From Dr Sioned Evans
Sir, - I am writing as someone on the front line of specialist
palliative care. I also happen to be a Christian and a clergy wife,
regardless of which I would be taking this stance.
Much has been written about the moral and legal impacts of the
proposed assisted-dying Bill for the terminally ill. I concur with
all concerns regarding the risks to the vulnerable and the
resulting shift in the moral compass of our society that a change
in the law would inevitably bring.
Yes, there is room for improvement in how we care for the dying;
and, yes, we need more education and financial support to improve
this; but, no, we do not need medical staff to be trained to end
lives, as proposed by a retired senior doctor in public health.
I have been humbled during my 21 years as a doctor by the trust
that is placed in our profession. It seems we are among a
diminishing number of professions who still have this trust
bestowed upon us. I want to raise the concern I have regarding the
impact this will have on that trust. Part of my work is to have
sensitive conversations with patients and relatives about
end-of-life care.
Under the current protection of the law, these patients and
families and I know that a choice to accelerate death is not on the
table. What if it were? How would that affect the dynamic? Would
more patients feel that this is what they should do? Would
they see me as "doctor death" and have an inherent mistrust of my
motives? How can it be right that one of the options I have in my
"medical bag" is a prescription to kill?
It has been said that the decision is a matter for Parliament,
not for doctors. It is not, however, the MPs who will have the
responsibility for prescribing the lethal cocktail, or, in the case
of euthanasia, administering it? I cannot and will not kill
someone. My motive for becoming a doctor was to cure, and, if cure
was not possible, to provide comfort and relief. Would you trust
your doctor in the same way, knowing that he or she had a licence
to kill?
As doctors, could we truly reassure ourselves that the lethal
dose we have just prescribed was justified because it ended
someone's suffering? In the darkest hour of the night or deep in
our conscience, could we really deny the truth that we had
intentionally killed someone? This is a huge burden to put on the
medical profession.
It seems incongruous, and a true irony, that the country that
pioneered the modern hospice movement would be among a few
countries in the world to legalise assisted suicide. We should note
the cautionary tales within Europe, and that it is likely that
before long there will be further legislation to expand the current
proposed Bill, should it become law.
So, let us not train doctors to end lives, but teach them to be
doctors who support a natural death and all the responsibility,
care, and compassion that this entails.
SIONED EVANS
Associate Specialist in Palliative Care
Address supplied
From the Revd Stephen Cooper
Sir, - I have read Lord Carey's Daily Mail essay
explaining his changed views on assisted dying, and listened to
Bishop James Jones's Thought for the Day contribution to
the debate. Apart from one minor passing reference, neither
commented in detail about the safeguards that such legislation
might require.
As Bishop Jones made clear, the argument made is between the
"right to choose" and the relative sanctity of life. But above both
of these comes the responsibility of us all, and of Government
particularly, for the protection of the weakest and most vulnerable
in society.
In this debate, the need of those who are frail, elderly, and
perhaps easily confused for protection from exploitation and
coercion from the venal and the selfish who are more interested in
an inheritance or the avoidance of costly care bills is constantly
put to one side by the proponents of assisted dying. It would be
great to think that such things would not happen, but all too often
this facet of human nature has not changed.
How would such protection be provided? By doctors? They have
shown themselves incapable of sustaining safeguards over the long
term under the 1967 Abortion Act, and, with the greatest of
respect, there is no evidence that they would be any more capable
of exercising judgement of motives and sustaining safeguards under
assisted-dying legislation. The Court of Protection? It might seem
to be an obvious choice, but the "behind closed doors" nature of
its judgments means that the public has no way of either knowing
whether fair judgments are being made, or learning from them.
The current system requires that, when someone takes the life of
another out of compassion, the evidence for those motives is tested
in open court to decide whether there was reasonable cause, and
therefore a defence against unlawful killing. It remains the only
way I have yet seen which provides the necessary level of
protection of the weakest and most vulnerable in our society. It
would not be an act of compassion to undermine this, which we would
do at their peril under the proposed legislation.
STEPHEN COOPER
The Vicarage, Goosnargh Lane
Goosnargh, Lancashire PR3 2BN
From A. Wills
Sir, - I agree with your article "But what about terminal care?"
by the Bishop of Dover, the Rt Revd Trevor Willmott (Comment, 11 July), which
drew attention to the need for good palliative care at the end of
life. Many people are concerned that they will have a painful and
undignified death.
It has recently been reported that, since the Dr Harold Shipman
case, not enough morphine is being given to relieve the pain of
dying patients. Doctors can now fear being sued if the morphine
given to relieve a terminally ill patient's pain happens to hasten
their death. Some close relatives say that they remain traumatised
after seeing their terminally ill loved one suffer greatly.
On 1 July, The Daily Telegraph reported that "Almost
100,000 terminally ill people don't get proper palliative care."
This was found to be the case by the Royal College of Physicians,
who say there is a lack of palliative care in hospitals,
particularly at weekends and during the night. Hospices are experts
in pain relief, and they make dying people comfortable, but there
are not enough of them for everyone who needs one.
Can we wonder that there are calls for doctor-assisted help to
die when this is the case? We serve a compassionate God; so
Christians should try to secure palliative help for patients at the
end of life.
A. WILLS
67 Dulverton Road
Middlesex HA4 9AF