The dissenting voice

Tucked away in the BBC's website report of today's campaigning report of assisted dying was a sentence which caught my eye. "However, one of the 11 commissioners, Reverend Canon Dr James Woodward, disagreed with the conclusion." I'd corresponded with him last year after my somewhat intemperate refusal to give evidence to the "commission", and apologised for tarring all the commission with the brush of prejudice at the outset. I've made no secret of my feelings about the whole exercise, but I have to say that Dr Woodward's statement in Appendix 3 of the lengthy report repays reading and for me is its redeeming conclusion. It can't have been easy to differ from the majority vote. 

He seems to me to have identified important issues, in particular breaking our society's taboo of discussion of death and dying, and having a broader debate about the kind of society we want to live in before thinking of changing any so fundamental law.

"As set out in the executive summary to this report, I do not feel able to put my name and support to the more specific recommendations that are made in chapters 11 and 12 of this report concerning the majority decision of the Commission that the present law could be changed to allow assisted dying in restricted circumstances. I support the coherence, rigour and quality of this work and hope that it will be read and used as a basis for further research, work and public debate. I regret that some have felt unable to contribute to the process of discussion, engagement and listening that has characterised the process. I wish to continue to work with my fellow Commission members to promote a deeper and wiser dialogue that moves away from polarised and entrenched positions on assisted dying that are incapable of listening to a wide range of issues and experience.

"In our work it has become clear that there are significant difficulties with the present law. My visit to Switzerland to learn something of the law and practice there raised many more questions about the way a culture views and values life, death and the freedom to choose. However this complex and contested area of human life cannot be dealt with through the law or medicine alone. We need to engage further with the social and ethical reflections on experiences of death and dying. The ethical debate is not over and it is the responsibility of all ‘sides’ of the debate to listen more carefully to the questions and concerns of one another.

"Further there are important theological questions about suffering, personhood and the value of the vulnerable that need to inform a more open conversation about death and dying in Britain today. I am particularly concerned about the adequacy of UK health and social care where dignity and compassion are values that are universally affirmed but often not part of the day to day practice of those who are tasked to care.

"In conclusion I believe that a broader societal debate is required before any attempt is made to move to a change in the law on assisted dying. As a society we need to bring all our collective wisdom to bear on these questions in an open and honest fashion. I understand that my particular view is a minority one and I both respect and admire my fellow Commissioners in their views and recommendations. I hope that the report will be read carefully — it is an important contribution to the debate."

I have written to thank him, and I very much hope his thoughtful voice will be listened to. Meanwhile, in response to my last post, Sally, a doctor friend of ours, could have begun part of the discussion with this powerful message: "Years ago, while working in a hospice, I admitted a patient who was in agony having had totally inadequate analgesia in a prior hospital. His wife was screaming at me to end his life, and he was rolling around in agony, but within in a short time he was sound asleep with good analgesia. He slept for about three days having been completely exhausted by being left in severe pain. He eventually woke up and subsequently had a good death. 

There is such a thing as a good death, but death is remote and almost taboo in contemporary society. We should not abdicate responsibility for striving for excellence in palliative and terminal care. We should not turn doctors into executioners. This is not a religious discussion. Civilised secular society has a role in addressing the concept of a good death which has no need whatsoever to involve killing."

Lord Falconer's Choice Illusion

So the Falconer "commission" has rebranded itself as a "panel of legal and medical experts" and confessed to being funded by and packed with assisted suicide supporters. In fact, the MP involved said, there was no one on the panel previously opposed to it. 

The fundamental issue seems to me to be a matter of choice, but it's not a matter of individuals choosing how they want to die. Rather it's a matter of us deciding what sort of society we want to live in.

This is the article I'd hoped would be published in a national paper, but wasn't in the event.

