By Polly Toynbee (THE GUARDIAN, 12/05/06):
My Lords temporal, today is the day to rise up against the regiment of Lords spiritual and proclaim the values of enlightenment, compassion and common sense. All you peers of sound and rational mind, delay your weekend plans and turn up to vote this evening.Today at 5pm a cabal of bishops, rabbis, imams, Catholics, evangelicals and other believers is organising a coup against the assisted dying for the terminally ill bill. Civil-rights lawyer Lord Joffe's bill would allow the dying to be given drugs to end their lives. But the religious are trying to shut down this debate, to deny the Commons a chance to discuss it. The right to die is a popular cause, so killing it off quickly on a Friday evening is their best chance.
Today is not the day when the issue itself will be decided. Today is the day when the forces of superstition will try to cut off any further debate. But then democracy never was an ecclesiastical habit, which is why no religious leaders should be given seats, ex officio, in any reformed House of Lords. Today's behaviour may help focus on that anomaly, as the 26 bishops and the collective of other faiths try to stifle discussion of a reform that has for years had overwhelming public support.
Through virtually unprecedented procedural shenanigans, unless enough sane lords turn up to vote to keep the bill alive, the religious will kill it off. By convention, private member's bills such as this are never voted out at second reading. (The last time was eight years ago on the welfare of pigs. Since then 105 private member's bills have had second readings without a division.) The Lords select committee on the bill agreed unanimously that it should proceed to a joint committee of both houses. Shamefully, some on that committee have reneged - the Bishop of St Albans, Lord Carlile and Baroness Finlay. Having lost the argument with the public, they prefer to shut it down.
In the polls, over 80% support the right to die and have done for the last 25 years. Even 80% of practising Catholics and Protestants support it, plus 76% of Church Times readers. Take with a pinch of salt that vote by the Royal College of Physicians claiming 76% of doctors oppose the bill: only 3,741 voted against it out of an electorate of 16,000. In any case, doctors don't know best. When the end comes, each of us knows best.
So many bills come and go through parliament with great sound and fury signifying nothing much. But here is one that could relieve untold suffering and much fear. As people grow old and their friends die one by one, they see so many needlessly bad endings. Most people come to fear not death itself, but the many terrible ways of dying. So much more attention and campaigning has been given to the idea of the "good birth", with all those classes to prepare. Yet the good death is rather more important: it lasts longer and, as with birth, the worst suffering is largely avoidable.
The small but vociferous campaign Dignity in Dying (once the Voluntary Euthanasia Society) is up against the Care Not Killing alliance, which has an annual income of £11.8m, not counting large subventions from both Anglican and Catholic churches. The Catholics boast that this is their biggest campaign ever. They have sent out 500,000 DVDs, claiming the old will be slaughtered in their thousands by greedy relatives while the NHS dishes out suicide pills to purge aged bed-blockers. There will be no more palliative care, they claim, when doctors can simply kill people off instead. Yet still public opinion has not budged. People want the right to die at a time of their own choosing. Too many families have watched helplessly as a relative dies slowly, longing for death.
Virtually every speaker against the bill in the last Lords debate was religious. The devout Catholic Baroness O'Cathain gave the game away when she blurted out angrily: "I have been advised not to mention the Christian faith. I regard that as almost unbelievable." The whole tenor of the debate was coloured by the Bishop of London's mantra that "we are not autonomous beings". Only God can dispose of life and death. We must await His call in what may be His torturing antechamber.
Jane Campbell, writing on these pages this week against the bill, is severely disabled, but she not only loves her life, she is one of social care's most effective advocates. No one who has met her could fail to admire her vitality and sharpness of brain. But she regards the assisted dying bill as a social threat on a slippery slope towards extermination of the inconvenient. She is dead right about everyone's right to the best care possible at every stage and condition of life. But she should be in there supporting this bill too. For the right to have control over your own body and your own life that is at the heart of disability campaigns is the same principle as the right to die with dignity as you wish. The best care on earth cannot prevent us all dying in the end. In the final months each person finds out for themselves what they can and can't tolerate. Thresholds of pain, indignity and incapacity are entirely personal. It is not for officious doctors, let alone cardinals and bishops, to deny us that last right to choose when enough is enough.
Lies have been told by Care Not Killing about Oregon, where a Death with Dignity Act allows assisted suicide. They claim palliative care has withered, but evidence to the Lords committee showed that, on the contrary, it has become the best care in the US, with an absolute right to it for every citizen even in the most remote areas. Openness about death has led to greater care about all aspects of dying. Research suggests Oregon now has no illegal help with dying, unlike the blurred medical distinctions here: a transparent law makes everything clear for doctors too. Of the first 240,000 deaths, only 246 of the dying actually used the Oregon law, but knowing there is an escape in extremis takes away much fear of death.
This bill has strong safeguards. It is not euthanasia, not an advance directive in case of future mental incompetence. It only allows those within six months of death who are of sound mind, as certified by two doctors, to request self-administered drugs, once they have had a palliative care consultation.
My mother begged doctors to end her life. She was beyond the physical ability to swallow enough of the weak morphine pills she had around her. When she knew she was dying I promised to make sure she could go at a time of her choosing, but it was impossible. I couldn't help. Since writing about it, I have had so many stories from others appalled to find that even the best palliative care (which my mother certainly had) may not end pain. Don't imagine death comes gently on a cloud of morphine: often it is slow, with the indignity of excruciating morphine-induced constipation. (Bishops never mention that.)
Palliative-care doctors tend to be against this bill, claiming they can fix everything. But often they can't. I don't know if, like Mother Teresa, those who choose to work with the dying may be religious-minded. But it worries me if they think that they are the best judge of what is bearable for each of their patients. Infantilisation of the dying is one reason why people facing the end want to choose when to go, with their sanity and dignity still intact.
So, you Lords, rise up! Give us a universal right to a good death - or at least the chance to debate it.