Vatican at UN warns of ‘contagion of violence’ in Gaza

TomasiStatement by H.E. Archbishop Silvano M. Tomasi, Permanent Representative of the Holy See to the United Nations and Other International Organizations in Geneva at the 21st Special Session of the Human Rights Council on the human rights situation in the Occupied Palestinian Territory including East Jerusalem (Geneva, 23 July 2014)

Mr. President,

As the number of people killed, wounded, uprooted from their homes, continues to increase in the conflict between Israel and some Palestinian groups, particularly in the Gaza Strip, the voice of reason seems submerged by the blast of arms. Violence will lead nowhere either now or in the future. The perpetration of injustices and the violation of human rights, especially the right to life and to live in peace and security, sow fresh seeds of hatred and resentment. A culture of violence is being consolidated, the fruits of which gaza-hamas_2403473bare destruction and death. In the long run, there can be no winners in the current tragedy, only more suffering. Most of the victims are civilians, who by international humanitarian law, should be protected. The United Nations estimates that approximately seventy percent of Palestinians killed have been innocent civilians. This is just as intolerable as the rockets missiles directed indiscriminately toward civilian targets in Israel. Consciences are paralyzed by a climate of protracted violence, which seeks to impose solution through the annihilation of the other. Demonizing others, however, does not eliminate their rights. Instead, the way to the future, lies in recognizing our common humanity.

In his Pilgrimage to the Holy Land, Pope Francis demanded that the present unacceptable situation of the Israeli-Palestinian conflict be brought to an end.

1. “For the good of all,” he said, “there is a need to intensify efforts and initiatives aimed at creating the conditions for a stable peace based on justice, on the recognition of the rights of every individual, and on mutual security. The time has come for everyone to find the courage to be generous and creative in the service of the common good, the courage to forge a peace which rests on the acknowledgment by all of the right of two States to exist and to live in peace and security within internationally recognized borders.”

2. The legitimate aspiration to security, on one side, and to decent living conditions, on the other, with access to the normal means of existence like medicines, water and jobs, for example, reflects a fundamental human right, without which peace is very difficult to preserve.

Smoke and fire from an Israeli bomb rises into the air ove Gaza CityThe worsening situation in Gaza is an incessant reminder of the necessity to arrive at a cease-fire immediately and to start negotiating a lasting peace. “Peace will bring countless benefits for the peoples of this region and for the world as a whole,” adds Pope Francis, “and so it must resolutely be pursued, even if each side has to make certain sacrifices.” It becomes a responsibility of the international community to engage in earnest in the pursuit of peace and to help the parties in this horrible conflict reach some understanding in order to stop the violence and look to the future with mutual trust.

Mr. President,

The Delegation of the Holy See reiterates its view that violence never pays. Violence will only lead to more suffering, devastation and death, and will prevent peace from becoming a reality. The strategy of violence can be contagious and become uncontrollable. To combat violence and its detrimental consequences we must avoid becoming accustomed to killing. At a time where brutality is common and human rights violations are ubiquitous, we must not become indifferent but respond positively in order to attenuate the conflict which concerns us all.

Gaza horrorThe media should report in a fair and unbiased manner the tragedy of all who are suffering because of the conflict, in order to facilitate the development of an impartial dialogue that acknowledges the rights of everyone, respects the just concerns of the international community, and benefits from the solidarity of the international community in supporting a serious effort to attain peace. With an eye to the future, the vicious circle of retribution and retaliation must cease. With violence, men and women will continue to live as enemies and adversaries, but with peace they can live as brothers and sisters.

Thank you, Mr. President.

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Baroness Campbell’s speech on assisted suicide

The following speech was made in today’s debate in the House of Lords on the Assisted Dying Bill 2013-2014 by Baroness Campbell of Surbiton:

My Lords, I have fought for autonomy the whole of my life. I have fought for that for myself and for others. I do not want this Bill.

First, I must declare a very important interest. This Bill is about me. I did not ask for it and I do not want it but it is about me nevertheless. Before anyone disputes this, imagine that it is already law and that I ask for assistance to die. Do your Lordships think that I would be refused? No; you can be sure that there would be doctors and lawyers willing to support my right to die. Sadly, many would put their energies into that rather than improving my situation or helping me to change my mind. The Bill offers no comfort to me. It frightens me because, in periods of greatest difficulty, I know that I might be tempted to use it. It only adds to the burdens and challenges which life holds for me.

