MPs should be brave – and finally vote to give us the right to die

http://www.theguardian.com/commentisfree/2015/sep/08/mps-brave-vote-right-to-die

Version 0 of 1.

How brave is your MP? Watch what they do on Friday. Will they turn up and vote for the assisted dying bill, or duck out and hide? Some MPs are religious, a far higher proportion than the general public – and many more pretend to be. The cowards will be MPs who agree with the principle of assisted dying, but dare not turn up and vote for it. Allowing the dying to escape unbearable last days of suffering is a desperately important matter. It’s not a dry debating society question and shouldn’t be decided by religious dogma. It concerns people dying in agony – or fearing they may – whose pain and anxiety could be eased if they could hasten their end painlessly at a time of their own choosing.

On this difficult issue good people sincerely differ. Some fear it as a back-door way for the state or families to end expensive care of inconvenient old people. But that worry has been stoked up with grotesque misrepresentations of what’s in the bill, by religious leaders who, from their pulpits, still command such a grip on policy-making.

Related: MPs to debate assisted dying legislation

The Falconer bill passed unanimously in the House of Lords, but failed to reach the Commons before the election. Rob Marris’s private members bill is virtually identical and arrives on Friday with a fair wind after the Lords added extra safeguards: one doctor “attending” and one independent must predict someone is likely to die within six months, is mentally competent, and all palliative care has been given. Doctors who conscientiously object can opt out. Finally, a high court judge must approve, and the patient must be able to take the fatal dose themselves.

These are tight conditions. Oregon has had such a law for 18 years and only 0.3% of the dying have used it: there have been no cases of abuse. Thankfully, few face last months in a suffering that can’t be alleviated by good palliative care. This bill is for those few, terminally ill like my own mother, whose suffering was unrelieved. She’d had enough pain and humiliation and begged us to take her to Dignitas in Switzerland, but was too ill to travel to a miserable death clinic far from home.

MPs’ postbags have been inundated, as usual, with religiously motivated letters from the pews of all faiths, as preachers call their congregations to lobby against the bill. One curiosity is the religious campaigners’ denial of their own faith, St Peter-like. Justin Welby, the archbishop of Canterbury, says his stand against the bill, in a letter signed by 25 multifaith clerics, is “ not an attempt to push ‘the religious’ viewpoint”. That sounds a little disingenuous, when all that these signatories have in common is their faiths, which ordain that only God decides the time of our death.

If you suffer agonising last days, your palliative care doctor is the least likely to ease you gently out of life

Why does the religious lobby try to disguise itself? Last time this was debated, Care, one of the key Christian opponents, sent out instructions: “Please do not express your opposition to the bill using faith-based and ‘religious’ reasons … base your letter on … the risk the bill poses to the vulnerable.” That’s exactly what Welby and his signatories have done. This hiding of their faith under a bushel has just been denounced in the Lancet by its editor-in-chief, Richard Horton. He called their use of deliberately misleading arguments to hide their true religious objections “Fibbing for God”.

He takes to task, in particular, Ilora Finlay, the most formidable opponent, on account of her many roles – professor of palliative care, chair of the National Council for Palliative Care, past president of the BMA and a member of the BMA ethics committee. She appears to speak with the full weight of experience, and references to her faith are surprisingly hard to find. Horton writes, “palliative care physicians should not have a monopoly” on this issue and notes claims that “some have deeper reasons for their opposition, reasons that have little or nothing to do with the quality of care of the terminally ill. Personal religious belief, for example.”

Baroness Finlay’s specialism frequently over-claims that palliative care can always ease terminal pain: those of us who have seen a bad death know that’s not true. Horton exhorts Finlay to stop objecting: “Blindly resisting all efforts to meet the expectations of the terminally ill seems more about ideological (or religious) purity than high-quality healthcare.”

Palliative care does relieve the suffering of most of the dying. But doctors in that speciality are far less likely to ease those they can’t help into a gentle death. Research in the Journal of Medical Ethics shows that palliative care doctors are more likely to be strong Christian believers than other doctors. Non-religious doctors are more likely to have given “deep sedation until death, taking decisions they expected or partly intended to end life”. Doctors in other specialisms were 10 times more likely to say they had done this compared with palliative medicine specialists. In other words, if you are unlucky enough to suffer agonising last days, your palliative care doctor is the least likely to ease you gently out of life, obliging you to suffer until God calls. It’s a good idea to ask your doctor if they believe in God, and what sort of God insists you exit life slowly through the torture chamber.

Whatever bishops, imams and the like may say, believers are not so different from the rest of us. A YouGov poll found 78% of those attending a place of worship once a month supported assisted dying. A poll shows disabled people equally in support of their right to choose to speed their last days. Polls shouldn’t decide laws: MPs are representatives not slaves to public opinion on, say, punishment or migration. But the right to die is not a public policy affecting others, but personal, a final private right to control our own bodies – and 82% of people want the right to decide when they have had enough. People are more rational about their own deaths than MPs realise.

None of us know if we will go gently or how we will face easeful death, bravely or in terror. How reassuring it would be to know the end days are in our own hands, since only we can know, when the time comes, what we can bear.

In the Commons Keir Starmer, former director of public prosecutions and a new MP, will make a powerful speech about the state of the current law, and his guidelines that stopped prosecutions of those assisting suicide for compassionate reasons. He will point to the injustice of allowing travel to Dignitas for those who can afford it, but denying most people a choice. As he speaks, both Dignity in Dying and Care Not Killing will hold rallies outside the Commons. But what’s required is an act of bravery from those inside.