Podcast: Discussing Assisted Suicide With a Palliative Care Doctor

This article is part of the Affinity Talks Gospel Podcast series.

In this episode of the Affinity Talks Gospel Podcast, Lizzie Harewood and Graham Nicholls explore the pressing issue of assisted suicide with guests from the Christian Medical Fellowship (CMF) – Dr Sarah Foot, a palliative medicine doctor, and Dr Susan Marriott, CMF’s Head of Public Policy.

Together, they discuss the current legislative landscape, the theological and ethical concerns surrounding assisted suicide, and the far-reaching consequences of legalising it in the UK. What does it mean for vulnerable individuals, families, and healthcare professionals? How should Christians respond to this cultural shift? And how can we advocate for a society that truly values life?

With personal insights, professional experience, and biblical wisdom, this episode sheds light on a crucial debate and urges listeners to engage thoughtfully and prayerfully.

The Christian Medical Fellowship (CMF) is a community of 5,000 qualified and student members working in medicine, nursing, and midwifery across the British Isles. CMF unites and equips these Christian doctors, nurses, and midwives to live and speak for Jesus Christ. Find out more: https://www.cmf.org.uk/

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Topics addressed in this Podcast:

• The current legal landscape of assisted suicide in the UK – Updates on the proposed legislation and its potential impact.
• Ethical and theological concerns of assisted dying – A Christian perspective on the sanctity of life and why assisted suicide is a moral and societal issue.
• The impact of assisted dying on healthcare and society – How legalising assisted suicide could affect medical professionals, vulnerable individuals, and cultural attitudes towards life and death.
• The role of palliative care – The importance of holistic, compassionate end-of-life care as an alternative to assisted suicide.

Transcript

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[0:10] Hi, I’m Lizzie Harewood. Hello, and I’m Graham Nichols, and you are listening to the Affinity Talks Gospel podcast. You might be watching it too as well.

[0:21] Great to have you listening in, watching in. We are here to speak for a few moments about really the topic of assisted dying, but we’ve got a couple of friends from CMF, Christian Medical Fellowship, to help us think through the topic and just update us with what’s happening. So we’re very much looking forward to that. Perhaps you two could introduce yourself. We’ll start with Sarah and work on from there. Sarah, tell us a little bit about yourself. So I’m a palliative medicine doctor working in a hospice in Essex. I’m trained hospital consultant. So basically all the people, I mean everyone’s dying, but you’re dealing with people who are close to death all the time that’s your day-to-day day-to-day work.

[1:15] Yeah so um the phrase we use is uh living with a life-limiting illness so any illness that can’t be cured um we we will work with you to help you to live well uh to manage your symptoms and to die well yeah yeah i i have had very recent personal experience my father-in-law died in the autumn and so uh of of myeloma um so the whole palliative care process was was very present with him um right through to the last stages uh so i’ve got i’ve got some more immediate experience um with my other parents dying it was it was a different process but yeah so i can kind of imagine you as it in in the situation because we interacted with uh palliative care doctors and nurses through that process um although he stayed at home uh uh so yeah.

[2:08] Thank you for for that um and thank you for for being on board and um susan yeah so my name is susan marriott and i work for cmf and lovely to have sarah one of our members uh with us on the podcast as well so my role at cmf is i’m head of public policy um so i’m a doctor by background but i’m not actually working clinically at the moment i used to be a gp um at the moment uh yeah the job with cmf is looking at how we can equip our members and sometimes speak as well as kind of CMF as a whole collective on issues and where kind of health policy could be kind of shaped perhaps by a Christian worldview or we might have something to say to help people flourish through the policies that government or royal colleges or others put into place and so yeah that’s a part of what CMF does just one part and I work in that area.

[2:58] Yeah, lots of people in CMF seem to be either still practicing a bit or were practicing, which I suppose makes sense really, that you don’t get people from perhaps outside the medical profession who are in there. Yeah, we have one or two who are really valid, but yeah, a lot of the senior staff are former doctors or nurses or current doctors or nurses. Yeah, and just remind listeners, CMF supports who in a bigger sense? Yeah, so we support Christian doctors, nurses and midwives to kind of live out their Christian faith through their work. Very good.

[3:37] So on this subject of assisted suicide, I don’t know if perhaps one of you could kind of bring us up to date with where we’re at.

