Lord Carey's intervention on assisted dying is like Nixon going to China

http://www.theguardian.com/commentisfree/2014/jul/14/lord-carey-assisted-dying-nixon-china

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Ever since he retired as Archbishop of Canterbury in 2002, Lord Carey has held himself in readiness to assist his successors with suicide. Over the weekend his intervention in the debate on assisted dying had a seismic effect. In an article for the Daily Mail – which is strongly opposed to a change in law, but puts a good story above principle – Carey announced that personal experience had led him to abandon the traditional position. The church must not "promote anguish and pain", he argued – that was the opposite of the true Christian faith.

In church politics it is the equivalent of Nixon going to China. Carey has, up until now, stood for a reliably conservative and authoritarian platform on matters of personal morality. No more than any other opponent of Lord Falconer's bill did he actually want anyone to suffer unnecessarily, but this seemed less important than the maintenance of the principle that doctors should not kill people.

It may be helpful to the church that his shift of position makes it harder to portray the discussion as one between rigid doctrine and compassionate atheism. There is nothing that makes the opponents of assisted dying angrier than the suggestion that they lack compassion and that their opponents have it. They see themselves as the representatives of compassion for the unwanted and disregarded, and they have strong points to make against the Falconer bill, which would make it legal for doctors to provide terminally-ill patients with the means of suicide and, if they can't do the job themselves, to help them.

It is very notable that Falconer's bill will not address any of the most emotional cases. Tony Nicklinson would not have been helped at all by it, since no doctor could have predicted when he would die. By pretending this is only about terminal illness and that these cases can clearly be distinguished from all others, the supporters of the bill are deceiving themselves.

A central objection – which seems to me completely inarguable – is that this really is an extremely slippery slope. Once the principle of autonomy has been conceded as a moral one, it becomes immoral to interfere with it.

There is no line to be drawn. Once we concede the principle that it is up to the patient to determine whether his life is worth living, and that the doctor's duty is to facilitate this wish, no amount of safeguards in law will matter. The patient's right to choose will become an absolute, just as the woman's right to choose has done. And that will put huge pressure on doctors to act against their own consciences, just as abortion does.

What is more, opponents are correct that it isn't really the patient's right to choose. As Giles Fraser keeps saying, we are not as autonomous as we currently pretend. Old people and others are hugely influenced by those around them. And – let's be frank – when those others have a financial stake in an early, cheap death, they will value the patient's life less. So will the patient. The desire "not to be a burden" is pretty deep rooted in social animals like us.,

Anyone who has been a parish priest will have seen an enormous amount of human wickedness and greed, not just in their congregation. They will not believe that human goodness is enough to solve this problem.

But with all that said, the overriding problem is that we are already making these decisions. Given that there is no important moral difference between killing someone by deliberately withholding treatment and doing so by injection, we already have doctors "playing God" all the time.

The problem is that they do it so badly. The NHS is constantly deciding, as it must, whose life is worth which resources. And at present the patients who are to die are killed by horrible means: mostly starvation and dehydration. This is dreadful for everyone involved. Similarly, the argument from conscience cuts both ways. Doctors have traditionally assisted death when there was no hope for life. Any whose conscience tells them to do that now are forced to act against it by an increasingly bureaucratic and risk-averse management culture. The dogma that keeps people heartlessly alive is not religious but entirely secular: it is the fear of lawyers and not the fear of God which runs health policy today.

So since these decisions are unavoidable, it is better to make them in the open and with full consciousness of what we are doing. The old system where doctors did what they thought best and told us what society needed to hear might have been better. I think it was. But we can't get back there, especially after Shipman, and the present compromise is clearly unstable. Honesty may be our least worst policy.