Former Archbishop of Canterbury opposes Assisted Suicide Bill

Dr Rowan Williams - Wiki image

Source: St Gabriel News and Media

Rowan Williams, the former Archbishop of Canterbury and Archbishop of Wales, has strongly denounced assisted suicide just days after his predecessor reiterated his support for the controversial practice.

In a statement submitted to the British Medical Journal, Lord Williams of Oystermouth warned medics that a change in the law would lead to "overstrained families" and "overstretched medical resources" exerting pressure on many patients to take their lives by assisted suicide.

He questioned whether the progress and provision of palliative care in the UK could survive "overburdened budgets" when enabling the suicides of people who required nursing and hospice care became the cheaper option.

Lord Williams also raised grave doubts about ability to make correct prognoses of illnesses that might justify the prescriptions of lethal drugs envisioned by the Assisted Dying Bill of Baroness Meacher, noting that it was a question that also deeply troubled groups supporting the rights of disabled people.

His position directly contradicted that expressed by Lord Carey of Clifton, also a former Archbishop of Canterbury, who just days earlier reaffirmed his well-documented support for assisted suicide, and declared in an article in BMJ that there is "nothing holy about agony" (see for further information below).

Lord Williams said: "We have to be aware of the reality of pressure on seriously ill patients to take certain decision ... which may very understandably come from overstrained families as well as overstretched medical systems. We should note that fear of such pressure within the medical system may discourage seriously ill patients from seeking appropriate medical help; the issues of doctor- patient trust involved are real."

He said: "This country currently has an enviable record of progress in and provision for palliative care. Will this survive in the world of overburdened budgets if there are less expensive options?"

He added: "There are immensely complicated questions around how the law is to identify conditions that would 'justify' medical intervention that has the direct and intended consequence of ending life. The obvious risks in labelling certain conditions in this way are of alarmist messages to patients at large, and of pressure to claim greater prognostic certainty than is realistic. Many disability groups also have strong views on this set of problems."

The comments of both Lord Williams, who served as Archbishop of Canterbury from 2002-2012, and Lord Carey, who was in office from 1991-2002, follow the introduction into Parliament of the third Bill in six years aimed at decriminalising assisted suicide in England and Wales. A similar Bill has also been introduced into the Scottish Assembly.

The Assisted Dying Bill, a Private Member's Bill of Baroness Meacher, the chair of Dignity in Dying (formerly the Voluntary Euthanasia Society), would "enable adults who are terminally ill to be provided at their request with specified assistance to end their own lives". It would license doctors to supply lethal drugs, on request, to terminally ill patients who appeared to meet certain conditions. This is assisting suicide, which is prohibited by the Suicide Act of 1961.

At present, the Bill proposes to permit assisted suicide to mentally competent but terminally ill adults with a settled wish to die and who have six months of life remaining. Two doctors and a High Court judge would be asked to authorise the prescription of lethal drugs and a nurse or a doctor would be present when they are ingested by the patients.

Also supporters of the Bill insist the provisions are modest, opponents of assisted suicide argue that the proposed safeguards are symbolic, meaningless and unenforceable. They say the law would soon permit the rapid expansion of assisted suicide, and possibly euthanasia, to broader categories of people following the experiences of every jurisdiction in the world where such practices have been legalised already (see link to films below).

The Assisted Dying Bill is scheduled to receive its Second Reading in the House of Lords on October 22.
On Tuesday, the British Medical Association will debate proposals to abandon its traditional opposition to assisted suicide in favour of a position of neutrality.

The statement of Lord Williams follows in full.

The Assisted Dying Debate

The Parliamentary debate on assisted dying is about to be reopened. Public and professional opinion seems to have shifted somewhat since this was last considered in Parliament, and the support of some prominent religious figures has added a new element to the discussion, as recent contributions to the BMJ show. But it is hard to see that any new facts have emerged in recent years that would justify the changes envisaged. The arguments remain essentially the same, and in a matter like this it is important to weigh them in their own right.

Some continue to say that opponents of this change are deliberately condemning people to protracted physical and mental agony for the sake of the religious or moral convictions of a minority. In fact, no serious contributor to this debate believes that merely prolonging life at all costs is a good in itself, or that it is morally inadmissible to scale back medical intervention or to use procedures for the relief of pain that are known to have potentially life-shortening side effects. But two broader points need to be made clearly here.

