The BBC and assisted suicide

The BBC, described as a cheerleader for assisted suicide, has again been accused of bias after the broadcast documentary this week of a man taking his own life at a Swiss clinic.

Simon Binner, a British businessman, had motor neurone disease. His wife Debbie was opposed to his taking his own life. "Watching him plan his own death, while I still wanted more time, was overwhelmingly traumatic," she said. "He had rights, but how much of his life was mine?"

The BBC was said to have made last-minute changes to the documentary, How to Die: Simon's Choice, after early copies were released to journalists. Footage of Mr Binner's corpse and scenes involving the drug used were edited after an executive from the Samaritans raised concerns that the BBC might fall foul of guidelines that prevent broadcasters from giving detailed guidance about suicide methods.

Leading blogger Archbishop Cranmer said of the programme: "This wasn't human action morally scrutinised, but political policy advanced emotively. How to Die wasn't so much concerned with how to die as why on earth not? . . .

"When will the BBC sensitively follow a pregnant woman through her BPAS or Marie Stopes counselling? When will they explore the views of her distraught partner as he weeps and longs for a chance to become a father? When will they broadcast the contentious performance and harrowing process of carrying out an abortion, and justify it all to the Guardian on the grounds of it being 'ambitious,' 1compelling,' 'groundbreaking' TV journalism of 'one of the toughest decisions there is to make'? 

"Or is it that changing the law on abortion is simply not on the BBC's political agenda?"

A petition has been organised protesting the BBC's bias and requesting them, in the interests of journalistic responsibility, to air a documentary about someone who is terminally ill and deeply opposes assisted suicide.

You can sign it here 
     .

Helping the terminally ill

Baroness Ilora Finlay is a heroine of mine.

She is a professor of palliative medicine. She promotes palliative care, opposes euthanasia and assisted suicide and argues eloquently against their legalisation.

What some people didn't know as she argued against an assisted suicide bill some years ago was that her 84-year-old mother was lying in a hospice with advanced cancer, wanting to die. The old lady didn't want to be dependent. She didn't want to be a burden. And if assisted suicide were legal, it was clear, she would go for it. The situation, Baroness Finlay said, was tearing her in two.
 
"The hospice chaplain, experienced enough to know we all have a story, asked Mum to tell him hers. It was in this telling that it dawned on Mum that her decrepit body still held an active mind. Suddenly, she realised that if she wasn't going to be allowed to kill herself, she had better make the most of what time remained.

"She took more pain relief. Then, almost miraculously, the radiotherapy began to work, her pain disappeared and she was able to leave the hospice and go home.

"My mother would go on to live for another four years and it's no exaggeration to say that those four years were almost more precious than the 84 that had preceded them. Carers came every day. Friends visited. She saw the birth of two great grandsons. 

"Eventually illness came back. But I will never regret that our law protected her; preventing her from ending her life when she was vulnerable to despair.

"Those four years we shared were the most precious gift. Without them, Mum would have missed what she described as some of the richest times in her life and we would have missed understanding just what an amazing person she was.

"I'm so grateful for the fact she was 88 when she died and not 84. But best of all? So was she."

Baroness Finlay's Palliative Care Bill has its second reading in the House of Lords on Friday.

The UK is a global leader in the provision of palliative care services; the bill is designed, however, to rectify gaps in the present system, ensuring that all patients have access to palliative care around the clock, regardless of age, where they live, their level of education and their type of illness. 

I wish it well.
     

A barrier that should not be crossed

Britain is inching towards legalised euthanasia. Make no mistake, Britain will have legalised euthanasia - unless people get their act together and stand up for the laws we already have.

In Holland, where euthanasia is permitted, it is admitted that people are now being killed without a request on their part. In Belgium, where euthanasia is legal, children are able to ask to be killed, and psychiatric patients are being put to death. It couldn't happen here? Oh yes, it could.

Well financed organisations here in favour of euthanasia have decided that assisted suicide should be the first step. There have been umpteen attempts to revise the law in recent years. All have failed - so far. Lord Falconer's assisted dying bill in the Lords ran out of time in the last Parliament. Labour MP Rob Marris has taken up his cause in the Commons. His bill will have its second reading in the next two weeks.

We are told that a majority of people are in favour of allowing assisted suicide. We are fed with a steady stream of high profile stories of a small number of people apparently in desperate straits. Why should they have to go to Switzerland? Why shouldn't they be allowed to decide when to end their own lives, and have help when they need it?