However, it is not just about me. My story is echoed by the majority of disabled and terminally ill people in Britain today. Many of them are outside this House, protesting against the Bill. I urge your Lordships to go and talk to them. Many more will have written to your Lordships. Supporters of the Bill argue that there is a hard and fast distinction between terminal illness and disability. I can tell you absolutely that there is not. We, the folk this Bill claims to serve, know that. The Bill purports to offer choice—the option of premature death instead of pain, suffering and disempowerment—but it is a false choice. It is that of the burglar who offers to mug you instead. That is not choice. Pain, suffering and disempowerment are treatable—I have to believe that—and they should always be treated. My long experience of progressive deterioration has taught me that there is no situation that cannot be improved.

I have spent my life developing ways to prevent people in vulnerable situations feeling powerless and burdensome. They do get cajoled and do feel a burden, especially when they are at home with no one to come and assist them to go to the toilet and to have dignity. I have seen this transformation when people have been helped. Those whom society once saw as totally dependent have become active and valued human beings. I am afraid that assisted dying will bring back outdated beliefs that devalue disabled and terminally ill people, when we have tried so hard to get away from them. Small wonder then if some succumb to those beliefs and see premature death as the only answer. Small wonder if family, friends, doctors and others see it as their duty to support that goal. It appears easier, cheaper and quicker—and it is.

The Bill is motivated by fear and pity but as the greatest French novelist, Balzac, observed,

“pity is death to us—it makes our weakness weaker still”.

Death is seen as a release from pity, for both giver and receiver, but there are far better ways of responding. We must put our energy into providing the best support, be it medical, social, practical or emotional, to disabled people and terminally ill people. We are nowhere near there yet. Helping people to live with dignity and purpose must surely be our priority. Disabled people and terminally ill people do not deserve pity. They deserve so much better. The Bill has become a runaway train, and the more frightening because of that. Please let us pause and find ways to reflect further. The Bill is not the answer.

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Lord Brennan’s speech on assisted suicide

The following speech was made in today’s debate in the House of Lords on the Assisted Dying Bill 2013-2014 by Lord Brennan:

My Lords, to make it lawful for doctors to assist people to commit suicide is a profound step. This morning’s editorial in the Guardian said that it would change the moral landscape of our nation. A Bill that proposes this therefore demands, whether you are for it or not, rigorous examination. If one applies that examination at this early stage, the Bill can be seen to be dangerous in its effect.

First, it favours the few invulnerable against the many vulnerable, who may be pressured into it by fears of being a burden, either through physical dependency or financial cost or both. I use those adjectives, “invulnerable” and “vulnerable”, following Lord Sumption, one of the judges in the recent case. He used them in counterpoint to explain the difference between the strong and clear-minded and the weak, depressed, ill and confused. At paragraph 228 of his judgment, in referring to the risk to the vulnerable, he said:

“There is a good deal of evidence that this problem exists, that it is significant, and that it is aggravated by negative modern attitudes to old age and sickness-related disability”.

The problem will surely get worse. Over the next 25 years, people of 60 and above will become 50% of the population of the nation, presently estimated to take up 60% of the National Health Service’s costs. Can it be doubted that the problem that Lord Sumption identified is not going to get worse? Of course it is, both in the individual case and in society, where the cost of living as an old or sick person will be balanced against the treatments of death under these arrangements. We must be realistic. Limited today, it will be extended soon enough if necessary.

Secondly, there is a danger to the medical profession. This Bill dismantles the Hippocratic oath by creating two kinds of doctor: those who will not help you to kill yourself and those who will. I cannot imagine more diametrically opposed medical standards than those. How is it to be resolved within the profession? How can it help public confidence in doctors and nurses?

Thirdly, the Bill is limited in its effect, but the prospect of litigation and further legislation is obvious. The more we are told about autonomy and choice, the more a group of litigants will say to the court, “I want to exercise my autonomy and my choice. Why is it restricted to the terminally ill? Why six months? Why the discrimination between those types of cases and me? Look at the Equality Act”—et cetera, et cetera. It will come. The noble and learned Lord, Lord Falconer, has not told us, nor has any of his supporters thus far, what they will do in the future if this Bill is passed. Is this a first step or the last step?

Fourthly and finally, there is a danger to Parliament. If one doubts that it is as serious as I have suggested, look at Clauses 8 and 9. The Bill states that execution, oversight and regulation are given by us to the Executive to devise and implement without reference to Parliament. I find that astonishing.

