Church of Scotland's position on the proposed End of Life Assistance Bill.

The Church of Scotland today urged MSPs to reject the proposed Lend of Life Assistance (Scotland) Bill, to be debated in the Scottish Parliament on Thursday 25th November.

Rev Ian Galloway, Convener of the Church and Society Council of the Kirk drew the attention of MSPs to the Committee which has undertaken intense scrutiny of this proposed legislation. He said: “The conclusions of the Committee are unequivocal: no change of the law in this regard is either required or desirable, as they say in their report that “the Committee was not persuaded that the case had been made …and, accordingly, does not recommend the general principles of the Bill to the Parliament.”

The ELA Scotland Bill proposes that, under certain circumstances, assistance to end their lives should be allowed for those who wish to. The Church argues that any legislation which endorses the deliberate ending of a human life undermines us as a society. The worth and dignity of every human life needs to be emphasised and celebrated; in particular, the deliberate ending of life would be a matter to be deplored if person was perceived (or perceived themselves) as merely a burden.

Legislation of the type proposed in the End of Life Assistance (Scotland) Bill represents much more than simply a tinkering with the law. Breaching as it does the societal prohibition on the taking of human life, it carries implications for attitudes to many aspects of health and social care, not simply for the determined few who are pushing for change.

Rev Galloway continued: “An important aspect of our life as a society is in caring for the most vulnerable in society. While we are sympathetic towards the fears and desires of those who may be afraid of a painful death, what is proposed in this Bill is not the solution. Rather, there is a necessity to ensure that, as far as possible, all have access to good palliative care, which, in the widest sense, involves caring not just for the physical but also the emotional and the physical and spiritual needs of people coming towards the end of their lives.”

Scots End-of-life Bill could lead to 1,000 deaths a year

Scots End of-life Bill could lead to 1,000 deaths a year. These are really stark projections of people presumably willing to commit suicide per year in Scotland. Palliative care nurses are also warning that if passed, this legislation would bring into Scotland, people willing to end their lives, pretty much in the same way as people travel to Switzerland. Cristina Odone, from the Centre for Policy Studies, has recently published a report starting that this legislation would make elderly and frail people extremely vulnerable to succomb to pressures for assited suicide. If life is considered expendible, because some people cannot contribute on economical and social terms to society, and there is a lgeal way of ending such lives, there might always be the temptation to view suicide as a normal way out. However, this position is not acceptable within a Christian outlook on life, that values everyone's contribution to society and that considers life sacred.

Nurses to express their views on end of life issues

Nursing Times has developed an online questionnaire asking nurses about their feelings and experience around assisted suicide. the purpose is to gain a comprehensive picture of how nurses deal with this difficult issue in hospitals, in the community, in hospices and nursing homes. The survey is anonymous and the full results will be reported in an issue of Nursing Times and on www.nursingtimes.net soon.

If you are a nurse, please fill in the questionnaire and express your views on this important subject. It is crucial to have all medics on the front line od this difficult subject express their opinions.

The End of Life Assistance (Scotland) Bill: Views from the trenches. Part 4

This posting is the fourth and final part of the article that Dr Stephen Hutchison MD FRCP(Glasg, Consultant Physician in Palliative Medicine at the Highland Hospice has written on the End of Life Assistance (Scotland) Bill.

The doctor is also responsible for determining at any stage in the process, including during the final act, whether any comment ‘however informal’ by the person indicates a wish to stop the process. How does a doctor qualitatively evaluate statements or questions in this context? For instance, do expressions of hesitation or doubt, or concerns about the family, constitute informal revocation? Can any assurance be given that where hesitation is expressed to someone else that this is passed on to the doctor, rather than suppressed with well meaning or malicious intent? In the context of the decision in hand, how can a doctor determine with the required confidence what would and what would not amount to an informal revocation. So not only is this a vague ‘safeguard’ it actually prejudices the care of anybody going through the process, because it inhibits open dialogue with the doctor which is so important when approaching death.