Hard cases make bad law. Permitting assisted suicide would place intolerable pressure on  elderly and sick who feel they are a burden to relatives.

A group of almost 80 doctors have written an open letter to MPs, published in the Telegraph. "We regularly come across patients who feel a burden to their relatives and to society." Assisted suicide proposals, they say, devalue the most vulnerable in society.

Some families would use the law to exert pressure on relatives. "Most families are loving and caring, but some are not. We do from time to time come across cases where there are signs of subtle pressures being exerted. These are difficult to prove, but they can be very real, and we fear that if Parliament were to legalise assisted suicide for terminally ill people, they would be given free rein." 

The discussion and vote at the second reading of the Marris bill is on September 11. September 11 is a Friday. Some MPs leave early on Fridays to go home or to their constituencies for the weekend. A number of MPs have indicated that they will not be there for the vote. If it passes at second reading, they say, it will still be possible to prevent it from becoming law.

But a victory for the pro-euthanasia lobby at second reading would be a tremendous psychological boost and make it much more difficult to prevent awarding the bill further parliamentary time in the future. Write or visit your MP and point out that it is vital to attend the vote. If you require further information, you will find all you need here or here.

Parliament has never hitherto been willing to condone doctors' taking innocent human life. That's a barrier that should never be crossed. What we need is good quality care, not killing.

The law has only to be changed once. If it changes, it will change forever.
         

Scotland says No to assisted suicide

The Scottish Parliament has again rejected a bill - by 82 votes to 36 - which would have allowed people with a terminal illness to seek help to end their lives.

Had the bill succeeded, Scotland would have been the first part of the UK to legalise assisted suicide.

The bill was originally brought forward by the late Independent MSP Margo MacDonald, who died last year. It was taken up by Green MSP Patrick Harvie.

It would have allowed assisted suicide for mentally competent adults from 16 years old with "a terminal or life-shortening illness" or a "progressive and terminal or life-shortening condition" who had "concluded that the quality of their life is unacceptable."

A Holyrood committee concluded that the bill contained "significant flaws," but said the full parliament should decide. The Scottish Government did not support the bill. MSPs had a free vote.

Gordon Macdonald, convenor of Care Not Killing in Scotland, commented: "Vulnerable people who are sick, elderly or disabled can so easily feel pressure, whether real or imagined, to end their lives so as not to be a burden on others. Parliament's first responsibility is to protect the vulnerable. That is what has happened."
          

Doctors should 'always care, never kill'

Brittany Maynard was the 29-year-old woman who chose assisted suicide in Oregon rather than suffer a slow decline because of a brain tumour.

Before her death she made two videos which went viral on YouTube. Not surprising, says the bioethics group BioEdge, as a professional story-telling consultant was employed as part of a multi-platform media campaign directed by a public relations firm on behalf of the assisted suicide group Compassion and Choices.

BioEdge quotes Ryan T. Anderson, of the Heritage Foundation:

"Allowing physician-assisted suicide would be a grave mistake for four reasons. First, it would endanger the weak and vulnerable. Second, it would corrupt the practice of medicine and the doctor-patient relationship. Third, it would compromise the family and intergenerational commitments. And fourth, it would betray human dignity and equality before the law. . .

"Doctors should help their patients to die a dignified death of natural causes, not assist in killing. Physicians are always to care, never to kill."

Here is a video by Maggie Karner, a woman with exactly the same complaint as Brittany Maynard, pleading with her not to take her life, but live. It is worth watching. You can see it here.
        

Mother pleads for child to die

A 12-year-old girl has died in hospital after having food and drink withheld - with court permission. It is the first time a child not on life support and not suffering from a terminal illness has legally been caused to die.

Nancy Fitzmaurice was born with hydrocephalus, meningitis and septicaemia. She could not walk, talk, eat or drink. She needed 24-hour hospital care and was fed and watered by tube.

Her mother, Charlotte Fitzmaurice (36), of Ilford, said "Simple things like birds singing and hearing children play would put the most beautiful smile on her face. She loved Michael Buble, and when I slurped my tea she would give out a hearty chuckle." 

Nancy had apparently developed neurological problems and screamed with pain, despite painkillers.

