Four easy ways to oppose the Marris Bill on assisted suicide

On Friday 11 September, MPs will vote on the Assisted Dying (No.2) Bill which aims to allow doctors to prescribe lethal drugs to mentally competent adults with a terminal illness.

It's a Private Members' Bill tabled by Labour's Rob Marris MP, with the support of campaign group Dignity in Dying (formerly the Voluntary Euthanasia Society). 

Here are four easy things you can do to oppose the bill ahead of Friday's vote in Parliament.

Read, Act, Pray and Go!  

Read - CMF and the Care Not Killing Alliance have produced a number of excellent reading materials to inform your arguments against the bill. Read this CMF Blog on why the current law is not 'broken' and doesn't need 'fixing'. Also read this useful guide on the bill.  

Act - Social media is becoming increasingly powerful as a tool to influence public opinion. If you're on Facebook would you share this post on your networks? Also if you're on Twitter please Retweet this Tweet. Together, our voice is stronger.

Pray - Please pray ahead of and during the vote that God's will would be done and that vulnerable human lives would be protected.

Go - If you are free this Friday please join us for a rally in Old Palace Yard (adjacent to Parliament Square), whilst the bill is being debated, beginning at 8.30am. All details here.  

‘Speak up for those who cannot speak for themselves’ (Proverbs 31:8).

Doctors writing in the Guardian in support of assisted suicide are the ‘usual suspects’ and do not speak for the wider medical profession

The Guardian has today published a letter from 27 doctors and two nurses – along with a commentary - in favour of Rob Marris’ Assisted Dying (No 2) Bill, which receives its second reading in the House of Commons this coming Friday 11 September.

Marris wants to make it legal for mentally competent adults with less than six months left to live to commit suicide using lethal drugs prescribed by a doctor.

The Guardian acknowledges that the letter was put together by Jacky Davis, an NHS radiologist and chair of Healthcare Professionals for Assisted Dying (HPAD), part of the Campaign Group ‘Dignity in Dying’ (DID) (more on HPAD here). 

Closer scrutiny shows that this is indeed a letter from the ‘usual suspects’. Amongst the 29 signatories there are:

•         five present or past officers of HPAD (see here and here)
•          twelve publicly listed HPAD supporters (see here and here)
•         two more DiD-linked (see here)

The views of this tiny group of well-known assisted suicide advocates, affiliated to the former Voluntary Euthanasia Society (now DID), are well out of step with the profession at large and every disability rights organisation in the UK.

The vast majority of UK doctors are opposed to legalising all forms euthanasia along with the British Medical Association, the Royal College of Physicians, the Royal College of General Practitioners, the Association for Palliative Medicine and the British Geriatric Society.

Those closest to dying patients are most strongly opposed because they both understand patient vulnerability and know how to manage symptoms at the end of life (and so do not feel the pressure to resort to killing people they don’t know how to treat).

Last month a group of 80 doctors, mainly engaged with end of life care, wrote to MPs urging them to reject the Marris proposals and arguing that 'assisting suicide runs counter to our duty of care'.

This was further underlined by three letters (scroll down from here) from experts in palliative medicine, published alongside the DID letter today, but not otherwise highlighted by the Guardian.

Baroness Ilora Finlay, Professor of Palliative Medicine in Cardiff, and joint chair of Living and Dying Well, writes:

‘Having been involved in the care of thousands of dying patients, I know that open conversations and good palliative care can transform life for the terminally ill. Sadly, bad deaths… still occur, but it is often a case of “we know what to do but just aren’t doing it”. Legalising assisted suicide would do nothing to improve the care of the dying. It suggests hopelessness and that they should contemplate suicide. This is not a message for the medical profession to endorse.’

In a similar vein, Robert Twycross, Emeritus clinical reader in palliative medicine, Oxford University argues:

‘…90% of palliative care doctors are opposed to the Marris assisted dying bill. From everyday clinical experience, we know that more people will be harmed than helped by legalising assisted suicide for the terminally ill…One of the most supportive responses to the patient who asks for “an injection to finish me off” is for the doctor to reply along the lines of, “I can’t do that – for one thing, it’s against the law. But, tell me, what made you say that?” This gives the patient the opportunity to express his distress and his fears. The conversation would conclude along the lines of, “This is what I suggest we do… And we can come back to the question of an injection to finish you off in a couple of weeks.” When challenged after this time, the patient invariably says, “I don’t feel like that any more.”’

