The assisted dying bill
It’s not a new topic.
Discourse and policy surrounding assisted dying has been around for decades. The subject first came to me in the form of a Religious Education class, when the word '“Euthanasia” became a definable thing. We spoke of it in the context of typical religious beliefs, focusing on Christianity, and looking back it was well done. We were encouraged to discuss it and were given both sides of the story, arguments “for and against” to then inform our own opinions, if indeed we wished to form one at all. This form of conversation-making is important and, now, influential in how we are to consider the newly proposed law.
GPs, when asked, tended to be split into two camps (article). The split is around 50/50 when considering the new law, allowing the facilitation of assisted dying by GPs, under strict guidelines. Even if the law is passed fully-fledged, it is still a doctor’s own choice whether they will be involved or not in these processes, handing patients to other GPs if it becomes necessary. What this switch would do for the treatment process, I am uncertain.
Arguments against centralise primarily on the concern that patients will feel like a burden to those around them. This may then stimulate a feeling of it being better if they were “out of the way”, potentially leading to a request for assisted dying. Without knowing the ins-and-outs of the process, I would hope that within these decisions, there is careful screening of patients, both for previous mental health conditions and well as more generally. One cannot easily dissect the family life of a patient, however, leading to another potential risk of the law. It is deeply unsettling, but there may be cases in which coercion by those around them has led to a patient deciding to take the assisted dying route. I question the commonness of this, but these dynamics do exist. Patients can be in a vulnerable place, however does this assumption somewhat take away their agency, particularly when considering the elderly and a “lack of capacity” to fight a decision. This is why these cases must be considered with a fine-toothed comb.
Further reasons provided by GPs that were against the new law included religious beliefs. It is reassuring to see that doctors who do not wish to be involved have the choice to step back, however this grace should also extend to one’s patients. To restrict everyone from a choice due to one’s own personal beliefs or opinions is largely hypocritical, and I worry that, if the law is not passed, this only reinforces a feeling of patient-doctor/patient-system distrust or insecurity. A focus on improving palliative care is essential, as for a long time I have spoken on our current treatment of the elderly and how disgraceful it can be. Even so, improvements in palliative care do not remove the pain of the people with the illnesses. End-of-life care is about making one as comfortable as possible, but surely one should have the agency to stop their suffering if those final days, weeks, or months be only that.
There are legal implications to this. While a law would certainly clarify the situation, it must be noted that, in certain circumstances, there may be pushback at a decision. For example, if the family do not support the patient, it may have consequences for the doctor, even if it is only an inquiry with no conviction. I am sure there will be strict measures in place to circumvent this kind of happening, but it is important to reflect on these details.
People naively cite these cases as murder. In the article linked above, while I certainly agree with the sentiment of “better care”, a CEO of a business dedicated to campaign extends to “better care not killing”. Unsettlingly, the business is called ‘Care Not Killing’, which makes the statement come across as a promotion, rather than from a place of sincerity.
Do we truly wish to make jingles from this matter?
On the other side of the coin, there is the concept of a “dignified death”, and while “dignified” may not be quite right — the connotations that the choice comes as a noble pursuit, an antithesis to the end for the “weak” with an ableist streak — there is something in the element of choice. People may be in great degrees of pain and distress, and significantly this choice is only offered people when they are given six months or less to live. This precision can be indeterminate at best, adding a barrier to assisted dying for many who may wish for the option.
This law is not built to force death onto people. Most importantly, it allows people agency over their own care and lives. Some want to shape how they will be remembered.
Choice in death is tinged with morality, whether it be personal, societal, or religious. Framed as a self-less act, something to unburden loved ones, to gift them with the best memory, and it also seems like the greater good. Seen as an unnatural end, a weakness, a move against palliative care, and the choice becomes a transgression. Since everything seems very 50/50 at the moment, accounting for the fact that GPs may not necessarily equally represent the demographic of the UK, it’s hard to prophesy which way this will go.
Above all, I believe it comes down to choice. We’ve asked the doctors, how about the patients?