The mother told the High Court "My daughter is no longer my daughter, she is now merely a shell. I truly believe she has endured enough. For me to say that breaks my heart. But I have to say it."

Justice Eleanor King, granting permission for nutrition and hydration to be withheld, said of Nancy "In her own closed world she has had some quality of life. Sadly that is not the case now."  It took 14 days for Nancy to die.

Said Charlotte: "Watching my daughter suffer for days while they cut off her fluids was unbearable. She went in pain. All I wanted was for my daughter to die with dignity with me holding her hand. Although I will live with the guilt forever, I know I have done everything I can for her and she is at peace.

"Although I know it was the right thing to do, I will never forgive myself. It shouldn't have to be a mother's decision to end a child's life. I believe hospitals and parents should be able to decide without mothers or fathers going to court."

Said Dr Andrew Fergusson, of Care Not Killing: "It is never ethical to speed up the process of dying by any intervention which has the primary intention to end life. Weakening laws that protect the sick, disabled and elderly would put vulnerable people at risk."

ASAN, an American charity, said "Euthanasia of people with disabilities is an extremely dangerous and wholly inappropriate solution to inadequate pain management. In cases where painkillers are insufficient, a number of alternatives for pain management exist."
    

Not a slippery slope, but 'an avalanche'

Frank Van Den Bleeken, who is serving a life sentence for rape and murder, has become the first prisoner to be given permission by a Belgian court to undergo euthanasia.

He is 50 years old and is not terminally ill, but claims he is suffering "unbearable psychological anguish." "What's the point in sitting here until the end of time and rotting away?" he says.

Some 15 other prisoners have now reportedly made inquiries about euthanasia.

Since euthanasia was legalised in Belgium some 12 years ago, qualifications have been steadily expanded. Says Paul Moynan, of CARE for Europe: "With euthanasia being packaged as palliative care, our care homes are not safe. With its extension this year for all ages, our children are not safe. And now the mentally ill are not safe. This is not a slippery slope, but a rapid avalanche."

This is the danger of making so-called mercy killing legal. Wherever it has been permitted, it has become increasingly easy to obtain.

Since 2006, British parliaments have been asked to legalise euthanasia or assisted suicide three times. Each effort has been unsuccessful. But the House of Lords is now believed to be more favourably inclined to a change in the law. And in a recent appeal, the Supreme Court upheld the law, dismissing the appeal, but hinted that if Parliament does not make a satisfactory change it would consider allowing individuals wishing assisted suicide to have their cases heard by a High Court judge.

 Lord Falconer's Assisted Dying Bill, which has already passed its second reading, has been criticised for its lack of adequate safeguards. It would allow doctors to dispense lethal drugs to adults who were mentally competent, judged to have six months or less to live, and to have a "settled wish" to end their lives. These conditions are difficult to assess. Apparently it would only be necessary for a doctor to say it was his "genuine view" that these conditions applied for lethal drugs to be given.

All major disability rights groups in the UK oppose the bill. It would allow assisted suicide for a few - but place pressure on a far greater number of vulnerable people - old, sick, disabled, depressed - to end their lives for fear of being a burden to others.
    

The debate goes on

After almost 10 hours of impassioned debate, Lord Falconer's Assisted Dying bill passed its second reading in the House of Lords without a vote, which enables it to have further consideration by a full committee of the House. Assisted suicide, of course, is still not legal. It would need a further debate and a successful vote, and would then need to go to the House of Commons.

More than 20 faith leaders - Anglican, Roman Catholic, Methodist, United Reform, Pentecostal, Baptist, Jewish, Muslim, Buddhist, Sikh and Zoroastrian - signed an open letter against assisted suicide.

"Vulnerable individuals," they said, "must be cared for and protected even if this calls for sacrifice on the part of others. Each year many thousands of elderly and vulnerable people suffer abuse, sadly, often at the hands of their families or carers. 

"Being perceived as a burden or as a financial drain is a terrible affliction to bear, leading in many cases to passivity, depression and self-loathing. The desire to end one's ;life may, at any stage of life, be prompted by depression or external pressure; any suggestion of a presumption that such a decision is 'rational' does not do justice to the facts. 

"The Assisted Dying Bill can only add to the pressures that many vulnerable, terminally ill people will feel, placing them at increased risk of distress and coercion at a time when they most need love and support."