So, as always, there are two sides to the argument. Although there are some strident campaigners, for the most part those on each side approach the issue with compassion at heart and we should acknowledge that. If you favour this legislation, you have to address its inadequacies. And if you oppose it, you have to recognise that you are left with very difficult questions about personal choice and suffering. Let’s avoid arrogant, polarised, gut reactions. Alienating the opposition makes good journalese but doesn’t encourage informed, intelligent debate. Our politicians are exercised by this issue and public ranting doesn’t help them. They have a free vote when it comes to parliamentary debate. We always tend to think that they have a responsibility to us, but forget our responsibility as constituents to let them know what we think. Why not write to your MSPs and give them some constructive thoughts about this issue?

The End of Life Assistance (Scotland) Bill: Views from the trenches. Part 3

This posting is the third part of the article that Dr Stephen Hutchison MD FRCP(Glasg, Consultant Physician in Palliative Medicine at the Highland Hospice has written on the End of Life Assistance (Scotland) Bill. The article will be posted in 4 parts to facilitate reading.

The House of Lords Select Committee made several recommendations to guide the drafting of legislation about assisted dying. It would have been wise to have accommodated these when drafting the present Bill, but unfortunately they have been largely disregarded. The Bill does not draw a clear distinction between assisted suicide and voluntary euthanasia or set out clearly the actions which a doctor may and may not take in either case. There is no guidance whatsoever on what a doctor may or may not do, or agree to, in bringing about the person’s death. It does not adequately address the need to identify psychological or psychiatric disorders. Whilst the wording regarding prognosis in terminal disease is an improvement on previous legislative attempts, the Bill does not acknowledge the everyday clinical realities of prognostic inaccuracy. It does not focus on unrelievable suffering, but only on intolerability. In making provision only for discussion of palliative care, the Bill does not require patients to experience such care before taking a final decision. And finally it makes no allowance for conscientious opt-out for doctors.
I mentioned safeguards. The Bill requires a staged formal process, with stipulated discussions at each to determine that the person knows exactly what they are asking for, is aware of the alternatives and that they can stop the process at any time. Two psychiatric assessments are required, but it is permissible for both to be conducted by the same person, who is only required to report that the patient is acting voluntarily and with capacity, and not on how appropriate it is to continue with the process. The decision as to whether the process should be carried through rests solely with the designated practitioner. Approval of the second request must be by the same doctor who approves the first. It is a stretch of the imagination to construe this as an independent second opinion! The doctor is expected to ensure, at several points in the whole process, that the patient is not acting under undue influence. There is no indication as to how this should be determined, or of what amounts to undue influence. Is it enough to ask the requesting person? Will that also require a formal statement? The witnesses also have to attest that the requesting person has not come under undue influence. Yet again there is no indication as to how this should be determined. What enquiry are the witnesses required to undertake? How would reliability be assured? What happens where there is a conflict of opinion amongst all these people about the influence? It is impossible to ascertain undue influence, because the influences under which we function are many and varied, internal and external, and can be very subtle. Doctors are used to dealing with uncertainties. Clinical judgments are not always binary – yes or no. But when the outcome is deliberate action to end a human life, the opposite principle to that under which doctors currently work, uncertainty cannot be entertained.

The End of Life Assistance (Scotland) Bill: Views from the trenches. Part 2

This posting is the second part of the article that Dr Stephen Hutchison MD FRCP(Glasg, Consultant Physician in Palliative Medicine at the Highland Hospice has written on the End of Life Assistance (Scotland) Bill. The article will be posted in 4 parts to facilitate reading.

Dignity in health care has come to be synonymous with assisted dying. The Voluntary Euthanasia Society is now called Dignity in Dying, and if you go to Zurich to end your life, it is to the Dignitas organisation. All political attempts to legalise assisted dying base their case on dignity. The MacDonald Bill, as you can see, does the same, but doesn’t define dignity, or explain why it should be enhanced by the Bill.

