Column
Assisted dying
Care
Comment
4 min read

Proposed euthanasia safeguards insult our NHS

We must defend a collective sense of care and generosity.

George is a visiting fellow at the London School of Economics and an Anglican priest.

A gable end mural depicts a nurse in scrubs and a mask turning and looking towards the viewer.
A mural of an NHS nurse during COVID, Manchester.
Mural Republic

It was, I believe, the late political satirist Simon Hoggart who coined the Law of the Ridiculous Reverse, which held that, if the opposite of a statement is plainly absurd, then it was not worth making in the first place.  

This law comes to mind when Labour MP Kim Leadbeater promises that her Assisted Dying Bill will have the “strictest safeguards in the world”, one of which is that those patients who have ordered their fatal dose “would be allowed to change their mind at any time.”   

Where, exactly, has it ever been suggested that an individual, having asked for an assisted death, would not be allowed to change their mind? I’m just wondering which legislator or medical professional has proposed that once a lethal draught has been prescribed then there is no turning back.  

I’m struggling to picture the circumstance in which a terminally ill patient is pinned down and killed, the last words that they hear being: “I’m sorry Mrs Simpkins, but everyone’s gone to a lot of trouble. You asked for it and you’re jolly well going to get it.” 

This is important because, apparently, being able to change your mind about asking for help to kill yourself is one of the strictest safeguards in the world. I hope Ms Leadbeater will forgive me for pointing out that this doesn’t really stack up. 

 And what’s serious about it is that it’s also a massive straw man argument. The clear and rather devious implication is that one of the arguments being made against the introduction of an assisted suicide law is that patients won’t be able to change their minds about it, which I think we can all accept simply isn’t a fact at all. It’s absurd – a Ridiculous Reverse. 

So I’ll defend the NHS with a religious fervour. To my mind, healthcare is a holy mission. We meddle in law with the Hippocratic Oath at our very deep peril. 

It’s also hugely contemptuous of the medical profession in general and rude to the NHS in particular. That’s because there’s a snide impression behind Leadbeater’s comment there may be hundreds of budding Harold Shipman out there, but her powerful safeguards are going to protect us from them. 

We’re in danger of becoming inured to this kind of insult from politicians directed at the NHS. And it’s worth exploring why they might think we need to be protected from unscrupulous doctors and nurses. In this case, one possible reason is that the NHS isn’t being particularly helpful in giving the euthanasia enthusiasts what they want. 

Doctors and their staff have plenty of ethical objections to assisted suicide. But leave those aside for a moment. At the practical level, the NHS has made it clear that it doesn’t have the infrastructure to operate a policy of assisted deaths safely. And it can’t afford to set one up. So a government that introduces assisted suicide is going to have to organise and regulate its own assisted death agency. 

“Oh,” the assisted dying lobbyists seem to exclaim, “we’d presumed you’d do as you’re told.” Just hand out the hemlock. Take your instructions from the legislature. 

But the NHS is better than that. And it’s that kind of high principle that so infuriates feckless politicians. It was the late Nigel Lawson who said, somewhat ruefully, that the NHS “is the closest thing the English have to a religion”. The right wing of politics regularly tells us it’s time to renounce that religion. 

To worship the NHS as a religion would, literally, be idolatrous. But it’s not so to acknowledge its religious qualities. Just look at the word – the Latin religio means something like “good faith”, the essence of who we are, what makes us good. 

The NHS, in its post-war incarnation, has been central to who we are as a people and what defines us. It’s something to do with our collective sense of care and generosity to one another. Its members, like our national Church, make up a single body. 

This is not to co-opt the NHS as the medical wing of the Church. It’s no part of the NHS’s brief to proselytize – rather the reverse; Christian medical staff have been in deep disciplinary trouble for evangelising. It is a profoundly secular organisation. 

So the NHS emphatically isn’t in the business of propagating the gospel. But that’s not to say that we can’t be in the same business. Many priests have stories of their most affirming work being in the company of people of other faiths or of none. 

The NHS’s proud heritage is to offer treatment free to anyone at the point of access. Put another way, it will seek to heal anyone who comes to it. I make no apology for saying that sounds familiar. 