"Last year, in the midst of austerity and recession, the BBC’s ‘Children in Need’ raised a record £26,332,334 by the end of a single evening.  Today the self-styled Commission on Assisted Dying under the chairmanship of Lord Falconer, champion of the legalization of assisted suicide in England and Wales, will be presenting their conclusions.  Considering the ‘commission’ is funded by and predominantly made up of similarly-minded people, it’s not been hard to predict what some of those conclusions might have been.  They’ll be couched in reasonable and balanced terms no doubt, and they’ll hardly be novel.  However, on the principle that if you keep repeating something enough times, it will eventually be believed, they’ll serve their purpose. 

"One of the main themes, let me guess, will be that of freedom of choice.  The argument runs something like this: since 1961 suicide has ceased to be a crime.  Terminally ill people, for example with Motor Neurone Disease or Locked-in Syndrome, reach a point when they are unable to take their own lives.  Thus they are deprived of a civil right and unfairly discriminated against.  They, it is said, of all people might well want to end their lives - and the law as it stands means they can’t, because the same Suicide Act (amended 2009) goes on to state: “A person (“D”) commits an offence if (a) D does an act capable of encouraging or assisting the suicide or attempted suicide of another person, and (b) D’s act was intended to encourage or assist suicide or an attempt at suicide”.  It does also leave the jury discretion to convict or not, and only permits proceedings “by or with the consent of the Director of Public Prosecutions” - which explains the minimal convictions under the Act in 50 years.

"If someone like myself should wish to leave our disease behind, why should we not say so and why should we not be assisted, without the fear of our assistants’ facing prosecution?  Surely it’s my life and my choice? 

"In discussions people have said to me, “Suicide’s been legalized.  That means it’s my right to take my life.”  The wording of the Act does not exactly express that meaning: “The rule of law whereby it is a criminal act for a person to commit suicide is hereby abrogated.”  To say that the state will not regard a suicidal person, whether successful or unsuccessful, as a criminal, is not the same as saying that the state sanctions or encourages suicide.  In fact the wording of the 2009 amendment was widened in order to cover internet sites promoting suicide, implying that the state’s inclination is to discourage suicide.  Mr Justice Baker’s judgement in the recent case of patient ‘M’ summed the principle up: “The factor which does carry substantial weight, in my judgement, is the preservation of life. Although not an absolute rule, the law regards the preservation of life as a fundamental principle.”

"The question is whether personal choice can trump the preservation of life.  It is, of course, not true that we have unfettered freedom of choice.  For example, we are not free to drive on the right or without a seat belt, because the state does not want us to kill either ourselves or each other.  Similarly, where we may smoke is restricted.  Even what we may say and write is limited.  There are good reasons for such things, but the point is choice is not an inherent right.  Autonomy, the oft-touted synonym for choice, literally means “having one’s own laws”.  That is incompatible with being part of a larger society.  Therein lies the flaw in arguing for legislation which allows for a variety of practice in the taking of life, or assisting to die.  Once you say that it’s possible to decide your own personal laws in matters of life and death you have no fundamental ground to say a particular action is unacceptable.  It will all depend on circumstance and motive – and that is shifting sand.  Even ‘compassion’ is an elusive and subjective motive.  You may set apparently water-tight perameters, but they also will shift.

"To abandon the preservation of life as a fundamental principle of our society’s laws, in the name of personal choice, would be to retreat from centuries of hard-won progress.  It was, after all, only in 1969 that Parliament voted to abolish the state taking life.  During the debate on the abolition of hanging, Duncan Sandys led the opposition to the vote, arguing that “We have no right to assume that the firmly held views of the overwhelming majority of the British people are unworthy and misguided.”  His view was shared neither by the Commons nor the Lords, and so even the life of the murderer was protected.  (It will be interesting to see whether Sandys’ contention about public opinion, which seems predominantly to favour euthanasia, will be echoed by the ‘commission’.)

"So what will society say to me when I get near the end of my MND – if it’s not to allow someone to top me when I’ve had enough?  I hope it will say, “We will see you through this.  We will give you the best quality of life that’s possible.  We will provide all the palliative care that you need, including supporting your carers.  We will do everything possible to ease your symptoms and to control your pain.”  And I would say, “Please keep me comfortable.  If the pain relief should shorten my life by hours or days, that’s all right.  You’re only doing your job.  And when I should die, just let me be.” 