These sentiments are echoed by Dr Kathryn Mannix, another Consultant in palliative medicine:

‘My experience of in-depth discussion with around 14,000 dying people over 30 years is that most deaths are gentle; that although people ask about “help to die” early in their illness, requests for earlier death are vanishingly rare as dying approaches; and that becoming ill enough to die makes even the strongest-minded vulnerable to fear of becoming a burden on their loved ones. Sadly, we also see occasional loveless families where coercion to “die sooner” would certainly occur should the law allow it.

Similar experience explains why those disciplines of medicine most familiar with patients’ experience at the very end of life are those most opposed to a change in the law. This includes palliative medicine, geriatric specialists and GPs. Is this because we are all religious zealots? No. It is because we recognise that the need to accelerate death as a means to end suffering is almost never required, and that the number of people who would be vulnerable to requesting unwanted assisted suicide as an act of generosity to their loved ones is considerable.’

When MPs vote later this week they should take seriously the views of those doctors closest to the dying patient and not be swayed by a group of largely retired activists who do not represent the wider medical profession. 

Recent cuts in proven cancer drugs will steer people toward assisted suicide if Marris Bill passes

The news broke last week that more than 5,000 cancer patients will be denied life-extending drugs under plans which charities say are a ‘dreadful’ step backwards for the NHS.

If, in addition, assisted suicide is legalised in Britain - and Rob Marris’s Assisted Dying (No 2) Bill is to be debated this coming Friday – then it would also leave vulnerable cancer patients being steered toward suicide as a cheaper ‘treatment option’.

The Cancer Drugs Fund was launched in 2011, following a manifesto pledge by David Cameron, who said patients should no longer be denied drugs on cost grounds.

Since its launch four years ago it has benefitted more than 50,000 patients, who received treatment which NHS rationing bodies had refused to pay for.

But now the fund’s budget is massively overspent.

Health officials have just announced sweeping restrictions on treatment, which will mean patients with breast, bowel, skin and pancreatic cancer will no longer be able to receive drugs funded by the NHS.

In total, 17 cancer drugs for 25 different indications will no longer be paid for in future.

The decision means that in total, two thirds of all treatments which were paid for by the scheme will no longer be paid for by the NHS.

Drugs which will no longer be funded include Kadcyla for advanced breast cancer, Avastin for many bowel and breast cancer patients, Revlimid and Imnovid for multiple myeloma, and Abraxane, the first treatment for pancreatic cancer in 17 years.

Note that these are drugs with proven therapeutic effectiveness.

Mark Flannagan, Chief Executive of the charity Beating Bowel Cancer, said: ’Nothing has changed in terms of the clinical effectiveness of these treatments. They remain as clinically effective now as they were when they were added to the list of funded drugs.’

There is also a much darker side to this move as we learn from the experience of the US state of Oregon, where assisted suicide was legalised in 1997.

Barbara Wagner (pictured) had recurrent lung cancer and Randy Stroup had prostate cancer. Both were on Medicaid, the state’s health insurance plan for the poor that, like some NHS services, is rationed.

The state denied both treatment, but told them it would pay for their assisted suicide, although they had not even considered the latter and did not ask for it.

‘It dropped my chin to the floor,’ Stroup told the media. ‘[How could they] not pay for medication that would help my life, and yet offer to pay to end my life? ’(Wagner eventually received free medication from the drug manufacturer. She has since died. The denial of chemotherapy to Stroup was reversed on appeal after his story hit the media.)

Despite Wagner and Stroup’s cases, advocates continue to insist that Oregon proves assisted suicide can be legalised with no abuses. But the more one learns about the actual experience, the shakier such assurances become.

If AS were to be legalised in the UK end-of-life care would be likely to worsen under financial pressures because it costs on average £3,000 to £4,000 a week to provide in-patient hospice care, but just pounds to pay for the drugs which would help a person commit suicide.

Cancer treatments like chemotherapy, radiotherapy or surgery cost much more. Do we really wish to place that temptation before families, NHS managers and Health Secretaries in cash-strapped Britain?

Because if we pass this law this is exactly what will happen. Assisted suicide will be costed just like any other ‘treatment’ and will be assessed alongside other ‘options’ for ‘cost-effectiveness’. And vulnerable cancer patients will be steered toward suicide. 