[3:49] Some of us might be familiar, some not, with kind of where the process is at. And then we could talk about some of the issues. so before you do that graham i just noticed that um in your kind of introduction to this you called it it’s a stid dying i know i make the mistake i call it something no no no i i’m i’m this this isn’t a point of order this isn’t how language it really but how we should actually talk about this you know as christians should we be should we be frank and honest should we be trying to humiliate our language around what’s happening here or should we in good faith kind of respect what the government is saying i just i don’t know as someone who’s very interested in language that’s something i mean but we can always come on to that a bit later but yeah go on give us the lowdown yeah i think that’s a really interesting point lizzie i think um i’ve tended to talk about the current bill in terms of assisted suicide um because it is amending the suicide act so that’s what the current bill in westminster is is looking to do so at the moment um assisting or abetting someone to end their life through suicide is against the law and the current bill is looking at making an exception to that in certain circumstances that they kind of limit in the bill so they’re looking at people who a doctor would say had an expected life expectancy of around six months or although one of the issues is that that’s obviously not very precise.

[5:14] And we could talk about that but yeah so it’s talking about a particular group of people but it is making an exception to this criminal law that currently exists about assisting people or abetting them. Yeah, I mean, just to say my preference is to say assisted suicide, but it’s so persistent in the brain that I find myself about half the time saying dying and then correcting it. I don’t know why. It’s just those neural links that have just been made that are really difficult to unmake. So I think in principle it’s better, but not to be too legalistic about it because in the end it is assisting someone to die, but it is better to say suicide. And I wonder, Sarah, yeah, because I guess a lot of what you do at work could be considered assisted dying in the sense you’re assisting people who are dying. Yeah, I think because.

[5:59] My patients are all dying either within hours, days, weeks, months, or years. And my whole job is about assisting them. And I think the confusion between assisted dying and assisted suicide is really real. I’d much rather use assisted suicide as what it is, call it what it is. I have to say, though, Graham, I have used assisted dying when I’m trying to have conversations with people who I need to have a conversation. I will use the language that other people are using so that I can meet them and at least have a discussion.

[6:37] So if other people are using assisted dying, I will use it in conversation so I don’t lose them on the first sentence. Is anybody surprised? I was slightly surprised. I was doing radio interviews about this for years.

[6:51] You know, just come up every now and then and I’d do a radio interview and you kind of think, and then suddenly it gained almost kind of momentum. And it’s a thing now, which slightly surprised, perhaps it’s not a surprise. Maybe it’s just a perfect storm of, of enough cultural acceptance plus a Labour government. But, It slightly catched me by surprise that it happened so quickly. The fact that a bill was brought forward that got enough time and that got enough momentum that quickly. Yeah, I guess it’s interesting that because of the way we kind of do politics in this country and these things being conscience votes, it’s never going to be in manifestos. And there’s lots of actually really good and healthy things about these sorts of issues not being made party political. But it does mean it can kind of go under the radar at election time and not be part of the discussion.

[7:39] So I think it wasn’t really discussed over the election even though some of the key players within some of the parties were very keen on this, so I think some of us who’d been following things did sort of expect that this parliament would be a ripe time to bring this bill but I guess we weren’t necessarily expecting it to come top of the parliament’s ballot at the very first sitting of the parliament so it did come very quickly in this new parliament So just to land so everyone knows where we’re at Where are we at sort of in legislative terms? Yeah, so this has been brought as a private members’ bill, and they’ve had a vote and a debate about the kind of principle of the bill. And for the first time in England and Wales, that vote has gone yes. So we’ve had other bills in the past, but it’s never got past that stage. So this is the furthest this has ever got in England and Wales. It doesn’t mean it’s definitely going to become law, but it’s certainly a significant step. And at the moment, they’re in the committee stage. So a selected group of MPs are discussing the bill in a bit more detail, looking at any amendments they might want to make to it and that sort of thing. And then it will come back to Parliament for what’s called the third reading.

[8:45] And that is expected to be at the end of April. And on the basis of that vote, if they vote yes to that, at that stage, it would be pretty certain it would become law.

[8:55] It would still have to go through some other stages, go to the House of Lords. But at that stage, yeah, we’d be pretty. And the essence of the bill is that someone could be permitted if they’ve got a six-month diagnosis, six-month terminal diagnosis, they will be permitted to self-administer a drug to kill them. Yeah, and there’s a few more stipulations on it. So, for example, they have to be 18 or older and they’d have to be assessed by two doctors. And at the moment in the bill, a judge as well would have to sign that off. Some of these things might be amended before it comes back to Parliament. But yeah, that’s basically what it is. So self-administered suicide, well, suicide by definition is self-administered, isn’t it?