The Bible forbids the taking of innocent human life. The majority of doctors are opposed to assisted suicide. The majority of organisations supporting the disabled are against it.

The pro-euthanasia lobby has made progress with talk of "compassion," "ending suffering" and."freedom of choice." We are living in a society which is increasingly less motivated by the facts, even where they recognise they exist, and increasingly influenced by feelings. Therein lies the danger.
  

'Keep assisted suicide illegal' - dying cleric

A plea from a dying clergyman for assisted suicide to remain illegal has been sent to every member of the House of Lords by the Church of England in an attempt to prevent a change in the law.

Lord Falconer's bill on assisted dying is expected to be voted on at its second reading in the House of Lords on Friday.

The Rev Christopher Jones, former chaplain of St Peter's College, Oxford, and a tutor in doctrine at Cranmer House, Durham, wrote of his experience when he was dying of cancer. He died in 2012.

He said he experienced intense stress and a sense of hopelessness when he realised his condition was terminal, and might have been open to ending his life by legal means, had they existed. Since then, he had experienced renewed energy and vitality "beyond anything I could have expected, and I am enjoying life in this period of 'remission.'

"The legal prohibition of this course was immensely helpful in removing it as a live option, thus constraining me to respond to my situation more creatively and hopefully. . . I now know that had I taken this course, I would have been denied the unexpected and joyful experience of being 'recalled to life' as I now am."

There was great danger in giving decisive significance to a sick patient's judgment that their life was no longer worth living as their feelings could change drastically in a short space of time.

Lord Falconer's bill would allow doctors to prescribe lethal doses of drugs for terminally ill people who were expected to die within six months. He says there have been more than 200 new appointments to the House of Lords since the matter was last debated five years ago, and he believes a majority of peers now support a change in the law.

Baroness Jane Campbell, the disability rights campaigner who is herself disabled, will be fighting the bill. "Assisted dying is to abandon hope and ignore the majority of disabled and terminally ill," she said.

Paralympian Baroness Tanni Grey-Thompson, who is also wheelchair bound, said: "An assisted dying law is playing with fire, especially when there are no safeguards in place. Lord Falconer's bill just isn't fit for purpose."
   

Voting on your 'right to die'

The BMJ's coming out in favour of legalising assisted suicide has sparked a storm. (I do not apologise for a second blog post on such a serious matter.)

Wrote Cristina Odone: "The medical profession is supposed to take in the tired, the poor, the huddled masses vulnerable to disease and dying - to care for them, not kill them off. . . Whatever happened to care, compassion and the 'do no harm' principles once embedded in good clinical practice?"

A considerable number of medical practitioners cared sufficiently to voice an opinion. One said legislation would corrupt the profession and hurt public trust. "Instead of killing patients, why not try talking to them?"

Another pointed out the UK had abolished the death penalty. "Make no mistake: the Falconer bill will reinstate the death penalty for those who do not think their lives are worth living."

"Once 'assisted suicide' is legal," wrote a third, "it is in order to persuade people to have themselves killed."

Said yet another: "I do not object to the statement that 'People should be able to exercise choice over their lives,' but I fail to understand why doctors and nurses who are devoted to saving and preserving life should do the work for them. Hospitals are places for saving lives and not for killing oneself."

I will leave the last comment to Cranmer: "Death is not simply a divine distalgesic. It is the passing of the soul to judgment and into eternity. . . This is about 'rights' and 'choice' and 'compassion' and 'dignity in dying,' because leaving it all to God is a manifest denial of rights and choice, totally lacking in compassion and devoid of any dignity whatsoever. Death can be painful and messy, so let's make it quick and clinical. . . 

"The anxieties and traumas of life are not pointless, nor is the morphine in our dying. It adds to our human experience, and witnesses to our divine purpose and profound meaning."

There are a considerable number of new members of the House of Lords, and some of them will be voting on the issue for the first time. Will you write to one or two of them and ask them not to change the law? You can find their names and addresses here.

There are now 10 days to the proposed vote.
      

The BMJ steps out of line

One of the world's most prestigious medical journals, the BMJ (formerly the British Medical Journal) has come out in favour of legalising assisted suicide.

The publication - which claims to advance healthcare worldwide by sharing knowledge and expertise  - says "Lord Falconer's Assisted Dying Bill is expected to receive its second reading in the House of Lords this month. The BMJ hopes that this bill will eventually become law. . . let us hope that our timid lawmakers will rise to the challenge."

