— In my work as a congregational rabbi I see people die in pain, needlessly
By Rabbi Dr Jonathan Romain
As someone who passionately values the gift of life that we each have, why have I now become head of the campaign in Britain to legalise assisted dying, whereby a person obtains a prescription for life-ending medicine that they themselves take?
It is precisely because of my work as a congregational rabbi and many years of visiting hospitals and hospices, where I see people die in pain, despite the best efforts of medical staff.
They often beg doctors and relatives “Can’t you help me die in peace?”, but at present that is not legal. I see no merit in individuals being forced to live out their last days in misery if they want to avoid it.
In Ecclesiastes we are told that ‘There is a time to be born and a time to die’ (3.2). It is noticeable that it does not stipulate who chooses that moment.
Suicide is rightly discouraged in Judaism, but that assumes the person may otherwise live on for many years if not decades. Assisted dying is for those dying who wish to die well.
If we control all aspects of our life – where we live, what job we have, who we marry – why should we not determine when we leave it if we are facing a terminal illness?
A key factor for those wishing to die is the desire to avoid pain, but for others, it is the lack of control over their bodily functions or the unwelcome image of being sedated into a state of narcotic stupor.
Some might object that assisted dying means ‘playing God’ – but this ignores the fact that we frequently ‘play God’ – doing so every time we give a blood transfusion or provide a road accident victim with artificial limbs. Should we stop doing that? No more hip replacements or heart transplants?
We can believe in the sanctity of life – how precious it is – but that does not mean believing in the sanctity of suffering, or disregarding steps to avoid it. There is nothing holy about agony.
If terminally-ill patients do not wish to live out their last few weeks in pain, for what purpose should they be forced to do so, and in whose interest is it that life is prolonged?
There are strict safeguards being proposed to prevent any abuse. They include the stipulation that the person is terminally ill, is mentally competent and makes the request of their own free will.
In addition, there is a rigorous process for ensuring the above: it can only be initiated if requested by the person him/herself, and they must be assessed by two independent doctors to ensure that they are terminally ill and of sound mind.
On top of this, the person must have been fully informed of palliative care, hospices and other options, while they can change their mind at any time, right up to the last minute.
Meanwhile, the British Medical Association and almost all other Medical Royal Colleges have dropped their previous opposition to assisted dying. That is very significant.
Another persuasive factor is that we are in the fortunate position of knowing in advance what will be the likely effects of permitting assisted dying. This is thanks to the experiences in Oregon, which has the closest system to the legislation being proposed here.
Since it was introduced in 1997, several thousand dying patients per year enquire about assistance to die, but only around 0.4% of the overall deaths in a year opt for it. That is twenty-five years of hard evidence.
It indicates that many people wish to ‘know it’s there’ and have the emotional safety net of knowing they can resort to it if their situation makes life intolerable, but never find they reach that stage.
While many in the religious hierarchy still hold to the traditional opposition to assisted dying, there are a growing number of rabbis who now favour it.
At the same time, attitudes are changing within the general population too. A recent Populus poll revealed that 79% of those from religious backgrounds – defined as people who take their faith seriously enough to attend services at least once a month – said they supported the law being changed. Amongst Jews it was 83%.
If there is a right to die as well as possible, it means having the option of assisted dying, whether or not it is taken up.
It is also a matter of compassion – the compassion not to force other people who are suffering to keep on suffering if they reckon it is time to let go.
We need to tackle it for their sake. But who knows if we ourselves might one day need it?
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