Death is part of our human experience

There are times when it is better to "let nature take its course".

The debate around assisted dying is undoubtedly a difficult and sensitive one. However, Nelson Jones's recent blog, conflating as it did two very different issues, served only to muddy the waters.

In the piece, Jones sought to argue that because, in certain situations, a clinical decision is made by medical personnel not to attempt resuscitation of the patient, this is essentially equivalent to the medical profession making the decision to end the life of a vulnerable person. It would be more honest, Jones argued, to allow the choice of when their life should end to be made by the patient.

There can be little doubt that medical technology is now such that we can artificially prolong the lives of people through interventions which are at times inappropriate. However, in our death-denying culture, there are times when we need to remember that death is a part of our human experience, and that not every death is the result of a medical failure. There are times when the better decision is to let go, to step back and “let nature take its course”. This is the purpose of the “do not attempt resuscitation” (DNAR) decision: that further medical intervention would be futile and of no benefit to the patient.

However, the withholding or withdrawing of medical treatment differs fundamentally from the deliberate ending of life. The Church of Scotland is active in many projects offering care, comfort and support to the vulnerable in many practical ways. We therefore find the prospect of legislation allowing assisted dying to be deeply concerning, as it has the potential to undermine focus on the care and comfort of all as they move through the last stages of life- especially those who are placed in a vulnerable position as a result of age, incapacity or other circumstance.

While personal autonomy is indeed an important issue, it is a dangerous fallacy to believe that a person can act independently of all others, with their actions having no consequences for anybody else. Interpersonal relationships are vital: life is lived and death experienced as part of community. Assisted suicide cannot be a personal choice because it will inevitably effect everyone, and how tragic if those most vulnerable in our communities begin to feel that their lives are somehow less worth our resources. What a tragically bleak view of human life- and how far removed from the call of the church to show love and concern, compassion and support for all around us.

Death, as a natural process, cannot be avoided: despite the inevitable sadness involved in saying farewell to a loved one, emphasis should be placed on ensuring that all participants in the process experience as fulfilled and comfortable a final journey as possible.

We would emphasise the need for all aspects of care to be improved; there is concern, however, that assisted dying legalisation will undermine, rather than enhance, other aspects of end of life care and the manner in which society values every human being. Clearly it would be a step too far if vulnerable patients felt pressured to opt for assisted dying because of a lack of resources to give them an acceptable quality of life in their last months.

In common with many people of faith, the Church of Scotland would affirm that the worth and dignity of every human life needs to be emphasised and celebrated. Indeed, the Gospel of Jesus Christ which the Church of Scotland seeks to live out emphasises the value and worth of all human life, no matter the circumstances. Any legislation to bring about the deliberate ending of a human life would be a sea-change in how we perceive one another. Society places a prohibition on the killing of others (because we understand the profound commonality of life): this is a line which we must not cross.

Rev Sally Foster-Fulton is Convener of the Church and Society Council of the Church of Scotland, and is Assistant Minster of Dunblane Cathedral. For further information on the work of the Church and Society Council, see their website.

Death is a natural process. Photograph: Getty Images
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Theresa May's U-Turn may have just traded one problem for another

The problems of the policy have been moved, not eradicated. 

That didn’t take long. Theresa May has U-Turned on her plan to make people personally liable for the costs of social care until they have just £100,000 worth of assets, including property, left.

As the average home is valued at £317,000, in practice, that meant that most property owners would have to remortgage their house in order to pay for the cost of their social care. That upwards of 75 per cent of baby boomers – the largest group in the UK, both in terms of raw numbers and their higher tendency to vote – own their homes made the proposal politically toxic.

(The political pain is more acute when you remember that, on the whole, the properties owned by the elderly are worth more than those owned by the young. Why? Because most first-time buyers purchase small flats and most retirees are in large family homes.)

The proposal would have meant that while people who in old age fall foul of long-term degenerative illnesses like Alzheimers would in practice face an inheritance tax threshold of £100,000, people who die suddenly would face one of £1m, ten times higher than that paid by those requiring longer-term care. Small wonder the proposal was swiftly dubbed a “dementia tax”.

The Conservatives are now proposing “an absolute limit on the amount people have to pay for their care costs”. The actual amount is TBD, and will be the subject of a consultation should the Tories win the election. May went further, laying out the following guarantees:

“We are proposing the right funding model for social care.  We will make sure nobody has to sell their family home to pay for care.  We will make sure there’s an absolute limit on what people need to pay. And you will never have to go below £100,000 of your savings, so you will always have something to pass on to your family.”

There are a couple of problems here. The proposed policy already had a cap of sorts –on the amount you were allowed to have left over from meeting your own care costs, ie, under £100,000. Although the system – effectively an inheritance tax by lottery – displeased practically everyone and spooked elderly voters, it was at least progressive, in that the lottery was paid by people with assets above £100,000.

Under the new proposal, the lottery remains in place – if you die quickly or don’t require expensive social care, you get to keep all your assets, large or small – but the losers are the poorest pensioners. (Put simply, if there is a cap on costs at £25,000, then people with assets below that in value will see them swallowed up, but people with assets above that value will have them protected.)  That is compounded still further if home-owners are allowed to retain their homes.

So it’s still a dementia tax – it’s just a regressive dementia tax.

It also means that the Conservatives have traded going into the election’s final weeks facing accusations that they will force people to sell their own homes for going into the election facing questions over what a “reasonable” cap on care costs is, and you don’t have to be very imaginative to see how that could cause them trouble.

They’ve U-Turned alright, but they may simply have swerved away from one collision into another.  

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to British politics.

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