Assisted Suicide

Pastoral Letter on Assisted Suicide
12/13 October 2024

My brothers and sisters,

This Wednesday, 16 October 2024, a bill will be introduced to Parliament proposing a change in the law to permit assisted suicide. The debate will continue for a number of months, in society and in Parliament, before a definitive vote is held there. This puts in the spotlight crucial questions about the dignity of human life and the care and protection afforded by our society to every human being.

As this debate unfolds there are three points I would like to put before you. I hope that you will take part in the debate, whenever and wherever you can, and that you will write to your Member of Parliament.

The first point is this: Be careful what you wish for.
No doubt the bill put before Parliament will be carefully framed, providing clear and very limited circumstances in which it would become lawful to assist, directly and deliberately, in the ending of a person’s life. But please remember, the evidence from every single country in which such a law has been passed is clear: that the circumstances in which the taking of a life is permitted are widened and widened, making assisted suicide and medical killing, or euthanasia, more and more available and accepted. In this country, assurances will be given that the proposed safeguards are firm and reliable. Rarely has this been the case. This proposed change in the law may be a source of relief to some. But it will bring great fear and trepidation to many, especially those who have vulnerabilities and those living with disabilities. What is now proposed will not be the end of the story. It is a story better not begun.

The second point is this: a right to die can become a duty to die.
A law which prohibits an action is a clear deterrent. A law which permits an action changes attitudes: that which is permitted is often and easily encouraged. Once assisted suicide is approved by the law, a key protection of human life falls away. Pressure mounts on those who are nearing death, from others or even from themselves, to end their life in order to take away a perceived burden of care from their family, for the avoidance of pain, or for the sake of an inheritance.

I know that, for many people, there is profound fear at the prospect of prolonged suffering and loss of dignity. Yet such suffering itself can be eased. Part of this debate, then, must be the need and duty to enhance palliative care and hospice provision, so that there can genuinely be, for all of us, the prospect of living our last days in the company of loved ones and caring medical professionals. This is truly dying with dignity. Indeed, the radical change in the law now being proposed risks bringing about for all medical professionals a slow change from a duty to care to a duty to kill.

The third point is this: being forgetful of God belittles our humanity
The questions raised by this bill go to the very heart of how we understand ourselves, our lives, our humanity. For people of faith in God – the vast majority of the population of the world – the first truth is that life, ultimately, is a gift of the Creator. Our life flows from God and will find its fulfilment in God. ‘The Lord gave, and the Lord has taken away; blessed be the name of the Lord.’ (Job 1:21) To ignore or deny this truth is to separate our humanity from its origins and purpose. We are left, floating free, detached, in a sphere that lacks firm anchors or destiny, thinking that we can create these for ourselves according to the mood of the age, or even of the day.

The clearest expression of this faith is that every human being is made in the image and likeness of God. That is the source of our dignity and it is unique to the human person. The suffering of a human being is not meaningless. It does not destroy that dignity. It is an intrinsic part of our human journey, a journey embraced by the Eternal Word of God, Christ Jesus himself. He brings our humanity to its full glory precisely through the gateway of suffering and death.

We know, only too well, that suffering can bring people to a most dreadful state of mind, even driving them to take their own lives, in circumstances most often when they lack true freedom of mind and will, and so bear no culpability. But this proposed legislation is quite different. It seeks to give a person of sound will and mind the right to act in a way that is clearly contrary to a fundamental truth: our life is not our own possession, to dispose of as we feel fit. This is not a freedom of choice we can take for ourselves without undermining the foundations of trust and shared dignity on which a stable society rests.

As this debate unfolds, then, I ask you to play your part in it. Write to your MP. Have discussions with family, friends and colleagues. And pray. Please remember: be careful what you wish for; the right to die can become a duty to die; being forgetful of God belittles our humanity.

