Well, here I am back from my enforced “holiday”, which is mainly down to Bell Alliant for failing to do a number of things, turning off my services before they were supposed to, failing to leave the other cable line into the house, and just generally making my transition back to Eastlink an unhappy experience. But I am up and running now, with a new router, which still is having some growing pains, and a tangle of wires behind my desk that makes it something of a miracle that anything actually works. I assume that the wires are all connected to the right places, but I will spend the rest of the day (after finishing this post first, of course) trying to bring some order out of the chaos — sort of a God of the wires, rather than of the trumpet blast.

During my down time I began doing some housekeeping on my computer, and came across the following video — which I have divided into a number of shorter clips — in which the Bishop of Carlisle (for those of you who don’t know, it’s a diocese in the North of England, on or near the West coast, just across the border from Scotland). James Newcombe, the bishop, is speaking about assisted dying on behalf of the Church of England. As usual, of course, and consistently with his boss, the Archbishop of Canterbury, Rowan Williams, he opposes assisted dying, and suggests that things are fine just as they are, which is where the video begins:

The law on assisted dying, says Newcombe, is adequate, despite the fact that in England there is no law on matters of assisted dying at all. There are prosecutorial guidelines, which were drafted in response to a decision of the high court in the Debbie Purdy case, which indicated that people who assist someone, at the suffering or dying person’s choice, who is living in severe or chronic pain and disability, to die, should not suffer the full rigours of the law of assisted suicide, which, like Canada’s similar law, prescribes a maximum of 14 years imprisonment for anyone assisting a suicide. The fact that the courts have not, in recent years, imposed this penalty on anyone acting in good faith in respect of a person’s request for assistance to die, left the law uncertain and of dubious authority, at the same time that it left persons requesting assistance to die in a sort of “no man’s land”, without any clear legal markers for their actions. To call such a law adequate is sheer misrepresentation and bluster.

In its report on the judgement in Debby Purdy’s case, the Guardian said this:

Britain’s highest court issued a historic judgment today that could finally remove the fear of prosecution from people who travel abroad to support relatives seeking an assisted suicide.

In a unanimous ruling, the law lords ordered the director of public prosecutions to immediately draw up a policy that would spell out when prosecutions would and would not be pursued.

The ruling was strongly in favour of Debbie Purdy, 46, who has multiple sclerosis and who has been fighting to protect her husband, Omar Puente, should he accompany her to a clinic in Switzerland that specialises in euthanasia. She had argued that the law was unclear and uncertainty surrounding the issue breached her human rights.

To suggest, under these circumstances, that the law is adequate, is ridiculous. But to go on as Newcombe does, to emphasise palliative care is not a reasonable response to those who are demanding the legalisation of assisted dying. There is no inconsistency between providing good palliative care and assisted dying for those who request it. Indeed, any reasonable account of palliative or hospice care must take into consideration that the experience of dying is for some people horrific, and that a remedy for the horror ought to be provided for those who wish it. It has been suggested that if we provide assisted dying for those who make that choice, advances in palliative care will cease, since we can now simply “kill off” the aged and the unwanted (as we will hear Bishop Newcombe suggest in a moment), but there is no evidence that this will happen. It is a scare tactic often used by those who oppose assisted dying on other grounds, but there is no reasonable substance to the claim, though there is real substance to the claim that those who experience palliative care sometimes ask for help to die, because their suffering is too great and their dignity is quickly slipping away.

The next clip shows the bishop developing his scary threat scenario further:

The elderly are vulnerable, says the bishop. Well, perhaps, but there is no obvious reason we should infantilise the elderly — or the disabled, for that matter. Indeed, the suggestion that older people are more likely to be pressured into ending their lives than younger people, or that people in wheelchairs are, in general, less able to govern their own lives than people who are not, is almost certainly simply false, besides being disagreeably patronising. However, when you consider that people who are disabled may, in fact, want the option to end their lives, as Daniel James ended his, because, as the Guardian put it, he “wasn’t prepared for a second-class life,” (“second-class life” being Daniel James’s own assessment of life as a quadriplegic in pain) it is not only condescending to speak of such people as especially vulnerable, this kind of condescension becomes especially ugly when it amounts to a determination to control and limit the decisions of others regarding their own lives. As to it becoming a duty, there is certainly no reason why a moral person, in circumstances where they are using up resources at an enormous rate to preserve a life that has become greatly burdensome to them, ought not to be permitted to think that dying might be a supererogatory duty as well as a welcome relief. Bishops may be, as they style themselves, “fathers in god”, but they have no right to act as everybody’s father.

Bishop Newcombe further says, without any evidence (since there is none) that “there is a real danger that the right to die will become a duty, and that what is meant to be an exception will speedily become the norm.” This is false, and it is based upon the assumption, apparently made when the law of abortion was liberalised in Britain, that the availability of abortion was meant to be used only in exceptional cases. This may have been the intention of Parliament in liberalising abortion law, but there was no reason to suppose that women who sought change in the law of abortion intended that it should be so. Though I do not have the book with me, it has been estimated that there were as many illegal abortions in Canada before the law of abortion was struck down by the Supreme Court as there were after abortion became legal and readily available. The reasons why women seek and receive abortions vary, and range from the inconvenience of a pregnancy at a particular time to saving the woman’s life. The reason for legalising abortion lies in the right of women to control their own reproductivity, and cannot depend on someone else’s conception on where the line ought to be drawn. The same applies, in general, to the question of assisted dying. However, in jurisdictions where assisted dying is legally available there is no indication that assisted dying has become the norm. Indeed, it is almost always the exception rather than the rule. However, if it became a norm, that is because people would have made it so by their own choices.