"Is it a Utopian ideal?  In fact it’s the legal situation now.  But aren’t there doctors out there who’ll betray one’s trust?  Aren’t there trusts and commissioning consortia who will try to trim their care costs?  There are horror stories of the neglect of the elderly in hospitals, after all.  (It’s worth pondering whether one factor beneath the horror stories is the progressive devaluing of the dependent person?)  Well, there are risks, but the society which firmly holds the preservation of life as a fundamental principle will be on the lookout for such breaches and, most importantly, put its resources where its principle is.  And the risks are small beside the risk of abandoning the principle that life is precious above all else. 

"‘Children in Need’ projected on our TV screens the courage and beauty of disabled, dependent and often dying children.  It showed us the incredible endurance and compassion of those who care for them.  There can be no question as to their worth and of the value of enhancing or at least ameliorating their lives.  We know it's right.  The society which cherishes life, even at its most tenuous, is far preferable to one which admits the principle that some lives are disposable.  'Children in Need' or the 'Commission'?  I know which vision I prefer."

from Children in Need website

I know the so-called experts are not calling for euthanasia, but only for assisted suicide of mentally competent adults, but my point is that once the preservation of life is breached as a foundational principle of law and life-taking is permitted a Rubicon will have been crossed, and we shouldn't be fooled that it's the end of the road for the advocates of euthanasia.

A new year

Before the media frenzy breaks tomorrow with the launch of the "eagerly awaited" - listen out for that phrase - it could be part of their press hype - report of the phoney Falconer "commission" (it's already been launched - or "advertorialised" as Peter Saunders pungently put it - in The Telegraph and The Observer), time for me to reflect in the lull.

With Jane's broken collar-bone I've entered the realm of employing a carer. Ralph comes in to give me my stretches, get me up, dressed and down to breakfast, leaving after I've been to the toilet. My usual chair's been replaced (again) with the riser-recliner so that Jane doesn't have to haul me on to my rollator. So most of the day is spent here, where I'm sitting, with necessary toilet breaks, of course, (sorry to mention it again), until Rachel gets me ready for and in to bed. It's the first time someone who's not family has had to deal with me like this, and I wondered whether I'd find it embarrassing or undignified as some people seem to. Or would I feel I was being "man-handled" like Tony Nicklinson? I have to report I felt none of those.

It seems to me it's largely a matter of attitude rather than reality. I'm not minimising the experience of dependency and diminishing powers. However we are simply mistaken to call it undignified. Actually, as Archbishop Cranmer says, there's Dignity in Living (as opposed to the mantra Dignity in dying).

On a lighter note, yesterday my three brothers and their wives came to lunch. We try to meet up once a year after Christmas - saves on postage for the presents! Because Jane couldn't drive, we changed our original West Country venue to here, with the others doing all the catering. It worked well - and we're still left with remnants of the meal.

My brothers and I still enjoy giving each other presents: I gave them a jolly little monkey that waddles along playing a pair of cymbals. (I can't work out whether he's like me or Lord Falconer. Like me he's wobbly on his feet; like the peer he looks good but does a lot of banging to little effect.)

One of them gave me a proxy goat, another a clock which has a different bird singing every hour (now banished to the conservatory), and the third "The Perfect Man", which has the following verses attached:

"They say good men are hard to find.
I know this to be true
But I hunted far and wide
And found one just for you!

He is no good at DIY,
He cannot fix the car;
But his socks are never smelly
And he doesn't stray too far.

He always listens patiently,
He won't pester you in bed
And if you get fed up with him -
You just bite off his head!"


It was, in case you'd not guessed, a packet of five of these cheery fellows. . . .

I wish you a cheerful new year.

No, non, niet - no idea!

"Who was responsible for ethical compliance?" I've just been watching the evidence of the News of the World's lawyer, Tom Crone, to the Leveson Inquiry. When asked that question, he seemed totally stumped, and in the end came up lamely with, "The Chief Executive, I suppose," (i.e. James Murdoch). When it was pointed out that the CEO had notional responsibility for everything, he responded that his own role he considered to be litigation compliance for articles. It seemed to me disturbing that it emerged that neither the legal department nor anyone else in a newspaper was responsible for the morality of what it publishes - disturbing and symptomatic. I'm hoping that the Inquiry will have the effect of shifting the press from unethical towards ethical journalism.