Doctors will then be left in the terrible position of having to present assisted suicide as an affordable ‘treatment option’. 

‘I’m afraid you have breast cancer. There is a drug called Kadcyla, which we used to prescribe to around 800 women a year. It has been shown to extend life by an average of six months, with fewer side effectives than any alternatives. But this drug is sadly no longer funded. We can however pay for your assisted suicide as it is so much cheaper.’

This is just one of the consequences of legalising assisted suicide.

You will find much more information on why we should not change the law in a new paper published this week by Care Not Killing: ‘Don’t Make Oregon’s mistake: Ten reasons why England and Wales should not follow suit and legalise assisted suicide’.

Three new worrying conscience cases – Christians must be prepared to pay the price for obeying God in the face of legal threats

There were three interesting stories this week involving people getting into trouble for exercising freedom of conscience.

The striking thing was that each of these occurred in supposedly democratic countries which pride themselves in upholding human rights – Canada, France and the United States.

In the first the Canadian Medical Association (CMA) voted to reject a motion to protect the conscience rights of physicians who refuse to refer patients to die by euthanasia. This requirement is not yet law but the lack of support for conscience rights from the doctors’ own representative body does not bode well.

The second case involved a French Muslim registrar who was sent to court for refusing to perform a same-sex marriage. The Marseille penal tribunal will render its judgment on 29 September. The maximum penalty for a registrar who illegally refuses to give access to a legal right is a 75,000-euro fine and 5 years' imprisonment.

In the third case a Kentucky county clerk has already been jailed for refusing to give marriage licenses to same-sex couples.

I tweeted about all three of these cases yesterday. The two tweets involving same sex marriage generated the most response and three people came back to me suggesting that custodial sentences were justified for conscientious objectors.

I’ve pasted their tweets below. Interestingly all three were doctors. I found their open hostility quite revealing – a sign of things to come perhaps. I also wondered how they themselves might react if forced to do something they considered morally wrong.

The Bibles teaches that God institutes human authorities and expects us to obey them:

‘Let everyone be subject to the governing authorities, for there is no authority except that which God has established. The authorities that exist have been established by God.  Consequently, whoever rebels against the authority is rebelling against what God has instituted, and those who do so will bring judgment on themselves.’ (Romans 13:1,2)

But Scripture is equally clear that if laws which discriminate against Christians are passed, and obeying such laws involves disobeying God, then there is a place for civil disobedience. In fact when we are forced to do something wrong it is a Christian duty.

When the King of Egypt ordered the Hebrew midwives to kill all male Hebrew children they refused to do so and God commended and rewarded them. (Exodus 1:15-22)

Rahab the harlot similarly refused to co-operate with the king of Jericho in handing over the innocent Israelite spies and was later praised for her faith.( Joshua 2:1-14)

Even death threats did not stop Shadrach, Meshach and Abednego refusing to bow down to the image of the king or Daniel persisting with public prayer.( Daniel 4:6-8, 6:1-10)

When Peter and John were commanded by the Jewish authorities not to preach the Gospel they replied, 'We must obey God rather than men' and continued to do it.(Acts 5:29)

So whilst recognising that we have an obligation to obey the governing authorities God has instituted, nonetheless our obedience to God himself takes precedence if the law of the land requires us to disobey him.

Of course we should do our best to oppose the passing of laws which seek to criminalise normal Christian behaviour. And if their passing looks inevitable we should seek for reasonable accommodation to be made. The Abortion Act and Human Fertilisation and Embryology Act, for example, both contain conscience clauses protecting those with a moral objection to the activities they legalise from being forced to be involved.

But we may not be successful, so in such circumstances we also need to be willing to count the cost and to pay the price for being faithful to God in the face of threats.

The long list of heroes of faith in Hebrews 11 contains those who were delivered from the legal consequences of civil disobedience but also those who paid the price.

And paying the price through facing discipline, dismissal, a fine, imprisonment or even execution may be what God requires us to do in similar circumstances.

In all this we have the confidence that we follow in the footsteps of a Saviour, who in facing everything the greatest Empire on earth could throw at him, willingly carried the cross and emerged ultimately victorious.