[9:35] It feels like, I mean, I watched on the day that this vote took place in Parliament, I watched the debate in the chamber. And I came away feeling very depressed and crying out really to God. And, you know, as a Christian, we believe that all life is sacred. And obviously there are lots of biblical reasons why we believe in the Bible. You know oppose this um but also pragmatic and um and cultural reasons why we we should be concerned about this is there room is there time now for resource for this because as you say we’re in committee stage what does that actually mean is that just just just the MPs getting together in a room and sort of going through the bill or do people still have the opportunity to give their a voice?

[10:30] Yeah, thanks, Lizzie. So I think there are, so some people including CMF and a number of CMF members have written in evidence to the committee for them to consider as part of their deliberations. But also I think the biggest way that we still have a voice is with our individual MPs. So there’s another vote, you know, after this committee stage has happened, there’s another vote. And actually a number of MPs who voted yes at second reading said that they still weren’t quite sure or that they had some reservations but they wanted the conversation to continue.

[11:00] So actually if around 30 or so MPs switched their vote it could go the other way in April so there’s still a big opportunity for people to be speaking to their MPs actually whichever way they voted because we need people who voted against it to continue to vote against it we need those who previously voted in favour to continue considering the details because it’s one thing to say sort of in principle i’m in favor of this but actually once you get looking at the nitty gritty as christians it’s maybe not a surprise to us and some of this is not quite so simple to do in a way um that actually values everyone um and keeps um some of the most vulnerable groups safe and cared for so i think looking at the nitty gritty sometimes makes us realize that you know the principle isn’t so simple um and so we’ve still got this opportunity with mps now to encourage to actually engage with this you know not just to walk in and vote but actually engage with the detail think think it through think how it would be and think is this actually something that we think is good in the detail and perhaps some of them may move um away from a yes vote into a no and so that that would be the big push would be engaging with your mp on it just on the theological before we’ll talk particularly with sarah with some of the pragmatical issues and as to why it’s i think it’s appalling for all kinds of reasons whether you’re a believer or not but.

[12:18] On the theological some younger people i’ve spoken to would be a bit more sympathetic i would say and there’s the kind of i don’t know if it’s the saving private ryan argument but i think it’s from that film but a typical of number of films where you’ve got someone who’s.

[12:31] Bleeding out on the battlefield, they’re going to die in the next couple of hours and another soldier just shoots them as an act of mercy sort of thing. And I’ve had that example sort of given to me. So, I don’t know, theologically, where would you address that?

[12:50] Yeah, and I think we have to find space for all these hardest of cases that get brought up and to engage with those with kind empathy and care, and these are not easy things. People have had real and hard experiences in lots of different ways. I guess, ultimately, assisted suicide, I guess what you described was actually euthanasia, wasn’t it? That was somebody actively killing them. But assisted suicide is an act of kind of hopelessness.

[13:19] And I think I would want to encourage people to say, actually life is good and God is good and so we are a people of hope and we want to say that it’s good that each person is in the world, and it’s good that we depend on one another so actually there might be kind of hard and costly things about caring for people at the end of life but actually that’s the way that we’re made, we’re made to depend on one another to care for one another and God can redeem suffering as well, I don’t think that’s the kind of primary reason that i would put forward theologically i’ll talk about the value of life and um yeah the value of every moment and the goodness of caring for one another and but also even where there is suffering included at the end of life that’s not beyond the redemption of god um and we must trust him um as we walk through trying to alleviate suffering um with one another um in that moment yeah i think i also argued that, you can’t make law from very exceptional cases, because once you’ve crossed the Rubicon of saying it’s okay, in this case to euthanize someone, but to shoot someone if they’re likely to be dying soon, then you’ve crossed something into an area where anyone could be shot for any number of reasons.

[14:38] So it’s you’re preserving the principle, and in a sense that person suffers for the principle, uh even if they have to sort of bleed out for another hour it’s it’s it’s a bigger principle that’s being respected uh in that process but yeah and i think there are ways i i’m not an expert on battlefield medicine but actually from a palliative point of view there’d be ways of having seen that situation we would want to say well what can we do better um actually what can we put in place so that if that situation does come up there are available you know sedatives or you know those are readily available for people who need them to palliative even in the extreme situation but as you say yeah it’s a hard case though because people emotionally connect with that um and they feel like it’s right you know in the way in the way often films are constructed it feels like that’s the best thing to happen and that’s kind of heroic in a way um so that’s how that’s how sort of culture is influenced um yeah uh from a a practical point of view sarah just Just tell us a bit about your experience and how you feel about this bill. Does it unnerve you? Oh, unnerve me. I think that’s great. I think it’s the biggest threat to palliative care amongst an NHS that’s in crisis, an aging population.