I gather that a new expression has entered the language. It's "doing a Clegg" and means something like going AWOL. It of course arises from the deputy prime minister's conspicuous absence from his boss's side when he triumphantly reported his "NO" to the cheering/jeering House of Commons. Strictly speaking David Cameron did not veto the Merkozy plan; he didn't forbid or block it. He just opted the UK out. Still it made good press, echoing nicely President de Gaulle's "NON" to Britain's entry into the EEC in 1967. Now that was a veto. We had to wait until his fall before applying again and becoming a member in 1973. One can only hope that our PM doesn't follow that other theatrical "NO", or rather "NIET"-sayer, Nikita Khrushchev's habit of banging his shoe on the table to emphasize his immovability. So unEnglish!

I've recently read an essay by the distinguished Nobel Laureate, Professor Amartya Sen, entitled Violence and Civil Society (in CAM 64) in which he argues that conflict is not best solved by state-sanctioned force. He carefully examines the commonly perceived factors giving rise to violence, such as class, poverty and religion. But they aren't the whole story.

There were two passages which struck me: "For example, appeals to country and nationality played a rousing role in the immensely bloody war in Europe between 1914 and 1918, and a shared religious background did nothing to stop the Germans, the British and the French from tearing each other apart. Yet, today, the Germans, the French and the British mix with each other in peace and tranquillity and sit together to decide what to do in their continent without reaching for their guns." Well, that was the vision behind the EU! Quite important we don't forget it.

Then there was this: "Democracy is more than a collection of specific institutions, such as balloting and elections - it is also dialogue, freedom of information and unrestricted discussion. These are also the central features of civil paths to peace." For some reason this put me in mind of the Occupy camp in the heart of that least transparent of places, the City of London, outside St Paul's Cathedral.

I've been asked why the Falconer "Commission" has taken longer to come out than expected. The answer is, I have no idea. I don't think it's because they got wind of something I'd written in anticipation  - I'm not that important or that vain, I hope. I imagine it's a matter of waiting until the serious news clears out of the way to leave it room for maximum publicity.

In this context, I found Amartya Sen's comment on what he calls "the solitarist approach to human identity" (which sees human beings as members of just one group, defined solely by their native civilisation, or religion etc) illuminating: "The solitarist approach is an excellent way of misunderstanding (my italics) nearly everyone in the world. The same person can be, without contradiction, of Asian origin, a Christian, a socialist, a woman, a jazz musician, a doctor, and one who believes that the most important problem in the world today is how to make South Africa the cricket champion of the world." I doubt whether the professor knows such a person, but it's a point well made. To assume that one factor in somebody controls all they think and do is dumb. We are not machines; we're complex individuals trying to live together.

Watch out!

Watch out! It appears that Dignity in Dying (formerly the Voluntary Euthanasia Society) is rolling out its overdue autumn offensive, with a little help from its friends. It must seem a shame that there's been so much important news hogging the headlines, such as the euro-crisis, the Leveson Inquiry, the Chancellor's autumn statement, the public sector strike, Egyptian and DRC elections, Pakistan border incidents.... But the Falconer "Commission" promised to report late November. Maybe, like the government's prediction for balancing the books, it had to be moved on a bit in the light of events.

BBC filming at Cornerstone

Well, yesterday afternoon I received a message from a friend saying was I going to be on the BBC later on. She thought she'd heard me on Radio Oxford. "Not that I know of," I replied. However in due course an item about a chap with locked-in syndrome accompanied by a picture of Tony Nicklinson, whom I'd met in the summer, was trailed for Inside Out South. And lo and behold, at 7.45 or so on came the piece which had been produced for Bristol. Listening to it again, there's one misleading piece of commentary near the end which says something like, "Now both Tony and Michael are awaiting the report of the 'commission' to see its recommendations...". No, I'm not. I'm aware that it's a done deal, and that the 'commission' was fatally compromised from its inception. I would be interested in what a Royal Commission had to say.