'Blessed are those who are persecuted because of righteousness, for theirs is the kingdom of heaven. Blessed are you when people insult you, persecute you and falsely say all kinds of evil against you because of me. Rejoice and be glad, because great is your reward in heaven, for in the same way they persecuted the prophets who were before you.'(Matthew 5:10-12)

Britain's law on assisted suicide is not 'broken' and does not need ‘fixing’

On Friday 11 September MPs will vote on the Assisted Dying (No 2) Bill tabled by Labour’s Rob Marris. In case you were wondering, it’s called ‘No 2’ because an almost identical Assisted Dying Bill has been tabled in the House of Lords by Labour Peer Lord Falconer.

Marris wants to change the law to allow mentally competent adults with less than six months to live to obtain help to kill themselves with lethal drugs.

Over the next month hundreds of thousands of pounds will be spent by the campaign group Dignity in Dying (the former Voluntary Euthanasia Society), who drafted the bill, aided and abetted by its principle cheerleader, the BBC, who can be guaranteed to give it the full oxygen of publicity and to grant an international platform to anyone who supports it.

Expect to see more celebrities coming out to back what they perceive to be a popular cause, more opinion polls telling us that most people want to see a change in the law and more cynically timed cases of people having to journey to Switzerland to end their lives at the Dignitas facility because there is no similar opportunity here.

Expect also to see other campaign groups with more radical agendas entering the fray in an attempt to see the bill’s provisions extended to a far wider group of people.

The presence of determined and well-funded groups like the Society for Old Age Rational Suicide (SOARS), The British Humanist Association, the National Secular Society and Exit International assures us that any change in the law to allow assisted suicide for anyone at all will be followed by a continuing clamour to broaden its provisions even more. It Marris’s law passes it will be only the beginning.

One of the major arguments put by all of these campaigners is that our current law is broken and needs fixing. In fact Dignity in Dying plans to plaster up ‘Fix our broken assisted dying law’ posters all over London throughout the summer. 

Leading politicians across all major parties have already signalled their opposition to a change in the law. They include SNP leaders Nicola Sturgeon and Alex Salmond, Labour leadership candidates Andy Burnham and Jeremy Corban, past and present Liberal Democrat leaders Nick Clegg and Tim Farron and most of the Tory government’s cabinet, including Prime Minister David Cameron himself.

But even Cameron, who has been consistent and resolute in his opposition, seems to weakening under the pressure to concede that the current law is not fully fit for purpose. In an answer to a recent parliamentary question he suggested that although he did not support Marris’s and Falconer’s proposals, he conceded that there were ‘imperfections and problems with the current law’.  

But is our law broken? What is the actual evidence for this claim? I am struggling to find any at all.

Dignity in Dying are working hard to convince us that there is a huge demand for assisted suicide and that thousands of well-meaning and compassionate relatives risk prosecution under the current law for ‘helping’ their loved ones because the law is not clear enough about whether they will be prosecuted or not.  

But in fact none of this is actually true.

Under the current law, the Suicide Act 1961, it is not against the law to commit, or to attempt to commit, suicide.

On the other hand, ‘encouraging or assisting a suicide’ is a crime carrying a discretionary sentence of up to 14 years imprisonment.

The law carries this blanket prohibition of helping people kill themselves in order to protect vulnerable people from exploitation and abuse. Any change will remove legal protection from those who are elderly, disabled, or suffering from physical or mental illness.

It will thereby encourage those who stand to gain financially or emotionally from their deaths, either to coerce them or subtly suggest that they take this course, or at very least not to stand in their way. Yes the law provides a very strong deterrent.

The reason the law makes no exceptions is because laws are best defended when they hold to strong consistent principles and don’t try to make exceptions for individuals with arguably extenuating circumstances. Imagine a speeding law that was accompanied by a list of excusable reasons for going above 30 mph in a built up area ahead of the event. It would be utterly unworkable.

Managing exceptions is far better left to the police, the crown prosecution service and the courts.

This is not a legal fudge but one of the foundations of the British Justice system.

The handling of an individual hard case is dealt with, not by a piece of paper, but after careful consideration by professionals who know the law, but are able to apply it in any given case with discretion and kindness, to temper justice with mercy.

When a case of alleged assisted suicide is brought to attention it is first investigated by the police who submit their finding after a careful examination of the facts to the Crown Prosecution Service (CPS) which must then make a decision about whether to prosecute.