[16:00] I think actually this is a huge threat to palliative care. So Palace of Care came about because of a Christian, Cicely Saunders, who saw that there was another way. And Susan talking about the hopelessness of shooting someone. Palace of Care forces you to be imaginative, which our God is. Our God is an incredibly creative God. and palliative care is about not just going oh there’s nothing we can do here you’re dying it’s about going you know what’s important to you how are you um how can we help you to live and there are times when that is really really difficult and there will always be people who have um.

[16:54] Really extreme symptoms at the end of life, things like pain and fear and agitation. But still with palliative care, we travel that road alongside people.

[17:08] So the very least we can always do is value someone for who they are, value their life.

[17:17] And the most powerful act we do is to just be there to to to be able to be in the room with someone who is dying and their relatives when it’s really difficult to um just sit there and listen when people are scared uh to hold a hand um and i think some of that will be lost if when we get to the point of going this is hard and i can’t make it easy i could i could give you the medications so you can end it um that will lose um the the power of love that that positive care has what do you think i mean we use this phrase crossing rudicon what do you think that then ultimately does to that there’s various dimensions of relationship there’s a doctor patient there’s patient and their family and there’s also the relationship that say the state has with with society how do you think this would impact because i have to say sometimes i think well yeah it might be just a kind of thing you know if someone is without hope and they’re requesting it then they’re an autonomous individual what but what impact does this have on our society and on individuals within society or could it have?

[18:42] I think it shifts the power massively. So I already hold all the power in relationships with my patients. I yield the medication. I know the rules. I know how the system works. So I already have all the power and I can’t end their lives, which means lots of patients arrive in palliative care terrified because they’ve already travelled through an NHS system where well-meaning staff have ignored their requests for help for pain relief or have had.

[19:16] Poorly constructed conversations around diagnoses, prognoses or things like do not resuscitate plans. So to give me that power to end your life I think is terrifying for patients and I think it changes um uh i think we mentioned this already at the beginning the value of life that there are, um there are some lives that are worth saving so the um, 20-year-old who tries to commit suicide because they’ve got depression, your life is worth saving. But your 90-year-old gran, who is bedbound and of no functional use to society anymore, her life, she can take her life. That’s okay. And that’s what I think. And that’s really brutal. And I realize that sounds brutal as I say it, but that is what we are legalizing.

[20:11] And i think in terms of what you say that what it changes i think it it changes what we each will have to think about in that situation so at the moment when you know somebody receives a terminal diagnosis um at times we might feel do i have the strength to go on and we might feel oh gosh i’m being i’m requiring so much input from the family um i’m stopping people maybe working or um yeah I’m costing so much money, which could go to grandchildren for an inheritance. All those thoughts we might have at the moment, but they’re not a reality. They’re thoughts that we can put aside, that we know family members will put

[20:50] aside. It’s not a possibility to think in this way. There’s a social stigma, there’s a societal pushback to that. Whereas now, each of us would have to ask in that moment, well, would it be better if I committed to this side? Actually, am I a burden to family? Are they thinking that? Are they thinking that it would be better? Have they heard about other people who’ve taken this and wondering why I don’t? All of that burden is added to every dying person.

[21:17] So I think that would be a huge change. And to families as well. Carers may occasionally have these kinds of thoughts, but of course you put them aside. But there will be a temptation then to dwell on that thought in a way that would be very unhelpful to you. But at the moment, you would just put that thought aside if you had it briefly. But then if that becomes a possibility, it opens up a new way of thinking. I think I heard from the committee stage actually that, depression is very common, particularly in the early stages of diagnosis, and often with a good palliative care regime, that sort of depression and desire to end life sometimes not always goes away. So it is quite a transitory thing. Is that true in experience?

[22:04] I don’t know the numbers. I don’t know if Susan said it. The number of people who have a life-limiting illness and have concurrent depression is incredibly high. And that makes sense because it’s hard living with something like a life-limiting illness. And I have met numerous patients who have either expressed a wish to die, have attempted to take their own lives and they haven’t had any contact with us. They had no idea of like the pain relief options they had available to them or just the sort of, I say just, the support that having say a counsellor coming alongside them can make or indeed starting the appropriate antidepressants um so it’s um we we and i know and i i don’t ever want to to lie and say every single person who’s depressed who comes to us it’s all good we sort it out um but again the the vast majority of people that the kind of sigh of relief when they come under palliative care where they’re like oh these people they they they’re going to be with me they’ve got a plan to help my symptoms you know what if that doesn’t work they’ve got another plan and another plan and another plan because that’s one of the things that marks us out as doctors is we’re probably the most.

