The assisted dying debate: A law that fails to solve the real problem – trust

28 November 2024, 12:01 | Updated: 28 November 2024, 12:04

The proposed law on assisted dying is an infernal mess that satisfies no one. Perhaps that is because no legislation to govern death can solve the problem it is intended to address.

For our secular society, obsessed with ‘following the science’, risk-management and preparedness death is particularly frightening. Most of us no longer see it as a transition to the next world but as an end.

We know it will happen, but we don’t know exactly when, or exactly how, what it will feel like, or what will come after.

There is no experience that we can learn from; no one to tell us how to do it well. Death has no meaning, and we fear its sting.

We fear pain, we fear suffering and we fear losing control. Perhaps this is why the notion of a law to permit and regulate assisted dying seems attractive to many.

It is not simply about concerns about extreme cases. It seems to be a way of managing the unmanageable. Uncertainty is not quite so uncertain if we can make some part of it sure a law to permit assisted dying may not be able to stop death, but it creates the comforting allusion that we can control how and when we die.

Or at least we can if we fulfill a raft of criteria and regulatory procedures crafted to prevent deaths being provided for ‘bad reasons and slippery slopes into bad reasons.

But even the wisdom of Solomon would be insufficient to draft a good law on state-sanctioned assisted dying – because how a dying person is assisted is subject to context and empathy and trust and the contextual judgement of understanding a person – not the rules of a law-court.

So, at what point did society decide that a ‘good death’ required the legislative framework of regulations that a parliamentary Bill provides?

When did we decide that our dying should be separated from the care and judgement of those who have cared for us through our last illnesses and detached from the intuition and love of family members.

When did family members change from being the persons most concerned with the comfort and well-being of an elderly relative into how they are seen now: potential abusers most concerned about inheritance?

Trust in family has diminished to the point where sons and daughters are seen as a safeguarding risks not support for the elderly

And when a new generation of workers feels no shame in alleging it’s parents have benefited at its expense, resenting money spent on pensions and age-related benefits – who can blame us for fearing the kids think we are better off dead?

Then there is the purpose and quality of health care.

For generations as we approach life’s end, our expectations, has been that our death will be ‘assisted’ in the sense that we will help to live our final hours with required medicines help our physical pain care for us, to calm our anxieties. Palliative care teams, hospice care take on the role that antenatal care has in birthing. Yet memories of care-staff serial killers, allegations of COVID cover ups, health care fundings and other failings strip confidence and trust from those whose job should be to provide professional support.

Can we really trust the NHS to provide what we need to ease our dying when its indices of failure are so many.

And so having lost faith in the institutions and people whom we need to trust we seek to assert our own control over our own death.

We aim to tame the terrifying uncertainty of the unknown by framing death as a matter of choice. We try to mask that we have no control over a certain end, by determining the timing and the manner of our end.

This Bill is such an attempt to take control. It born out of fear that a good death is one that is planned for, prepared for an executed before life gets out of hand.

It is born from the death of trust that those who love and care for us will aid us. It is born from a loss of trust in our own ability to cope with our dying.

German author Hans Feluda was right in this 1930’s novel to conclude that ultimately everyone dies alone, We die alone in the sense that no one passes with us.

But in a sense, we die – as we born – in a value-based society and of which we and others have expectations.

Sometimes those standards fall short of the mark but properly, that would generate a social consensus that we should raise them, not abandon them.

If palliative care and hospice care at the end of life need improvement, then let’s improve them. If medical staff are scared to administer pain relief to the dying fearing allegations that they ‘hastened’ death, then we need to address that fear.

The problem we need to fix is the problem of Trust and faith – not just in institutions but in each other.

A Bill that legislates for state-sanctioned killing of a few does not have to be a ‘slippery slope’ to the state-sanctioned killing of the many for it to be a problem.

It is already an expressivist statement that the best we can do to value the lives of those passing out of live is to hasten their journey. That confers no value at all.

• Ann Furedi is the former CEO of BPAS and author of “The Moral Case for Abortion: A Defence of Reproductive Choice”

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