In the debate in the General Synod last year, the Church of
England affirmed that the current law on assisted suicide, and the
Director of Public Prosecutions' guidelines for its administration
provide a fair, balanced, and compassionate approach (News, 17
As a nationwide community organisation, the Church has the same
rights, duties, and obligations as other socially aware
organisations to participate in the continuing debate on assisted
suicide. Its approach is based on the following four main
AFFIRMING life: for the good of society and individuals,
it is essential that both the law and medical practice embrace a
presumption in favour of life. The current debate is not only about
an individual's wish to die; it is also about the limits that ought
to be placed on one person actively participating in bringing about
another person's death. To allow such participation would be to
introduce a novel and dangerous concept into British law, with
potentially unforeseen consequences.
The right to life is universally recognised as a fundamental
right in domestic and international human-rights legislation,
placing an obligation on governments to protect and promote it.
This right is based on the belief that every human being is of
intrinsic value. This belief is central not only to the law, but
also to medical, nursing, and social care.
Arguments in favour of assisted suicide often favour an
evaluation of human life based either on "quality of life" or on an
individual's sense of personal worth. While these are important
considerations, they ought not to undermine the central importance
of the intrinsic value of every person's life. Eroding this
principle would inevitably have a corrosive effect on many aspects
of our communal life.
CARING for the vulnerable: individuals seeking assistance
in ending their lives are often vulnerable, but this must be placed
alongside the vulnerability of very many others. Many people,
especially elderly people, are already vulnerable to malicious
actions by others. Each year in England and Wales, more than
300,000 people suffer elder-abuse, and at least another 100,000
suffer neglect. The majority of this abuse is perpetrated by carers
or by family members, often with financial gain as a motive.
It would be negligent to believe that such people would not seek
to exploit a change in the law in order to pursue their goals.
Similarly, many elderly, infirm, or even disabled people would feel
under pressure to "do the decent thing" and remove themselves from
"being a burden". We know that this is the case, because many
individuals have said so.
It would not be possible to put into place effective safeguards
against such abuse or pressure if the law were to be changed. The
Francis Report into events at the Mid Staffordshire NHS Trust
serves as a warning: the NHS's high motives and rigorous monitoring
policies did not prevent individuals' acting inappropriately. It
is, of course, too late to try to remedy matters after the event. A
change in the law on assisted suicide would provide additional
scope for further individual and systemic abuses.
The key consideration is whether a change in the law would put
increased numbers of vulnerable people at greater risk of harm; it
is untenable to think that it would not.
BUILDING a caring and cohesive society: the aspirations
of individuals are important, but it is not possible to view these
in isolation from the effects that they might have on others and on
society in general. When viewing legislative change, we must ask
ourselves what sort of society we are building.
A change in the law on assisted suicide would give, at the very
least, mixed health-care signals. We rightly expend resources on
suicide-prevention initiatives, and we encourage individuals who
are ill or struggling with life to believe that their lives are
worth living. Permitting assisted suicide clouds this message.
It would also create a number of problems for health-care
professionals. There are real difficulties in obtaining an accurate
prognosis of how long any individual might live, beyond an
estimation of "hours or days" towards the very end of life. It
would be wrong to place doctors in the position of having to
estimate a person's life-expectancy for the purposes of their
gaining access to any proposed assisted-suicide services.
It also takes time to ensure that an individual is not suffering
from depression or other mental illness - much more time than even
a tentative prognosis of "days or weeks" would allow. In addition,
any involvement, however indirect, in assisted suicide by
health-care professionals would irrevocably change the
understanding of health care in the UK. The professional
patient/client relationship would be altered detrimentally.
RESPECTING individuals: while assisted suicide is
contrary to the principles outlined above, other end-of-life
decisions ought to be respected. This means respecting the
decisions of patients who choose not to receive treatment, besides
respecting the wishes of those who do.
It is also essential that high-quality end-of-life care is
available throughout the country, and hospices and palliative-care
units are adequately resourced. The excellent care pioneered by the
hospice movement has demonstrated that holistic palliative care,
which treats every individual with respect and dignity, is a
viable, life-affirming alternative to assisted suicide.
QUESTIONS about the end of life are complex: it is not appropriate
to address them through the blunt instruments of opinion polls and
online surveys. Respecting individuals necessitates careful
consideration of all the issues; the process cannot be telescoped
into a few short questions and answers.
The Church of England accepts that a range of opinion is held
both by its members and by others in society. None the less,
because of the considerations outlined here, the Church, through
its bishops and through its elected representatives in the General
Synod, continues to support the current law on assisted
The Revd Dr Brendan McCarthy is the National Adviser on
Medical Ethics and Health and Social Care Policy for the