In weighing this decision the Director of Public Prosecutions (DPP) must decide whether there is enough evidence to bring a case (there often is not) and whether it is in the public interest to do so. 

Only if the answer to both these questions is yes does it proceed to court. And in the extremely rare event of a conviction resulting, the judge is also given discretion to make the punishment fit the crime. 

Fourteen years is an absolute maximum sentence which is virtually never given. Those who are convicted and sentenced generally go to prison for far less or do not receive a custodial sentence at all.

So how is this law actually working? According to the CPS’s latest figures 1 April 2009 up to 24 April 2015, there have been only 110 cases referred to the CPS by the police that have been recorded as assisted suicide. This is less than 20 per year or under two every month.

Of these 110 cases, 70 were not proceeded with by the CPS and 25 cases were withdrawn by the police. In fact in all the high profile cases we see on our television screens the overwhelming majority result in no charges being brought, let alone any convictions.

Of the remaining 15 cases eight are ongoing and six were referred onwards for prosecution for homicide or other serious crime. Yes, some assisted suicide cases turn out to be cleverly disguised murders where the key witness to what really happened is dead. This is another reason why it is so crucial that all cases of alleged assisted suicide are properly investigated. It is the threat of an investigation that keeps us safe.

Since 2009 only one case has been successfully prosecuted, that of Kevin Howe in October 2013. 

Howe was jailed for twelve years after supplying his suicidal friend Stephen Walker with petrol and a lighter in order to set fire to himself. Walker suffered 90% burns but miraculously survived and now faces a life of treatment and disability as a result.

The only other person, not yet on the CPS website,  who has been convicted and sentenced, whom I am aware of subsequently, is Lyndsay Jones who provided another suicidal man Philip Makinson with a heroin and a syringe in order that he could kill himself with a lethal injection. She was jailed in July this year for four and a half years.

These are the sort of cases that end up in prison under the present law. 

We are also told by campaigners of the vast numbers of people who are making one way trips to Switzerland to end their lives at the Dignitas facility. But the reality is 273 cases in the 16 years from 1998 to 2014 – fewer than 20 a year. Although each individual case is a tragedy, the numbers are tiny when we put them alongside the 500,000 people who die in Britain each year from all causes and the 1,300 and 15,000 annual assisted suicide deaths we would have annually under the laws currently in place in Oregon and the Netherlands respectively.

Their significance has been magnified in a hugely disproportionate way by the media. If fact several have gone to Zurich accompanied by television news teams or have planned their deaths at strategic moments in the campaign in an almost cynical attempt to influence public opinion and place pressure on decision-makers. Most also did not need assistance to end their lives. And most notably not one relative or helper has so far been prosecuted.

The reality is that Britain’s law on assisted suicide is clear and right and is working well.

The strong penalties it holds in reserve act as a strong deterrent to exploitation and abuse as evidenced by the tiny number of people breaking it.

It is also being exercised compassionately as the discretion it gives to judges and prosecutors means that only two people have so far been convicted and sentenced under it in the last five years. And neither of these received the maximum sentence of 14 years.

Having a clear strong and simple law like this offers protection for disabled, sick and elderly people from those who have an interest, financial or otherwise in their deaths. Of course it does mean that those who wish to push its boundaries and break it – for whatever reason – run the risk of a police investigation, a prosecution and a possible custodial sentence.

But this is a very small price to pay given the protection that it offers.  

The law on assisted suicide is not broken. It is clear, just, merciful and fair. It does not need fixing. 

Official - Chimps are not legal persons - I explain what this judgement means for Cecil the lion and others

In an astounding move last week, the Manhattan Supreme Court ruled that chimps are not persons under the law.

Judge Jaffes was not persuaded by the case presented by The Nonhuman Rights Project but did suggest that animal ‘personhood’ is possible in the not too distant future.

‘Efforts to extend legal rights to chimpanzees are thus understandable; some day they may even succeed,’ she wrote in a 33-page decision. ‘For now, however, given the precedent to which I am bound, it is hereby ordered, that the petition for a writ of habeas corpus is denied and the proceeding is dismissed.’

The ruling will come as a huge blow to animal lovers – especially in the wake of the recent killing of the popular Zimbabwean lion Cecil by an American dentist.

