Assisted dying: MPs must re-think

Those of us who work with people who are dying with complex symptom-management needs occasionally find ourselves wishing that death could be hastened to relieve suffering.

But we swiftly remember that legislating on the back of very rare cases is akin to the road to hell being paved with good intentions.

There can be no doubting the good intentions of Rob Marris MP and his supporters in seeking to make assisted dying legal. The inevitable unforeseen consequences, however, should cause them to rethink.

Significant decisions we make about our own lives will always impact on others, more than most of us imagine.

The often-lauded concept of the autonomy of the individual is at best a philosophical fallacy and at worst a denial of the reality of our community-based humanity. We may demand freedom of choice but we must recognise that our choices inevitably impact on others: that is a part of being human - "No man is an island".

But how free is a patient's choice? Seeing their loved ones in distress at their imminent demise, a dying person may well feel compelled to relieve that distress; relatives themselves might suggest relieving the burden for the sake of the patient.

Hospices encounter daily the complexity of people's mixed motives.

We can too easily leave the vulnerable seeing themselves as a burden, simply by a word, a gesture or a look. We can't allow the ambiguity of all that makes us human to be sacrificed in an attempt to sanitise the reality of our humanity, to cleanse the human condition as a precondition of what some would call dignity.

Dignity for me, however, is found in the fullest expression of our common humanity, in the bearing of one another's burdens and in being open in love to whatever our fellows might need from us. I have one of the most privileged jobs there is: leading an organisation which seeks to walk alongside the most vulnerable members of our community, bearing their burden as they wish, respecting their vulnerability and experiencing in that vulnerability the most profound reality of their being, their dignity. It is not unusual for a nurse to spend hours, in the loneliness of the night, hearing the confession of the dying, not from a religious perspective but with a profound understanding of the spiritual, respecting the individual's dignity.

And who would dare to frustrate the possibility of a death-bed reconciliation, whether with a loved one, with their Creator, or even with life itself? We don't have statistics concerning the reliability of a six month prognosis of death (the requirement in the Bill) but what we do know from palliative medicine consultants is that such a prognosis would prove to be wrong in a significant proportion of cases. I was once called to give the last rites to someone in hospital deemed to have just a few hours to live. Twelve months later I shared afternoon tea with her at her home. And what proportion of patients at the Dignitas Clinic fail to die as a result of their lethal medication?

Whilst my faith undoubtedly plays a part, it is my experience of working in a hospice with palliative care clinicians which is the principal informer of my belief that to legislate for assisted dying would put thousands of society's most vulnerable members at risk. It could also put hospices at risk.

Some of our local funding streams from the NHS have been chipped away in recent years and those remaining have become more dependent upon doing things in the way the NHS requires. Rue the day when funding becomes dependent upon hospices' willingness to facilitate assisted dying.