Desmond Tutu’s arguments for assisted dying will fuel existing prejudice against the elderly, dying and disabled

It is perhaps in the nature of celebrities to champion causes they perceive to be popular. Celebrity bishops are no exception and Desmond Tutu’s support for Lord Falconer’s Assisted Dying Bill is not surprising but deeply disappointing.

Dignity in Dying, the former Voluntary Euthanasia Society, has assembled over 50 actors, sportsmen, entertainers, authors and other celebrities to add weight to their campaign - similar  people to those advertisers draft in to provide endorsement for consumer products.

The implication is that we should follow these celebrities and embrace their preferences.

And there is no doubt that so-called ‘assisted dying’ resonates strongly with the spirit of the age and its commitment to the beliefs that personal autonomy should trump all other considerations, that it is better to be dead than to suffer and that there are no moral absolutes.

These celebrities also fit the description of those who make most use of the law in the US state of Oregon – white, healthy, wealthy, college educated people who are used to being in control in life and want similarly to be in control in death.

Desmond Tutu has always been popular amongst the metropolitan liberal elite who disproportionately occupy the corridors of influence and power in Britain – parliament, the institutions, universities and the worlds of the arts, entertainment and media, and particularly the BBC.

His endorsement of the assisted dying cause will further strengthen their personal conviction that they are right.

However there are elements of Tutu’s argument that I find deeply disturbing, which I believe are deeply damaging to social attitudes towards the vulnerable and which greatly endanger our future cultural trajectory.

I would recommend that people read beyond the headlines of ‘Tutu embraces assisted dying’ and read his argument in full.

It’s clear first of all that Tutu has been profoundly influenced by the death of Nelson Mandela and the way his life was artificially prolonged nearing the end.

There are few people who would not sympathise with Tutu here. Life has a natural end. All of us are mortal. There is, as the good book says, a time to die. Intrusive ‘treatments’ at the end of life where the burden imposed on a dying person clearly outweigh any benefit should be avoided. Sometimes the treatment can be worse than the disease. We should not be ‘vitalists’, artificially prolonging life indefinitely just because we have the technology to do so. 

There comes a time when we must recognise that death is imminent, inevitable and that we are powerless to stop it, and that our priority must be to make the dying process as comfortable and bearable as possible. Part of that process will involve the withholding or withdrawal of inappropriately meddlesome therapeutic interventions. That is all part of good palliative care; it is in short good medicine.

But Tutu is arguing for far more than easing natural death. He wants to make it legal for doctors to kill people by prescribing legal drugs – and that goes against both the Hippocratic Oath which has for 2,500 governed the practice of medicine, and also thousands of years of the Judeo-Christian ethic as embodied in the sixth commandment  ‘Thou shalt not kill’.

What disturbs me most about Tutu’s argument are two key arguments that he uses to support his case.

First, Tutu argues that there is a duty for older people to die in order to make way for the young.

‘Dying is part of life. We have to die. The Earth cannot sustain us and the millions of people that came before us. We have to make way for those who are yet to be born…. But why is a life that is ending being prolonged? Why is money being spent in this way? It could be better spent on a mother giving birth to a baby, or an organ transplant needed by a young person. Money should be spent on those that are at the beginning or in full flow of their life.’

Such comments play into the hands of the likes of population controllers like Jonathon Porritt, chairman of the UK Government’s Sustainable Development Commission, who in the tradition of Malthus and Ehrlich, warn of ecological and environmental disaster ahead unless we do something rapidly to curb population growth. 

Up until now they have mainly argued that the best way of curbing population growth: contraception and abortion must be at the heart of efforts to combat global warming and couples who have more than two children are irresponsible. 

But it is a subtle extension of this same argument to say that the dependent elderly should make way for the younger generation by bringing forward their deaths. The right to die can so easily become the duty to die and the generation that has killed its children through abortion could very easily become that which is killed by its children through euthanasia and assisted suicide. Add in economic crisis, debt, cuts in health and welfare and the argument gains force by playing on popular prejudice against those perceived to be a drain on families and the state.