I accept the misery that can come with illness and the time near to death, but in the 21st century, with all the technology and medical advances that we have, are we driven to the conclusion, in the words of one of the royal colleges, that it is best to be compassionate by eliminating suffering through elimination of the sufferer? Surely we can do better than that.

Legislating for hard cases nearly always produces bad law. In the rigour that we apply to this Bill, let us make sure that we do not make that mistake again.

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Baroness O’Cathain’s speech on assisted suicide

The following speech was made in today’s debate in the House of Lords on the Assisted Dying Bill 2013-2014 by Baroness O’Cathain:

My Lords, I believe that a great strength of this House whenever we look at a Bill—we have looked at a lot of them—is that we seem to have a mental checklist of things that we should always take into consideration; an impact statement, in effect. One of the things we always take into consideration is the effect of the Bill, whatever its subject or object, on the population as a whole, particularly on the vulnerable and on those who do not really have the capacity to decide what is the right way of doing things. In my view, this proposed legislation turns that on its head. In effect, there is a grave danger that if the Bill were to be enacted, the vulnerable would be the most negatively affected. We are talking about the vulnerable as if they are the subject and object of the Bill, but we are not going through the effect on individuals.

We know this from the huge number of letters we have received and, indeed, from our own personal experience. Time and again we are moved by these letters, but the thing that shrieks at me from them is whether anybody has done anything about depression. In fact, I do not think depression has been mentioned at all in the debate so far. I have personal experience, both from my own very close personal relationship and from my best friend. Both cases were desperately difficult deaths over the long term—years and months. In both cases, when the victims, so to speak, were actually treated with anti-depressants and given a regime aimed at lifting their hopes, they became much more amenable to friendship, to discussing life and to planning for reuniting with their maker, in a way that would not have been possible if they had had this option, three or four months earlier, to say, “I want to end my life”.

Time and again I have read of the serious deep anxiety that many have of the prospect of being a burden. I am sure most of us feel that—I feel that. That is fine, up to a point, but what we have to do is instil a complete change in our attitude to the elderly in terms of realising that they can still, even at the end of their lives, teach us a lot and help us with many things which we will use in the future. What about the effects of assisted dying on those who administer the means, whatever they are, of moving these people on? We had a moving speech from the noble Lord, Lord MacKenzie of Culkein. So far as I could gather, his point was that is all right for us who do not have to do the deed, but what about the people who do and how long does it stay in their memory?

Polls have already been referred to and, I am sure, will be again. We have had so many polls that we are befuddled. The one result of polls of which I am certain is that people constantly change their mind—even the Guardian today has changed its mind. What really bothers me, however, is that, behind the headline figures, the polls show a shocking apathy. I think that, when people are polled, they do not think of the depth of the meaning behind the question. The ComRes poll that appeared yesterday gave the most disturbing result that 47% of supporters of the Bill would still support it even if it resulted in people being pressured into ending their lives early so as not to be a burden. Are we really sure that this is what this country believes?

Let us not forget that the World Health Assembly adopted a ground-breaking resolution on palliative care on 23 May this year. Nowhere was assisted suicide—or its euphemism, assisted dying—mentioned. Instead, the need for greater palliative care and the importance of hospices in end-of-life care were resoundingly echoed by elected health experts from around the world. Not for the first time in your Lordships’ House, I wholly endorse that hope.

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Lord MacKenzie’s speech on assisted suicide

The following speech was made in today’s debate in the House of Lords on the Assisted Dying Bill 2013-2014 by Lord MacKenzie of Culkein:

My Lords, I am sorry that I am unable to support the Bill in the name of my noble and learned friend, although I know that it has been introduced from the very best of motives. I speak as a nurse who has been on the nursing register for some 39 years. It is some time since I practised, but I have spent a good deal of my working lifetime representing nurses and nursing. Of course, nursing has changed in that time; social attitudes have evolved since my first entry into nursing as a student nurse. But I am clear about this: what has not changed is the ethical basis and ethos of nursing.

I have always understood the central tenet of nursing to be duty of care—about promoting and maintaining health, preventing and/or treating illness and injury and helping patients to recover and, where that is not possible, giving the best quality of life until death. I do not believe that giving the best quality of life until death can include the nurse delivering and assisting the patient to ingest a lethal lytic cocktail on the authorisation of an attending physician.

