A seasonal reflection from Fiona

Fiona wrote:

"The pioneering hospice revolution shows us the way to serve those at the end of life.

As the cold nights draw in, and as families gather to celebrate Christmas together, it is an important time of year to remember those who find themselves in the most difficult situations – difficulties to which the season may provide comfort, but not respite.

Amongst them, are those facing terminal or chronic illnesses. Coping with terminal illness is distressing and difficult both for the patient and their families. Their cases are truly moving and evoke the highest degree of compassion and emotion.

In these difficult situations, it is right that we continually ask what more can be done to help those suffering. We should therefore be proud of Britain’s pioneering work in this area. The Hospice movement may have been a quiet revolution, but it is one of the most compassionate and innovative revolutions of the past century. It began with Dame Cicely Saunders, a volunteer nurse who, from 1948, committed herself to training as a doctor and understanding the issues surrounding care of the dying. As she cared for and got to know patients at the end of life, and saw how hospitals often found it hard to treat long-term terminal patients, she began to recognise the need for a place specifically to provide end of life care.

Just 51 years ago, there were no purpose-built hospices. But from the founding of the first hospice in 1967, this movement has spread across the country and across the world – changing for the better how we care for those facing life-limiting illnesses. I am proud to be a Vice President of East Cheshire Hospice. The expertise, care and compassion they show on a daily basis is a tribute to them and a great service to our local community.

One question sometimes raised in response to the challenges of terminal illness is whether Parliament should legislate to allow doctors to assist some of their patients to end their own life. I know this is a question which interests many of the reader of the Chronicle, and so I thought I should outline my own views briefly.

The House of Commons looked in detail at this issue in 2015, culminating in a debate lasting over five hours, and a vote which strongly sided against legalising assisted suicide, 330 votes to 118. I was one of those MPs who spoke and voted against such a change, as I believe it would make vulnerable people less safe. There is sadly no perfect solution to the challenges of terminal illnesses and the end of life, but I do believe that the example of the hospice movement and the UK’s world-leading palliative care is the best way for us to serve those in these hard situations.

If, as a society, we made assisted suicide legal, we would be legitimising the fears and anxieties of so many sick and vulnerable people who worry that they are burden on those around them and on society more widely.

For every person that we might consider to have a clear and settled wish to end their lives, there are countless others who are vulnerable, despairing and often lacking in support who may feel under pressure – internal or external – to go through with this decision. At a recent event at the House of Commons, Dr Sandy Buchman, who had been brought over from Canada to make the case for legalising assisted suicide, admitted that, now assisted suicide has been legalised in that country, “coercion is a constant challenge and always will be.” This echoes the serious concerns raised with me by disability rights campaigners in the run-up to the 2015 vote on this issue.

This is the main reason that no major disability group favours a change in the law. This Bill legitimises the idea that suicide is a solution for disability and severe sickness. Where assisted suicide is legal around the world, the data shows that those who choose suicide are almost invariably disabled. But they need assistance to live – not assistance to die. As a compassionate society, our response to suicidal feelings must never be a lethal injection.

The promoters of this change in the law point to safeguards as the remedy to this problem. But, as years of debate on this issue in the House of Lords have shown, there is no safeguard that would be sufficient to stop a person who feels a burden on their family, friend or caregivers from ending their life; nor can doctors accurately assess this, or worse, pressure or abuse which does regrettably exist in certain cases. A doctor is not a detective and cannot reasonably be expected to investigate all of the relevant social factors involved in such a grave decision. That would take a close, consistent and long-term relationship which very few doctors have with their patients today.

I am also concerned that, as has been the case in other countries, legalising assisted suicide would lead to demands for legalisation of other forms of euthanasia. For example in Belgium, where in 2002 a euthanasia law was passed for adults, in 2014 a law was passed enabling children to be euthanised. The international precedents are therefore a cautionary tale for the UK, rather than an encouragement for us to follow suit.

In Britain, we lead the world in palliative care. Our response to the physical and emotional pain of terminal illness must be to show compassion by extending and developing this further. Not by letting people die when they most need encouragement and assistance to live. As evidence from other countries has shown, a right to die would for many become a duty to die, and we should therefore reject such a law for that reason.

Christmas reminds us that every human life is intrinsically valuable and deserves support, and Dame Cicely Saunders lived out this truth when she set up the first hospice in 1967. We should follow her example."