In the US state of Washington, where has enacted a law like Falconer’s, over six in ten of those making use of it do so because they believe they are a ‘burden’ on family, friends and caregivers. The law has removed the protection that vulnerable people currently have against the subtle coercion of relatives shouldering the care burden and anxiously eyeing a dwindling inheritance.

But the reality is that the overwhelming majority of elderly people want quite reasonably to live for as long as they can in the best state of health that they can. And the mark of a civilised society is that it makes sacrifices for the weak, rather than sacrificing the weak. ‘Bearing one another’s burdens’ is what St Paul said is at the very heart of the teaching of Jesus Christ; it is what true love really is (Galatians 6:2).

Second, Tutu argues that lives which depend on heavy medical intervention or technological support are not worth living.

‘I think when you need machines to help you breathe, then you have to ask questions about the quality of life being experienced and about the way money is being spent. This may be hard for some people to consider.’

I have two close friends who suffer from sleep apnoea so severe that they require CPAP (continuous positive airway pressure) machines to help them breathe at night. They each have a serious disability, and yet with the help of this medical technology are able to maintain ministries as international conference speakers.

I think of my many friends from the disabled community for whom technology – motorised wheelchairs, hoists, ventilators, dialysis machines, catheters and a bewildering array of drugs – make the difference between a life of utter dependency and one where they are enabled to function at an unbelievably high level. This is made possible by ongoing research and development, considerable financial investment and a willing supply of helpers and assistants.

There is a myth dangerously gaining traction today that medicine and technology have made our lives worse – that people are being kept alive by machines and that this is resulting in prolonged misery. The reality is the opposite. Because of medical and technological advances people are living longer than ever before and enjoying a better quality of life than ever before. And the overwhelming majority of people with terminal and chronic illnesses or disabilities do not want assisted dying but assisted living – help and support to live as long and as well as they can.

People who are dying and disabled value their lives in a very different way than those who are able bodied and have a remarkable ability to adapt.

This is why disabled people will be rallying in force outside parliament next Friday when Falconer’s bill is debated. They don’t want people like Tutu and others making judgements about whether or not their lives are worth living and suggesting that they are using up valuable resources that should instead be consumed by the young, vigorous and fit. We need to listen to them.

At the heart of the Christian story is Jesus Christ, the creator of the universe, who took the form of a servant to seek and save the lost. He brought compassion and healing to the elderly, dying and disabled and gave himself for us walking in the shadow of the cross and bringing the hope of life beyond death.

This is where Christians should be today – not campaigning like Tutu for lethal draughts of barbiturate to be made available for vulnerable people whose lives are judged not worth living in order to ease the burden of others who might have to care for them – but getting mobilised to provide time, money and manpower to make the lives of those who are dying and disabled as good as they possibly be until natural death intervenes in good time.

Desmond Tutu’s arguments in support of assisted dying will simply fuel existing prejudice against those who are elderly, dying and disabled. They should be seen for what they are and given the short shrift they deserve.

Why Lord Carey is so desperately wrong about legalising assisted suicide

Lord Carey, former Archbishop of Canterbury, has surprisingly come out today in favour of Lord Falconer’s Assisted Dying Bill which is due to have its second reading in the House of Lords on Friday 18 July.

Falconer advocates licensing doctors to dispense lethal drugs to mentally competent adults with a life expectancy of less than six months and a ‘settled wish’ to die, in order that they might kill themselves (Falconer calls this ‘assisted dying’ but, legally speaking, it is assisted suicide for a specified subset of people).

The Church of England's position on the matter is (refreshingly) unequivocal: 

‘The Church of England cannot support Lord Falconer's Assisted Dying Bill… Patient safety, protection of the vulnerable and respect for the integrity of the doctor-patient relationship are central to the Church of England's concerns about any proposal to change the law. Our position on the current Bill before parliament is also consistent with the approach taken by the Archbishops' Council, House of Bishops and with successive resolutions of the General Synod.’

In response to Carey, the current Archbishop, Justin Welby, has said today that legalising ‘assisted dying’ would be 'dangerous, abusive and mistaken’.

