In previous posts I have explained why Christian Social Teaching has always opposed something like euthanasia. In light of the Bill being presented to Parliament, however, here are five reasons to oppose it that are not founded upon spiritual convictions.
Before proceeding further, I generally avoid all public political controversy. As a pastor my job is not to take sides between different political parties. In this case, however, the issue is recognised as one of conscience and not political allegiance. Moreover, given how many could die as a result of this Bill, I strongly urge people to do all they can to resist its implementation.
This is the content of my own letter to my MP. You can write to your MP by following this link.
Dear [MP],
I write concerning the Assisted Suicide Bill due to be before the House of Commons later this week. For the following reasons I urge you in the strongest possible terms to vote against this bill in any form:
- It places the aged, ill or vulnerable in an impossible and damaging position.
- All experience of euthanasia from elsewhere in the world demonstrates that the proposed safeguards and limitations rapidly come under pressure and are revised, almost inevitably to widen the scope of euthanasia.
- It fundamentally changes the nature of healthcare provision for all and, in particular, the relationship between a doctor and patient.
- It undermines the provision and funding of proper social care and particularly end-of-life care.
- Terminating the lives of the vulnerable, sick and elderly is intrinsically unethical, attacks the assumptions that have underpinned social care and the welfare state, and will have repercussions for the rest of society.
I briefly elaborate on each of these reasons below.
The Burden on the Vulnerable
The introduction of euthanasia for patients places an intolerable burden on them precisely at the point at which they are most in need of care and protection. The elderly and vulnerable often feel an acute sense of guilt or shame at the burden they perceive their care or situation to be placing on others. The pressure, intended or otherwise, to take a step to end their lives not because they truly want to but because they think it better for everyone else will be inevitable and powerful.
This is not a fanciful suggestion. Following the introduction of similar legislation in Oregon, 50% of people opting to end their lives cited the perceived burden upon others as a reason for their choice.[1] This is a terrible and invidious position for us to place those individuals in. Moreover, this position will be widely known and recognised. The physicians responsible for ending the patient’s life will therefore know that there is, in all likelihood, a 50% chance that they are doing it because they feel that they should in order to decrease the burden on others and not because they wish to end their own suffering.
Any lawyer can relate cases in which elderly people are placed either directly, or indirectly, under pressure to make transactions that are disadvantageous to themselves because they feel that it would lessen the burden on others or feel an inappropriate duty to do so. We have developed large legal frameworks to try and protect them precisely because we recognise that someone in that position is vulnerable to feeling under pressure to make such decisions even if that is not the intention of anyone else involved. Property transactions are reversible and the individual involved can be protected, to some extent at least, retrospectively. Euthanasia cannot be reversed. It is final. If even one person were to die because they felt under undue pressure to do so s then this Bill would be a disaster. In reality that situation cannot be avoided and the Bill should not pass.
Expanding Terms of Reference
Experiments with euthanasia in other comparable countries have shown that its safeguards and terms of reference are often rapidly and dramatically revised so as to expand the scenarios in which it is available. For example:
- In Oregon, the model proposed for the UK, the law was reinterpreted to apply to individuals who would otherwise live with medical treatment.[2] This includes illnesses such as diabetes.
- In Canada euthanasia has been offered to people as an alternative to a new wheelchair ramp,[3] for those seeking help to live independently at home,[4] and even for otherwise healthy people suffering with depression or suicidal thoughts.[5]
Noone envisaged this being the situation when Oregon or Canada introduced euthanasia. This was not part of the intended outcome. But once euthanasia has been introduced as an acceptable method of treating certain conditions the pressure to expand its use to other situations has proved irresistible. There is no reason at all to believe that in some way the UK would prove to be different from others who have followed this path.
Change in the Nature of Healthcare Provision
The fundamental settlement that underpins healthcare provision in the modern West is the principle that doctors seek to heal their patients. The patients, by contrast, agree to submit to practices that in other situations would be intolerable (being cut open, ingesting unknown substances etc) because they know that the doctor will always act to promote their physical good. Euthanasia fundamentally undermines this relationship by introducing a layer of ambiguity into it.