Another important point that Newcombe seems to miss is that in an aging society, where there will be an increasing number of deaths, the likelihood of some of those deaths being “hard” will not diminish, and therefore provision for assisted dying ought reasonably to be thought to be more important, rather than less. To make the increasing number of deaths a reason for leaving the laws respecting assistance in dying as they are simply makes no sense, and to suppose, as the bishop does, that the elderly are more vulnerable than others, is, as I say, simply unjustified.

The dying are especially vulnerable, and to deny them the right to die as they choose is to take advantage of a vulnerability which is uniquely acute, since, at that stage, many people have lost the ability to provide the option of dying as they choose. That is why my wife Elizabeth chose to die when she did, because she was still fully in control, and could make a decision and carry it out. Had assisted dying been readily available in Canada she would have lived longer, and would also have lived her last years with greater confidence and assurance, knowing that, when the time came, she could choose to die as she wished, before becoming completely imprisoned in her body. It is because she would have become so desperately vulnerable at that stage that she chose to die some months before she otherwise would have done. I regard the laws that shortened her life with a great deal of contempt, and reserve my special contempt for the cowardly Members of Parliament who would not even consider amending the law for fear of losing votes from their religious constituents.

Newcombe has a way of expressing his opinion by speaking in terms of things being a “real danger,” as he does again in the following clip:

Yes, indeed, dying can be depressing. Who knew?! However, it is simply not true that depression necessarily impairs reasoned judgement. As Ronald Lindsay says in Future Bioethics:

In addition to the lack of empirical evidence correlating depression with a desire for hastening death, there is no support for the implicit assumption made by opponents that depression impairs a person’s judgment to the extent that he is no longer competent to decide on the course of his medical treatment. [111]

Depression does not necessarily impair clarity, and may in some cases enhance it. What the bishop is doing is looking for reasons to act in loco parentis, but he really must do better than this. This becomes particularly clear when he goes on to say, regarding people he has known, who have said things like, “I’m really glad there wasn’t any opportunity to hasten my death, because at such-and-such a time, had this opportunity been available, I would have chosen it, but now I am better, and I’m glad I never had the chance.” This is just word spinning. There is no reason to believe that the persons in question either would have made such a choice, had the option been available, or would have been qualified to make the choice, had the law of assisted dying been changed, and guidelines and restrictions been encapsulated in law. In Oregon, for example, of those who qualify, many people never make use of the drugs provided for hastening death, although the availability of this option is a great comfort to them, because they know, if things get too bad, they have the option.

However, there is another point of equal or greater importance. Had a person made the decision to die at a certain point, because of the gravity of their illness or the intractability of their pain, and carried out that decision, they would not be around to make the claim that they are glad that the option was not available. It’s a bit like those who say: “I’m glad my mother didn’t have an abortion, even though life has been hard for me, because I love my life.” This is completely irrelevant to the issue of abortion, since, had the “mother” chosen to have an abortion, she would not have been the mother of this particular person, and the issue would not arise. Someone else might have lived instead to love his or her life.

The last clip contains what is arguably the worst argument of them all. We must ask ourselves, says the bishop, what kind of society we want to live in, and what life is all about. Well, yes, we do, and generally the answer regarding the best kind of society is a society in which there is the greatest amount of freedom consistent with the greatest amount of good. As to what life is all about, that’s at least part of what freedom is for, so that no one is forced to live their lives in the light of one particular answer to this question. First, watch the clip, and then we can consider if there is anything more that needs to be said.

Well, what is life all about? Well, first of all, it should be about honesty, and the drive-by remark about “killing people off” is simply dishonest, and the bishop must know this. Assisted dying is about choice and autonomy, not about killing. However, there’s no one answer to the question of the meaning of life, although, no doubt, the Bishop of Carlisle has one to offer. But no one is bound to accept his answer, and laws should not be based upon it, as, no doubt, the Church of England would wish, and strives mightily in the House of Lords to ensure. Some people, like the pope (and Margaret Somerville), think that the world is going to hell in a handbasket. Margaret Somerville — Canada’s radio darling when it comes to bioethics, even though she is not, properly speaking, a bioethicist – puts it in terms of what she calls “unbridled individualism”:

Our society [she writes] is based on “intense individualism,” even in connection with death and bereavement — possibly, individualism to the exclusion of any real sense of community. If this highly individualistic approach is applied to euthanasia, especially in a society that gives pre-eminence to personal autonomy and self-determination, it is likely to result in the belief that euthanasia is acceptable. [Death Talk, 108]

Yes, no doubt, and why not? Later on the same page she says that “legalizing euthanasia is a result of unbridled individualism” (my italics), but of course this is because Somerville has a sense of community that derives from the authoritarian community of the Roman Catholic Church, and she looks back with considerable longing to a time when people knew their place and acted according to the prescriptive will of their “betters.” She finds modernity threatening, and modern freedoms distasteful. She is certainly welcome to think so, but a free society is better than a society governed by popes and kings, and if she wants to live in such a society, perhaps she should go and live in the Vatican. As for Bishop Newcombe, he really must do better than this if anyone is to take him seriously. His little talk, framed as it is by the institutional drama of his cathedral, studiously avoids the horrors that some people experience as they die, or the horrors that others, suffering from degenerative conditions such as ALS (motor neurone disease) or MS, are still forced to endure. Palliative care may be improving, but that should not mean that people have only that option at the end of life. It is doubtful, in any case, that we will be able ever to afford adequate palliative care for all who require it, and many would choose to die rather than go through the kind of misery that dying can be, even with the best of palliative or hospice care. Like the abolition of slavery and the recognition of the rights of women, as well as the increasing recognition that children have rights, the rights of the dying will be recognised, no matter what ancient superstitions may say. Good speed the day.