May God bless us all at this critical time

Right Reverend Patrick Joseph McKinney
Bishop of Nottingham

Pastoral Letter on Assisted Suicide

appointed to be read at all Sunday Masses celebrated in the Diocese of Nottingham on the Thirtieth Sunday of the Year, Saturday 26th and Sunday 27th October 2024

Dear brothers and sisters in Christ,

A Bill has been introduced to Parliament which proposes a radical change to the law. If passed it will allow a terminally ill person the possibility to seek lethal drugs from their doctor, so as to end their life prematurely. Proponents of this change in the law speak of ‘assisted dying’, but let’s be clear, this Bill isn’t about giving people access to palliative care to relieve their suffering, and it isn’t about a patient having the right to decide to stop life-prolonging treatment; people in this country already have these rights. No, this Bill is about allowing a doctor to assist a person to take their own life, to help someone commit suicide, without criminal consequences.

This Bill is about assisted suicide. As Catholics we can never support assisted suicide, in any situation or any circumstance. The Commandment, ‘You shall not kill’ makes clear that to deliberately kill or assist in the killing of an innocent human person is a grave violation of the moral law. This commandment demands that we value and safeguard human life at every stage of life, until its natural end. It is never permissible to take the life of a human being, even if a person requests it. Life is a gift from God, to be treasured and protected in all its vulnerability, and it is God alone, the author of life, who will call us back to Himself at the appointed hour. This respect for the sacredness of life and the dignity of the human person is foundational to our care for the sick, the aged, and the most vulnerable in our society.

The Church has always been a strong defender of the sanctity of life at all stages, but especially when life is at its most vulnerable: at its beginning and its end. This Bill has the potential to initiate a paradigm shift in how we understand, value, and protect the sacredness of every human life, and so to profoundly affect the very fabric of our society. Laws to legalise assisted suicide strike at the foundation of the legal order; the right to life sustains all other rights, including the exercise of freedom. While real and emotional descriptions of painful suffering in dying and death resonate powerfully with all of us, the ardent desires of a few cannot outweigh our obligations to the greater common good, which includes protecting the lives of all, especially the most vulnerable.

Supporters of this legislation argue that the elderly, disabled and other vulnerable persons will be protected through a careful framing of the Bill, with stringent safeguards and strict criteria. But evidence from other jurisdictions, where assisted suicide has been legalised, shows the very real danger that, once legalised, the initial criteria can quickly become broadened. Canada, with a similar health system to ours, provides a salutary tale in this regard. So called ‘medical assistance in dying’ was introduced in a similar way to this current Bill, yet five years later it has been rapidly expanded to include chronic illness, disability, mental health, and it has even been offered to patients for reasons linked to old age, disability, and other social issues. In New Zealand, within just a year of being legalised, evidence is emerging that people are choosing euthanasia due to financial concerns, or because they felt a burden to their family, or because they felt alone and abandoned. Once exceptions are made, the evidence is clear that such legislation knows no end.

Furthermore, one can only imagine the moral and emotional pressure this Bill will place on our hard-pressed doctors and other medical professionals. The need for medical care is born in the vulnerability of the human condition, and it encompasses the responsibility to care for and promote human life, underpinned by the principle to ‘do no harm’. This Bill risks changing forever the relationship between patients and doctors, those to whom we have always looked for medical advice and care in times of need. Whilst some would argue that doctors have a duty of compassion and a duty to relieve their patients’ suffering, incurable cannot mean that care comes to an end, and compassion cannot extend to taking the life of another person. In this respect, palliative care constitutes a precious and crucial instrument in the care of patients during the terminal stages of illness. The excellent work of hospices across our country bears witness to what it means to holistically accompany, and compassionately care for, a person in their final days. Britain founded the modern hospice movement, and so it a very sad reflection on our society that access to hospice care is a postcode lottery, and that hospices in this country are so poorly funded and so heavily reliant upon charitable donations. It should also be noted that in many countries where such laws have been introduced there has been a gradual decline in funding for palliative care. Whilst it is never morally licit to take the life of an innocent person, whatever the situation or circumstance, we must also be deeply concerned by the particular context in which this Bill is being introduced. It arrives at a time when cost cutting measures are being sought by the government, and public services are under enormous pressure. Our greatly valued NHS is at breaking point, social care provision is struggling, winter fuel payments are being withdrawn from many pensioners, and access to high quality palliative care is at best patchy and seriously underfunded. There is also a growing elderly population who need care and support, many of whom already feel a burden to their families and public services, alongside disabled persons who struggle to get the support they need in daily life. As many have pointed out in this debate so far, a right to die runs the risk of very quickly turning into a duty to die, and even more so given the current state of our society.