It is perfectly possible to imagine a scenario in which a particularly sick or depressed individual is not honest with his doctor for fear of the conversation it would open up. Or that it would change the nature of consultations to know that in some circumstances the person prescribing your medication would also administer drugs intending to kill you.
Moreover, the impact on medical professionals would be incalculable. They would be required intentionally to terminate their patients’ lives, the exact opposite of the calling they initially undertook. It radically alters the nature of the doctor’s profession and will inevitably have profound impacts on the mental, spiritual and moral wellbeing of those involved. I have not seen any long-term studies done of the impact of altering policy on those responsible for carrying it out. How can it be right to put medical professionals in this position without any sense of how it will impact them?
It is grossly irresponsible to proceed with a Bill that could have these profound consequences.
Undermining the Provision of Palliative and Social Care
The proposed reforms would undermine the provision of end-of-life care and social care. As the Health Secretary has noted,[6] end-of-life care and social care are already badly underfunded and poorly managed. The effect of this is that many of those involved would feel a pressure to euthanasia because of the sense of burden they might be to a system already under pressure and because the care they are receiving is not itself of a high enough quality. Such a situation would be unacceptable.
We saw an example of individuals making the decision to sacrifice themselves because they felt a pressure to do so in order to reduce the burden upon healthcare systems during COVID. It has been well documented that many, including many with signs of early-stage cancer, refused to go to hospital or to GPs because of the sense that the services were under strain and it was their duty not to go. It is at least possible, if not likely, that many would feel the same given the state of end-of-life care and the well documented pressures it places on the healthcare system’s resources.
Moreover, the provision of a relatively cheap alternative to end-of-life care will almost inevitably become attractive if not for the individuals involved then for the culture implicit in the systems themselves. This is not to say that any particular person would choose to push people towards euthanasia instead of offering them expensive palliative or other care. It is, however, likely that that pressure would begin to be felt simply because of the financial and other factors implicit in the system.
Finally, on this point, the presence of euthanasia as a relatively inexpensive alternative to properly funded and reformed end-of-life care would significantly weaken the position of those arguing for that funding and reform.
Long Term Consequences for Society
Finally, euthanasia will have long-term and as yet unexplored consequences for society as a whole. Modern British society is founded upon an intuition that all lives are valuable and are worth preserving. That is why we have policies of redistributive taxation, welfare provision, and healthcare for all. There is a fundamental understanding that all people are worth caring for, even at our expense.
Euthanasia damages this understanding in the most fundamental way. It is founded upon a noble desire to help those who are suffering. Yet it does so by ending those lives we would otherwise consider priceless. It introduces the idea that at a certain point it is better off if someone’s life does not continue and that we have the right to end it. Such a position attacks the principles that underpin the rest of the society we have built.
Viewed in this light the developments in Oregon and Canada are unsurprising. Once we have conceded that it is legitimate to end life in some circumstances, that assisted suicide is a proper tool for public policy, then why not deploy it in other situations. Almost inevitably the consequences of this shift will not be felt uniformly. They will be experienced most harshly by those from minorities, the poor and the vulnerable; changes like this always are.
For all of these reasons I strongly urge you not to support this Bill.
I am, of course, happy to talk about any of the issues raised in this letter.
Rev. Phil Fellows,Hersham Baptist Church,
80 Vaux Crescent, Hersham, Surrey, KT124HD
[1] Oregon Health Authority, Public Health Division, Center for Health Statistics (2021) Death with Dignity Act, 2020 Data Summary, p12. See https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year23.pdf
Accessed 19 Jan 2023.
[2] https://www.carenotkilling.org.uk/articles/six-months-redefined/
[3] https://www.ctvnews.ca/politics/paralympian-trying-to-get-wheelchair-ramp-says-veterans-affairs-employee-offered-her-assisted-dying-1.6179325
[4] https://www.ctvnews.ca/health/chronically-ill-man-releases-audio-of-hospital-staff-offering-assisted-death-1.4038841
[5] https://www.independent.co.uk/news/world/americas/vancouver-hospital-canada-assisted-suicide-maid-b2390914.html
[6] https://www.telegraph.co.uk/politics/2024/09/07/end-of-life-care-assisted-dying-health-secretary-streeting/
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