A compromise between individual rights and ethical safeguards, said Canadian prime minister Justin Trudeau of forthcoming legislation to legalise assisted suicide. From a liberal stance, overturning time-honoured beliefs is inherently progressive, and while no political leader could afford to overlook the latent conservatism of the electorate, the direction of travel seems set.

In his poem Dover Beach, Matthew Arnold lamented the ‘long, withdrawing roar’ of Christianity. He was writing in 1867, when Charles Darwin’s theory of evolution heralded a world bereft of spiritual meaning. As Peter Hitchens argued in a recent debate held by The Conservative Woman, we have become an irreversibly post-Christian society. A stark illustration of the eschewal of our Judeo-Christian culture is in the matter of life and death. Once sacrosanct, human life has become a social construct, disassembled and reshaped to suit postmodern prerogatives of individual rights and identity politics. A brave new world is being created, with noisy campaigners, legislators and a growing proportion of the public on side.

From foetus to centenarian, existence is being determined not by grace but by instrumentalism: Most people are not callous, but the prevailing secular relativism and narcissistic culture have licensed people to put their own needs to the forefront:  the woman whose career may be disrupted by an unwanted child; the son who sees his frail father’s assets disappearing into the coffers of a private care home. The vulnerable are protected by the State and its systems of health and social care, one might think. But attitudes are changing, and influential voices have swayed opinion in the health professions, which have abandoned a clear position on preservation of life.  The long march through the institutions continues apace, and dark forces will surely triumph if good women do nothing.

Think of the fully-formed boy or girl, nestling in the womb. Cathy Warwick, leader of the Royal College of Midwives, has pledged the support of her association to the ‘We trust women’ campaign of Britain’s most prolific abortionist. The British Pregnancy Advisory Service wants decriminalisation of abortion at any stage of pregnancy. In response to the furore, Warwick asserted the purpose of the RCM as ‘advocate for women’. Yet as observed by Ann Widdecombe, this obfuscates the role and responsibility of midwives, whose dual concern is for the pregnant woman and her baby. Midwifery serves humanity, not a feminist campaign.

In extending the territorial claim of midwifery to a broader ‘reproductive health’, Warwick states that only the woman has rights, denying any moral responsibility for the unborn child. It would be grotesque individualism to assimilate decisions about whether to complete a pregnancy to a choice of ‘still or sparkling’ in a restaurant.  Reassuringly, a large number of midwives have voiced their opposition to Warwick’s policy, which has no mandate from the membership. Sally Carson, who signed the ‘Not in my name’ open letter, urged a return to ‘the humane principles on which our profession should be based’. Let us hope that the next leader of the RCM can restore public and professional confidence.

At the other end of life, older people are imperilled by the euthanasia lobby. Although Lord Falconer’s Bill was defeated in Parliament, there is certainly momentum towards legalising medically-assisted suicide, and many among the health professions support this. Such thinking is informed not only by widely reported cases of severe neurological disability, from which a fully cognisant sufferer seeks final relief. Some doctors and nurses are openly doubting the value of patient’s lives, particularly those of older people with terminal conditions (which could include everybody in their later years). ‘Traumatising’ was how one of my students described a ward for people with dementia. The student thought that nurses were keeping patients alive for no good reason: despite appearing content, they lacked mental capacity and therefore the care team should decide to stop feeding.  Some patients had a file note ‘not for resuscitation’, but why wait for a heart attack?

In an opinion piece in a nursing journal, I warned of the dangers for people with mental health problems or dementia should assisted suicide be legalised. The nursing profession has failed to engage in this debate, leaving campaigners a free rein. Rebuttals of their arguments are rarely heard, despite the fundamental change to the principles and practice of nursing that would ensue. Proponents of assisted dying argue that a permissive Act would be tightly framed, but the scope would inevitably widen. Although Falconer and fellow travellers would bar people of unsound mind, this would soon be challenged as discriminatory: effectively, a person would be punished for losing decision-making capacity. Hundreds of Dutch people with dementia have been put to sleep, as was a young woman who had been sexually abused. Case law would soon stretch the boundaries, and assisted suicide would become as readily available as abortion.

Both late-term abortion and euthanasia for the old are illegal in this country, but for how long? Falconer and his followers will be back with another Bill, and official suicide statistics are becoming as inaccurate as immigration data, as numerous people take a one-way ticket to Dignitas and other ‘clinics’ abroad. We need an assertive polity to reinforce the right to exist. To be or not to be: that is the question, and the answer must not be decided by the forces of deconstruction. Live and let live.

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