The first is the plain fact that those resisting legal change include religious believers and unbelievers alike, as well as a large proportion of those most directly involved in end-of-life care and palliative medicine - i.e those most immediately concerned with and responsible for the management of pain and distress.

The second is that the actual arguments against a change in the law are routinely about its effect on patient-doctor trust, on attitudes to certain kinds of disease or disability, on the apportioning of resources in a strained care system and a good many other practical issues. Many - including myself - are indeed opposed on religious principle, but fully recognise that this alone is not a reason for maintaining the legal ban. The concerns that continue to be expressed are about what we believe to be the unacceptably high price of a change in the law.

To summarise briefly:

- We have to be aware of the reality of pressure on seriously ill patients to take certain decisions - something which Kathryn Mannix's 2017 book, With the End in Mind, reports and discusses in a non-partisan and unsensational way - pressure which may (very understandably) come from overstrained families as well as overstretched medical systems;

- We should note that fear of such pressure within the medical system may discourage seriously ill patients from seeking appropriate medical help; the issues of doctor-patient trust involved are real;

- This country currently has an enviable record of progress in and provision for palliative care; will this survive in the world of overburdened budgets if there are less expensive options? This is emphatically not to suggest any cynicism in the proposals for change, but to recognise an undeniable reality in terms of the routine triage within the funding systems of health care;

- There are immensely complicated questions around how the law is to identify conditions that would 'justify' medical intervention that has the direct and intended consequence of ending life. The obvious risks in labelling certain conditions in this way are of alarmist messages to patients at large, and of pressure to claim greater prognostic certainty than is realistic. Many disability groups also have strong views on this set of problems.

More could be said, and there are many questions of detail about the effects of implementation in other jurisdictions that need fuller treatment. But these are still the considerations that persuade many to say 'No' to a legal change in the UK.

Rowan Williams

Dr Gordon Macdonald, Chief Executive of Care Not Killing commented: "We welcome Lord Williams' timely intervention and strong criticism of attempts to legalise assisted suicide and euthanasia, which evidence from around the world suggests would lead to widespread discrimination against the elderly and disabled people as safeguards are eroded or simply ignored. We only have to look at the Netherlands and Belgium which introduced laws for terminally ill mentally competent adults or those suffering unbearable pain to see what can happen. Now both countries regularly kill disabled people, those with chronic conditions, individuals with mental health problems, such as patients with dementia, depression, anorexia even a victim of sexual abuse, non-mentally competent children and babies and want to extend this further to those tired of life."

"We also know in jurisdictions like the US State of Oregon, six in ten (59 per cent) of those ending their lives in 2019 cited the fear of being a burden on their families as a reason and further 7.4 per cent cited financial worries. While in Canada, 1,412 people cited loneliness as a reason for having lives ended.

"There are other problems too. Legalising assisted suicide and euthanasia appears to lead an increase in the suicide rate in the general population. As one major study from Oregon noted, legalising Physician Assisted Suicide was associated with an increase of 6.3 per cent in the numbers of suicides, once all other factors had been controlled. Among over 65s the figure was more than double that."

Dr Macdonald concluded: "No, there is nothing progressive about legalising euthanasia or assisted suicide. Quite the contrary.

"At a time when we have seen how fragile our health care system is, how underfunding puts pressure on services and when up to one in four British people who would benefit from palliative care, but do not currently receive it, pushing an extreme ideological policy not only is the height of folly but incredibly dangerous."

LINKS

Article by Lord Carey of Clifton: www.bmj.com/content/374/bmj.n2094

Further information on assisted suicide: www.dyingwell.co.uk/ www.carenotkilling.org.uk/ https://livinganddyingwell.org.uk/ http://notdeadyetuk.org/

Highlights from 7 September presentations to Parliament by five doctors from Oregon, Belgium and Canada, on the dangers of legalising assisted suicide in light of their experiences: www.youtube.com/watch?v=WPePLAj52yw&t=1579s

Euthanasia: A Slippery Slope? a film about the assisted dying experinces of doctors and nurses in Belgium: www.youtube.com/watch?v=JmCv6up_LMo&t=12s

St Gabriel News - https://stgabrielnews.co.uk/