The significance of the item dawned on me today when my son pointed out to me the first item on the BBC website's News England page, headlined, "'Right to die' man seeks ruling" which linked to the "debate" I had with Tony. The article is about Tony Nicklinson applying to the High Court to grant permission for a doctor to end his life. As I've said before, he's a brave chap. I couldn't help but be moved and sympathetic when we met. I can understand why he felt his frustration unbearable, but I agree with someone who watched it (herself suffering from a painful degenerative disease); she said, "Sad he felt there was nothing to live for, not even his misguided but loving wife. Sad that people think their lives are their own to choose." 

I imagine the case will get a lot of media coverage. I can't imagine that his advisers have held out great hope of success, since the taking of life is still illegal in this country. But of course there'll be a lot of discussion of inequality/discrimination and choice. And justifiable public sympathy and less justifiable indignation.

Next will come the "Commission" with a great hullabaloo and media circus - with an appearance of being official, and carefully researched, and balanced, and no mention of the the fact that nine of the 12-strong panel had previously declared in favour of assisted dying and none had declared against it. I imagine it will be presented to MPs as the definitive exploration of the issue and conclude that with tight safeguards doctors be allowed deliberately to take the life of someone so inclined.

In Canada, as I said yesterday, there's been a similar exercise. One response came from my friend Alison Davis, who has multiple disabilities and what many would call an unbearable "quality of life", who described her experience of asking for death to the Calgary Herald.

Alison Davis

Re: "No right to be killed; Doctor assisted suicide should not be allowed," Editorial, Nov. 20. 

I was glad to see your excellent editorial stating the case against euthanasia. If it had been available to me some years ago, I wouldn't now be writing to you. I have several severe disabling conditions. I use a wheelchair full time and a vent at night. I have severe pain, which even morphine can't control. 

I wanted to die for more than 10 years, at a time when doctors thought my life expectancy was very short. I attempted suicide seriously several times, and was saved, only because friends found me in time and took me to the emergency room, where I was treated. 

At first, I was angry with them for thwarting my wishes. Now, I'm eternally grateful. I want to live now, even though my pain is worse than it was when I wanted to die. What changed my mind is friends who refused to accept my view that my life had no value, and a group of very poor children, who loved me wonderfully and overwhelmingly. I found a reason to live in reaching out to help others, rather than turning the negativity on myself. If assisted suicide had been available then, no one would ever have known the doctors' prognosis was wrong, or that I'd be missing the best years of my life.

Alison Davis, Blandford Forum, U.K.

On the radar?

Last Wednesday I spent the day (well, from midday to 5 o'clock) being interviewed for a 2nd-year Film Production assignment, by three students from the University of Gloucestershire. The documentary was, predictably, a "balanced" 9-minute film on assisted suicide. I was providing the balance. It was a long afternoon.

Near the end the chap interviewing said he had two questions from one of Dignity in Dying (formerly the Voluntary Euthanasia Society)'s extensive staff, Mylinh Cao (their press trainee). My ears pricked up at that point. I felt vaguely flattered that I featured on DiD's radar!


First question: "We've noticed that your articles don't give you the title 'Rev' nowadays. Is there a reason for this?" Answer: "a. I'm retired. b. It's no secret. c. It's irrelevant. d. It's just cheap for people to diss views with a 'He would say that, wouldn't he?' whereas the arguments are too important for that.


Second question: "Is your attitude to assisted suicide a result of your religious beliefs?" Answer: "My view is primarily based on societal reasons. It's to do with the effects on the disabled and aging. A society that doesn't value human life is in trouble. So is one that allows people to terminate each others' life. Clearly my faith in God is important and informs all my life, including my philosophy of life. But in fact everyone has a faith of some sort - whether it's in God, or in science, or in technology, or in atheism, or in nothing. We all start with presuppositions. The question is what's the substance of the arguments.