Dignity is a complex social construct, involving honour and esteem, merit, grace, relationship and dependence, who we are and how we behave. There are ways of identifying factors which compromise dignity in health care and good evidence on how to enhance it. Dignity is cheapened by simply equating it to assisted dying. Arguably the MacDonald Bill diminishes dignity in dying because of the requirement to submit to a formal protocol, with numerous consultations, scrutiny of one’s mental health, within a short time frame and without the opportunity to discuss hesitation or distress lest that should be interpreted as a wish to stop the process, all at a time when life is already deemed to be intolerable!
So what about choice and autonomy? Isn’t autonomy a basic human attribute? Dictionary definitions of autonomy include; ‘Freedom to determine one’s own actions; to govern our will by our own principles and laws; to make choices regardless of the influence of, or effect upon others’. Proponents of assisted dying say that we should be free to make our own choices about these deeply personal issues, without having to defer to anybody else. But if we think about it a bit, is there anything we can do or decide, trivial or important, which does not have a potential or actual effect on others? In reality, is autonomy not a limited concept? Maybe it is actually a myth! We are in fact created and designed to be relational and interdependent and our very dignity is intrinsic to that. Choice is something we do have, but we must choose responsibly.

Margo MacDonald’s Bill recognises that people can come under inappropriate influence, and it describes safeguards to prevent this. Scrutiny of the safeguards reveals inadequacies, but that is not the point I want to make here. What I want to say is that when people are seriously ill or incapacitated, they are particularly vulnerable to internal and external influences. The availability of the choice for some to have their lives ended would create a powerful societal influence which would place others – a greater number of people - at risk. Exposure in the course of debilitating and terminal illness to the very influences created by this Bill would increase the risk to a vulnerable majority. One individual insisting on the right to die will affect others. When people say that life and death are individual matters, they are wrong.

What does the Bill propose? To summarise, if it should become law in its present form, it would be legal, under certain circumstances, to assist a requesting person to die, or to help someone else to assist the person to die. It is usually assumed that such a procedure would be carried out by a doctor, but this Bill makes allowance for this to be done by lay people who meet certain eligibility criteria, and provided a doctor is present. The requesting person must be at least 16 years old, with either a terminal illness with a life expectancy of six months or less, or a physical debility which renders them unable to live independently, plus they must find life to be intolerable. The formal procedure includes two independently witnessed written requests by the person, assessments by the doctor to whom the request is made, assessments by psychiatrists, discussion with the doctors about the illness or disability from which the person suffers, feasible alternatives to assisted dying, the means of causing the person’s death, who should do it, where it should be done, and the option to stop the process at any time.

Given that the doctor is the only professional mentioned in the Bill and related documentation, it is reasonable to assume that the doctor will be responsible, not only for clinical assessment and drug administration (assuming that to be the chosen means of ending life), adjudication of the degree of dependence caused by a disability and the level of intolerability of life arising from this or from a terminal illness but also for scrutinising the credentials of the witnesses, and determining that the eligibility criteria of witnesses are met. The Bill is completely silent on the means by which death is to be brought about, as this is left to the supposed expertise of doctors. There is no opt out for doctors who conscientiously object to assisted dying, and referral to a willing colleague is obligatory. It is therefore possible that the requesting person could end up being assessed by a doctor who does not know them, and who would certainly have some difficulty assessing the degree of intolerability, and the level of influence under which the person is acting, let alone the legal ins and outs. And as far as the legal side of things is concerned, it is interesting to reflect on the comments of Julia Cumberlege, former health minister, House of Lords, who said; “The medical profession is there to treat, cure, and care for sick and disabled people. Once lawyers get involved the whole premise changes: bitterness, strife, and serious money take over, families are divided, and suspicion reigns. Doctors should steer clear of assisted suicide—or more accurately of putting people to death—if they want to retain the trust of their patients.” This Bill depends largely on the cooperation of doctors to make it work, but there has been no prior focussed consultation with the medical profession. Moreover there doesn’t seem to have been any thought about the level of competence a doctor would need before providing this service, how doctors will be trained for that, or about personal and professional support for those who are willing to be involved. Nor have similar needs for lay people been considered.

Continued on next posting...

The End of Life Assistance (Scotland) Bill: Views from the trenches.Part 1.

We are very fortunate to be able to publish an article that Dr Stephen Hutchison MD FRCP(Glasg, Consultant Physician in Palliative Medicine at the Highland Hospice has written on the End of Life Assistance (Scotland) Bill. The article will be posted in 4 parts to facilitate reading.