Doctors are busy people with time at a premium. It is nurses who are with patients for 24 hours out of 24, so it likely to be the nurse who would be, in the words of the Bill, the “assisting health professional” duly authorised to carry out the function of actually assisting the death of the patient by preparing these lethal drugs. I hesitate to use the word “medicine”, which is in the Bill, because medicine, if my Latin is any good, is something to do with healing and not death. The nurse would prepare the medical device, load the syringe driver or, as the Bill says, assist the patient to ingest.

The Bill tries to give safeguards by saying that the final act of self-administration lies with the patient. How will a patient with motor neurone disease who cannot swallow and cannot move their arms because they are paralysed carry out that final act? They will not. They are excluded from the Bill. So the compassion, which we all share, is selective. It does not apply to all people with serious, progressive neurological conditions, for example.

I do not want nurses to be in a position where in the course of their normal duties a patient might say—it could be said as a joke, but it might be said seriously out of concern by a vulnerable patient—“I hope, nurse, you’re not one of these who assist dying”, or perhaps in the more vernacular, “I hope you’re not one of these who bumps people off”.

Many in the medical profession say, rightly, that assisted dying facilitated by a physician will fundamentally alter the patient/doctor relationship. In my opinion, that applies in exactly the same way to the nursing profession. I see any legislation based on the Bill as leading inexorably, maybe a long time in the future, to assisted suicide as a right rather than an exception. We have heard about slippery slopes. I am sure that the noble Lord, Lord Steel of Aikwood, when introducing the Abortion Bill in 1967, said many of the same things that have been said today. Now we see how society has evolved and that position has changed.

If that happens in this country to the public perception of assisted dying, it could follow that there will be seen to be a duty on nurses and doctors to be involved. That is not something that I want any part in facilitating, conscience clauses notwithstanding. This is an enormously difficult area, but there are too many unresolved issues at the heart of the Bill, not the least of which, as it is presently drafted, is that it would lead to nurses being in serious contravention of the Nursing and Midwifery Council code.

Given the intervention of the Supreme Court, there is a powerful argument, despite what my noble and learned friend has said, for a royal commission to take a long, hard look at this issue before it returns to Parliament. For those reasons, not the least of which is the potential for serious damage to the ethics and ethos of nursing and the public trust of nurses, I regret that I cannot support the Bill.

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Baroness Finlay’s speech in the assisted suicide debate

The following speech was made in today’s debate in the House of Lords on the Assisted Dying Bill 2013-2014 by Baroness Finlay of Llandaff:

My Lords, like many others, particularly doctors who will be expected to be involved in assisting their patients’ suicide, I do not support this Bill. But the Supreme Court has asked Parliament to look at the issue and we should not oppose it at Second Reading. I have worked caring for dying patients for more than 25 years and I have registered my interests.

This Bill has broad categories into which almost anyone can be shoe-horned and it comes within a whisker of full-blown euthanasia. Are there safeguards? No, there are only broad categories into which you will find some doctor who would state that almost anyone fits. Let us take a prognosis of six months: there is no accurate test at all. Even a best guess is so surrounded with inaccuracy that the only honest answer to the question, “How long have I got?”, is to say, “I honestly can’t tell”. Even of those thought to be likely to die within 48 hours, about 4% improve and some even go home. But this Bill is not about them or about better care at the end of life; it is about assisted suicide, effectively on request.

Nor is it about a right to die. Everyone will die. If you do not want treatment that might prolong your life, you can refuse it. For those with motor neurone disease on a ventilator who want to stop treatment, we can manage their dying peacefully and gently as they die of their illness. When treatment is withdrawn, it is not withdrawn with the doctor’s intention of bringing about the patient’s death; when lethal drugs are supplied, they are supplied with that intent. This Bill is about licensing doctors to supply lethal drugs to some of their patients and helping them to commit suicide, however long their life might otherwise have gone on for. I have seen the strongest people, including politicians and senior doctors, be the most vulnerable when facing dying—vulnerable to coercive influence and vulnerable to their fears. The role of my profession is to address those fears and to support those people, not to encourage them, even silently, to believe that they should foreshorten their lives.

Today’s doctors are worn down by workload. They do not know their patients in detail. They know only what they are told in a brief encounter. They cannot possibly detect coercion from family. I cared for a lady whose family we all believed were loving but they stopped visiting as much once her fixed-term life insurance expired. What about subtle coercion from staff attitudes that are negative or instil hopelessness?

