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Rabbi Jonathan Romain: We all deserve the right to dignity and compassion in death

To help somebody to die is illegal in this country. The law regards assisted dying not as compassion but as murder. That’s why I am campaigning to allow doctors to help the terminally ill to die, says Rabbi Jonathan Romain (above)

When a friend or loved one is ill, one question springs instinctively to our lips: ‘Is there anything I can do for you?’

We say it without stopping to think. It’s a natural, heartfelt response — we want to make life easier, to alleviate suffering.

But for many people with terminal illness, either enduring great pain or the terror of a death without dignity, the one thing they truly want cannot be given. Anyone helping someone to take their own life runs the risk of facing the full force of the law — and the possibility of 14 years in jail.

To help somebody to die is illegal in this country. The law regards assisted dying not as compassion but as murder.

That’s why I am campaigning to allow doctors to help the terminally ill to die. And at last, I believe politicians in Britain are willing to listen.

We find it difficult in this country to talk about death. That’s a complete reverse since the Victorian age, when death was treated with a morbid sentimentality but sex was never discussed.

Our ancestors filled churchyards and public places with Gothic memorials to death. It was even commonplace to have photographic portraits of children after death. All sexual matters, on the other hand, were completely taboo.

Today, we talk constantly about sex, and death is the great taboo. The reasons for that are complex, though I suspect it is partly because of the decline in religious affiliation.

With a loss of belief in the hereafter, people feel they have to hang on to life at all costs because it is all they’ve got. This makes it very hard to have a mature, rational discussion about whether it can be right for anyone to choose their own death, rather than being forced to die in painful and sometimes degrading ways, inch by horrible inch.

We find it difficult in this country to talk about death. That's a complete reverse since the Victorian age, when death was treated with a morbid sentimentality but sex was never discussed. (File image)

We find it difficult in this country to talk about death. That’s a complete reverse since the Victorian age, when death was treated with a morbid sentimentality but sex was never discussed. (File image)

Some people will want to hang on until the last breath and we should help them do that. But if that is not their wish, why are we so afraid of giving the choice?

A new bid to legalise assisted dying was launched in the Scottish Parliament this week. Lib Dem MSP Liam McArthur put forward proposals for a Private Members’ Bill which, if passed, would permit adults who are both terminally ill and mentally competent to end their lives.

Last month, a similar Private Member’s Bill for England and Wales was brought before Parliament, with a second reading due this autumn.

Under the terms of the Bill, a patient with a terminal illness could apply to be helped to die at a time and place of their choosing — for example, in their own home, with their family around them. This application would have to be approved by two independent doctors and a High Court judge.

To push for this change in the law, I have helped set up a collective of leaders from all faiths, the Religious Alliance For Dignity In Dying, of which I am the chair.

The group’s aim is to challenge the inaccurate view that people of religious faith are flatly opposed to assisted dying.

My experience is that many members of the clergy in all religions are sympathetic to the idea, and that the overwhelming majority of worshippers — Christians, Jews, Muslims, Hindus and other faiths — support it.

One poll showed that 84 per cent of people who regard themselves as religious believe that assisted dying should not be forbidden by law.

I have not always held this view. When I became a rabbi in 1980, I felt that nobody had the right to play God, as I saw it.

A new bid to legalise assisted dying was launched in the Scottish Parliament this week. Lib Dem MSP Liam McArthur (above) put forward proposals for a Private Members' Bill which, if passed, would permit adults who are both terminally ill and mentally competent to end their lives

A new bid to legalise assisted dying was launched in the Scottish Parliament this week. Lib Dem MSP Liam McArthur (above) put forward proposals for a Private Members’ Bill which, if passed, would permit adults who are both terminally ill and mentally competent to end their lives

Like many people in Britain at the time, I thought assisted dying was a euphemism for euthanasia, and that it could lead directly to appalling consequences — the state-sanctioned murder of people with severe disabilities, for example.

Also, I worried that it would put immense pressure on the elderly to opt for medical suicide, rather than live on in expensive care homes or as a ‘burden’ on their families.

There was in addition the alarming spectre of greedy people ‘hurrying’ their elderly relatives on their way, so they could inherit sooner.

Gradually, I have addressed all these concerns. My opinions have changed, but this did not happen quickly. All the same, I can identify one moment when the penny dropped — when I was suddenly aware that my previous assumptions had been entirely wrong.

As a congregational rabbi in Maidenhead, Berkshire, one of my duties is to visit seriously ill people, both in hospices and hospitals, and at their homes. Palliative-care nurses, particularly in hospices, do a wonderful job with infinite patience and kindness. But there are some people they simply cannot help, because their pain is too great or the horrors of their death are too appalling.

One day I entered a hospice room to find a man kneeling on the bed, doubled over, face down with his head between his legs. He was in unspeakable agony from stomach cancer and nothing he could do would ease it.

His wife was sitting beside the bed in silent tears, helpless. Her own agony was awful to see too.

Something I often hear both patients and their families say in such situations is: ‘You wouldn’t let an animal suffer like this. A dog is treated better than a human.’ And that’s true.

Why should such people be forced to stagger on, if they don’t want to? Why can they not be offered the option of a death with compassion and dignity, instead of being dosed with drugs into a stupor — a stupor which dulls everything, until there is nothing left of you?

The more I thought about it, the more I realised that should I reach that point, I could wish for nothing better than to die at a time I chose myself, when I was still conscious and able to tell my family one last time that I loved them.

