Health: End of Life

Lord Singh of Wimbledon Excerpts

Thursday 12th December 2013 Lords Chamber

[Lord Singh of Wimbledon (CB)]

My Lords, this debate takes us into new ethical territory with complex medical, legal and emotional implications. Rational discussion is made more difficult by a polarisation of attitudes and opinions. I saw something of this about 12 months ago when I attended a meeting of the All-Party Parliamentary Group on Assisted Dying. I raised some concerns and was made to feel that there was something wrong with my thinking if I could not immediately see the open-and-shut case for changing the existing law. I am also too aware of the opposite arguments, couched in religious terms, that life is a gift from God and we should never, ever, even think of curtailing it.

I served for some years as a member of the BMA Medical Ethics Committee and am well aware of major changes in society and bewildering advances in science and medicine that require us to constantly look anew at previously accepted views and attitudes. Sikhs accept that life is a gift of God to be cherished and preserved wherever possible, but we are also required to bear in mind the important Sikh teaching of compassion, dignity and care for the suffering. These two considerations are not necessarily incompatible. However, I am unhappy about a narrow focusing on individual autonomy to justify attitudes that clearly affect others. We have seen some of this today. We constantly hear the argument that we are all individuals and that our happiness and needs are all-important to the exclusion of our responsibility to others. I believe that this over-focusing on self, on me and my, is responsible for many of the ills in society today. For example, we are all aware that religious teachings suggest that marriage is a committed partnership for mutual care and support and for ensuring that children grow up as responsible adults. What I believe to be a short-sighted contemporary social attitude encourages us to believe that it is okay to look exclusively at our rights, without consideration of the effect on others. This focusing on individual needs rather than on the family as a whole is, at least in part, responsible for the growing increase in dysfunctional families, with children frequently ending up in what we euphemistically call care, or with them mirroring the narrow thinking of their parents. A person’s decision to end their own life has an effect on friends and, importantly, on the message it can give to wider society of trivialising life. We all have wider responsibilities in all that we do.

I shall pull together these different threads in rational and compassionate decision-making to arrive at the way forward. First, we should always respect the gift of life and question the concept of autonomy. Secondly, there are times when those in ill health feel that life is not really worth living but, within a short time, they often feel that it is not really that bad. It is worse for those who find themselves with severe disabilities but, as the Paralympics showed, despite such disabilities, it is often possible to live a meaningful life. Relatives and carers sometimes find looking after someone onerous, and they can inadvertently make their feelings known to those they are caring for, making them feel an unnecessary burden. Sadly, there are others who may have more mercenary motives. A seemingly hopeless situation today may not always remain so. Huge strides are constantly being made in combating previously incurable diseases, as well as in palliative care.

In summary, while we should always be on our guard against the notion of individual autonomy trivialising life, we need to recognise that, from an individual’s perspective, life can become pretty intolerable and there is an argument for helping to end it in strictly controlled circumstances. The danger is that, if we go down this path, it could itself be a slippery slope to trivialising life, altering the very ethos on which medical care is provided. I feel, on balance, that we should leave the law as it is.