‘Abuse, coercion and intimidation can be slow instruments in the hands of the unscrupulous, creating pressure on vulnerable people who are encouraged to ‘do the decent thing,’ he writes in The Times.

‘Even where such pressure is not overt, the very presence of a law that permits assisted suicide on the terms proposed by Lord Falconer is bound to lead to sensitive individuals feeling that they ought to stop “being a burden to others”.

‘What sort of society would we be creating if we were to allow this sword of Damocles to hang over the head of every vulnerable, terminally-ill person in the country?’

Lord Carey also previously held to the church’s official position but for some reason, which remains a mystery to me even after reading his article today in the Daily Mail, he has now changed his view.  I would have to say that I found his article quite unconvincing. 

Carey first argues for a limited change in the law and makes reference to abuses in the Netherlands highlighted just this week in the Daily Mail: ‘It would be outrageous if it were extended beyond the terminally ill to an ever-widening group of people, including the disabled and the depressed. Such a step would impose terrible pressures on some of the most vulnerable people in our society.’

But then he says that the cases that have led to him changing his view were those of Tony Nicklinson and Paul Lamb, two men with severe paralysis who were not terminally ill and would not have qualified under Falconer’s proposed law anyway. In so doing he demonstrates the impossibility of framing a limited law that would encompass all who might like to make use of it. The point is that many people who wish to kill themselves are not terminally ill, not mentally competent and not adults. And the vast majority of those who are terminally ill want assisted living, not assisted dying. 

So why a law just for the terminally ill? It seems utterly illogical.

Carey focuses on two disabled people with a wish to die but does not tell us that all major disability rights groups in Britain, including Disability Rights UK, SCOPE, UK Disabled People’s Council and Not Dead Yet UK, oppose any change in the law believing it will lead to increased prejudice towards them and increased pressure on them to end their lives. Nor does he touch on the issue of elder abuse, and the way a law allowing assisted suicide brings a huge new dimension into that problem.

Action on Elder Abuse, for example, states that more than 500,000 elderly people are abused every year in the United Kingdom. Sadly, the majority of such abuse and neglect is perpetrated by friends and relatives, very often with financial gain as the main motive. It would be very naive to think that many of the elderly people who are abused and neglected each year, as well as many severely disabled individuals, would not be put under pressure to end their lives if assisted suicide were permitted by law.

Carey also suggests that because powerful painkillers like morphine can occasionally shorten life (although this virtually never occurs in skilled hands because the therapeutic dose is lower than the lethal dose and it is possible to kill the pain without killing the patient) we should therefore dispense lethal doses of barbiturates (not a painkiller but an anaesthetic) with the deliberate intention of killing people. This is to misunderstand the difference between proportionate pain relief, where the intention is to relieve suffering rather than to kill, and assisted suicide where the clear intention is to end a life. The first is good medical practice. The second breaks both the Hippocratic Oath and the Judeo-Christian ethic and has been considered unethical by the medical profession for over 2,500 years. Carey appears not to understand that clear distinction.

Carey then cites a BMJ editorial and some comments by a public health doctor (with no experience of managing dying patients) in favour of euthanasia as support by the medical profession for his view. But he fails to tell us that the vast majority of UK doctors are opposed to legalising euthanasia along with the British Medical Association, the Royal College of Physicians, the Royal College of General Practitioners, the Association for Palliative Medicine and the British Geriatric Society.

He advances pain as the main driver for a change in the law. But he fails to mention that in Oregon, which legalised ‘assisted dying’ in 1997, fewer than three in ten people making use of the law cite inadequate pain control or (even) concern about it as a reason for wanting to end their lives. The top reasons in Oregon relate to loss of meaning and purpose: loss of autonomy (93%), having less ability to engage in activities making life enjoyable (89%), loss of dignity (73%) and feeling they are a burden on family, friends and caregivers (49%). These are existential or spiritual rather than physical symptoms. Is Carey not aware of this or is he actually being disingenuous? 