In just over a month’s time, on Friday 29th November, this Bill will receive its second reading. This is the moment when there will be a general debate, and MPs can vote on it in the House of Commons. So, I urgently encourage you to write to your MP and share your concerns about this Bill. There are tools and resources on the diocesan website to help you to do this. Please join with me in praying and working to help ensure that this bill will not be passed into law.

Bishop of Nottingham

Eight Reasons We Must
Not Legalise ‘Assisted Dying’
Professor David Albert jones www.bioethics.org.uk

1) It overturns a fundamental principle of law and medicine
‘Assisted dying’ is the intentional ending of the life of a patient by a doctor (‘euthanasia’) or a patient ending their own life with a lethal drug supplied by a doctor for this purpose (‘assisted suicide’). These practices violate the prohibition of intentional killing, which is ‘the cornerstone of law and of social relationships.’ Affirmed by Hippocratic Oath and World Medical Association, and of course by the Commandment, ‘Thou shalt no kill’.

2) Changing the law changes things for everyone
Everyone eligible must now live with this as a possibility. Some will feel that, once eligible, they have to justify their existence. Assisted suicide and euthanasia are not isolated individual acts but social practices. In Canada doctors obliged to raise this even if patient not asked, including patients who cannot get the health or social care they need.

3) People feel pressure to end their lives because they feel they are a burden to others
Nicholas Tonti-Filippini said that, ‘fear of being a burden is a major risk to the survival of those [of us] who are chronically ill.’ In Oregon assisted suicide because of fear of being a ‘burden on family, friends / caregivers’ increased from 13% in 1998 to 54.2% in 2021. Matthew Parris society ‘simply cannot afford’ to care for older people ‘may one day be the kind of unspoken hint that everybody understands. And that’s a good thing’[!]

4) It normalises taking your own life for some categories of people
Assisted and unassisted suicide not always so different. Some people who attempt suicide are older or have an incurable illness. Legalising assisted suicide undermines the imperative of suicide prevention, that ‘every suicide is a tragedy’. Data from the USA shows that change in the law is associated with a significant increases in conventional suicide in the population (6% overall, 13% among women).

5) Once legalised it expands far beyond what was originally intended
‘Assisted dying’ expands in numbers (in Canada 13,241 deaths in 2022) and in eligibility criteria. In Belgium first adults then extended to children, in the Netherlands extended to people with dementia who can no longer consent, in Canada extended to people whose death is not ‘reasonably foreseeable’, in Colombia extended people not ‘in the terminal phase’, in Oregon physician-assisted suicide for ‘terminal illness’ has been extended to anorexia, hernia and arthritis. Begins as a ‘narrow’ law but leads to something worse.

6) It jeopardises funding and provision of palliative care
Belgium palliative care provision increased at first (from 2002 to 2011) but since 2012 it has fallen behind non-euthanasia countries. In 2022, New South Wales promised $743 million over 5 years, but 2023 palliative care annual budget was cut by $249 million. Palliative care must compete for funds with ‘assisted dying’. Causes moral distress to doctors and nurses who leave the profession. In Canada at least one hospice closed.

