Conflict of the Sympathies

Today the Parliament will debate and vote on permitting medical authorities to assist patients with terminal diagnoses to commit suicide. I think it’s beyond doubt that palliative care in the UK has been devastated by austerity policies (policies that benefit the wealthy while grinding down people who rely on government services to get by in hard times); that much must be addressed regardless of the outcome of today’s vote.

The remaining question concerns the situation of terminally ill patients whose condition impels them to wish for death’s relief. Should the law permit medical staff to aid them in managing a quiet, deliberate death?

I do not oppose acts of mercy for people who suffer greatly and whose physical conditions show no sign of possible recovery. I’ll get back to this, but I want to acknowledge that their condition has to be met with generosity and understanding.

I am unswervingly committed, however, to protecting vulnerable people from cultural pressures to end their lives: people with non-terminal illness, mental illness (particularly acute depression), and any other cause of intense suffering. Most specifically with relation to this bill, I worry that terminally ill sufferers may themselves be led to suppose that it’s their duty to request medical suicide. For very terminally ill patient who desires suicide, there are many others for whom that prospect is not urgently appealing — who may plausibly fear death, or have other reasons for raging against the dying of the light. Once the bill becomes law, these patients will have to answer, every day at every turn, when they will ask to die, why they aren’t volunteering, what makes them so stubborn, and so on. The law is not simply permissive — it indicates a tacit commendation, and a distinct trajectory of change (manifest in every other polity that has allowed medically assisted suicide). It changes the role of medical staff from presumptively unalloyed defence of life to a consumer-service agent who in some cases will deliberately kill and in other cases sustain life, a vast change in the role of the vocation.

Add to this other circumstances that don’t fall within the ideal-case ‘dignified death’ of the unquestionably terminally, agonisingly ill patient: the patient who ‘doesn’t want to be a burden’, the patient whose relatives don’t want to support a determined terminal patient through their last days, the non-terminally ill patient whose suffering may, arugably, rival the pain of terminal illness, the patient with second thoughts who feels unable to voice their doubts, the medical staff whose bearing and whose workload communicate indirectly the ‘need’ to move the patient on to death.

Most pertinently: if there be any risk of any unwilling patient being moved to suicide by the fact that they and their medical carers have legal permission so to do, those lives must not be sacrificed in favour of the availability of suicide for thsoe who truly, honestly, top to bottom desire it. One unwilling life is not balanced out by any number of willing suicides. That’s murder, and a civil society may not make peace with murder.

Plus, religious reasons — but since many of my neighbours don’t share those, I haven’t advanced them here. Yes, it’s about religion — but it’s very far from being only about religion.

To return to the souls who demand the prerogative to end their lives of suffering: I do not favour prosecuting every sympathetic medic who in exceptional circumstances risks the force of law in order to relieve a soul in agony. I don’t endorse that, but I can envision circumstances in which the police or the prosecutors may not think it fitting to bring a case against a doctor or nurse. But I do think it very much for the best that such people know and understand that their position is at risk, that their actions transgress the legal norms of a society that values and supports all human life.

Vote against this private member’s bill. Lives depend on it.

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