News

Mangling together two philosophies that have dominated UK politics during the past 50 years was always going to spew out some dangerous ideas. The first philosophy is the public provision of "cradle to grave" support for our citizens. Overlapping this more recently has been the belief that a government's "success" should be judged by the degree of choice extended to individual citizens.

It naturally follows that the "manglers" believe that policies affecting the manner of one's death should also fit comfortably into both philosophies. In other words, they embrace the state's role in helping us leave this life in as pain-free and dignified a manner as possible. However, they also want to satisfy the desire to allow individuals to exert the maximum influence about how they die. A worthy aim - but littered with pitfalls.

For instance, Lord Filkin, the constitutional affairs minister, talking to the Alzheimer's Society in April, described his latest proposal for living wills thus: "When faced with a degenerative condition like Alzheimer's (these) can provide some reassurance and a sense of empowerment in the face of difficult and distressing circumstances". He went on to talk of "giving people a much needed element of control".

There's a rather hackneyed mantra that originated from the Conservative PR guru Tim (now Lord) Bell, that "perception is reality". Unfortunately, it encourages too many political activists of all parties to believe that most people are too stupid to spot rubbish when it is emptied all over them.

If you doubt this, just ponder for a moment the decision taken by ministers to change the name of the proposed legislation affecting living wills from the Mental Incapacity Bill to the Mental Capacity Bill to help calm the critics of the first draft.

And what about the words "living" and "wills"? These "wills" are not about living; they are about dying. And however you dress it up, surely what these "wills" may require is that a carer hastens the death of their charge? Some go further and would regard themselves as, effectively, murderers.

But at this point I hit a barrier because in many policy areas, I am a serial "mangler". Hence, I feel seriously challenged by the question of choice - or, more accurately, control - over how and when an individual chooses to die.

At the same time I recognise that the political pursuit of giving us all more control over our own lives and deaths hits the buffers when one acknowledges that there are times when none of us will enjoy that luxury.

This fact is much more obvious on a daily basis to carers and health professionals than to most of us. For we can largely avoid thinking too much about the consequences of losing the mental or physical capacity to care for ourselves and others.


In our society, it is now perfectly possible for large swathes of the population to have little or no knowledge or contact with the seriously ill, the mentally ill or handicapped and the dying for much of their lives. And we are all, of course, fooling ourselves.

Of course Lord Filkin did not talk about people "fooling themselves" but talked about giving a "sense" of empowerment. But it is much the same thing. It is an admission that his aim is to make a highly vulnerable person feel better by knowing that an instruction exists that will mean, when they lose control over their own minds and bodies, they will not have to endure for long.

It is only natural to feel - and want to express - such sympathy. Until, that is, one envisages the scene, apparently sanctioned by Durham Council, where a carer is "instructed" to stand and watch someone quite literally choke to death. I could find no mention in the minister's speech of sympathy for the carer's plight.

In the UK, not only have medical treatments advanced rapidly, but also the belief that we are entitled to a healthy, pain-free life. These are issues for medical staff dealing with the terminally ill; not for others who care for them, certainly not for councils, nor, if possible, for judges.

The sooner that those charged with caring for our most vulnerable people start campaigning for safeguards in the redrafted Mental Capacity Bill the better. To wait for the first legal case to give clear guidance may enrich quite a few lawyers. But I would not give it much chance of fostering relationships of total trust and confidence between cared for and carers.

Sheila Gunn is a political commentator and a Conservative councillor in the London Borough of Camden.