Assisted Dying is very much back on the agenda, both north and south of the border. BBC Radio 4’s Any Questions (Friday evening and Saturday afternoon) came from Beccles Public Hall and Theatre in Suffolk. On the panel: Rushanara Ali, Labour MP, Annabel Denham, Telegraph columnist, Tobias Elwood, Conservative MP 2005 – 2024, and Adrian Ramsay, MP, co-leader of the Greens in England and Wales. The first questioner to the panel pointed out that it had been ten years since Parliament had last voted on the issue of Assisted Dying. Had public opinion changed sufficiently, such that a different outcome might be expected?
It was an interesting way of framing the question. It suggests that politicians are rather like weather vanes, pointing in the direction of public opinion. There were three MPs on the panel, two currently standing, one recently released from the responsibility. Why not just ask, how will you, or would you, vote? After all, this is a “conscience” vote; there is no whip. Yet clearly the questioner felt that public opinion mattered. Perhaps this is how MPs function. You develop a sense of what impending innovations might be à la mode – “finger in the air” – and vote accordingly. Is this not what it means to represent the public will?
I have to say I thought the responses to this question were extremely poor. Rushanara Ali thanked the questioner for the question. It was a sensitive issue. She had voted against Assisted Dying in 2015. She was aware of a shift in public opinion. This was a private bill, introduced by Kim Leadbeater, a free vote and therefore a conscience vote. (The word “conscience” came up a lot, but there was no real analysis of what the dictates of conscience might be, or the foundations on which such might rest.) Yes it’s an important issue. As a minister, Rushanara Ali had a neutral position. It would be inappropriate for ministers to express views.
(Let me see if I’ve got this right. We live in an open democracy, enjoying freedom of speech. A free vote arises, but it would be “inappropriate” for a minister to express a view. Really?)
Tobias Elwood. What is your stance? …Difficult question. (Clearly he had scruples.) What is the role of the GP? Will terminally ill people feel they are a burden? Lots of questions, but apparently no answers.
Annabel Denham. There has been insufficient debate. This ought not to be rushed through. In favour in theory, but not in application. Look at Canada. Massive increase in assisted dying. Slippery slopes. Is there a forum for public debate?
I found myself yelling at the radio, “Yes! But what do you think?” Or, “What do you think?” – putting my emphases on unusual words after the fashion of former-Friend Chandler Bing, aka the late, much missed Matthew Perry. “Could you be more evasive?”
Adrian Ramsay. Consider the evidence. Palliative care good. Right to choose good.
I don’t suppose I should have been surprised. Politicians are past-masters in the art of saying nothing. There was no consideration of evidence from around the world. Does mission creep exists in reality? What are the statistics? Are they even measurable? People at the end of life who consider themselves to be a burden are perhaps unlikely to own up to the fact.
You might have thought that a free vote would, indeed, free politicians up to express an opinion. The Chief Whip gives them free rein. But look what happens. They clam up. It turns out that they are only comfortable coming down on one side of an argument when they are toeing a party line, when they are reiterating a dogma. Take the politics out of the equation, ask them what they really think, and they are struck dumb. I think they are terrified of expressing a view that might be in contravention of some established, or perceived established, Zeitgeist. They lack the courage of their own convictions; and because of that, they lack convictions.
If I were an MP, or an MSP, I would vote against Assisted Dying, not, I hope, because I lack compassion for the terminally ill, and their loved ones, but because I suspect the project would be taken over, in short order, by a hidden agenda that has nothing to do with compassion. As a medical practitioner, I would certainly not take part. It seems to me that the administration of a lethal cocktail is entirely alien to the practice of medicine as I have known it. I wonder what would happen if the entire medical profession declined to take part. Presumably specialists – call them thanotologists – could be trained up for the role. I wonder if that would sit comfortably with the public.
So I wrote to The Herald last week. Dear Sir…
The Assisted Dying for Terminally Ill Adults (Scotland) Bill is once more about to be scrutinised by the Scottish Parliament (“Campaigners raise further fears over safety of assisted dying legislation”, Herald, September 30). For MSPs who may be undecided on this issue, may I recommend a trip, should they have time and space, to Berlin, specifically to Herbert von Karajan Strasse, just off Tiergarten Strasse. In front of Philharmonie Halle, home of the Berlin Philharmonic, there is a series of exhibits relating to Aktion T4, or Aktion Tiergarten 4, a campaign of mass murder by involuntary euthanasia in Nazi Germany. On a note dated 1st September 1939, the Führer entrusted the medical profession with the responsibility to identify patients, both children and adults, “after a most critical diagnosis, on the basis of human judgment”, who were incurable, and to grant them “mercy death” (Gnadentod). Conditions considered incurable included schizophrenia, epilepsy, Huntingdon’s Chorea, “imbecility”, chronic alcoholism, Down’s syndrome, microcephaly, hydrocephaly, spasticity, and paralysis.
Now it is perfectly true that Aktion T4, and the Assisted Dying Bill are radically different in one respect: Assisted Dying is voluntary, but the Nazi euthanasia programme was compulsory. But these two programmes do share one common feature. They are both clandestine. Children were removed to “Special Sections” and gassed. The cause of death was recorded as “pneumonia”. Buried away in Paragraph 17 of the Assisted Dying Bill, believe it or not, is this extraordinary statement:
For the purposes of section 24 (certificate of cause of death) of the Registration of Births, Deaths, and Marriages (Scotland) Act 1965, the terminal illness involved is to be recorded as the disease or condition directly leading to their death (rather than the approved substance provided to them by virtue of section 15).
In other words, MSPs will make, remotely, a pathophysiological diagnosis that was not the patient’s cause of death and, in the normal course of events, might never have been the patient’s cause of death. How dare they?
There are some people who believe – or say they do – that Assisted Dying is coming, is inevitable, and like a tidal wave, cannot be stopped. Lass’ sie nach Berlin kommen. Let them come to Berlin.
jamescalumcampbell 