Carey writes about Jesus’s mission being underpinned with ‘compassion’ for those suffering to whom he brought ‘comfort, healing and a new sense of dignity’. But he barely mentions the specialty of palliative medicine or the hospice movement, in large part pioneered by Christians and in which Britain is a world leader, which seeks to do exactly that. Nor does he tell us that symptoms accompanying dying are less to be feared than at any time in history, because of medical advances, and that requests for assisted suicide or euthanasia are extremely rare amongst those who are properly cared for.  Nor does he bring a call to make this excellent care much more widely accessible. In fact, to the contrary, he seems to be suggesting that we need to legalise assisted suicide because there is a postcode lottery of hospice care.

But what I find most astounding about Carey’s article is the almost complete lack of any theological framework for his argument. There is a vague reference to Christian principles of ‘open-hearted benevolence’ and ‘compassion’ and one mention (above) of Jesus.

But there is no discernible Christian world view underpinning what he says. Nothing of the fact that God made us and owns us; nothing of biblical morality or the sixth commandment; no doctrine of the Fall; little insight into the depths of human depravity and the need for strong laws to deter exploitation and abuse of vulnerable people; nothing of the cross or the resurrection; no hope beyond death; nothing of courage and perseverance in the face of suffering; no recognition of the need to make one’s peace with God and others before death; no real drive to make things better for dying patients and no real empathy with the feelings of vulnerable disabled and elderly people who fear a law like Falconer’s and will be campaigning in force outside parliament next Friday.

Carey has instead produced a piece that is high on emotion but weak on argument that capitulates to the spirit of the age; that enthrones personal autonomy above public safety; that sees no meaning or purpose in suffering; that appears profoundly naïve about the abuse of elderly and disabled people; that looks forward to no future beyond the grave and that could have been written by  a member of the national secular society, British humanist association or voluntary euthanasia society.

Carey’s case for legalising assisted suicide is a counsel of despair devoid of Christian faith and hope.  I still cannot believe he wrote it. He will disappoint many people, but will also awaken deep concern for him personally in many others.

Carey is a good man who has done a lot of good. But right now I think he actually needs our prayers.  

101 not out for pioneering plastic surgeon and missonary

A forward-thinking, retired Salvation Army officer, surgeon and CMF member – who spent a lifetime working overseas, transforming the lives of leprosy sufferers – celebrates his 101^st birthday in Hawick on Sunday 13 July 2014.

Commissioner (Dr) Harry Williams, who was born in 1913, will commence his celebrations on his birthday with a few friends and family in the village of Melrose. Celebrations will continue at Hawick Salvation Army hall on Sunday 13 July with a morning worship service led by Commissioner Robin Forsyth and the sharing of cake. The meeting will include a feature on the commissioner’s life and a gift presentation – although, Dr Williams was quick to remind people that donations to the Harry Williams Hospital in Bolivia would be much more appreciated than birthday gifts!

Harry was working in insurance in London at 19 years old when he decided to become a missionary surgeon. After qualifying at the London Hospital, he trained in plastic surgery under the pioneering surgeon Sir Archibald McIndoe. Later commissioned as a Salvation Army officer (minister), Harry was sent to India where he served more than 30 years as a surgeon and later chief medical officer.

During his ministry as an officer, Commissioner Williams used his expertise in reconstructive surgery – refashioning noses deformed by leprosy and working to change attitudes towards the disease. He also redesigned buildings, reorganised departments and devised new medical programmes. The commissioner was a Territorial Commander – the national leader in Southern India, New Zealand and Australia – and later the International Secretary responsible for the administration of The Salvation Army’s work in the Americas and Australasia. He oversaw the beginning of medical work in Bolivia and The Salvation Army named a hospital in his honour. 

In retirement, Commissioner Williams remained active as an officer, artist and author. He has written novels and Salvation Army history books – the most recent written well in to his nineties. He has also sold many of his paintings to raise funds for Salvation Army projects.

Hawick Salvation Army Corps (church) leader Lieutenant Caroline Brophy-Parkin said: ‘At 101, Commissioner Williams is still active and takes a keen interest in the life at the corps and especially loves the young families and children. He remains passionate about The Salvation Army’s health ministry.’