Some people because of actual or anticipated physical or existential suffering will wish to end their lives, and sometimes people with serious and incapacitating illnesses do not receive an adequate standard of care. However, it is justified to conclude from this that we need the facility of legalised assisted dying?

Most of us have strong opinions about this. We tend to adopt deeply entrenched positions, shouting from one side about suffering, choice, autonomy and rights, and replying from the other with a sort of “Thus saith the Lord: Thou shalt not kill, and nothing more need be said” approach. Maybe it is difficult to find a middle ground here, and I suppose I am in my trench too, but it is important to appreciate the view from the other trench, so that this complex issue gets more than the knee-jerk response we usually hear. We need to avoid knee jerk responses ourselves – it isn’t just others who are guilty of that.

Most of us hope to avoid severe suffering, and in that event, the option for life to be ended humanely has appeal. Many doctors, including me, facing terminal care situations where treatment is not providing sufficient relief will have been attracted by the idea of being able to gently end life and bringing release. Sometimes the distress of life’s circumstances is beyond anything that a doctor can address. One of the fundamental things about being human is that we have choice. Choice, autonomy and dignity are buzz words nowadays. When presented on the one hand with unbearable pain, loss of control of bodily functions or dependence on others for basic care, and on the other hand to have the option for our lives ended with dignity, the choice seems obvious. How could anyone think that option was wrong? And can we not devise safe legislation to enable the inclusion of this ultimate act of compassion into medical care? These are difficult questions. Glib answers don’t convey much love and compassion, and the sort of right wing intolerant so-called Christian responses I sometimes hear on radio phone-ins are particularly irritating. For goodness sake let us recognise the real challenges around this issue, and Christians in particular should be avoiding un-Christ-like hard hearted responses.
We need to approach this issue compassionately, but also intelligently. One of the problems with public opinion is that people have not been well informed about what exactly such legislation would mean for patient care, and for society generally. The report of the House of Lords Select Committee, set up to comment on Lord Joffe’s recent attempts to introduce assisted dying, contains an extensive section about public opinion. It concludes that the issue of assisted dying is extremely complex, and that the real views of the public are obscured by inadequate information and appreciation of the implications of such law, for themselves and for society. Current public opinion, whilst generally in favour of assisted dying, is largely superficial and does not have sufficient rigour or quality to guide legislative change.

The policy Memorandum accompanying Margo MacDonald’s Bill mentions several distressing instances of suffering. They certainly should distress us. However, it is a matter of fact that people usually think they would like assisted dying to be available just in case they get severe pain, or other symptoms, in a terminal illness, rather than the actual experience of these. In other words it is fear of pain rather than actual pain which underlies the request. People experiencing terminal illness have a similar spread of opinion as the wider public. Of those who do express the wish for their lives to be ended, many have depression. Anecdotally, others change their minds once they have received good palliative care. So when I read about pain, distress and suffering in the Policy Memorandum, I wish I had more information about the level of care these patients received, and if it wasn’t good enough, I want to know why – because in the UK we have a magnificent standard of palliative care and that should have been available. We also need to be a bit careful about the assertions in the documentation that assisted dying goes on under cover anyway and it would be better to legalise and regulate it, and also that is compatible with palliative care. There is good evidence that doctors in the UK rarely engage in such practices, and if we look at the definitions of palliative care as well as the experience of palliative care practice in societies where assisted dying is legal, the claim that the two are compatible becomes less than convincing. The debate on assisted dying will inevitably be passionate, on both sides, but we need to be careful how we interpret evocative anecdotes about suffering, and not take everything at face value. We need to subject the information we are fed to careful scrutiny if we want to develop an intelligent opinion about this.

Margo MacDonald’s Bill declares its purpose as the “provision or administration of appropriate means to enable a person to die with dignity and a minimum of distress”. The wording sounds wholesome, and implies that the Bill makes provision for this. But provision for that is already made in health care, and palliative care in particular is directed to precisely these objectives. Opponents often say that we should call a spade a spade – this is killing and we should use that word. That may be true but it sort of implies a callous or murderous attitude, and whilst one of the undoubted dangers of such legislation is the potential for malicious motivation, compassion for the requesting person is likely to be the predominant influence. Maybe it would be more honest, to describe the purpose of the Bill as the legalisation of intentional ending of life.