So I’ll defend the NHS with a religious fervour. To my mind, healthcare is a holy mission. We meddle in law with the Hippocratic Oath at our very deep peril. 

And when NHS professionals tell us where we can stick our assisted suicides, I respectfully suggest we give it our solemn attention, rather than patronisingly offering a Law of the Ridiculous Reverse.

Article
Care
Comment
Mental Health
4 min read

Suicide prevention cannot be done in isolation

Community response is needed, not just remote call-handling

Rachael is an author and theology of mental health specialist. 

 

 

Three posters with suicide prevention messages.
Samaritans adverts.

Suicide is a tragedy that leaves devastation in its wake for individuals, families and communities - but it remains shrouded in stigma. Whilst those who die by suicide are grieved and mourned amongst their communities, those who experience suicidal thoughts or who survive suicide attempts are often dismissed as ‘attention-seeking’ or ‘dramatic’.  

The truth is, our response as a society to suicide is one which often ignores those who are most vulnerable until it is too late. According to the UK Office for National Statistics, the number of people dying by suicide has risen steadily since 2021, and whilst some of this can be attributed to the way in which deaths are recorded, it also represents a real and urgent need to change the narrative around suicide and the suicidal.  

As the need has risen, we have also seen that services seeking to support those struggling with rising costs and rising demand.  

Just 64 per cent of urgent cases and 72 per cent of routine cases were receiving treatment within the recommended time frames and the proportion of NHS funding being allocated to mental health falling between 2018 and 2023 highlights that the parity of esteem for mental health promised back in 2010 seems to grow further away. 

Against this backdrop, for over seventy years, the Samaritans have been synonymous with suicide prevention, working where the health service has struggled to be. It’s sometimes been referred to as the fourth emergency service and has been providing spaces, mainly staffed by volunteers, in person, on the phone and online for people to express their despair in confidence.  

And yet earlier this year, it was announced that over the next decade, at least 100 of its branches would be closing, moving to larger regional working and piloting remote call-handling.  

Whilst this might be an understandable move considering the economic landscape for the Samaritans, it risks not only a backlash from the volunteers upon which Samaritans relies but also reducing the community support that locally resourced hubs provide.  

Suicide prevention cannot be done in isolation; it has to be done in and with community.  

Even the most well-trained and seasoned volunteer might find particular calls distressing, and the idea that they would have to face these remotely, without other volunteers to support them, is concerning.  

I think this needs to be a wake-up call, not just for the sector - but society as a whole. Because when it comes to suicide, we need to work together to see an end to the stigma and a change in the way people are supported. 

Suicide prevention cannot be left up to charities, we all have a role to play. 

It matters how we engage with one another, because suicide can affect anyone. There are undoubtedly groups within society who are at a higher risk (for example, young people and men in their middle age).  

Still, nobody is immune to hopelessness, and even the smallest acts of kindness and care can help to prevent suicide.  

In the Bible story of the Good Samaritan, from which Samaritans take its name, Jesus tell the story of a man brutally robbed and left for dead on the roadside. A priest and a Levite avoid the man and the help he so clearly needs, but a Samaritan (thought of as an enemy to Jesus’ audience) was the one to not only care for his physical wounds, but also pay for him to recuperate at an inn.  

We need to have our eyes open to the suffering around us, but also a willingness to help. It probably won’t be by giving someone a lift on a donkey as it is in the story(!) but it will almost certainly involve asking the people we meet how they are and not only waiting for the answer, but following it up to enable people to share.  

It might require us to challenge the language used around suicide; moving from the stigmatising “committing suicide” with its roots in the criminalisation of suicide which was present before 1962 to “died by suicide”, and shifting from terms like “failed suicide attempt” to “survived suicide attempt” so that those who must rebuild their lives after an attempt are met with compassion and not condemnation.  

Above all, we need to be able to see beyond labels such as “attention seeking” or “treatment resistant” to reach the person whose hope has run dry, and allow our hope to be borrowed by those most in need, both through our language and our actions.

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