A matter of life and death


A matter of life and death

LORD JOFFE’s Physician Assisted Suicide bill was blocked in the
House of Lords on 12 May but he has pledged to reintroduce it at a
later date. Claire Job, a Palliative Care Specialist Nurse and a member
of the Socialist Party relates her concerns about the bill.

The bill enables a competent adult who is suffering unbearably as a
result of terminal illness to receive medical assistance to die at his
or her own considered and persistent request. The doctor can provide
the patient with the means to end their life (in other countries this
is a large dose of barbiturates) or, if the patient is physically
unable to do so, to end the patient’s life.

So what are the main issues that socialists may need to consider
when deciding to support or not support this bill?

Firstly, take a step back and look at the mess the NHS is in at this
moment in time. Throughout Britain at present, many workers are
fighting to save NHS services, jobs and hospitals. Nationally the NHS
is being run into the ground and dismantled through neglect.

Providers of palliative care (aimed at improving quality of life for
patients and families facing problems associated with life-threatening
illness, such as pain) rely on charitable funding to hold up services
that are chronically under-funded by the state. These services are
viewed at times of financial constraint as non-essential services that
can be left without proper funding for staff and resources.

Many palliative care services barely have the funding to support
cancer patients and those with other life-threatening illnesses. Many,
such as Motor Neurone Disease and Multiple Sclerosis, are excluded from
palliative care – this is often a post code lottery.

We live in a society where there is a marked gradient in the
incidence of most health conditions in the poorer sections of society
and this is due to income, the environment in which people live and a
lack of education on health promoting activities/behaviours. People
living in the most deprived areas are not only more at risk of diseases
such as cancer but the community health care available to support them
is usually under-resourced and stretched.

Access to health care is not equal. Cancer Research UK estimates
that Britain could have over 100,000 extra cases of cancer in 2024
because of its ageing population – this will intensify pressure on our
cancer services that are already cash-strapped.

The government has no intention of addressing the causes of ill
health in our society – deprivation, improving air quality, providing
decent housing, non-hazardous employment, affordable nutritious foods,
recreational facilities and investing in health promotion programmes.
Cynically I could argue that the government is more than aware of this
predicted increase disease burden on the NHS that will require
investment in health and social care in order to support patients.
Physician assisted suicide however will not cost a penny and go some
way to easing the burden.

Lord Joffe’s Bill states that a specialist palliative care
professional, be it a doctor or nurse, must attend the patient to
discuss the option of palliative care. Therefore the bill is stating
that palliative care is the first step in trying to alleviate patient
suffering. However, until palliative care is resourced properly we
can’t assume that it has failed – many of us are ignorant of what
modern palliative care can achieve. One of the main functions of good
palliative care is that it returns power and control to the individual,
enabling them to make choices about the last days of their life such as
whether they are cared for at home or in hospital or a hospice.

I am not in principle opposed to physician assisted suicide, however
I am concerned that we protect the most vulnerable from subtle
pressures in society – pressure of feeling a drain on resources and the
pressure of being a burden on family. The motives of such a bill cannot
be trusted in a capitalist society that is driven by profit not care.
We should demand equal and properly funded access to palliative care
for all before pursuing suicide or euthanasia.

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