This is because the Manhattan ruling casts Cecil’s own personhood status into doubt.   

However, those mourning the passing of Cecil and regretting this judgement will be comforted to learn that his brother Jericho, apparently also a lion, has now been confirmed to be alive, contrary to an earlier report of his demise.

The Zimbabwe Conservation Task Force, which had reported Jericho’s death on its Facebook page on Saturday, said on Sunday that the lion was ‘alive and well’ and has adopted the cubs of Cecil, whose recent killing sparked global outrage over big-game trophy hunting.

‘We apologize for reporting that he had died but were confident that our sources were in fact correct. This was a case of mistaken identity,’ the non-government task force wrote in the post.

In a fascinating twist, Jericho may in fact be relieved by the Manhattan court ruling, which although not legally binding in Africa, does add legal weight to his non-person status. Given Zimbabwe’s human rights record he is probably better off being a non-person and is not therefore expected to appeal the judgment.

Perhaps in celebration of this, the 11-year old lion on Sunday was observed ‘feeding on a giraffe kill with the lionesses from his pride’.

Another corollary of the Manhattan ruling, of course, is that giraffes are also non-persons, although judging by the lack of outrage about the (nameless) giraffe’s death at the paws and jaws of Jericho, some non-human non-persons (lions) are clearly of higher status than others (giraffes).

Whether this higher non-person status applies to all carnivores, or merely to those with higher intelligence, will need to be determined in subsequent judgements. The relative status of lions and chimpanzees, for instance, has not thus far been tested in court.

Although it may simply be that, as the said giraffe was killed by a member of another non-human species rather than by a legal person, the muted media response may be because a non-human non-person rather than a human person was responsible for his (or her) death.

In the meantime, the widespread international support for the harvesting and selling of human fetal parts by Planned Parenthood, a ‘charity’ financed by the US taxpayer, suggests that being a human non-person under the law (all US human unborn babies are legally non-persons) might be the most perilous position of all.

So perhaps the Manhattan court ruling might be good for chimpanzees after all. Better to be a non-human non-person (chimpanzee) than a human non-person (unborn baby).

Especially given that full personhood status might be just around the corner for Chimps. 

The assisted suicide of Gill Pharaoh reminds us that there are actually limits to choice

You can listen to my interview on this case on BBC West Midlands here

 Last week I was contacted by the Sunday Times who were planning to run a high profile story about a 75 year old retired nurse being helped to kill herself in Switzerland.

The story of Gill Pharaoh’s death was later published last Sunday under the title ‘Why I’d rather die than get old’(£).

It was subsequently rerun by national dailies (see here and here) and ITV.

Not to be outdone, the BBC, euthanasia cheerleader extraordinaire, has now made it into an international media story (which incidentally speaks volumes about their ideological bias given their deafening silence on the Planned Parenthood body part scandal).

Pharaoh requested help to kill herself in a Basel ‘clinic’ because she found the reality of old age ‘awful’, did not ‘think old age is fun’, did not want to end up as a ‘hobbling old lady’ and because she did not want to be a ‘burden’ to her children. ‘The thought that I may need help from my children appalls me’, she wrote.

She added that expecting help from one’s children is ‘a most selfish and unreasonable view’.

And yet the former nurse had no major health problems and was on no medication. She had intermittent back pain following a bout of shingles and had tinnitus - about par for the course for a person of her age.

This evening I found myself live on ITV London in one of the most surreal TV debates of my life. 

The debate was barely three minutes long and sandwiched between an account of a bus having its top taken off and an interview with a couple who had been married for 25 years after meeting on (recently deceased) Cilla Black’s ‘Blind date’.

The show passed seamlessly from story to story with each being treated with an equal seriousness that only TV presenters could manage whilst keeping a straight face.

I started by saying that most people had been shocked and appalled by the Pharaoh case and that it had led to outrage on social media. The key question was why a woman encountering the usual maladies of growing old might resort to such desperate measures.

Sitting opposite me on the programme was Michael Irwin, retired GP and Director of the Society for Old Age Rational Suicide (SOARS).

Irwin is a seasoned euthanasia campaigner and was in fact struck off by the General Medical Council (GMC) in 2005 for attempting to help an Isle of Man politician take his own life.

He was subsequently thrown out of the Voluntary Euthanasia Society (now renamed Dignity in Dying) for his propensity to break the law as a means to having it changed.