[23:19] Imaginative um we will keep pulling things out of the hat and keep going because that’s how we work um and so that the um the idea that the idea that people with life-limited illness can um, rationally choose to end their lives as well i think um you know we just talked about that kind of that constant gnawing feeling of being a burden, along with sometimes quite powerful drugs that will impact your cognition. But the idea that you can rationally choose to take your own life.

[23:53] I don’t really have the words to express just to hand nonsensical on that, is that you can’t rationally choose to do that because you are deciding your life isn’t worth living. And it just isn’t true.

[24:07] And I think even if there were a group of people who might say, I’m absolutely not making this up and as a pure kind of rationalistic, I’ve always said I would do this and this is what I want to do. I just don’t see how that group can be disentangled, and this bill certainly doesn’t do it, from those who are exactly the same as any other suicidal person in the sense of they are struggling with existential pain that is telling them I’m a burden, my life is not worth living, in a deeply painful but existential and perhaps relating to depression sense. Which in every other case, we would cover long-sides in a very multifaceted way, spiritually, psychologically, perhaps medically, and perhaps pharmacologically, to offer support. And this bill absolutely can’t say it disentangles. And the Royal College of Psychiatrists in their evidence said this, that this bill would not exclude a group of people who would have treatable mental health conditions that their suicidality might remit with treatment. This bill just simply cannot exclude that group and yeah i think the other thing that um i’ve noted.

[25:29] In some of the discussions and indeed when um in the committee when i’ve seen some um uh some individuals um giving evidence one of the things that um particularly impacted me was one doctor who said that.

[25:45] Um there’s been such a promotion of the idea that end of life is always going to be traumatic and undignified and painful and actually now that’s creating a sense of hysteria and, fear and therefore there are people who perhaps are getting more anxious about this and are now thinking well if that’s how it is then i want to choose this but in actual fact but you know millennia we’ve been kind of, going through this natural process that um that most people not all obviously can never say or you know undergo and and particularly recently here’s with the right care can be managed to a certain extent um i think it’s our profession that has really contributed to uh this fear of death uh that deaths are happening behind closed doors they happen in hospitals um in care homes and not in people’s homes anymore.

[26:45] And public health is brilliant. We live to an average age of about 80 in this country. So we don’t see death in the way that people have for millennia, where you would have siblings that would die. And that is a fantastic thing. I’m not in any way saying that is a bad thing, it’s wonderful.

[27:07] But we’re all scared of things we don’t understand and it’s that fear of the unknown. And the reality is most people are very comfortable at the end of life. I work in specialist palliative care so I see the people with the very worst symptoms and sometimes they aren’t all managed, but actually a lot of the time most of them are managed is very, very exceptional when people’s symptoms aren’t managed. But even with the, Some of the stories I hear of families who are really distressed, who are fighting for assisted suicide, I think some of it comes from a misunderstanding of what they’ve witnessed as well. They think they’ve witnessed someone who has a thing that gets used a lot, it’s like choking to death. I’ve never seen anyone choke to death because it just tends to not be how people die. Um so it is it’s creating a kind of a hysteria although it is also a good thing in that it is at least allowing podcasts like this to happen so that we are indeed talking about dying in a.

[28:16] Way that we also don’t as a society yeah my um my observation of palliative care uh for.

[28:23] My my my father died in hospital my mum died at home the home of my brother actually and my father-in-law who i mentioned earlier died just last autumn um in his home but with lots of palliative care treatment my observation in getting more and more experiences that from the outside you think it’s this kind of voodoo thing and it’s just to do with drugs or something but it’s all a bit it’s all a bit scary you think palliative care is just a way of of killing people but but sort of quietly or something and when you when you then experience it you you think it’s actually quite basic but it’s it’s a it’s a shift in mindset from from saying i’m going to cure this illness to i’m going to make this person the most comfortable they could be and really simple things to do with input and output and pain which greatly improve the quality of life so you have somebody who’s just been diagnosed with an illness and they’ve got all kinds of you know digestional problems and so forth uh uh that that are really changing the quality of their life and sometimes the most simple things suddenly mean yes they’re still going to die within months but their their day-to-day living experience is actually okay and they can socialize and um and you know relatives can come and visit and they can have nice chats and look at photos and watch films and sometimes be wheeled around and it’s amazing what very simple things i don’t know if that’s your experience Sarah.

[29:48] But it seemed to me I had to change my mindset from thinking palliative care is just about someone who’s got a few weeks to live and you just give them drugs so it’s not quite so painful.