The signature of a second doctor provides no assurance. Who is going to find this second doctor? He or she is likely to be known to the first doctor as someone who sees physician-assisted suicide as a reasonable response to severe progressive illness. Let us not forget that Dr Shipman’s 176 cremation forms were all countersigned by a second doctor.

Of course, palliative care does not have a magic wand to make everything right. Nothing in medicine has 100% success. Even assisted suicide sometimes fails to kill. But we do not kill patients with morphine properly prescribed to relieve pain, or with nerve blocks or other interventions. The Francis report showed how bad care can be. The well intentioned Liverpool Care Pathway failed: it became just another tick-box exercise. That is what this will be — a set of forms to be filled in, without proper scrutiny of the assessments, the processes and the administration.

Those of us at the sharp end who care for terminally ill patients day in, day out know that the real work of assisting someone to die is not just something on a to-do list. It calls for good care, dedicated support and time, and not the quick fix of offering the medical equivalent of a loaded gun.

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John Sentamu’s speech in assisted suicide debate

The following speech was made in today’s debate in the House of Lords on the Assisted Dying Bill 2013-2014 by John Sentamu, Anglican Archbishop of York:

My Lords, let me state at the outset that the official Church of England position was made very clear on 9 July 2005, when the General Synod voted on a motion referring to the joint submission of the Church of England House of Bishops and the Roman Catholic Bishops’ Conference to your Lordships’ House Select Committee. The motion argued strongly against making assisted suicide or euthanasia lawful. The vote was carried by 297 votes to one. This position was reaffirmed in a General Synod motion in 2012.

The present Bill is not about relieving pain or suffering; it makes that quite clear in its definition of a terminally ill patient to include those whose progressive illness can be relieved but not reversed. The Bill is about asserting a philosophy, which not only Christians but also other thoughtful people of good will who have had experience in care for the dying must find incredible—that is, the ancient Stoic philosophy that ending one’s life in circumstances of distress is an assertion of human freedom. That it cannot be. Human freedom is won only by becoming reconciled with the need to die, and by affirming the human relations we have with other people. Accepting the approach of death is not the attitude of passivity that we may think it to be. Dying well is the positive achievement of a task that belongs with our humanity. It is unlike all other tasks given to us in life, but it expresses the value that we set on life as no other approach to death can do.

We need time, human presence and sympathy in coming to terms with a terminal prognosis. To put the opportunity to end one’s life before a patient facing that task would be to invite him or her to act under their influence rather than dealing with them.

It is possible to think abstractly that one’s early death would be welcome to one’s nearest family and would spare them trouble. But in fact the best service one could do for them would be to accept their care and to show appreciation of them at the end of one’s life. When it was discovered that my mother, Ruth, had aggressive throat cancer, she was expected to live only a few weeks, but through the skill and care of the hospital and Trinity Hospice, she was able to live for 18 months. During this time, our children, who had been born in England, were able to get to know and love their grandmother, and she was able to delight in them. This was a gift.

The Bishop of Worcester, John Inge, recently wrote about his wife, Denise, who died of a sarcoma on Easter Day. He writes:

“How easy it would have been to succumb to despair when the diagnosis was given. It looked as though she had only days, or weeks at most, to live … as the dreadful effects of chemo took their toll and I became more and more … distressed at seeing her in such pain and discomfort … How tempting it would have been for me”—

if assisted dying had been legal—

“to have suggested that … it would be ‘for the best’ for her to end it all there and then.

Many … argue that it would have been the ‘compassionate’ and ‘caring’ thing to do”.

But Denise survived several more months, and during the times when I visited and prayed with her and Bishop John, I saw her emerge from the initial darkness to enjoy some precious time with friends and family. Shortly before she died she wrote:

“Contemplating mortality is not about being prepared to die, it is about being prepared to live. And that is what I am doing now, more freely and more fully than I have since childhood. The cancer has not made life more precious—that would make it seem like something fragile to lock away in the cupboard. No, it has made it more delicious”.

The Assisted Dying Bill could deprive some terminally ill individuals and their families of this very important time of shared love and wonder. I urge noble Lords to resist it. This is far too complex and sensitive an issue to be rushed through Parliament and decided on the basis of competing personal stories. It may be better if a royal commission were to look at this, with members from both sides not appearing as if they were shouting across the banks of a river.

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