Not just an issue of life and death - the British Social Attitudes Survey

David Donnison

New statistics on support for euthanasia amongst the British public show some startling trends. As part of probably the most influential and respected official survey conducted in Britain, Professor Donnison, the current Vice-Convener of VESS, authors the background work that VESS can use as political ammunition in the fight for reform.

Euthanasia - helping people out of this world when they decide that they want to leave it - has gone on since the dawn of time. But it was seldom talked about. People usually died in their own homes. What happened in their last hours was known only to their closest relatives and perhaps to a doctor or nurse. But now decisions about death are seldom out of the headlines for long. Why the change?

The advance of medical technology is bringing a steadily growing majority of deaths into hospitals where life, of a sort, may be prolonged for a long time. Someone has to decide what nature used to decide for us. Those decisions are no longer taken privately in a small family group but amidst a constantly changing crowd of doctors, nurses, patients and technicians.

Death itself grows harder to define. In Britain at any one time there are about two thousand people who have spent more than six months in a persistent vegetative state from which they will never recover. Many dread the pointless indignity of such a fate, and they are asserting their right to be heard with growing confidence. Whose death is it anyway?

Meanwhile, as drugs have been made less lethal suicide becomes harder to arrange without professional help. Ten years ago you could get a prescription for sleeping pills, go home and swallow the lot, and that was that. Now you just wake up with a splitting headache.

For these and other reasons, more and more decisions about the ending of life are brought to the courts which are ill-equipped to handle them. Can it be right that some people kill themselves while still capable of doing so because they know they cannot ask anyone to help them once they become incapable? Or that doctors are entitled to withhold treatment from dying patients if "best practice" suggests it would not be "in their best interests", but cannot then withdraw it unless the treatment has clearly failed? Or that a court should be asked to decide whether a feeding tube which accidentally fell out should be replaced? Or that many good doctors admit that they have risked their careers by helping patients to die when they were asked for that last service? Such dilemmas have led some of our best judges to conclude that it is high time Parliament reviewed the whole issue.

The increasingly angry debate about euthanasia helps to explain the reluctance of politicians to tackle this hot potato. On the one hand are those who say that "Life is a gift from God and is not ours to do with as we please". (Cardinal Winning's spokesman recently.) On the other are those who say that "There is a constitutionally protected interest in determining the time and manner of one's own death". (A recent decision by a U.S. Federal Appeals Court.) Both standpoints can be forcefully argued. But what do the British people think of them?.

The most thorough study yet made of their opinions appears in the latest of thirteen annual reports on British Social Attitudes, published today. This shows that the more extreme contenders on both sides speak for small minorities of our people. Seven situations which might justify euthanasia were described. Only 5 per cent of those interviewed would oppose euthanasia in every one of them; and only 7 per cent would approve it in every one. The great majority of our fellow citizens would approve it in some cases but not in others. They are a cautious, pragmatic lot without clear-cut principles: very British.

When seeking explanations for profound differences of opinion in Britain, the usual suspects are education, class, political allegiance and gender. But these throw little light on this case. The most resolute opponents of euthanasia are those who go regularly to church (of any religion); those who oppose abortion, suicide and capital punishment; and those who worry about the power of doctors and do not trust them. Other factors play a part, but these are the most important. Those who chose "the right to life" as their slogan may have tapped a deeply rooted seam of values cutting across class and politics.

But time is likely to be on the side of the reformers. Acceptance of abortion and suicide, abandonment of church going and other patterns associated with support for euthanasia are more often found among younger people than among the older people whom they will steadily replace as time goes by.

Reform, when it comes, will have to be by private member's bill, for each Party is pretty evenly split on the issue. Changes in the law will be piecemeal, opening a way to euthanasia in some cases but not in others, and leaving plenty of room for further argument. That may seem a disappointingly messy outcome. But it may be no bad thing that we shall have time to monitor what happens and make sure that proper safeguards are built in before we go further.

This article first appeared in the Glasgow Herald © and is reprinted here with kind permission.

David Donnison, Emeritus Professor at the University of Glasgow, wrote, with Caroline Bryson, the chapter on euthanasia in British Social Attitudes. the 13th Report, edited by Roger Jowell and others. (Dartmouth, 1996). It was Donnison's connections which enabled euthanasia to be included as a study area for the first time in this national Study. A lifelong champion of the poor, the homeless and the unemployed, Donnison has focussed his internationally renowned skills in Social Policy & Administration to the dilemmas presented in attempting reform for voluntary euthanasia to the great benefit of VESS. His engagements on behalf of the Society have included representing VESS at political party conferences and he has also been active penning articles on euthanasia for the press. He joined the VESS Executive Committee four years ago and presently serves as our Vice-Convener.