The medical sociologist who compiled the report for the British Medical Journal, Professor Clive Seale, found that non-religious doctors are twice as likely as religious ones to administer treatments either intended or expected to shorten the lives of terminally ill patients.
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Coverage of the report illustrated that headline writers are as influenced as doctors by their beliefs. Some wrote, “Atheist doctors are more likely to hasten death”, where they might equally have written: “Religious doctors prolong the agonies of the dying.” Neither headline explains the finding of the report adequately, and neither advances the cause of understanding the right way to think about care of the terminally ill.
I should, first, declare an interest. I am a patron of Dignity In Dying, an organisation devoted to promoting the right of people to receive medical help to die if they express a clear and settled wish for it. Dignity In Dying used to be called the Voluntary Euthanasia Society: “euthanasia” means “a good death”, and “voluntary” means that a person’s choice to end his or her own life is willingly and clear-mindedly made.
The new name, Dignity In Dying, reflects the fact that incontinence, drugged stupor, dependence, choking and excruciating pain (which despite modern analgesics is still in some cases unavoidable), in a dragged-out ending to a difficult illness, is not what everyone desires; and medical science is able to provide a peaceful and easy release if the patient wishes it.
These points are useful background for understanding the implications of Professor Seale’s research. He found that a higher proportion of specialist doctors involved in the care of the elderly tend to be Hindu or Muslim, while specialists in palliative care of the terminally ill tend to be Christian or white; but that white doctors are more likely to be non-religious.
He further found that doctors with a religious commitment are less likely to discuss with their patients treatments that have a tendency to shorten life, these principally being pain-control treatments. This is a significant point, because it means that religiously-inclined doctors are withholding relevant information from patients, and deciding on their behalf what they will do, with a tendency to prolong their lives as long as possible whatever their wishes and whatever they are experiencing or suffering.
A separate recent study published in the prestigious New England Journal of Medicine found that early discussion of treatment options results in what Baroness Finlay, the hospice expert, describes as “fewer futile interventions” in the course of treatment – meaning that unnecessary and undesirable treatments that briefly extend life are avoided when doctors and patients discuss the options early on, and plan the treatment course to be followed. Religious doctors, according to the Seale report, are less likely than non-religious ones to engage in such discussion with patients; and the consequence for patients is extended suffering.
It is inevitable that some in the religious lobby will use the Seale report to suggest that “atheist” doctors are less caring, or even pose a danger to patients in terminal stages of illness. But exactly the opposite is the case: compassion for the dying has to be premised absolutely on understanding patients’ wishes, and on realising that the ultimate and final palliation of suffering is the release afforded by death, which many patients in those circumstances actively desire.
Those who oppose giving such help to dying patients use the argument that inheritance-greedy or impatient relatives will directly or by suggestion coerce an ill or elderly person into asking for help to die. And indeed, in all human affairs we may always expect some abuses. But the fact is that in the vast majority of cases, it is the relatives, not the dying, who insist on prolonging treatment; it is the relatives who seek prolongation of life beyond the point that the sufferers themselves wish.
To the anxiety and grief of relatives who request prolonged treatment is added the scruples of those whose religious belief is that only a deity has the right to decide when a person can die. (These religious scruples do not invariably extend to opposing war or, say, execution of homosexuals and adulterers.) The implication that a deity is thus cruelly using human ingenuity, in the form of medical knowledge, to prolong the torments and indignities of terminal illness, seems not to have suggested itself to such folk.
But amid this talk about who has the right to choose the hour and manner of death, an important point hovers in the background. For it is a key contention of organisations such as Dignity In Dying that we human beings should be recognised as having that right, and therefore the correlative right to get help to die quickly and painlessly if we request it on the basis of a clear-minded and settled voluntary desire for it. This is the parallel of the right of the disabled and the ill to be helped to live as well and as long as possible, which we as a society should likewise honour to the full.
At present the law denies the right of terminally ill patients, and people suffering from permanent conditions that they find intolerable, to be helped to die. The blunt fact is that we are more compassionate to our dogs and cats than to our fellow humans in this regard. Repeated polling over the years shows that 80% of the British population supports medically assisted dying, yet a number of attempts to introduce legislation to that effect has been defeated in Parliament, largely and predictably because of the religious lobby.
In my opinion Professor Seale’s research reinforces something we have all always known: that religion is sometimes a serious barrier to genuine humanitarianism, and that deeper and truer concern for human suffering is often found among those who are not religious.
Anthony Grayling is an author and human rights campaigner. He is professor of philosophy at Birkbeck College, University of London