I was interested to read that Canada has its own phoney enquiry into assisted suicide which has just reported. I read this on the Secondhand Smoke blog:

I Told You The Fix Was In On Canadian Euthanasia Panel

Wednesday, November 16, 2011, 12:11 PM

Wesley J. Smith

The in-the-tank media is huffing and puffing, trying to make something important out of an entirely predictable recommendation by the Royal Society of Canada commission to legalize euthanasia.  But commissions can be created to obtain a specific result, as this one was and did.

In fact, I told you this very thing would happen two years ago, to be precise, on October 28, 2009.  Here’s the Secondhand Smoke post, “Stacking the Deck for Euthanasia in Canadian ‘End of Life’ Commission” in its entirety:”

“Expert commissions” to advise on contentious issues of public policy are usually political tools designed to come to a predetermined conclusion in order to pave the way for a desired  policy changes.  Remember that as we take a look at a new commission being appointed by the Royal Society of Canada to look into end of life issues.  From the story:

Queen’s Philosophy professor Udo Schuklenk has been selected to head a prestigious new international panel on “End-of-Life Decision Making” in Canada. Appointed by the Royal Society of Canada, the expert panel will investigate key aspects of this critical issue – including voluntary euthanasia and physician-assisted suicide – and prepare a public report.

Stories such as this never seem to look deeper than the job titles of the panelists, as if they come to their work with no preexisting positions. So, I decide to check, starting with Udo Schuklenk.  What a surprise: He’s a pro euthanasia philosopher. How do I know?  He’s said so.  For example, in an essay explaining why he is an atheist, he wrote:

No matter how unbearably patients suffer due to illness or injury toward the end of their lives, the world’s monotheistic religions stand as one in their rejection of many dying patients’ requests to end their lives in dignity. That we may well be of sound mind, and that there is no prospect of our condition improving, makes no difference to their stance. Our own considered judgment that life is not worth living any longer counts for nothing to organized monotheistic religions. According to them, we are not ethically entitled to ask for physician assisted suicide or voluntary euthanasia. This is surprising, given that at the end of our natural lives churches have promised us that we would be going to heaven – or hell, as the case might be. If at the end of a decently lived life we would go to heaven and enjoy eternal life, why are they fighting our earthly death so vigorously? None of this makes any sense at all if we take religious beliefs about our afterlife seriously. Once again substantial, avoidable human suffering is a direct consequence of religious interference with our end-of-life decision-making.

I don’t care about his religious views, but to chair a panel with such a clear view in favor of assisted suicide, indicates the direction in which the commission’s recommendations are expected (designed) to go.

But perhaps I am being too cynical.  Let’s see who else is on the commission:  Ah, Scot philosophy professor Sheila McClean who wrote The Case for Assisted Suicide, a book described as arguing fervently in favor of legalization.  Hmm, I wonder how she will vote?

Another commissioner is a Dutch euthanasia researcher.  Cute.

Then there’s Jocelyn Downie, author of Dying Justice, a book urging the decriminalization of both euthanasia and assisted suicide.  The bias isn’t even subtle.

I spent some time researching the views of the two remaining members, but neither seemed to be particularly involved in the issue.  So let’s count them, at least for now, as neutrals. No matter: Even assuming both are as adamantly opposed to assisted suicide as their co panelists appear to be for it, the deck is stacked, the fix is in, 4-2 for permitting assisted suicide in at least some cases.

The next step in this Kibuki Theater will be for the media to trip over themselves to report breathlessly that “the experts” have deeply pondered, and determined–after much hand wringing, there is always hand wringing–that assisted suicide should be allowed.  It is all so scripted and predictable.

Gee, I was right.  But then, on these matters, I usually am.

Watch out for the same coming here when the so-called "Commission on Assisted Suicide" under Lord Falconer reports in the next few days or weeks. You may recall that 9/12 of the commission members had previously pronounced in favour of assisting people to die. The Commission is funded by Terry Pratchett (assisted suicide campaigner), and the brainchild of ... guess who? ... Dignity in Dying - otherwise known as ....