7) All the more dangerous given the state of the NHS and social care
Even if someone believes ‘assisted dying’ is ethically acceptable in principle, could not be implemented safely unless adequate alternatives in place. Cannot be offered lethal drugs within days if have to wait months for the health and social care as Health Secretary Wes Streeting has said, currently would not be calls ‘a real choice’.

8) It is a greater threat to those who already face discrimination
Watch Liz Carr’s documentary ‘Better Off Dead’ where a succession of disabled people say that they have been told that, ‘if my life was like yours then I’d want to kill myself’. In a recent national poll, people were asked ‘Would you want your MP to vote for or against legislation to make assisted dying legal in the UK?’ Only 43% of people said ‘vote for’. Support slightly higher among NHS workers (49%) but lower among people with lifelimiting or terminal illness (41%), slightly higher among White British (46%) but lower among Asian British (24%) and Black British (24%). Those who have experienced discrimination in access to healthcare can see the dangers more clearly.

Writing or speaking to your Westminster MP

The Anscombe Centre is encouraging all citizens to contact their MP to raise concerns about this Bill so that MPs can inform themselves by hearing from a range of people (not jut the media).

Please do not write to an MP unless you live in their constituency. You can find names contact details for your MP through the Houses of Parliament website https://members.parliament.uk/members/Commons

In speaking or writing to your MP, it is always better to speak from experience, your own experience for example as a healthcare professional, or a carer, or as someone living with illness of disability, or from the experience of someone you are close to.

There are many different reasons why someone might oppose the legalisation of suicide and it is best to focus on the issue or issues that most concern you. It is a mistake to try to say everything rather than saying one or two things well. Other people will say other things.

The Anscombe Centre has resources on different topics which provide evidence showing that people are right to be concerned. Please see our dedicated web page https://www.bioethics.org.uk/educational-resources/resources-on-eas/

We are already the children of God

A Holy Hour on the Dignity of Human Life

Prayer before the Blessed Sacrament

Exposition

Song

After the people have assembled, a song may be sung while the minister comes to the altar.

Adoration

Suggested readings

1 Peter 1:3-4
Blessed be the God and Father of our Lord Jesus Christ! According to his great mercy, he has caused us to be born again to a living hope through the resurrection of Jesus Christ from the dead, to an inheritance that is imperishable, undefiled, and unfading, kept in heaven for you.

Psalm 71:9
Do not cast me off in the time of old age; forsake me not when my strength is spent.

1 John 3:1-2
See what kind of love the Father has given to us, that we should be called children of God; and so we are. The reason why the world does not know us is that it did not know him. Beloved, we are God’s children now, and what we will be has not yet appeared; but we know that when he appears we shall be like him, because we shall see him as he is.

          Reflection                                                                        Embrace and uphold a culture of life

We offer our prayers this holy hour for the dignity of human life. In particular our focus is on the end of life and praying together in front of the Blessed Sacrament that assisted suicide will not become law in our lands. This would greatly diminish the importance and innate value of every human person, akin to saying that our life is not a gift of God. Instead we would be asserting that life is our own possession to do with as we choose. But we are far more important than that. We are a gift of God – a gift that is freely given. Then, when God is ready, we are called back to Him.

During this holy hour, we pray that many minds and hearts will be open to this beautiful and great truth about the value, importance, and beauty of every human person. We pray passionately that we will not take a step in legislation that promotes a so-called ‘right to die’, that will quite likely become a duty to die and place pressure on doctors and medical staff to help take life rather than to care, protect, and heal.

When you are praying, please remember those who care and accompany people facing their last days. Especially pray for those who work in palliative care – nurses, doctors, people who are home visitors. They do a wonderful job with compassion, but they need more resources. That is what we should be investing in, not a piece of legislation that leaves us vulnerable and under pressure to seek an end to our life.

This is an important moment in our history. Please write to your MP to make your voice heard. Many have not yet made up their minds how to vote. May God bless us all, bless our countries, and bless those who make our laws with the courage to embrace and uphold a culture of life.