Irwin has helped over 20 people with advice about how to kill themselves in Switzerland and has actually accompanied four to their deaths but has somehow managed to evade prosecution for ‘encouraging or assisting suicide’, a crime punishable by up to 14 years in prison under the Suicide Act 1961.

I asked Irwin before the debate why he felt his life – at 84 he is nine years older than Pharaoh and hobbles with a walking stick – was worth living whilst Pharaoh’s was not. He said it was all about ‘choice’.  She had had enough but he had not.

What was it that gave his life meaning and purpose and made him think that life was worth living? Apparently being able to have debates on media on the issue with people like me! His commitment to the cause gave him a reason to live.

And here we come to the nub of the debate. This is not really about pain, or terminal illness or disability or even old age because these are not the real things motivating those who make one way trips over the English Channel.

It’s really about meaning, purpose and hope. This is borne out by the published facts from jurisdictions where assisted suicide is legal.

In the US state of Oregon those making use of the Death with Dignity Act give ‘loss of autonomy’ (93%), ‘loss of enjoyment of life’ (89%) and ‘loss of dignity’ (73%) as the top three reasons for ending their lives. In Washington 61% cite ‘fear of being a burden on others’.

These are not medical reasons – they are existential or, perhaps more accurately, spiritual reasons.

And feeling this way is not strongly correlated with health status either. There are many sick, elderly and disabled people (the overwhelming majority) who desperately want to live – to grow old with their loved ones, to enjoy the last vestige of what life has to offer.

Similarly there are able-bodied people who desperately want their lives to end – either because they have lost hope or, as in Pharaoh’s case, because of what they fear might happen to then in the future.

Which should surely, I would have thought, prompt the response of us doing all we can, both to restore hope and allay fear, by caring for the physical, social and spiritual needs of the whole person. Not to pass over a barbiturate-spiked drink or provide accompaniment for a grisly last journey. 

Pharaoh’s (and Irwin’s) main argument is autonomy – choice. But choice is a two edged sword.

If choice really trumps all then why deny assisted suicide to anyone who wants it – including the ‘troubled teen’ and the ‘bereaved elderly’ as Philip Nitschke has put it?  Why not set up euthanasia booths on every street corner and offer partakers ‘a martini and a medal’ before offering them the lethal draught, as novelist Martin Amis has seriously suggested?

That is surely what consistency about choice should lead us to accept.

But the truth is that choice, although resonating with the zeitgeist of our postmodern secular humanist society, is a lame and vacuous argument.

Each one of us actually believes that there are limits to choice. That is precisely why in a free democratic society we have laws. I’d even suggest it is in fact those laws which actually make us free. I am not free to speed on the freeway or to throw a brick through my neighbour’s window, or to run off with his wife – out of respect for my neighbour’s freedom and dignity.

Choice has limits and that is actually what this debate should be about – where those limits lie and why.

Every law on the statute books stops some person doing what they desperately want to do. But laws are necessary simply because the exercise of one person’s freedom may endanger or undermine the reasonable freedoms of another. The fact that I desperately want something is not sufficient reason to change the law so that I may have my wish granted.

And it has been consistently the judgement of parliaments, doctors' groups and disability rights' activists in this country that any law allowing assisted suicide would place a burden on vulnerable sick, elderly and disabled people to end their lives for fear of being a burden on others. It would undermine their freedom precisely because their choice would not thereby be free – it would rather be a coercive offer.

Being a burden is part and parcel of being human. All of us at some time of our lives – not least at both ends - will be a burden. But 'mutual burdensomeness' is what true family and community is all about. 

Because a truly free and humane society is one in which the strong willingly make sacrifices for the weak, rather than sacrifice the weak to preserve their own freedoms.

By promoting the idea, as Pharaoh has (with the assistance of the British media), that it is ‘selfish and unreasonable’ to expect one’s loved ones (and the wider community) to offer care and support in times of need, is very dangerous indeed.

It will have the effect of intensifying the guilt that drives vulnerable people to contemplate suicide as a solution to ordinary human problems.

We should have no truck with this. There is a far better way of ministering to those paralysed in their choices by fear, dependence and lack of hope.

Bearing one another’s burdens is, after all, the essence of the ‘law of Christ’ (Galatians 6:2).