Major James Williams, who supports retired Salvation Army officers from the church’s national headquarters, said: ‘Retired officers are the backbone of The Salvation Army. They bring a wealth of experience and knowledge into the present day. Retired officers were once fully engaged in ministry work and, like Commissioner Williams, continue to fulfil the call of God in their lives and in their community even beyond active service.’

HPAD gets slapped down at the BMA ARM

The British Medical Association (BMA) has always been opposed to euthanasia and assisted suicide. That is, apart from just one year, 2005, when under the influence of then Ethics chief Michael Wilks, it temporarily went neutral.

The BMA’s opposition to a change in the law has long infuriated advocates of assisted suicide, not least a small but vocal group of doctors who believe that they should be able in some circumstances to help their patients kill themselves.

In fact, campaigning for the legalisation of assisted suicide seems to be a major preoccupation (obsession even) for high profile retired secular humanist doctors (more here). Quite why is another story. 

Every year at the BMA annual representative meeting, this small group of retired doctors, now assembled under the umbrella ‘Healthcare professionals for assisted dying’ (HPAD), the medical arm of the former voluntary euthanasia society, floods the BMA with motions calling for a change in the law. And almost every year the matter gets debated and the BMA policy remains unchanged.

This year was no exception. HPAD members sent in motions from all over the country calling for a referendum amongst BMA members on euthanasia neutrality.

But not surprisingly, the BMA’s agenda committee relegated them to the ‘grey’ part of the programme – ‘unlikely to be reached’ – and prioritised other ethical issues instead.

Not to be outdone HPAD did everything that it could behind (and in front of) the scenes to force a debate. The matter eventually came to a head when HPAD chair Ray Tallis (pictured) attempted to highjack the Chair of Council’s Q & A session. You can watch the video here but it went as follows:

Raymond Tallis: ‘(I am) Raymond Tallis, North West Division, Declaration of Interest, Chair of Heathcare Professions for Assisted Dying: I am deeply curious to know why when twelve motions at least were submitted to survey the views of the BMA on neutrality regarding the issue of assisted dying that this motion did not actually make the agenda.  Given that the motion is extremely timely we know that Lord Falconer’s bill is receiving its second reading in the House of Lords in a couple of weeks I can only conclude and this may be the conclusion of some people in the represented body that people were afraid of doing a survey on neutrality as they were worried about the findings’.

Chairman’s response: ‘Thank you Ray.  I believe I answered that question earlier on. That is not a question for the Chairman of Council as I believe you know very well.  You had the opportunity to ask the RB (representative body) to prioritise that motion, the RB chose to disagree with you through the democratic process.  I do not want to hear any more about this because the RB said no. Next question…’

Well that was short shrift. But I expect Tallis and HPAD will be back again next year. He murmured at the end that he remained ‘unchastened’.

Meanwhile we can be thankful that the BMA has again stood on the principle that doctors should not kill their patients.

In June 1947 the BMA published a statement on ‘War Crimes and Medicine’ which it later submitted to the General Assembly of the World Medical Association in September1947.

It concluded: ‘Although there have been many changes in Medicine, the spirit of the Hippocratic Oath cannot change and can be reaffirmed by the profession. It enjoins…The duty of curing, the greatest crime being co-operation in the destruction of life by murder, suicide and abortion.’ 

Well they’ve done an about face since 1947 on abortion, but at least for now, they are standing firm on ‘murder’ and suicide. All is not yet lost.

Might Miliband be brokering a manifesto deal with Falconer over assisted suicide?

Lord Falconer’s ‘Assisted Dying Bill’ will receive its second reading in the Lords on 18 July. The former Lord Chancellor wants to license doctors to dispense lethal drugs to mentally competent adults who have less than six months to live and a ‘settled wish’ to die.

According to the Sunday Times he is claiming that a majority of peers in the House of Lords now support a change in the law.

That seems rather unlikely given that there are over 760 peers – and that most of them have not yet declared a view - but I suspect Falconer fancies his chances of obtaining a majority at a poorly attended Friday evening sitting in late summer.

