Eyewash, Flapdoodle and Bullshit

The UK Parliament is about to debate a bill put forward to change the law on assisted dying. In yesterday’s Observer, the current Archbishop of Canterbury had an opinion piece on why he believes assisting people to die would have detrimental effects both on individuals and on society.

Needless to say, I disagree with his viewpoint.

I can’t help feeling that he’s being a tad disingenuous when he claims:

With other faith leaders, I have joined in writing to members of parliament, urging them to oppose Rob Marris’s assisted dying bill.

We have written, not in an attempt to push “the religious” viewpoint on others, but because we are concerned that a change in the current law on assisted suicide would have detrimental effects both on individuals and on our society.

It sounds very much like pushing the “religious viewpoint” to me. While he might wish to claim that:

…the faith leaders’ letter represents the considered opinion of our communities that have analysed, discussed and debated the issue over many years. Their response springs from philosophical and theological reflections as well as from a vast range of pastoral experience and a profound sense of compassion.

…it really deserves little more than the Mandy-Rice Davies response: Well, he would, wouldn’t he? As Ophelia Benson writes, it’s typically loaded language that at its heart is little more than “eyewash, flapdoodle and bullshit”.

He sets up a completely false dichotomy:

…we need to reflect on what sort of society we might become if we were to permit assisted suicide. At present, we can show love, care and compassion to those who at all ages and stages of life are contemplating suicide.

We still can, and, more to the point, we still do here in The Netherlands where assisted dying is legal. It would be as well to get some facts on the table, and dismiss the “slippery slope” argument in Welby’s rhetoric:

The incidence of the different circumstances of death in the Netherlands since 1995 has been determined in several successive robust epidemiological studies (Onwuteaka-Philipsen et al., Lancet. 2003;362: 395-399). In 2005, of all deaths in the Netherlands, not 20% but 0.4% were the result of the ending of life without an explicit request by the patient (van der Heide et al., New England Journal of Medicine. 2007;356:1957-1965).

In the UK, the figure was 0.33%, i.e. quite similar to the 0.4% in the Netherlands (Seale, Palliative Medicine 2006; 20: 3-10). These instances have been found to be in dying patients who had become incompetent, were compassionate and are generally considered ethically acceptable (Rietjens et al. Death Studies 2007;31:205-221).

In 2005 in the Netherlands euthanasia was given in 1.7% of deaths and physician-assisted suicide occurred in 0.1%. These rates were somewhat lower than in 2001. Since the legalisation of euthanasia in Belgium its overall incidence changed little, but the care with which it is carried out improved markedly (Bilsen et al. New England Journal of Medicine 2009; 361: 1119-1121). If cases of euthanasia with no or only perfunctory precautions came to light, there would be prosecution. And if in the future there were to be evidence for anyone requesting euthanasia because of e.g. a waiting list for palliative care, there would be an outcry. Thus, legal euthanasia is one more safeguard against the health-care system falling short of its duty to offer optimal care at the end of life. In Belgium, legal euthanasia and palliative care are not opposites, but complementary and synergistic (Bernheim et al., British Medical Journal 2008;336:864-867).

Note that Welby uses the term “assisted suicide”. As a hospice director pointed out:

There is often a deliberate and emotive attempt to confuse the terms assisted dying and assisted suicide. These are subtly but fundamentally different. People with a terminal illness are not choosing to die, they are already dying. Assisted dying offers an individual with a terminal illness and clear prognosis to have some say in the timing and place of their death if they want it. And, what is likely to be proposed in the bill is restricted to people who are terminally ill with a prognosis of less than six months. Individuals would also be required to administer the medication to end their life themselves.

However, facts do not seem to concern Justin Welby overmuch. He seems more content with hyperbole, half-truths and lies:

We risk all this for what? Becoming a society where each life is no longer seen as worth protecting, worth honouring, worth fighting for? The current law and the guidelines for practice work; compassion is shown, the vulnerable are protected. In spite of individual celebrity opinions and the “findings” of snap opinion polls (that cannot hope to do justice to the intricacies of the issue) the current law is not “broken”. There is no need to fix it.

The current law in the UK is broken. I am relieved that I live in The Netherlands where I have the option of assisted dying, should circumstances bring me to that point.  I’ve lived a good life, and hopefully will continue to do so for many more years. I don’t think it is selfish of me to wish for a good death as well.