.... Continued on next posting.

Choose Life Programme.

Suicide is one of the principal causes of death for young people in industrialized countries, including Scotland. An advertisement will be aired in prime time television highlighting the need for everyone to support individuals contemplating suicide. The ad mentions that help might be as close as your nearest cabbie or your hairdresser and goes on to propose that people from all walks of life can be trained in providing help to potentially suicidal people. The ad is part of the Scottish Government’s Choose Life Programme, which is a 10 year plan aimed at reducing suicides in Scotland by 20% by 2013.
Rev. Ian Galloway, Convener of the church and Society Council mentioned in his blog that suicide is everyon'es business and that the Choose Life programme with its emphasis on early intervention and provision of initial help by trained members of the public was to be commended. It should be noted however, he continued, that there are many potential reasons for young people to become suicidal and that the advice of trained professionals and counselling staff carries the weight of evidence-based research.

Briefing paper on End of Life Assistance Bill

The Scottish Churches Parliamentary Office, SCPO has provided a very interesting briefing paper on the End of Life Assistance Bill. It provides wonderfully clear background reading on the Bill. Please follow this link to read the full text.

Is there a bias in BBC coverage about right to die?

The BBC has been accused of pushing the ‘right-to-die’ agenda by giving hours of airtime and leading news bulletins to the opinions of campaigners and publishing the results of opinion polls in a selective way. The BBC website has presented the views of celebrity fantasy fiction writer Terry Pratchett (last night’s Dimbleby lecture) and Mrs Kay Gilderdale (last night’s Panorama programme produced by Jeremy Vine) without giving similar space to opposing opinions.

If you care strongly that other views on this crucial issue be heard, please complain to the BBC about the bias of the coverage, and about the way that the views of disabled people in particular have been marginalised in a debate which affects them so personally. The complaints form can be accessed here.

Alternatively phone them on 03700 100 222 or write to BBC Complaints, PO Box 1922, Glasgow G2 3WT

Choosing Life, Choosing Death, book review

Dr. Murdo Macdonald, Policy Officer of the Science Religion and Technology Project, has sent us a link to to a book review that addresses important issues in our understanding of the reasons behind an educated choice against assited suicide. It’s a review of a book, “Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law” by Charles Foster. A couple of quotes from the review (I haven’t read the book itself...!)

"(Autonomy)… is commonly translated in the legal arena in positive terms of self-determinism and negative constraints of non-interference…..autonomy has arguably established itself as the dominant principle in medical ethics, operated above all else. This 'tyrannous' rule of autonomy is Foster's subject matter"

“Foster argues that autonomy, as a guiding principle, is at best unhelpful in determining a course of action (it lacks the prescriptive function the law so requires) and at worst leads to unsavoury conclusions.”

Assisted Suicide & the Value of Human Life

Margo MacDonald will be presenting to Parliament a Bill in draft form to legalise assisted suicide in Scotland. She has been a long campaigner for this issue and managed to secure the necessary support to prepare the Bill in draft form. Lord Advocate the Rt Hon Lord Advocate Elish Angiolini QC stated that legal guidelines on assisted suicide will not be prepared in Scotland despite of announcements on the law south of the border. "It is important to recognise the different legal landscape in Scotland, where involvement in a suicide might amount to homicide, as well as a different system of public prosecution". She said that any change in the law should “properly be a matter for the Parliament”. We are against a change in this law.

Palliative Care Bill

End of Life issues are on the agenda at the Scottish Parliament this month. Gil Paterson's proposed Palliative Care Bill has gathered enough support from MSPs to be taken forward. The draft Bill can be read here. The Scotsman published an interview with Mr. Paterson where he discusses his reasons for proposing the Bill. We are supportive of the principles of this Bill.

End of Life issues Presentation and Service

Last night I was at the evening service at St Andrew's Parish Church in Bo'ness where members from churches in the neighbourhood met to listen to a talk on end of life issues by Dr. Murdo Macdonald. Dr Macdonald is the policy officer of the Society, Religion and Technology Project at the Church of Scotland. He presented us with a much needed update of the current legal framework for assisted suicide in Scotland and the differences between the Scottish position and the position in England. His comments were based on the End of Life Issues report to the General Assembly last year.
After the talk, there was the possibility for questions and also prayer as some of the issues talked about were intensily emotional.