But how can something that has been wrong for centuries suddenly become right?

The BMJ's editors claim there are few dangers in legalisation (despite the well-publicised and well-justified fears of organisations supporting the disabled). They base their argument on patient autonomy:

"People should be able to exercise choice over their lives, which should include how and when they die, when death is imminent. In recent decades, respect for autonomy has emerged as the cardinal principle in medical ethics and underpins developments in informed consent, patient confidentiality, and advanced directives. Recognition of an individual's right to determine his or her best interests lies at the heart of efforts to advance patient partnership. It would be perverse to suspend our advocacy at the moment a patient's days are numbered."

So respecting choice is now more important than preserving life?

A strong influence in forming their argument is the experience of Oregon, in the USA, where assisted suicide is legal, and in their view, unproblematical. Based on figures from Oregon, they say legislation would hardly affect the lives of British doctors:

"Each year about one patient per general practice of 9,300 patients would discuss the issue of assisted dying; each general practice would issue one prescription for life-ending medication every five or six years, and every eight to nine years one patient per general practice would take life-ending medication."

Are they sure?

In Oregon in 1998 there were 34 prescriptions written and 16 assisted suicide deaths. By 2012 numbers had risen to 116 prescriptions and 82 deaths. That's a 380 per cent increase in prescriptions and a 430 per cent increase in deaths by assisted suicide.

The BMJ's publishers, the British Medical Association, immediately disassociated itself from the BMJ editorial. Said Dr Mark Porter, chairman of the BMA council: "There are strongly held views within the medical profession on both sides of this complex and emotive issue. The BMA remains firmly opposed to legalising assisted dying.. . Recent calls for a change in the law have persistently been rejected."

Said Dr Peter Saunders, of Care Not Killing: "About two-thirds of doctors in recent surveys are opposed to any change in the law along with all the major medical institutions including the BMA, RCGP, British Geriatrics Society and the Association for Palliative Medicine.

"In a free society choice is important, but it has its limits. The duty to protect life trumps the so-called 'right to die.'"
 
There are 11 days to the proposed vote in the House of Lords.
   

Death on the doctors' say-so

Voluntary euthanasia became legal in Belgium in 2002. I have previously pointed out that 32 per cent of assisted deaths there are carried out without request by the patient, and an estimated 57 per cent of all assisted deaths are not being reported. Belgium recently allowed euthanasia for sick children.

Now an official statement by the Belgian Society of Critical Care Medicine considers it acceptable to use drugs to shorten the lives of patients in palliative care, whether or not they are suffering and whether or not they have made a request to die. The statement is published in the Journal of Critical Care.

It refers to "the administration of sedative agents with the direct intention of shortening the process of terminal palliative care in patients with no prospect of a meaningful recovery." Shortening the dying process by administering sedatives beyond what is needed for patient comfort, it says, can be not only acceptable but in many cases desirable.

"Shortening the dying process with use of medication. . . may sometimes be appropriate, even in the absence of discomfort, and can actually improve the quality of dying." The statement also applies to children.

Involuntary euthanasia is against the law. Intensive care doctors appear to be putting themselves above the law. Commentators are waiting to see how the government reacts.

That's what happens when euthanasia is legalised for "a few hard cases."
 

Right to die gone mad

In Belgium, where deaths by euthanasia have increased by almost 500 per cent since euthanasia was legalised in 2002, it's said that 47 per cent of assisted deaths are not even reported. Yesterday the Belgian parliament decided by 86 votes to 44 to extend euthanasia to children of all ages.

There must be a "hopeless medical situation of constant and unbearable suffering that cannot be eased and which will cause death in the short term." The child must understand the meaning of euthanasia, must be determined in its decision, and the decision must be approved by the child's parents and doctors.

(When capital punishment was outlawed in Britain, it was promised that life would mean life. Except that it didn't happen. When abortion was legalised in 1967, abortion was for a few women in extreme circumstances. Except that we now have abortion on demand.)

Too young to drink, too young to drive, too young to marry, but old enough to decide to die?

Writes Cranmer: "Can six-year-old children really grasp the enormity of ending their lives? Is not a journey to the undiscovered country just an awfully big adventure, where one may soar through the sky with Peter Pan, frolick in the snow with Father Christmas or live happily ever after with My Little Pony?. . .

