October 2024
By James Woodward
Do you ever wonder how and when you will die? Have you made clear your wishes for your funeral service? Do you know the process by which you make decisions? How do you decide what the difference is between right and wrong?
All these questions are being played out in the public arena as we have another public vote on the important policy issue of assisted dying. Commentators and social activists have been hard at work setting out their position. Bishops have made the well-known position clear. Radio 4 has offered a platform to a range of public figures to tell their story and explain why a change in the law to allow, under certain circumstances, individuals to access assistance to die in the face of their terminal illness is a natural and good extension of care.
We should not doubt the integrity of those who wish to change the law. No one wishes to prolong unnecessary suffering or pain.
I have some history with all of this. In 2010 I was approached by a campaigning organisation to consider joining a Commission on Assisted Dying. I had conversations with several people including Lord Falconer, the former Secretary of State for Justice who was to chair the Commission. It was a highly skilled and experienced group of people, and the work was thorough and searching. It was supported by an excellent group of researchers from the democracy think tank Demos.
Twelve months of work was demanding, as the 12 commissioners took advice from over 2,000 practitioners, professionals and members of the public. It included fact-finding visits to countries where assisted dying is legal. I believe that the present bill in front of parliament next month is very largely shaped by Falconer’s Commission and the work of the assisted dying advocacy organisation, Dignity in Dying.
When the report was published in January 2012 for a day or so I had the adventure of travelling between news stations explaining why I had dissented from the findings. I believed then and still do, that there are huge difficulties in changing the law.
There were two turning points which I still believe to be relevant today as the public debate continues.
The first is related to a conversation with a leading campaigner for assisted dying. I asked her whether she had any doubts about a change in the law. There was a pause, which was followed by a statement of unswerving conviction in favour of change. I was told that the matter in hand was clear and persuasive and absolute. It was supported by evidence and public opinion, and it was our responsibility, she argued, to respond compassionately to those who did not want to die in pain.
As part of the work of the Commission I visited Zurich and the Dignitas clinic situated on the outskirts of the city. I met its founder and some individuals working there. The founding director, Ludwig A. Minelli, was welcoming and undefended. I saw the place and space where many had been given assistance to die.
This left me feeling that we simply cannot demand freedom to choose at any cost. We need more time to engage with how we view life, death, vulnerability and dependency. This is an area of life that cannot be dealt with through the law or medicine alone.
What may be lacking in this debate is a richer and more nuanced conversation from the middle ground. It needs to be related to the provision and quality of palliative care. It needs to be shaped by a mature and intentional conversation about our humanity, our vulnerability, and adult mortality. We need to be careful not to see the whole world through the subjective prism of our own story.
It is not clear whether enough safeguards for vulnerable people are in place. I think it is worth noting that most of the people calling for change can afford the best access to health care in the world. Financial security brings an ability to choose and death perhaps remains one of the few choices that lie outside the forces of capitalism.
I think aspects of this bill underestimate the complexities of communication and relationships in families. Some people change their minds. Some people have limited emotional capacity to make decisions. Others work out dubious motivations. It remains to be seen whether the modern health service has the space and compassion to negotiate this territory.
Any change would shift forever the relationship between the patient and the doctor. I think the present law does maintain the delicate balance between a need for release from unendurable suffering to an absolute requirement to protect the vulnerable. It is and has all the potential to be a complex and slippery slope.
The church and other religious communities might also wish to consider their role and place in all of this. Preoccupied with his own internal work of survival there has been much emphasis on strategy and growth. We easily overlook in our task-driven functionalism what is necessary here. It is a spiritual task. It is a task of nurturing imagination and compassion. Can we demonstrate with imagination how we can hold the sheer fragility and preciousness of life in the face of death? How do we do ethics together in the face of our mortality? Can we hold onto a theological conviction that there is no stage of human life, no experience – that is intrinsically incapable of being lived through in some kind of trust and hope?
How do we celebrate the sheer wonder and diversity of human beings and their experience through an approach to life and death that seeks a deeper wisdom forged out of listening?
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The Revd Canon James Woodward, Principal of Sarum College. is a practical theologian who specialises in health and healing, Christian ethics, old age, theological reflection and end of life care.
A bill to “allow adults who are terminally ill, subject to safeguards and protections, to request and be provided with assistance to end their own life” will be debated in Parliament on 29 November. Details
James is a panellist on the Can a ‘Good Death’ be Assisted? webinar presented by Modern Church and the Church Times on Thursday 28 November at 6pm.
Book your place on the Can a ‘Good Death’ be Assisted’? webinar
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