Leader: Time for a fresh debate on the alleviation of pain and suffering

ANYONE who has been at the bedside of a loved one during the last days of their life knows that it is the most awful of times, even when the death is peaceful. But unfortunately there are many whose last moments are of degrees of pain that must feel like torture.

This has given rise to the most dreadful moral dilemma: are there times when it is right to spare a person agonies by administering potions that would end a life sooner than would have been the case if events had followed their natural course? Is this merciful release, or murder?

This moral question has been with us ever since medicine advanced to the point where it can prolong natural life beyond the time at which injury or disease would have caused it to end. Now a Commission on Assisted Dying, set up by a think-tank, Demos, has sought to provide an answer. Chaired by a former Lord Chancellor, Lord Falconer, it has suggested that adults who are likely to have less than a year to live should be able to ask their doctor for a medication that will end their life. Any proposal that there should be medical intervention to accelerate death is highly controversial. Scotland has recently had such a debate through the courageous tabling in the Scottish parliament of the Assisted Suicide Bill by Margo MacDonald MSP. After much discussion, Ms MacDonald’s bill was voted down. But that cannot be the last word on the subject. Harrowing tales of individuals’ last agonising days, and of those who had the means to avoid them by flying to Switzerland to the Dignitas clinic, will continue to arise.

Medical and legal practice has quietly evolved to deal with this question. Since the late 1990s, doctors have made use of the Liverpool Care Pathway to look after people who, in their judgment, are dying. Put simply, if they judge that they have no medical means at their disposal which will restore meaningful and worthwhile life to a patient, then, with the approval of relatives, curative medical treatment can be replaced with palliative pain-relieving care until the patient’s condition overcomes them.

Legal practice, as opposed to the letter of the law, has gone a little further. Again put simply, doctors and relatives who assist a relative in intolerable pain or near-death conditions to commit suicide are unlikely to face prosecution. This legal blind eye is as much as can be turned until there is legislative approval.

Even these circumventions are an anathema to those who argue than only God has the right to give and to take life. This, however, seems an unsure foundation on which to base a definitive answer. For those who are believers must accept that God granted humankind knowledge which has manifested itself in the medical advances which have promoted this debate. Lord Falconer’s commission’s opinion will not be the last attempt to provide an answer. As long as there is pain and suffering, the question will continue to be posed. A new debate in Holyrood would be welcome.