"One cannot pursue both equality and liberty, and our post-Christian relativist culture offers no agreed way of interpreting moral argument or mediating between rival premises. And so the shrill rights of the child must necessarily include the right to die because they have the right to live."

The road to terrible change

Lord Falconer's bill to legalise assisted dying will have its second reading in the next month or two. The euthanasia lobby, we are told, is limbering up for the fight of its life: to change the law once and for all. Britain's peers are being bombarded with literature and pestered by people who want the law changed.

Writes Baroness Finlay, a professor of palliative care: "My opposition to legislation of this nature is well known. My experience of caring for dying patients over many years tells me it is just not safe and I meet doctors who feel that it is too dangerous to put 'assisted dying' in their hands.

"It may suit a small number of strong-minded and highly-determined individuals, but I can tell you that for every patient like that whom I have encountered there are 20 others who are more vulnerable - frightened of what the future might bring and anxious not to place an unwanted care burden on hard-pressed relatives.

"These are the people I am concerned for and these are the people the law now protects. The law is there to protect the weak, not to increase options for the strong. We should leave it as it is."

Lord Falconer's bill is the fourth to come before the House of Lords in the last decade. The three previous bills were defeated, and this bill is almost identical to the last. So why introduce another one?

James Mumford, writing in the Spectator, says 200 new peers have been created since the last bill in 2006, and it's hoped enough of them can be swayed to vote for change.

He says the bill is full of faults. There is the difficulty of predicting death from terminal illness within the qualifying period. There is the danger of "doctor shopping" for a compliant doctor. And there's "the thin end of the wedge."

"Incremental steps, minor adjustments, tiny turns - that is how great and terrible change occurs."

Euthanasia for children now

The Belgian Senate has voted by 50 votes to 17 to allow euthanasia for sick children. Some say that children are not old enough to understand what's involved in giving up their lives, but the majority of Belgian senators seem to consider that serious illness gives them an understanding. The measure will also extend the right to request euthanasia to adults with dementia.

It will now go before the House of Representatives, and is likely to be approved.

In Belgium, deaths by euthanasia have increased by almost 500 per cent since euthanasia was legalised in 2002. It is said that 47 per cent of all assisted deaths in Belgium are not being reported, and 32 per cent of all assisted deaths are being carried out without request.

In the Netherlands, euthanasia of children under the age of 12 remains technically illegal, but a number of infants have been euthanised without prosecution under the Groningen protocol.

Nearer home, in Northern Ireland, where abortion is illegal, justice minister David Ford says he is going to consult on changing the law to allow women carrying babies with "fatal foetal abnormalities" to have an abortion.

Once upon a time adults seemed pretty well agreed on the need to protect children. Now they seem to be getting pretty well agreed on the need to kill them (in the children's best interests, of course.)

What are we coming to?

Here's another question you may wish to consider: Are you and I doing all that we are able to present a godly alternative?

Supreme Court to rule on 'right to die'

Nine of Britain's most senior judges will meet within the next few days to hear attempts to introduce a ”right to die” under human rights legislation.

A full panel of Supreme Court judges, headed by Lord Neuberger, president of the Supreme Court, will hear the culmination of three separate legal challenges to the current ban on assisted suicide. The three cases have been put into one “super case,” the Telegraph reports, to allow a sweeping judgment on the current state of the law in England and Wales.

Tony Nicklinson, a 58-year-old father of two who was almost completely paralysed after a

 stroke, fought a long and public campaign for a doctor to be allowed to help him end his life. He died  last year after refusing food following the rejection of his case at the High Court. His wife, Mrs Jane Nicklinson, was granted special dispensation to continue the case in his place, taking it to the Court of Appeal and now the Supreme Court.

Paul Lamb (57), a former lorry driver, was left quadriplegic by a car accident 23 years ago.

A man known only as Martin wants to go to the Dignitas suicide clinic in Switzerland, but his wife has made clear that she feels morally unable to help him die. All three cases have been rebuffed by lower courts.

“I am hopeful. We would not be doing this if we didn’t think we had some prospect of success,” said Mrs Nicklinson. “I know it is a huge thing we are asking for, but the fact that we are sitting in front of nine judges shows that they are taking it seriously.” 

Legal papers for Mrs Nicklinson and Mr Lamb refer to "the extraordinary and cruel consequences for them of the current law prohibiting assisted suicide in England and Wales under [the] Suicide Act 1961.”