[29:59] It’s it’s a holistic thing is that fair i agree you uh you put words to it so much better than i have like a lot i just it is we call it holistic there it’s where we’re looking at the person so we’re not going you’ve got this cancer so i need to do this treatment for the cancer it’s what is important to you so you want to watch films with your family or you want to go out for afternoon tea what’s stopping that what can we do um and yeah sometimes it’s the really simple going oh your tablets make you feel a bit sick in the morning should we just stop those tablets then um so you don’t need those ones anymore um or or working out that actually someone can’t get around their house easily so they need some bars up around the house just to grab so they can get you know through the house safely um it yeah it can be really really simple and it’s it’s why it’s such a joy to do because you are just working with people to help them live um and hearing those stories where they come back to you and go i had this wonderful afternoon and hospices do things like host uh weddings when people haven’t ever quite got around to it and then uh suddenly time is short and they will host a wedding there and you know we can make it absolutely wonderful a really really special day um or have a birthday party or you know film night with the kids that, just um we have to talk about sort of phrase like creating memories just just living having having having a good life in a way you can.

[31:26] Before I get lost can I just come back around on one question to you which was you mentioned about it would change dramatically your role do you think people like you would be the ones saying can I give you this thing that will help the pain or can I give you this thing that will bump you off do you think you will be in that horrible position of having those kind of dual roles of preserving life and ending life?

[31:51] So there is some conscientious objection written into the bill where uh doctors can say that they don’t do it um but you have to refer on um so i’m really scared about having that patient who is struggling and i say well i can’t but i’m obliged to refer on and you know in a shorter time period later i hear that they’ve died uh because i would have been a chain in that that sort of a link in that chain to it happening um i i think actually susan will come in here as a as a gp because i think gps are good i think gps are going to be the people that are going to get hit with a lot of this as gps get dumped with pretty much everything in the nhts um i think there will be i know lots lots of palliative doctors um and the association of palliative medicine backs us up that most palliative doctors do not wish to do it, because it just goes against, um, how most of us view palliative care, which is about living. Um, There will be some that will do it. And I think one of the worst things is our patients will think we can do it.

[32:57] You already said that there’s this kind of like you think everyone thinks, even some doctors think that, yeah, but you’re just giving them a little bit more morphine and midazolam to finish them off quickly. No, no, that’s illegal. And it will still be illegal, but patients will worry that that is what we’re doing because they’ll think we have that power. Even if we haven’t signed up to it even if we’re not doing it in that ward sure yeah i think oh, no sorry season i was just going to come in with the gp perspective i think it’s a big big worry that it could be the same people um you know actually in the moment that a patient expresses you know this kind of existential um angst as a human being and and as a christian i want to respond to them and say no it’s good that you’re in the world and we need that from one another, and you know the genesis account you know before there was sin in the world it wasn’t good for man to be alone you know we we are relational by nature and we need to be reflected truth to by one another about our value as human beings and so even to introduce into that moment.

[34:03] And the fact that well i won’t do it but i’ll refer you to someone else would feel intolerable to me in that moment and i know a number of cmf members have said the same thing that’s just not something they would be prepared to introduce into that moment they would find that abhorrent to their um beliefs and to their professional beliefs um and yet that that is currently what’s in the bill um can i just ask a question about um some of the intricacies and some of the the aspects of the bill then that perhaps um create danger outside of what we necessarily expect so you know the four of us here all you know very clear we are made all humans are made in the image of god we do not have the right to take life um you know that that is a bad thing to do it is not our right to intervene in that way but there are also other dangers on there in that this could make lots of people more vulnerable um i hear that you know this this bill um could fail to say protect people with anorexia and potentially go down that slippery slope and end up something like um the the case of made in in canada and could eventually you know um liberalized to include mental illness alone can you talk us through some of those things that are in the bill but also could um result in even being changed further.

[35:32] Yeah, I guess there are two kind of ways that bills extend, aren’t they? So they extend through interpretation and they extend through being changed. And so the kind of case that you mentioned about anorexia would be a case of kind of extension by interpretation. So it’s not that the people drafting the bill have ever said that they want to include that group. But good evidence was presented in the committee to show that in other jurisdictions and in some other court proceedings in our country.

[36:00] People with anorexia are given a label of terminal anorexia sometimes when the impact of the starvation is having an impact on their body and in those cases in other jurisdictions they have been included in assisted suicide and been able to request it for that reason. Other ones like that could be someone who has a condition that with treatment they might live for many years but if they stop the treatment it is something that they will die from. And one of my colleagues is a kidney doctor talked about you know someone who’s had a kidney transplant if they were to stop taking the anti-rejection medicine then yes you would say they had a short prognosis or if they continue to take that medication they could have many years.

