There is nothing progressive about allowing state-sanctioned killing in health care

Fix the NHS, properly fund palliative medicine, clean up social care – and then we can debate this issue

November 24, 2024 16:31(Update 16:44)

There will be a five-hour debate in Parliament this week that could lead to the adoption of one of the most consequential bills this century, in which MPs will be able to vote freely on a Private Members’ Bill allowing medically assisted suicide in the UK. This reform was previously supported by Sir Keir Starmer, enjoys widespread support and is often considered progressive. It was promoted by the admirable lady Esther Rantzen, suffering from terminal cancer, with her usual campaigning zeal. There are strong arguments on both sides of this moral minefield that deserve respectful examination.

However, there should be no illusions about the impact that introducing state-sanctioned killings has on our health care system. I would rather write about almost anything else this week, returning to work after the pain of the death of my own daughter.

But I have been researching the issue of assisted dying in Europe and North Americaand, inspired by her work, she campaigned for patient safety and the rights of citizens with learning disabilities. Therefore, it seemed inappropriate to shy away from such seismic proposals for change in society. No matter how the legislation is worded or how limited its intentions, this reform would leave the UK on a slippery slope. Already, some activists say the bill’s proposal to allow terminally ill adults up to six months old to get medical help to end their lives is too limited.

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Experts expect challenges to human rights laws from patients whose terminal condition prevents them from taking their own life, rightly arguing that this is discrimination. There will be emotional cases of parents pleading that suffering children should not have access to similar “treatment”.

Elsewhere, we have seen the number of assisted deaths continue to increase following legalization. And how the rules may be widened over time – to include children, couples wishing to die together, older people with dementia and young people with mental illness – despite initial promises to the contrary.

As one prominent ethicist from the Netherlands, which pioneered the reforms in 2002, said, their desire to help patients suffering the most painful deaths led them to introduce “something that we have discovered has more consequences than we ever imagined.”

Legalized euthanasia releases the genie from the bottle while fundamentally changing the nature of the physician in line with the oath to “do no harm.” It sends the message that killing is an acceptable form of treatment.

However, we know that it is difficult for doctors to predict the moment of death in cases of terminal illness and that they, like judges, are fallible people who can make mistakes, succumb to pressure or fail to recognize the coercion in everyday clinical stress.

Some will become fanatical about this cause – like a former obstetrician in Canada I spoke to earlier this year, who has assisted in over 400 deaths since euthanasia was introduced eight years ago. Canada is exposing the danger – and political irresponsibility – of incorporating such procedures into a struggling health care system like ours, with long wait times, poor treatment outcomes and inadequate care support. I spoke to patients urged by doctors to accept medically assisted death when life-saving treatment is available, and to an analyst who warned British MPs that euthanasia is intended to reduce health care costs. Almost two thirds of their assisted deaths are related to cancer, yet they have shorter waiting times and better outcomes for this disease than in the UK.

Health and Social Care Secretary Wes Streeting has boldly opposed the bill, saying it could harm existing services, while pointing out that the state of end-of-life care means the NHS cannot always provide “real choice in assisted dying”. .

I have seen the incredible support offered in times of suffering and pain by palliative care physicians. But one in four patients do not receive this help – and as palliative care doctor Rachel Clarke says, it is “unwise” to offer people the choice to die unless we also provide them with the care that makes life worth living.
Studies show that places that allow assisted dying provide significantly less palliative care than other states.

If Westminster really wants to show it is progressive, how much better to support this great branch of medicine pioneered in the UK – along with the scandalously underfunded hospice movement – to ensure everyone gets decent end-of-life care. Or maybe our politicians will finally want to fix the overburdened social welfare system, instead of constantly pushing it aside?

Then there is the question of trust – and whether we can really trust politicians and regulators to protect sick, elderly or disabled people who may face pressure to take their own lives after so many disturbing scandals exposing the exploitation of society’s most vulnerable.

Bert Keizer, a Dutch expert in assisted dying, said British experts were right to be skeptical when the Netherlands initiated reforms since their predictions had come true. “Those who choose euthanasia are walking down a slippery slope that irreversibly slides into the random killing of defenseless patients,” he wrote in a medical journal.

It’s important to remember that we live in a country where some of the worst neglect scandals have involved the mass killings of elderly patients and where the healthcare system has been allowed to rot. A country that still locks autistic people and citizens with learning disabilities in psychiatric hells with the consent of doctors.

Meanwhile, abroad there are confirmed cases of people euthanized due to autism or learning disabilities. Considerable evidence – even from places like Oregon, which is praised for its stringent protections – suggests that people who choose to die often feel they are a burden to their families.

As an atheist and liberal, my concerns about euthanasia are practical rather than ethical. However, after seeing the harsh realities of assisted death abroad and reporting on health scandals at home, I have deep concerns about the consequences of introducing this method here, with our inept legislators, which could result in creaking public services and public disdain for groups that could find themselves at risk. crosshairs.

Fix the NHS, properly fund palliative medicine, clean up social care – and then we can debate these issues with less fear.