Papers from Martin’s legal team make his case to end his life in stark terms. “He can move his eyes, and communicates, painfully slowly, by spelling out words on the screen of a special computer that can detect where on the screen his eyes are pointing,” they say. “Martin finds his circumstances undignified, distressing and intolerable. 

"He is not going to recover. He wants to end his life. That decision is settled, consistent, and reached with capacity.”

The three people's lawyers plan to draw on legal arguments developed by Lord Falconer, whose private  bill for assisted suicide will be heard in the House of Lords shortly. They will argue that the 1961 Suicide Act, which makes it a criminal offence to assist someone taking their own life, imposes “extraordinary and cruel” limits on individual freedom.
 
They will say the ban has already been partially unravelled by official guidelines issued by the Director of Public Prosecutions four years ago, amounting to “de facto decriminalisation” of assisted suicide for those who take loved ones to Switzerland to end their lives.
 
They will say the current arrangements discriminate against people who are unable to travel abroad, or take other steps themselves to end their lives, because of the severity of their condition.

 Crucially they will argue that a series of previous cases already establish a qualified “right” for people to choose how they die, but one which those with severe disabilities can not use, which amounts to a breach of human rights and renders the ban on assisted suicide “unjustified state interference."

Protecting the vulnerable

One of the remarkable things about euthanasia becoming legalised in countries in Europe is the rapid rate it increases in numbers and in scope.

In the Netherlands the number of deaths by euthanasia increased by 64 per cent between 2005 and 2010. The population grew by two per cent during the same period. Disabled newborn babies, including babies with spina bifida, are euthanised under the Groningen protocol, on the grounds of "their perceived future suffering or that of their parents." The Dutch are now discussing euthanasia for people with dementia, despite huge concens about informed consent.

Belgium is currently considering extending euthanasia to children. Euthanasia in Belgium has begun for organ donation, and for prisoners.

A new coalition, the Euthanasia Prevention Coalition of Europe, has just been launched to protect vulnerable people in Europe from the threat of euthanasia.

Says the organisation's co-ordinator, Dr Kevin Fitzpatrick of Not Dead Yet UK: "The UK, France and Germany are currently considering legislation, but overwhelming evidence from jurisdictions where euthanasia and physician-assisted suicide is legal, such as Belgium and the Netherlands, demonstrates beyond doubt how quickly and how easily euthanasia is extended to others, especially disabled people and elderly people.

"High profile cases have provoked international outrage, leading communicators to think of Belgium as the new world leader in exploiting euthanasia against those with disabilities and mental health issues."

The coalition's aims are to oppose the legislation of euthanasia and assisted suicide and work to repeal existing laws allowing them; to promote the best care and support for vulnerable people who are sick, elderly or disabled; and to affirm life through helping people find meaning, purpose and hope in the face of suffering and despair.

We wish them well.

Dying can be a great opportunity

What's the worth of a human life? If it's my life, can I do what I want with it? Do I have the right to end it when I feel like it?

Listen to John Wyatt, emeritus professor of ethics and perinatology at University College, London, writing in the current issue of Catalyst, published by CARE:

Many insist that we are like chimpanzees with extra brain, just one more species on the planet. Others believe we are basically machines, with brains like computers made of flesh instead of silicon and wires.

Another common attitude is narcissism or the elevation of the self, which is a form of idolatry. 'Everything that improves my life is great. Anything that diminishes it is negative. I have the right to choose how to live my life and also when it should end.' This mindset sees suffering as something to avoid, dismissing the idea that it could ever be of positive value. We see young people caught up in addictions that deaden the pain in and around them.

In secular thinking, human beings can be 'categorised' according to their value with high achievers and celebrities at the top all the way down to those who are totally unproductive and burdensome. Just think where this leads. 'Provided I am independent and able to choose, life is worth living but once I become frail, vulnerable, limited, I become less valuable - putting me out of my misery might be doing me a favour.'

Genesis 1 is clear that every human life is made in God's image. Psalm 139 describes us as 'knit together in our mother's womb. . . fearfully and wonderfully made.' Ephesians 2:10 says 'we are God's handiwork, created in Christ Jesus to do good works, which God prepared in advance for us to do.' Jesus became human like us, choosing to be vulnerable, experiencing human fragility.