[36:41] And so actually if that patient then stops that medicine well the doctor could sign them off through interpretation extending the groups that this was maybe aimed at but then also if it becomes normalized as you know people begin to accept that this is this is the right way to die this it’s a good way to die even and then there’d be pressure I’m sure for other groups to say well I’m suffering just as much as that person you know why shouldn’t I have it even though my diagnosis is 12 months 18 months or in fact I don’t even have a terminal diagnosis and like you mentioned Canada well my mental suffering is just as bad as that person’s physical suffering and in fact they seem to be getting it for mental suffering anyway it’s not really about their physical suffering why shouldn’t I have it for my mental suffering and and so you know by a kind of fairness arguments, we could see a pressure on Parliament to extend it further. Yeah, it’s all interesting in a bad way because.

[37:34] Some of the arguments are about autonomy, but actually the irony, which I suppose you’re not surprised at, is that in a way it takes away autonomy because it provides cultural pressure, which you can’t really mitigate for.

[37:50] It’s not as simple as, oh, this is good because it gives people choice.

[37:55] So if you’re thinking from a completely non-Christian point of view, oh, this is really good, it gives people choice, as though they’ve got this choice in a vacuum. Um but they haven’t because there’s there’s there’s cultural goods which is palliative care and all these other things and medical treatments but there’s also a kind of cultural message which is this is a good thing um so the person um is under immense pressure i mean i heard again in the the committee stage um someone admitting i think it’s from the royal college of nursing that the very suggestion that this is an option creates a pressure sure um so not even saying you should do this but to even just present it as an option is is instantly kind of putting pressure on is is that fair well if i can just jump in there so i i was surprised to hear um the other day that in jurisdictions where assisted suicide or euthanasia is legal and that rates of unassisted suicide also increase so this it’s almost it kind of breeds a kind of sense of you know cultural pressure or cultural acceptability that to take one’s own life is a real option and that really surprised me because I suppose um I didn’t I just thought well this is obviously for a very designated group of people who have a you know um quite contagious about suicide and And you do hear of that in other circumstances as well.

[39:22] When famous people end up taking their lives.

[39:25] That there are apparently spates of suicide in communities. So it would make sense then that there is some kind of contagion associated.

[39:33] And that inevitably puts vulnerable people in more danger, I think. But Susan, you probably know more of the statistics around that. Yeah, so I think at least we can say that unassisted suicides don’t fall in jurisdictions that have brought this in, which you would think that they should if part of the argument for this is to say, well, some of these people would be committing suicide in violent ways. And so we’re kind of helping by bringing in assisted suicide. So that should reduce unassisted suicides. And that certainly hasn’t been seen. And there’s also some jurisdictions where there’s some evidence. It’s difficult because it’s hard to know what would have happened, so you can compare against other states. But there’s certainly work done on this that shows that it’s certainly not decreasing and there’s some suggestion in some jurisdictions that it’s been increasing. But on the autonomy point as well, I think, This idea of unfettered autonomy just isn’t how the world is.

[40:33] Again, as Christians, that’s not a surprise to us. We know the way that God made us, we’re made in families and relationships. But this idea that people choose in a vacuum and that society needs no vision of the good, we can all just choose, is actually obviously a nonsense. If it’s only about autonomy, it’s only about yes or no, then our entire ethic is about power. Because what I can be made to say yes or no to by others, becomes what is right.

[41:00] There are some things where love says no to a request from another person because we have a vision of the good and as a society together we say that’s something we say no to when you ask and we don’t encourage people to ask for that and I think yeah I would say.

[41:16] Somebody who’s saying they want to commit suicide should come in that category and we all accept limits on our autonomy to live together in society. We all say there are some things that I can’t do with my autonomy that that’s not a right thing to do um uh you know traffic laws murder in general you know like all sorts of things are against the law and we happily submit our autonomy to to that for the for the sake of a good that we have together yeah can i ask a question hopefully slightly more positive uh that positively as well as the experience for the person dying Is it your experience, Sarah, that for the families, there’s actually a good in seeing a relative die, seeing through the process? That’s been my observation, that there’s actually a good in living the death, helps them to have some degree of closure in it. Uh i mean i again i keep doing these personal stories but i i benefited from being with my mum when she died and and being in uh in a house for a few hours after she was dead more than when my dad died where i was present but it was in a hospital and we were whisked away after five minutes and i hadn’t been involved in the care of him at all whereas with my mum and with my father-in-law i was a bit more involved and you feel like you kind of lived it.

