It never ceases to amaze me, how quickly people jump to the conclusion that assisted dying would put people in danger. In a piece in today’s Guardian, MP Daniel Poulter has concluded that assisted dying would put people at risk. It has to be read to be believed:
Before qualifying as an NHS hospital doctor, I was a strong supporter of people with terminal and progressive illnesses being given greater power over when to end their lives. Who was I to stop someone with a terminal illness from ending their life when they had expressed a consistent wish to do so?
But an [my italics] experience as a junior doctor changed my views. Alice (not her real name) was a woman in her 40s with advanced multiple sclerosis, no longer able to speak, and completely dependent on family and carers for all her activities of daily living. She was regularly admitted to hospital with chest infections, and on this occasion had been admitted with a pneumonia that was not responding to antibiotics. She was clearly in great pain and distress.
Conversations with her family suggested that much as they loved and cared for her, they believed her illness was at a stage where medical treatments were prolonging her suffering. Her husband said “she would never have wanted to be like this”. The palliative care team were called to provide specialist care and advice for what was likely to be the last days of Alice’s life.
Against all odds, Alice pulled through, and left hospital. Several weeks later, I met her husband again at the hospital shop. He told me the involvement of the palliative care team meant that she and her family had received specialist care and support in the community. He said he felt guilty for having even questioned the value of contemplating the end of her life.
There is simply no evidence that in this case an assisted dying law would have put Alice at risk. It wasn’t up to her husband, and it would have required a stability of decision that did not exist in this case before assisted dying could have been considered. Had assisted dying laws been in existence, Alice and her husband would have been able to talk freely about the options long before things reached this stage, and then, having reached it, assisted dying would not have enabled assisted dying to be carried out immediately, unless Alice had made decisions as to how she wanted her life to go. She might have decided that, having reached this stage of her disease, she would prefer to go, and, had that been a stable decision, perhaps she would have been helped to die. But how would that have put her at risk? Her having pulled out of her parlous situation on that one occasion does not show that she should not have been allowed to have brought her life to an end at a time that seemed best to her. And knowing the options would have put her in a position to make an informed decision. In my experience, people with MS make the decision to die long before the reach Alice’s state.
So what is the problem? In either case, Alice’s free decision is what counts, not her husband’s worry about finances. It really is getting so tiresome to hear this kind of shallow reasoning, and it’s time for people like Daniel Poulter to take the issue seriously, think it through carefully, and make some kind of decision, rather than playing the scare-mongering card on the basis of one — count it — only one — case. One case made him change his mind, and there is simply no evidence that Alice’s life, in this case, was at risk. Even if she had decided to bring her life to an end, in what way would this have been an unacceptable outcome? This kind of nonsense shows how really shallow opponents of assisted dying can really be.
I do not know what Poulter’s religious views are, and he does not express them in this Guardian article, but it wouldn’t surprise me to find that he is a Christian, and that his main opposition is based on religious grounds. It is fairly clear that it didn’t take much to change his mind. And that’s another thing. He seems to think that his having been in favour of assisted dying at one point in his career as a medical practitioner gives him some street cred, but it’s a bit like Alister McGrath’s teenage atheism, which he repeats ad nauseam as though it gives his present faith position some added credibility. It doesn’t. It’s a pose. And so, I believe, is Dan Poulter’s claim to have once favoured assisted dying.
Of course, as Dan Poulter points out, increased and improved palliative care facilities are needed. But there is simply no conflict between hospice and palliative care and assisted dying. They two go together like bread and butter. Hospice and palliative care are not panaceas, and assisted dying should be available for those who (i) do not want to go into hospices or palliative care units, and (ii) being in palliative care, find it is not adequate to palliate the worst aspects of their illnesses. It really does make me angry to read things like Dan Poulter’s empty nonsense, when there is absolutely nothing to suggest that palliative care and assisted dying need be in conflict with each other. And the experience of people in other jurisdictions where assisted dying is legally available shows that there need be none, and that, whatever long-term care facilities exist, or however good palliative care may be — and the English, especially if they happen to be religious — and Dan Poulter doesn’t wear his religion on his sleeve, so it’s hard to say where he stands on the belief-disbelief spectrum — think that palliative care in England is particularly good — not everyone wants to be cared for in this way, find it an undignified way to die, and want assistance in dying. And Daniel Poulter, MP, if we would base himself on what people really want, would stop playing games with people’s lives, and let them die as and when they choose, with assistance if they ask for it. Let’s not pretend, Daniel Poulter’s opposition to assisted dying is based on no more than a passing experience. It is not based on any evidence that assisted dying would put people at risk. I suspect, but cannot prove, that this is simply a religious prejudice on his part. If so, he should make it clear, instead of expressing his views in terms that scarcely measure up to the kind of thing a kid in secondary school could muster with a tiny bit of research. And this guy is a Member of Parliament, with his hands on the levers of power. The mind weeps that this kind of adolescent shallowness should be thought worthy to be published in a national newspaper.
That was a good question. I wonder if he found an answer? It’s not apparent from the article, though.
(NB: the link to the article doesn’t work, there’s an extra http:// at the end of it)
That was a good question, but that is simply reflective of his earlier views. His (one) experience led him to think that legalising what this person expressed a consistent wish to do would be dangerous. His article is a repudiation of that earlier view.
I corrected the link. For some reason it didn’t replace the highlighted “http”. Thanks.
So, he learned the importance of respecting the patient’s choices rather than the doctor’s or the husband’s choices, and that is somehow an argument against patient choice in assisted dying? The illogic of this boggles my mind.
Oh, I understand he’s changed his position. I just don’t want him to get away without answering the question: who does he think he is to decide?
As far as I understand, it is the fact that there is no law for assisance in dying that brought about this situation in which it seems nobody knew what the patient herself wanted. Without such a law people don’t talk about the end of life situations because they don’t have a choice, so talking about it seems senseless. So when the patient ends up in a situation like this, the outcome depends on what the family and/or doctors still find humane. Doctors who conclude the end is near and who find the suffering of the patient unbearable, will often enough help such a patient out of their suffering. But the decision is made without real involvement of the patient.
When the law was introduced, people realised this was something they had control over, so they started contemplating their options. This also meant that those who wanted to fight and undure whatever it was up to the last minute of their life, could make that clear too so that as a consequence nobody had to guess what he/she would have wanted.
(Third and last attempt to post this, so apologies if triple-posted!)
I don’t know what Poulter’s beliefs are, and maybe he isn’t a Christian, just a doctor who can’t apply critical thinking skills to the problem at hand. I wouldn’t want to be his patient.
For an antidote to this, can I recommend Melanie Reid’s article from yesterday’s Times, which I’ve reproduced on my blog because it’s behind the paywall:
http://goodgrieflinus.blogspot.co.uk/2012/03/melanie-reid-on-assisted-dying.html