God chooses for us to live in a web of dependency on Him and others. We did not choose the circumstances of our birth and arrived completely helpless. As we grow, others may rely on us, and later we might need looking after again. In love, God calls us into existence by name; His plan for us reaches beyond the grave. For someone with dementia, this is crucial. They may forget who they are, but God knows, and remembers, holding their identity safe.

Christians should be particularly concerned about protecting the most vulnerable!  The brain-damaged, the disabled baby, someone severely harmed by life's circumstances, a frail older person - are they not made in God's image - all equal, special beings?. . . 

Palliative care is about living, helping to maximise someone's final days positively. I know of many who have 'died well' - finding time to restore relationships, say goodbye and let go as they focused on meeting God, many receiving Christ as saviour. Vulnerably ill people sometimes express suicidal thoughts but skilled and compassionate caring support transforms the situation. Dying can, by God's grace, be a great adventure and an opportunity, right up to the end, for a person to find purpose in their life.

A last word on the LCP?

I have commented often (for instance here, here and here) on the shameful way the Liverpool Care Pathway has been used in the NHS, and I reported (here) that the use of the pathway in the NHS was to be scrapped.

Finally perhaps a few comments from Dr Patrick Pullicino, a consultant neurologist and professor of clinical neuroscience at the University of Kent, one of the pathway's most serious (and much maligned) critics:

"The Liverpool Care Pathway was a genuine attempt to improve the management of patients who are thought to be at increased risk of dying. The fact that the Neuberger report found major problems with the LCP and recommended it is abandoned shows how difficult it is to treat this group of patients.

"Firstly, we have to abandon labelling any patient or patient group as 'dying.' The failure of the LCP has brought to light that the diagnosis of 'dying' cannot be made scientifically. To falsely label the patient as 'dying' is dangerous, as it leads  to self-fulfilling prophecies. . . 

"It is also important to initiate a lot more research in this area, as most of the research to date is on cancer patients in hospices and not applicable to general hospital patients."

Knowledge that a patient is in a poor prognostic group or at high risk of dying must immediately be shared with relatives, medical staff and the patient if he or she can understand it, says Dr Pullicino. Secondly, all possible ways of treating the patient to improve their clinical condition must be openly discussed and second opinions sought if necessary.

Thirdly, a decision has to be made whether to treat aggressively or not. The patient's consent should be sought on any change of care plan. A recurrence of the withholding of fluids or using sedatives as a "chemical cosh" must never be allowed to occur.

The failure of the LCP also reflected badly on using a multidisciplinary team to take a central clinical decision about a patient's care without their consent, says Dr Pullicino. This reflected the shortcomings of the Mental Capacity Act, on which the framework of multidisciplinary team decisions was based. Diagnosis by multidisciplinary team needed to be re-examined and the Mental Capacity Act needed to be reviewed.

"A fundamental issue on which the LCP fell down badly was the issue of 'dignity.' The LCP was 'sold' on the basis that it was the ultimate method of providing 'dignity' for the dying patient. . . 

"I think we have to look carefully again at what 'dignity' means for the patient him- or herself. 'Dignity' is defined as 'the state of being worthy of honour or respect.' To be worthy of respect a person must be able to make decisions for themselves as long as possible, particularly with regard to treatment.

"When my wife was very ill and dying of cancer, she repeatedly refused opiate infusions, despite the fact that she was in pain, as this clouded her ability to talk to her children for as long as possible. That to me showed much bravery, and more than anything else, allowed her to show her dignity."

Wise words.

Death pathway to go

The Liverpool Care Pathway is to be scrapped by the NHS, it was announced yesterday.

Stories in the media of patients being appallingly treated led to an independent review. The review heard allegations of patients placed on the pathway without relatives' knowledge, being unnecessarily sedated and being denied food and water.

The pathway will be phased out in the next few months and individual care packages introduced, approved by senior clinicians.

The LCP was largely the responsibility of Professor John Ellershaw, medical director of the Marie Curie Hospice in Liverpool and clinical director of palliative care at the Royal Liverpool University Hospital, a man with a genuine concern for excellent care for the dying. The LCP, carefully used, can be of help where the patient is properly monitored.

But who in the world authorised the LCP to be rolled out across the NHS, where it can be so easily abused? And who thought up the idea of paying bonuses for the number of patients placed on the pathway?