Cardinal Vincent Nichols, President, Catholic Bishops’ Conference of England and Wales

Silence Intercessions

Let us pray that we will keep our minds and hearts open to the beautiful truth that the dignity of human life will be respected by all people from its natural beginning until its natural end.

We pray for those who are nearing the end of their lives, that as they prepare to make the journey to the eternal life prepared for us, they may know the tender love and mercy of God our heavenly Father.

For those who are receiving palliative care, that they may trust in God’s love even in the hardest moments, knowing that the Lord bears their suffering with them.

For politicians and those in authority, that they may have the courage to embrace and uphold a culture of life, and always work for the common good of all.

For doctors, nurses, carers and those who are home visitors, that they may be blessed in their work, and that they may have the necessary resources to carry out their vocation with love and compassion.

Benediction

The priest or deacon goes to the altar genuflects and kneels. A hymn, such as Tantum ergo, or other eucharistic song is sung.

The Prayer of John Henry Newman

Bringing to the Lord the shared aspect of death and suffering

O Lord, support us all the day long of this troublous life,  until the shadows lengthen, and the evening comes and the busy world is hushed, and the fever of life is over, and our work is done.

Then, Lord, in thy mercy, grant us a safe lodging, a holy rest, and peace at the last.

Amen.

Blessing

The priest or deacon puts on the humeral veil, genuflects, and takes the monstrance or ciborium. He makes the sign of the cross over the people with the monstrance or ciborium in silence.

Reposition

Reposition

After the blessing the Blessed Sacrament is replaced in the tabernacle.

Acclamation

As the Blessed Sacrament is being replaced the people may sing an acclamation.

Excerpts from Holy Communion and Worship of the Eucharist outside Mass © 1974 International Committee on English in the Liturgy, Inc. Scripture quotations are from the ESV® Bible (The Holy Bible, English Standard Version®), copyright © 2001 by Crossway, a publishing ministry of Good News Publishers. Used by permission. All rights reserved. Other material and layout © 2024 Catholic Bishops’ Conference of England and Wales.

Catholic Bishops of England, Wales, and Scotland unite in compassionate action to oppose Bill on assisted suicide

The Catholic Bishops of England, Wales and Scotland have issued a statement on Assisted Suicide ahead of the Second Reading of the Terminally Ill Adults (End of Life) Bill.

In it, the bishops explain exactly what ‘compassion’ means at the end of life – caring for and accompanying people, particularly during times of suffering.

The statement strongly defends the vulnerable in society who are at risk through this proposed legislation, and the bishops advocate for better funded palliative care to be consistently available to everyone in need in England, Wales, and Scotland. “People who are suffering need to know they are loved and valued. They need compassionate care, not assistance to end their lives,” say the bishops. “Palliative care, with expert pain relief, and good human, spiritual, and pastoral support, is the right and best way to care for people towards the end of life.”

They also assert that assisted suicide raises serious issues of principle that can’t be ignored:

“The time given for Parliament to consider the Terminally Ill Adults (End of Life) Bill, which will permit assisted suicide is woefully inadequate. Although the Bill indicates safeguards will be in place, the experience of other countries where assisted suicide has been introduced shows that such promised safeguards are soon forgotten. In Belgium, the Netherlands, Canada, and parts of the USA, the criteria for assisted suicide have been expanded significantly, in law or in practice, often to include people with mental illness and others who have no terminal diagnosis.”

The bishops affirm the Catholic belief in human dignity and sanctity of life, but fear that a law that allows for assisted suicide could lead some to experience ‘a duty to die’:

“Some may well feel their continued existence is a burden to others, and, implicitly or explicitly, be pressured into assisted suicide. This includes people who are elderly, infirm, and living with disabilities. The protection of such people is the foundation of civilised society. It is at the heart of good government.”

