07 February 2012

Assisted Dying, Observing a British Debate

I find myself in general agreement with Dr. Williams for a change.

What he calls, "palliative care"and Americans might call, "pain management" is one area where English medical care is starkly better than ours. And that does matter in this discussion. For us, with amazingly stupid laws regarding pain relief medications (most especially heroin) limiting our medical professionals, the discussion is a bit different. And we routinely fail to provide hospice care the English take for granted. So it is important to read him in context. English care is different from American care.

I also agree with his comments on the effect of law. When we change law, we do in fact, "legislate morality." We do that in two ways.

First the basic assumption of our law is that our laws express our moral judgement.This actually is the only reason we can justify law. Consider, that laws curtail freedoms. We decide to do that precisely because our moral judgement is that some freedoms must be curtailed.

Second when we use law to create what Dr. Williams calls a, "default position" we change the moral conversation and the moral tone of the society. We can see both good and bad consequences of any number of legal changes over time that have changed what we consider moral and what the society thinks is basic civilized behavior.

It is very easy to conceive of circumstances constituting pressure on those who are a financial or emotional weight on the eventual survivors of a terminally ill person. If some lives are worthless enough to be terminated by medical action, then the moral discussion becomes a consideration of which lives? That is a non-trivial and negative change.

Finally, the ugly idea that saying no to assisted suicide is the same thing as adopting the idea that all lives must be preserved at all costs must be dispelled. I have painful memories of some of our less devout family members simply and offensively assuming that because we are Christians, we must believe this stupidity. So on the record, sometimes, respirators need to be turned off, feeding tubes need to be withdrawn, and palliative care is exactly what should be on offer. And yes, under medical control, that means legal heroin.

All of that typed, here are Dr. Williams' remarks.
Archbishop Rowan Williams' contribution to debate on Assisted Dying:

First of all, let me express my gratitude to Sarah Finch for enabling us to have this debate at this particular moment. It is timely and necessary that we have an opportunity for clarifying some of what we want to say in this very complex and very important area.

Sarah referred to the fact that there have been a number of discussions in Parliament in recent years on this subject, and the emergence of this so-called Independent Commission and its report prompts the question “What has changed to make a re-opening of the question necessary?” Paradoxically, the answer seems to be that the only thing that has changed, and that is still changing, is advances in medical science and in palliative care. In other words, changes in exactly the direction which suggests that we do not need a change in the law such as envisaged. Our level of palliative care in this country remains the envy of Europe, if not the whole world, and I want to say very emphatically that anything which prejudices or jeopardises that level of palliative care is to be resisted with all our power.

But there are other questions around which we need to think about. Granted that this is not a time for theological debate, granted also that it is not the case that the Christian view has to be that life is in all circumstances to be prolonged at all costs (a familiar misunderstanding of where we stand), what exactly is wrong with what lies ahead of us if these proposals from the Commission were to go through?

Perhaps I can begin to answer that by making a general observation about what I believe to be the purpose of law itself. Law exists so that people may be protected, especially the vulnerable. Law exists to guarantee equality of protection to all. And when the law seeks to move outside that sphere it exceeds its proper function, a point which is not wholly immaterial to some of the matters that Mrs Andrea Williams touched on earlier, but that’s another story.

What we are faced with here in these proposals from the Commission is a legal outcome in which protection is diminished, not only for vulnerable individuals but also for medical professionals. A point has been made, and it needs to be made again, that it is front-line physicians who are going to find themselves more and more in a deeply uncomfortable – perhaps unsustainable – place in all this. My episcopal colleagues may have noticed that, in a recent issue of the in-house parliamentary journal, there was an article on this subject which made the very important point that if you want to find the best predictor for resistance to the legalising of assisted dying, it’s not necessarily in people of religious conviction, or not alone among people of religious conviction. It is among working physicians that you will find the best predictors - you are most likely to find resistance among those most obviously on the front line. And if we’re thinking about protection as a primary function of the law, I would argue that you have to think about the protection of those people as well as those who are in a vulnerable medical situation.

I would also want to underline the fact that priorities in palliative care are themselves matters in which we ought to seek the protection of the law, in so far at least as a change in the law prejudices those secure possibilities for the development and maintenance of the world-class palliative care we now enjoy.

Members of Synod, the point has been made by Sarah in her introductory remarks that changes in the law of this kind are, at the end of the day, changes in the default position that our society adopts. The default position on abortion has shifted quite clearly over the past 40 years, and to see the default position shifting on the sanctity of life would be a disaster. We are not, as I say, committed to the notion – the eccentric notion – that Christians believe that we should cling to life at all costs. We are committed, as Christians, to the belief that every life in every imaginable situation is infinitely precious in the sight of God. To say that there are certain conditions in which life is legally declared to be not worth living is a major shift in the moral and spiritual atmosphere in which we live. We can be realistic, we can be compassionate in the application of the existing law - that point too is argued in the article I referred to earlier in the parliamentary journal. But to change the law on this subject is, I believe, to change something vital in our sense of the value of life itself.

I hope we shall resist changes in the law, with all due acknowledgement of the extraordinary cost and difficulty this can entail for certain individuals, and with all proper attention to the compassion that we need for those who have taken decisions we cannot agree with. I hope we shall continue to say that anything in our legal settlement, the legal climate of our society, which has the effect of minimising the protection of the most vulnerable as well as of our medical professionals, is not something to which this Synod, or, I believe, the Christian church in this country, could ever assent.1


1 Dr. Rowan Williams on the floor of General Synod as quoted at his page dated 6 February 2011.

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