[42:38] But also so it gives you time to come to terms with it it gives you a real feeling that you’re you’re in in it which does help psychologically and you’d also learn all kinds of lessons through it as well and you show love in ways you hadn’t shown before perhaps and get to say things that you might not have said and uh share memories and all those sort of things sorry it’s very long-winded but is that is that your experience Sarah in in in families yeah I mean your experience I think is is really is is a really common one and people often say oh I hope I like just die in my sleep I’m like no no no you don’t because people want to make sure that they’ve sorted out their financial affairs that they’ve had a chance to say goodbyes um that they’ve got a chance to be a bit more honest than perhaps they would normally be, to say they love someone to the people they love.

[43:33] Relationships change when you’re dying. I know in my family, when my mother-in-law’s mother was dying, she had dementia and their relationship was profoundly different in the final um particularly the final year um and so there is still it’s not easy um it’s really hard to be in a room when someone’s in the last hours to be supporting someone in those weeks months um years you know with the hospital appointments the the increase um increasing frailty you know you’re having to come in and help do the shopping or or you know the practical stuff and the hardness that is so sad when someone dies.

[44:20] So it’s not easy, but there’s growth in your relationships. And I think in yourself that you can see, get the feeling you might have seen parts of yourself where you’re like, oh, I’ve never done that for someone before. I would never have thought to say that sort of thing to my mum. So I think… There is, and actually in the hospice, we sometimes have people who arrive in the hospice and die the following day. And that doesn’t happen very often. Normally people are in for a little bit longer than that. And you think, oh, was it worth them getting the ambulance coming to us? And actually even having a short window of peace where they know there’s professionals there who are going to look after it, where it’s okay. It’s going to be okay.

[45:10] And like people breathe the sigh of relief as they come in so even that short period of time there’s a real benefit from it and anything longer, I think it really helps people and really helps them in their bereavement time afterwards to know that there was some good that came out of what is a profoundly sad time in their life, So we’re nearly out of time.

[45:34] I’m wondering whether we could sort of wrap up with some of the key arguments So kind of an elevator pitch of why is this so bad, kind of summarizing some of the things we said, and then a quick elevator going down pitch, which is what should anybody listening do about it? So Susan, maybe why is this so bad? I think it’s so bad because it’s a failure of love. So actually the Christian calling is a higher calling and we’re called to love neighbor as self. And that means walking with a valuable image bearer and continuing to reflect their value to them and treat them with that value and dignity all the way to the end of their life. It’s a hopeless thing. It’s a hopeful thing. And it’s a failure of love. And what can we do? Because that’s something that I kind of feel like, well, I went to my MP last time. I actually went to see my MP. Is that it now?

[46:34] That’s uh you’ve done exactly the right thing lizzie so see how they voted um if they voted against it then thank them for it write to them again and say thank you for voting um share your concerns and you know like graham your experience is your personal stories your your your lived experience and we’ve all got someone who has had to travel through the car crash as the nhs at the moment so um share your your challenges of the nhs in crisis right now if you perhaps haven’t got that much experience of dying um share your fears and your concerns with your mp and urge them that you know they might agree with this in principle but it doesn’t work in practice um and that’s how they they need to vote against it at the next reading um and if they voted against it before thank them for doing that thanking them for being bold to sort of stand up for something and encourage them to carry on doing that.

[47:33] And anything for CMF we could be remembering to pray about that you’re doing with regard to this bill? Yeah, thanks so much. We really appreciate your prayers. I think healthcare professionals actually have a particular opportunity in this moment, I think, to speak and to be heard. So when I first wrote to my MP, the response I got back from my staff initially was to say, oh, your experience as a GP will be really valuable. Let’s think about how we can book you in. So I think a big prayer for doctors, nurses and other health professionals that you know and for CMF is to say, actually, we’ve got this responsibility to do good to all people as we have opportunity. And here’s maybe a particular opportunity for a Christian in those professions to speak up for the vulnerable and to express their concerns. And so CMF, a lot of the work we’re doing is to encourage and walk with people in the different ways that they’re using the voice that they have as Christian health care professionals at the moment. So let me pray for CMF centrally as we support them in that. Do support and encourage yourself, members you know, maybe in your churches, to do good in this way as they have opportunity. And I pray for CMF members, some of whom speak publicly, do radio interviews,

[48:37] some of whom lobby MPs individually or do bigger events. See, there’s lots of different ways that CMF members are involved in making their voices out in rural colleges as well. But yeah, I’d love your prayers for them as they do good in a way that they perhaps have been given a particular opportunity by God in this moment.

[48:54] Well, that’s brilliant. I think if that’s okay, we’ll wrap it there. Thank you both very much, and Lizzie as well. It’s been really helpful, but kind of harrowing. And we’re really praying that this wouldn’t go ahead because we think it’s morally wrong. I think it’s wrong before God. We think it’s really bad for society. So yeah, thank you very much. Yeah, thank you.