The bishops also express their concern that this Bill will fundamentally damage the relationship between medical staff and their patients. They fear it could lead to pressure on medical practitioners to recommend or facilitate such procedures:

“The impact on hospices, care homes, and those who work in social and community care cannot be underestimated. It will radically alter the ethos of trust and support which underpins our service to those in need and their families.”

Finally, two weeks ahead of the debate and vote in parliament, the bishops urge Catholics and those who share our belief in the dignity and value of every human life, to contact their local MP to make their opposition known, asking him or her to oppose or not support the Bill.

Many bishops have issued pastoral letters on assisted suicide. You can find those promulgated by the Bishops of England and Wales here: https://www.cbcew.org.uk/category/cbcew/life-issues/assisted-suicide

Full statement

Be compassionate

As Catholic Bishops in England and Wales, and in Scotland, we believe that genuine compassion is under threat because of the attempts in Parliament to legalise assisted suicide. ‘Compassion’ means to enter into and share the suffering of another person. It means never giving up on anyone or abandoning them. It means loving them to the natural end of their life, even if and when they struggle to find meaning and purpose. Compassion means accompanying people, especially during sickness, disability, and old age. This kind of genuine compassion is witnessed through the care and respect we show to people with terminal illness as they complete their journey in this life.

We appeal to those who share our Catholic belief in human dignity and sanctity of life, including fellow Christians, other religious people, and people of reason and good will, to join with us in defending the weakest and most vulnerable who are at risk through this proposed legislation.

Life is a gift to be protected, especially when threatened by sickness and death. Palliative care, with expert pain relief, and good human, spiritual, and pastoral support, is the right and best way to care for people towards the end of life. More adequate funding and resources for hospices and palliative care teams authentically serve and honour our shared human dignity. In the discussion around assisted suicide, so much is made of freedom of choice and autonomy; but autonomy is not absolute and must always be placed within the context of the common good of society as a whole. People who are suffering need to know they are loved and valued. They need compassionate care, not assistance to end their lives.

Assisted suicide raises serious issues of principle. The time given for Parliament to consider the Terminally Ill Adults (End of Life) Bill, which will permit assisted suicide is woefully inadequate. Although the Bill indicates safeguards will be in place, the experience of other countries where assisted suicide has been introduced shows that such promised safeguards are soon forgotten. In Belgium, the Netherlands, Canada, and parts of the USA, the criteria for assisted suicide have been expanded significantly, in law or in practice, often to include people with mental illness and others who have no terminal diagnosis. It is not always easy to predict the length of time a person with a terminal illness has to live, making this Bill unworkable.

We are alarmed by the impact that legalisation will have on the most vulnerable members of our society. The option to end life can quickly, and subtly, be experienced as a duty to die. Some may well feel their continued existence is a burden to others, and, implicitly or explicitly, be pressured into assisted suicide. This includes people who are elderly, infirm, and living with disabilities. The protection of such people is the foundation of civilised society. It is at the heart of good government.

We are also concerned that this Bill will fundamentally damage the relationship between medical practitioners and their patients. It will potentially lead to pressure on medical staff to recommend or facilitate such procedures. Will the right to conscientious objection for individuals and institutions be guaranteed? The impact on hospices, care homes, and those who work in social and community care cannot be underestimated. It will radically alter the ethos of trust and support which underpins our service to those in need and their families.

We urge all people of good will to oppose this legislation and, instead, to advocate for better funded palliative care which is consistently available to everyone in need in England, Wales, and Scotland. Please inform yourself and others about this issue and contact your Member of Parliament to make your opposition known, asking him or her to oppose or not support the Bill.

As Catholic Bishops, we call upon all Catholics, and invite all those who share our Christian faith, to turn in prayer to God our Father. Please pray that the dignity of human life will be protected and defended. On the cross, Christ united Himself to every form of human suffering and every person who suffers. In Him, life is changed, not ended. He shows us, in His own crucified and risen body, that love is always stronger than death.