There are already 92 peers who have put their names down to speak in the debate which means we might be in for a late night finish.

We have also seen from other recent debates that there has been a significant change in the composition of the House of Lords since the last election in 2010. Large numbers of both new labour and conservative peers of a liberal social disposition have come in and things may not be as one sided as they were when Falconer last tried to change the law on this issue with an amendment to the Coroners and Justice Bill in 2009. Then he lost by 194 votes to 141.

The 200 or so new peers may outwardly look like establishment figures but we need to remember than many of them were in their teens and twenties during the 1960s and imbibed fully that generation’s values (!). They are rich and powerful and also strongly politically correct. And assisted suicide is seen as a popular liberal cause.

Even if Falconer manages to win a second reading for his bill it needs to go through committee and third reading stage in the Lords and through three readings in the Commons before going for royal assent and finally becoming law. And this is a private member's bill, not a government bill, so no one is going to be in a great hurry to get it onto the statute books.

And with a general election looming in May 2015 there is not going to be much time for it either. Nor will there be much appetite for anything so controversial with election campaigns in full swing.  

Or will there? David Cameron is on the record as being strongly opposed to changing the law to allow any form of euthanasia on public safety grounds. There is therefore little possibility, even given a conscience vote, of assisted suicide ever getting the nod under a Tory-led House of Commons. But a Labour or Lab-Lib government after the next election may be another prospect altogether.

Ed Miliband, however, has not yet revealed his hand on the matter. Labour sources apparently say the party regards the issue as one on which MPs and frontbenchers should be given a vote. But insiders, according to the Sunday Times, say that Miliband sympathises with Falconer’s efforts and that the party is considering a guarantee of government time to discuss it if it wins the next election.

Falconer was Tony Blair’s former flatmate and it’s no secret how he was elevated to the peerage: Tony Blair appointed him. Again from the Sunday Times:

'He built up a successful career as a barrister but failed to be adopted as a prospective Labour MP because he refused to take his children out of private schools. But Blair made him a peer in 1997 and a minister soon after that. Falconer rose quickly through the ranks — solicitor-general, minister for the Millennium Dome, housing, Home Office and then, in 2003, lord chancellor and later justice secretary.'

He is now in a powerful position to further his personal agenda of legalising assisted suicide.

Again according to the Sunday Times:

‘Falconer is just about the only member of the Blair inner circle to be close to Ed Miliband. He has been appointed “head of the transition”, a rather grand piece of American jargon for Ed’s hoped-for move into Downing Street. This means Falconer will have a central role in any coalition negotiations and in the appointment of ministers…. He is a skilled lawyer, a proven political operator…’

It is then not beyond the realms of possibility that Falconer could be using his power to seal a deal with Miliband for some parliamentary time for his bill after the 2015 election, should Miliband have the good fortune to win. Perhaps he might seek even to get it into the Labour manifesto?

It will be a difficult call for Miliband. On the one hand he will be concerned about gaining the support of the growing super wealthy liberal elite – the coterie of celebrities, politicians, sportsmen, actors and entertainers who are gagging for this legal change. See Dignity in Dying's patrons' page for a taster.

Based on the evidence from other jurisdictions where assisted suicide is legal such as the US states of Oregon and Washington, it is precisely this group, those who are most used to being ‘in control’ in life, who are also the most likely to seek 'control' over the one thing they most fear… dying and death. The main reasons given for seeking assistance to take ones own life in the US North-West are not pain and suffering but rather loss of autonomy, loss of dignity and loss of enjoyment of life. 

But on the other hand the poor, weak and vulnerable – those who are sick, elderly or disabled – are the very ones who will be most at risk from exploitation and abuse should assisted suicide be legalised.

In a Britain where there is a widening gap between rich and poor, many are still struggling financially and, given increasing pressure on the NHS, are also those who are most likely to be subtly steered towards suicide either for fear of being a financial or emotional burden on their families, or because a glass of barbiturate is much cheaper than the costs of a care home, palliative treatment or a cycle of chemotherapy. In other words they will 'choose' assisted suicide because they can't afford any other of the 'choices' on offer and don't have the range of healthcare choices the rich and famous have. 