The Voluntary Euthanasia view on the Living Will

The VES wishes to make the provisions of a living will binding upon the medical staff involved. They see this as a first step towards fully legaliseing eithanasia and, for the same reason they wish to see a proxy document separately legislated for, as a separate deed from a living will. No Will can 'work' without the appointment of an executor. the appointment if a 'health-care proxy' to be in effect the executor of the living will would greatly assist the effectiveness of such a document.

At present, only the person making the living will has the right to enforce it, and he is by definition incapax (incapable of making valid legal decisions). To give treatment against the expressed wishes of the patient, however, is already assault at common law, and there is therefore nothing to prevent the patient refusing in advance. The wisdom of restricting the judgement of the doctor responsible for care at this sensitive time of life is a matter which would require careful consideration. The style of living will published by the EXIT, the Voluntary Euthanasia Society of Scotland (VESS) proposes the appointment of a tutor dative (an agent appointed by the court) by the Court of Session, but this is a cumbersome and expensive procedure.





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Living Wills

An Advance Directive, is a document in which an individual lays down instructions as to health-care management and treatment to be applied in the event of their incapacity to make such decisions or convey such instructions at the time of occurrence of the circumstances envisaged. In different states in the USA there is some diversity of definition between 'Living Will' documents, 'Advance Directives' and 'health-Care proxy' documents, but the Voluntary Euthanasia Society (VES) in a careful study of the matter perceives no need to impose such distinctions. They suggest that 'Living Will' is a concept sufficiently understood to be generally used.

The Limitations of a Living Will

The popular view that a will is inviolable is not true, even in the case of a property will, and conditions which are contrary to established law or public policy cannot be enforced. This is certainly the case in the Living Will instance, since such a will cannot instist that a doctor or anyone else should put the Will-maker to death.

What do doctors think about Living Wills?
The medical view as expressed by the British Medical Association, is that a Living Will may be welcomed as an opening for the discussion of the difficult questions raised by terminal illness, and considerable use has been made of them in the context of AIDS care and counselling. neither the BMA nor the AIDS support agencies, the Terence Higgins Trust and Milestone House, nor the Association for Palliative Medicinesee any need for legislative change.





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Biblical Truth and the affirmation of Life

"No one can keep himself from dying ort put off the day of his death. That is the battle we cannot escape; we cannot cheat our way out".

Legalisation of euthanasia will not produce a solution to the needs of the individual sufferer; or address the health-care challenges of contemporary society. It is the expression of an attitude to life which belittles the sovereignty of God, diminishes the importance of sustaining relationships, and inhibits the pursuit of life-affirming answers for people in need and distress. Christians must be active in promoting positive alternatives derived from Biblical truth, so that the momentum toward intentional killing may be curbed. The Church of Scotland has an obligation before God to assert God’s interest in life, rather than in death; to exercise Christian compassion towards the sufferer, the disabled and the dying; and to encourage the relief of symptoms and improvement in the quality of life for such people. The Church cannot support euthanasia as a means to anything of these ends, and rejects the introduction of death as a treatment option in any clinical situation. Jesus said: ‘I am come that they may have Life, and that they may have it more abundantly’ (John 10:10). This declaration applies at the end of life or in the midst of distress, just as much as it does in any other circumstances, or any other time.




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How do we go about caring?

In the previous post we spoke about Christian actions in caring for at-risk people. In this post we will be providing examples of practical actions.

We can

1) Provide spiritual, emotional intellectual and physical support for the sufferer and for carers, who may be themselves 'fellow sufferers'.

2) Help to patients and carers in defining their own needs.

3) Emphasise that a relationship is being developed by the patient, the carer, medical professionals and God. This relationship is developed in the positive context of Christian HOPE. The Church can and should be taking this as a challenge since it is a matter of 'coming alongside to help'. 'Paraclete' (one called alongside to help) is the word for, and the work of, the 'Spirit of God'. 'Bear ye one another's burdens and so fulfill the law of Christ'. (Galatians 6:2).