Those who can afford it might opt to go to the Dignitas clinic in Switzerland, which offers legal facilities for assisted dying. This is not cheap: the cost, with travel, can easily exceed £10,000. (File image)

Those who can afford it might opt to go to the Dignitas clinic in Switzerland, which offers legal facilities for assisted dying. This is not cheap: the cost, with travel, can easily exceed £10,000. (File image)

Perhaps I would choose to die at home, in my favourite armchair, after receiving hugs and farewells, and holding a loving hand. And if one of my congregation thinks that is better than to die on a ward or in a hospice bed, how can we be so arrogant as to think we have the right to forbid it?

For whose benefit are we making that decision? Certainly not for the patient who pleads to be allowed to die.

But I still didn’t realise what I needed to do, until a few months later when I preached a sermon for the Jewish New Year, Rosh Hashanah. It was one of my better ones, a rousing pep talk about seizing the opportunity for change and making a break with the past.

Afterwards, in a quiet hour of reflection, I asked myself how I was going to apply the sermon to my own life. At that moment, I knew I had to campaign for a change in the law, to help people who had suffered enough and wanted to let go.

Currently, all options are bad for people in pain with no hope of recovery. Too often, in the grip of terminal cancer, motor neurone disease or other incurable diseases, they feel driven to suicide — taking their own lives while they still can.

Sadly, people frequently decide to do this in secret, so that no blame can attach to their families. It is a lonely death. If their attempt fails, it can leave them in even more pain, and it causes great trauma to their loved ones.

If they do kill themselves, often a family member will find their body. I have counselled people in the aftermath of such a shocking discovery. I know how deeply upsetting it can be to have to untie the rope or mop up the blood.

Those who can afford it might opt to go to the Dignitas clinic in Switzerland, which offers legal facilities for assisted dying. This is not cheap: the cost, with travel, can easily exceed £10,000.

And the law around such a trip is not always clearly understood by British authorities. I have known of relatives who returned from Switzerland, only to have a knock on the door from the police.

They were interviewed, cautioned, threatened with prison, then left in fear and suspense for months — all while grieving for a parent or spouse. That is unforgivable, and we have a duty to put a stop to such cruelty.

Though the Religious Alliance was launched only last week, I have been involved in its precursor for the past five years — Inter-Faith Leaders For Dignity In Dying, an organisation that offers a safe place to discuss these issues for priests, rabbis, imams and all other members of the clergy.

The group was necessary because within the hierarchy of most religions, even to raise this issue is seen as trouble-making. Gradually, though, major figureheads have been voicing their support for choice — including the former Archbishop of Canterbury, George Carey, and Archbishop Desmond Tutu in South Africa.

Desmond Tutu said he would opt for assisted dying himself, if it is appropriate when his time comes. When such a revered personality speaks out, people listen.

Opposition at the British Medical Association may be beginning to soften, and neutrality is the new official position at the Royal Colleges of Nursing and Physicians. It seems the Government is also ready to take a more measured and mature stance.

Health Secretary Matt Hancock has launched an inquiry into suicide and end-of-life care, with a genuine willingness to examine the facts. I do not know his personal position, but I can see he is sympathetic to allowing debate

Health Secretary Matt Hancock has launched an inquiry into suicide and end-of-life care, with a genuine willingness to examine the facts. I do not know his personal position, but I can see he is sympathetic to allowing debate

An attempt to change the law in Scotland in 2015 was voted down by 82 votes to 36. Six years ago, when the House of Commons last voted on assisted dying, then-Prime Minister David Cameron made known his strong disapproval. Today, there is a shifting of tectonic plates.

Health Secretary Matt Hancock has launched an inquiry into suicide and end-of-life care, with a genuine willingness to examine the facts. I do not know his personal position, but I can see he is sympathetic to allowing debate.

There are legitimate concerns around any law that enables doctors to advance death. Crucially, assisted dying is different from euthanasia. The former allows a patient to self-administer a lethal potion or injection; the latter requires the assistance of a doctor.

Assisted dying can be possible only when the patient has mental capacity, to understand and express a desire. It could never apply in cases of advanced dementia, for example, because doctors could not know whether death really was the patient’s wish.

I would also not support the Dutch model, where people with chronic clinical depression have the option of assisted dying. Depression is a terrible illness, but it can be treated.

I have known people who have attempted suicide and survived, and gone on to lead fulfilled lives. There is, in moral terms, an enormous difference between helping somebody to die when they are terminally ill, and aiding their death when they could live in good physical health for many years.

In the same way, we must always remember people with disabilities, even very severe ones, can be helped to live happy, fulfilling lives. That is a very important red line.

Morality is not static. We are constantly fine-tuning it on the basis of the reality of today.

It is arrogant for people to say, as a matter of principle, that they don’t believe in assisted dying. We should never impose our morality for our own satisfaction.

And we should also have the courage to think about death, about our own deaths, and ask ourselves honestly what we want for ourselves. Would you really prefer not to have the option of being helped to die if life were unbearable and there were no hope of a reprieve?

Some people insist there is value in suffering, that it refines the soul from a religious point of view. I think that is wrong.

Where we can heal, we should. But when a life is beyond saving, we should bring comfort and assist people to let go of life when that is their wish.

Rabbi Dr Jonathan Romain is chair of the Religious Alliance For Dignity In Dying and Minister of Maidenhead Synagogue.


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