The fundamental problem with offering assisted suicide as a ‘therapeutic option’, which Falconer is attempting to do, is that killing oneself ‘with assistance’ will be by far the cheapest ‘choice’ available. 

And this alone will make it hugely tempting to greedy relatives worried about an inheritance being spent on care or to health ministers looking for budgetary cuts whilst faced with the burgeoning healthcare needs of a growing elderly population. And the so called 'right' to die could then very easily become the duty to die - doing the decent thing.

So which route will Miliband go? Will he accede to the wishes of the wealthy liberal elite, the politically correct? Or will he make protection of the poor and vulnerable his key priority?

At present he seems, perhaps deliberately, to have chosen to keep all options open.

Doctors strike back at BMJ editors over assisted suicide stance

BMJ editors Fiona Godlee (pictured) and Tony Delamothe are long-time supporters of decriminalising assisted suicide and have frequently used their editorial position in Britain’s most widely read medical journal to advance their cause.

This week they have written an editorial in support of Lord Falconer’s Assisted Dying bill which has understandably received a lot of media coverage (see here, here and here) and has got the blogosphere buzzing (see here, here, here and here).

They argue that assisted dying should be legalised because respecting ‘choice’ (autonomy) is now a more important priority than preserving life.

The BMJ is editorially independent from the British Medical Association (BMA) but is paid for by the subscriptions of BMA members, most of whom do not support changing the law.

So it is not surprising that their editorial has generated a lot of correspondence, almost all of it opposing Godlee and Delamothe.

Dr Mark Porter, chairman of the BMA council has said:

‘There are strongly held views within the medical profession on both sides of this complex and emotive issue.

The BMA remains firmly opposed to legalising assisted dying. This issue has been regularly debated at the BMA's policy forming annual conference and recent calls for a change in the law have persistently been rejected.

The BMJ is a wholly owned subsidiary of the BMA, and quite rightly has editorial independence. Its position on assisted dying is an editorial decision and does not reflect the views of the BMA or the medical profession. Our focus must be on making sure every patient can access the very best of palliative care, which empowers patients to make decisions over their care.’

A letter in the same print edition (so received before the editorial was published) from RCGP Council Chair Maureen Baker makes clear that the recent RCGP consultation on ‘assisted dying’ was comprehensive and conclusively in favour of no change to the law.

‘Our recent consultation on assisted dying was one of the most comprehensive ever undertaken, with 1700 members responding from all four nations of the UK.

The result was conclusive—77% of members who submitted responses directly to the college indicated that the RCGP should maintain its opposition to a change in the law.

Of the 28 RCGP bodies and groups who responded, 20 reported a majority view in favour of maintaining the college’s opposition to a change in the law and three reported a majority view in favour of a “neutral” stance. None reported a majority view in favour of active support for a change in the law.’

There is also an excellent contribution, again the same print edition, from Rob George, professor of palliative care, Cicely Saunders Institute, King’s College London. 

In an article titled ‘We must not deprive dying people of the most important protection’ he argues that the safety of vulnerable people must take priority over the determined wishes of individuals. Hard cases are already dealt with mercifully under the law which does not need changing.

‘Elizabeth Butler-Sloss, former president of the High Court, said, “Laws, like nation states, are more secure when their boundaries rest on natural frontiers. The law that we have rests on just such a frontier . . . The law is there to protect us all. We tinker with it at our peril.”

For me the real question is this: “Which is worse: not to kill people who want to die or to kill people who might want still to live?” In my experience it is impossible to separate those who might want to die from those who believe they ought to die and whose view is pretty well never “settled.” No one can be sure that some people not now at risk will find themselves so were the law to change.

A full blooded expression of autonomy includes the responsibility at times to restrain oneself on behalf of another: when it comes to having our lives ended, let’s keep it that way. Once this line is crossed there is no going back.’

I was briefly quoted in the Telegraph making much the same point about the limits of autonomy:

‘While autonomy is important it has to be balanced against other principles including public safety.

