From Professor Michael Marsh
Sir, - After last Friday's Second Reading of Lord Falconer's
assisted-dying Bill, we know that some law to permit the death of
another person in extremis will ultimately be sanctioned.
But, apart from this, where do we stand?
Fifty per cent in the Upper House expressed disquiet over this
Bill, raising great doubts whether the next Committee stage could
ever make a silk purse from a sow's ear. In my view, the old
Joffe-Falconer approach is dead; I hope that someone will
instantiate a completely new Bill, untainted by either suicidal or
murderous intent: that is, leave the Suicide Act intact, and
innovate something more thoughtful, if not original.
The key is to establish an assessment board (AB), chaired by a
legal person with access to the Director of Public Prosecutions and
the police, adjudicating requests from patients and relatives,
perhaps with solicitor, GP, or priest. This would immediately
eliminate most of the exclusive and contentious aspects of
Falconer, such as "terminal", "six months", "two doctors"
(unspecified), reporting "independently", and distrust generated
between public and doctors (possibly) authorised to kill patients
on NHS wards.
Instead, the AB would co-opt chosen specialists (palliative
care, analgesia, oncology, etc.) relevant to individual cases,
followed by open discussion with all parties, and from which
altered management might actually change minds.
Yet assessment of volatile mental states and capacity remains a
fraught difficulty, needing expert psychiatric input, and lengthy
examinations, perhaps on several occasions, with careful
differentiation of "depression" from states of hopelessness and
demoralisation, and their treatments. All this and more would have
to be concluded and agreed, the paperwork completed, and thus
available for accurate follow-up, review, research, and statistical
analysis (so to assess "slippery slopes") before dispatching the
patient. Undertakers could be on notice not to handle bodies
without the correct forms and authorisation.
Parliament must still decide the vexed question of those
lawfully certified to administer the lethal cocktail, without the
known distressing risks of failure.
The debate revealed death and dying as unknown quantities within
society, and that Churches needed to do more in opening up
knowledge in this field. We also need far deeper theological
reflection to determine the rightness of assisting death, and,
importantly, to assuage the sense of guilt, remorse, and shame of
relatives after acting in this manner.
Lord Carey, speaking in the debate, suggested Calvary as the
ultimate analogy; but this is mere statement, not argument, nor an
argument logically extended and developed. Moreover, psychological
distress stories only underpin a preceding need for legal change:
how odd that an archbishop and former archbishop starting from this
same premise have come to differing conclusions. That requires
elucidation, besides the meeting of the problems that arise for
friends and relatives, post-bereavement. Much obviously needs to be
affirmed and refined regarding this aspect of assisted dying.
Finally, would God-as-Father take great offence and displeasure
in our ending the life of another human being in these demanding
but varied end-of-life contexts?
MICHAEL MARSH
Wolfson College
Oxford OX2 6UD
From Professor Peter Davies
Sir, - May I suggest an amendment to the Archbishop of
Canterbury's statement that a "sword of Damocles will hang over the
head of every vulnerable and terminally ill person in the country"?
In fact, it will hang over us all, if the law is changed, as
anyone, at any time, may by accident or illness join these
ranks.
PETER DAVIES
Liverpool Heart and Chest Hospital,
Liverpool L14 3PE