4) Provide consistent and practical support for care establishments.

5) Facilitate the extension of the care principles applied in specialised contexts to general hospital and home care and practice. Hospices and specialist care establishments are only part of the answer.

6) Provide regular visiting and supporting the terminally ill or disabled in their homes or in hospital and meeting their specific needs as they become apparent. This si clearly as relevant for the spiritual needs of people in serious or terminal illness is as essential as the physical ministrations of medical or nursing professionals.

7) Make use of Christian 'homes'. The Lord commended this to His followers with the words 'I was a stranger and you took me in'. as well as 'I was sick and you visited me'. The CARE Home programme addresses rthis concept and relief has been given sometimes to terminally ill people themselves, but, more often, to their carers who are in need of respite. The Good Samaritan is a firther example of someone who while he did not use hos own home to receive the injured man, did apply first aid and paid the hotel charges and the treatment costs.

8) Campaign and motivate those in local and national government to improve resources; to stimulate professional bodies and organisations to take an interest in symptom relief as much as in cure; and to demand a positive alternative to the so-called 'easy option' of euthanasia, 'masterly inactivity', or therapeutic nihilism.


Credits
The photograph of the Good samaritan's stained glass window was taken by Lawrence OP.






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Christian Action in Caring for At-Risk People

It is not enough to oppose the progression of pro-euthanasia arguments, nor simply to oppose voluntary euthanasia societies and similar bodies. If the Church is not say 'no' to euthanasia, it must be ready to say 'yes' to life-affirming alternatives. The Christian Gospel is a Gospel of HOPE and in particular of hope in the context of death and hopelesness. In the situation of terminal care the challenge is to bring effective relief within the context of Christian hope. It has been characteristic of the Church though the ages that it has been in the forefront of work for the suffering, the dying, and the hopeless. The hospice movement owes its existence largely to Christian initiatives which, while they have been followed by secular involvement, remain a positive motivation.

The roots lie in the need for Christians to do, rather than merely protest. A belief in the eternal worth and dignity of human beings is the mark of the Christian since the Lord Himself gave the worth of His own life and death to each one and afforded us the dignity of His eternal love.

Where the elderly, the disabled, the dying and the dementing are held in respect as fellow human beigns, they cease to be seen in negative terms. They also cease to be seen as an alien 'other' kind of person for whom the best thing is to give up on life, but are valued as individuals and to the Christian as individuals for whom Christ died. To quote from Dr. John Wyatt, a prominent paediatric specialist:

In summary, Biblical Christianity does not devalue individuals becuase of their disability. In fact, from a Christian perspective, all of us are disabled in some sense.... and the differences between us are therefore only iun degree. The essence of humanity is not in our functional ability, which may be impaired rto a greater or lesser extent, but in our creation as beings made in God's image. Functional impairment in itself does not impair our dignity or worth as human beings. The central purpose of human life is seen not in the selfish pursuit of pleasure through use of our bodily functions, but in mutual loving relationships with others and with God Himself. In Christian terms it is these personal relationships of love and self-giving which give life its 'quality'. (Survival of the wakest: CMF Publication).

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The Christian Response

We have been discussing issues relating to the availability of euthanasia for children. It is therefore appropriate to ask what is the Christian approach to this difficult topic. The traditional Christian approach is as follows:

1. Palliative Care with response and resources and higher motivation.
2. Better communication in respect of the child, taking account of the need for counselling and a recognition and respect for the child, equally, as a person formed in the image of God.
3. Valid motivation: the phrase ‘compassion mingled with respect’, attributed to Mother Teresa, perhaps sums up the most constructive attitude and is very much in keeping with the spirit of the Lord’s words – ‘In as much as ye did it unto one of the least of these, my brothers, ye did it unto me’ (Matthew 25:40). The irreducible minimum of care was defined as – fluid and nutrition, analgesia and tender loving care (TLC). If a community is to claim to be civilised, it must care for its disadvantaged.

Here are some references if you wish to read more on the subject.

H Tristram Engelhardt, A Smith Iltis (2005)
End-of-life: the traditional Christian view.The Lancet.

RM Hare(1975)
Euthanasia: a Christian view.Philosophic exchange





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