None of us believes autonomy is absolute, if we did we would have to say that there was no place for law because every single law restricts personal autonomy.’

Godlee and Delamothe appear not to understand that autonomy has limits. They are also well out of step with medical opinion and do not speak for the medical profession.

About two thirds of doctors in most surveys are opposed to any change in the law along with all the major medical institutions including the BMA, RCGP, RCP, British Geriatric Society and the Association for Palliative Medicine.

In a free society choice is important, but it has its limits. The duty to protect life trumps the so-called ‘right to die’.

Bankrolling killing – how the rich and famous promote abortion and euthanasia

The world’s fourth richest person, Warren Buffett, ploughed $1.23 billion into abortion groups over eleven years, a media watchdog has found.

The Media Research Center (MRC), which analysed tax returns for Buffett’s foundation, labeled him the ‘king of abortion’.

The MRC says the money given ‘is enough to pay for the abortions of more than 2.7 million babies in the womb’ – which, it points out, equates to the entire city of Chicago.

MRC’s report lays out the money Buffett’s foundation gave between 2001 and 2012, saying it amounted to $1,230,585,161.

The money was given to groups which either ‘provided abortions themselves or advocated for abortion or access to abortion’.

Warren Buffett has made his money through investments, and is listed by Forbes as having a net worth of $65.4 billion.

According to Buffett biographer Roger Lowenstein, Buffett has a ‘Malthusian dread that overpopulation [will] aggravate problems in all other areas – such as food, housing, even human survival.’

This fear of an overcrowded planet is at least in part what gives him his enthusiasm for abortion. I guess he thinks that if there were more people on the planet his wealth might have to be shared.

Buffet is not alone amongst the mega-rich in having a record of funding population control. Also previously implicated are Ted Turner (founder of the Cable News Network), Bill Gates of Microsoft, David Packard, co-founder of Hewlett-Packard and financier George Soros.

In a similar way the pro-assisted suicide campaign in the UK has been bankrolled by wealthy businessmen.

Lord Falconer’s Assisted Dying Bill, which seeks to legalise assisted suicide for mentally competent adults with less than six month to live, follows on from his highly controversial Falconer Commission which laid its framework.

This was conceived by Dignity in Dying (DID), the former Voluntary Euthanasia Society, manned by euthanasia sympathisers and funded by DID patrons Terry Pratchett and Bernard Lewis.

Bernard Lewis is the English entrepreneur behind the River Island fashion brand and clothing chain and is estimated to be worth £1,030m (€1,484m).

Terry Pratchett is an English novelist who has a net worth of £42 million according to the Sunday Times Rich List.

They are small fry compared with Buffet and Gates but very well-endowed by UK standards.

Baroness Warnock is a moral philosopher who believes that elderly people suffering from dementia should consider ending their lives because they are a burden on the NHS and their families.

She said in 2008 that pensioners in mental decline are ‘wasting people's lives’ because of the care they require and insisted there was ‘nothing wrong’ with people being helped to die for the sake of their loved ones or society.

The 84-year-old added that she hoped people will soon be ‘licensed to put others down’ if they are unable to look after themselves.

It deeply troubles me when I hear of very wealthy and powerful people using their money to finance efforts to legalise medical killing through abortion, assisted suicide or euthanasia.

I wonder if part of the motivation is to protect their personal wealth from those who might have calls on it for care, support or treatment.

The real heart of a society is revealed in the way it treats vulnerable people – especially the unborn, elderly, sick or disabled. Does it make sacrifices for vulnerable people or does it choose rather to sacrifice them?

These rich men all use the language of autonomy, choice and compassion but taking another person’s life through abortion or euthanasia, or helping them to kill themselves through assisted suicide, is actually to eliminate all future choice.

In stark contrast stands the life of Jesus Christ, creator and sustainer of the universe, who gave himself for us when we were helpless and weak:

‘For you know the grace of our Lord Jesus Christ, that though he was rich, yet for your sake he became poor, so that you by his poverty might become rich.’ (2 Corinthians 8:9)

‘For while we were still weak, at the right time Christ died for the ungodly. ‘ (Romans 5:6)