
against unscrupulous relatives or physicians from pressurising the dying person
into requesting euthanasia by engendering feelings of guilt, fear etc.
To conclude: what is required is not procured death by killing but
dedicated, complete care of the person’s physical, mental, social and spiritual
well-being, which can be achieved through more and well funded, fully staffed
hospices. The dignity of the human person demands this; the capacity for compassion
for one’s fellow man delivers it, since compassion naturally inspires devoted care,
not killing.