SPEAKER_01

Hello and thank you for downloading this episode of the Speak Life podcast, episode 454. My name is Thomas Thurrogood, media producer at Speak Life. And today we bring you a conversation that Glenn had with Lord McColl about euthanasia, assisted dying, and end-of-life care. So I will hand straight over to Glenn and Lord McColl.

SPEAKER_03

Hello, I'm Glenn from Speak Life. We try to see all things through the lens of Jesus. Today we have a real treat. This is my conversation with Lord McColl. Ian McColl has had a distinguished career as a medic and as a parliamentarian. He was professor of surgery at Guy's Hospital for decades, and then he was the parliamentary private secretary to John Major. He then became the Shadow Minister for Health between the years of 1997 and 2000, and he is currently a lord. And he joins me from the House of Lords, where he is up here. We speak together about matters of life and of death, of what really matters in life and what really matters in death about the issues of physician-assisted suicide and euthanasia and the kind of society we want to be. Recently we released an interview with Professor John Keone about these same matters, but while Professor Keown's expertise is bioethics, Lord McColl speaks from the perspective of a medic and a parliamentarian and a lawmaker. I begin by asking Lord McColl about his Christian faith and where it all began.

SPEAKER_00

Well, I I know it began when I was a teenager. And it was meeting people who were Christian and being impressed with the way they lived their lives. They didn't ram their views down my throat, but they're just the way they were. And that's why what I wanted to be. I always remember, I mean, there were several uh young men who came back from the war, and uh they were great examples. There was one called Brant Burbage, and um I found him very impressive. But I'd no idea what a distinguished man he was because he was so modest. He died at the age of ninety-five, I think about ten years ago. When I read his obituary, I was astonished. He was he sh he had shot down more German planes at night than anyone else. And as a Christian he made a point of shooting at the engines, not at the pilots.

SPEAKER_02

Right.

SPEAKER_00

So they had some chance to escape. Then I went to Guise and that was a great stimulus to my Christian faith. Not only was I amazed to be asked to conduct ward services, but I I conducted three with with my medical student friends and nurses, uh three services every Sunday in the evening lasting for twelve minutes each. And uh wonderful opportunity, and we never had any opposition at all. Amazing. They're very different times.

SPEAKER_03

What what do you think your Christian faith has contributed to your view of the medical profession and about life and end of life kind of issues?

SPEAKER_00

Well, I mean, the example of Jesus really, the great healer and how important it is, and to believe that everyone is important. And I learned so much from the people of Bermanse, who many of them uh had well certainly had no university education and so on, but they had wisdom, and that was a very important ingredient.

SPEAKER_03

That will become very relevant as we um think about these these issues of assisted dying and and euthanasia. Um I I guess you had much experience of kind of life or death calls. Um how did your experience as a professor of surgery kind of start to form your views about the sanctity of life and um and how you care for people at the end?

SPEAKER_00

Well, I um I saw my job as alleviating suffering. And so I had no problem with relieving their symptoms. And um I had an interesting experience with a patient early on, um, age twenty-eight, she had a cancer of her throat and um uh was dying and um had difficulty in breathing as well. And she was quite distressed, obviously. And I said to her, now I can relieve all your distress and pain uh with an inject uh continuous injection of heroin. And we used to use heroin in those days. And um I slowly gave it and asked her to tell me when the pain had gone. And it was a hu it turned out to be a huge dose. And um not only did it not kill her, it gave her several weeks of pain-free life because unrelieved pain is the killer. And as a doctor, it's our job to relieve symptoms, and I had never had any problem doing that. But I was reluctant uh to give up when there was possibly some hope. For instance, um a man came in who ruptured his aortic aneurysm and he ruptured it into his intestines, and that's usually uh or was usually in those days fatal. Um I operated um and he recovered from the operation and then got every complication in the book and um started arresting, and the nurses were very good at resuscitating her him. And finally he said, I've had enough of this, I want to die. And I said, Well, uh, you've got a twelve-year-old son and your wife has died. Uh, your son needs you. So we'll do our best to keep things going. Well, there's tremendous pressure on me from all round to let him die. And uh it was really quite uh a strain, this pressure on me.

SPEAKER_02

Yes.

SPEAKER_00

But I wouldn't give way until a week later I said, All right, if he arrests again, we can let him go. And he never arrested again and went back to a fairly normal life.

SPEAKER_02

Wow.

SPEAKER_00

So um it the cynic is do not struggle officiously to keep alive. But that was written by a cynical folk.

SPEAKER_02

Right.

SPEAKER_03

Um Right, right.

SPEAKER_00

But you have to get it right.

SPEAKER_03

Yes. And and there are many different um values there that are in tension with one another. I mean uh I mean the patient's wishes are uh one strand. Yes. But you are recognizing that people are actually woven together into families and into communities. Yes. Yeah. And that the community and and the family more particularly kind of have claims on us. Yeah. Such that uh at at points, even our wishes can be overridden by that by that greater sense of of the fabric of of the communities. Is is that what's going on there?

SPEAKER_00

I found it important always to sit down and listen to the patient, but also sit down and listen to the relatives.

SPEAKER_02

Right.

SPEAKER_00

Because you know, they're all one.

SPEAKER_03

Ha. That you don't you don't hear that very much these days, do you? I I think we we live in such an individualistic age. It's it is about the the desires of the individual, and who is anyone else to say differently. But I guess that's quite an atomistic picture of of humans. And when you're up close and personal at the end of life, you see very clearly that it is not just one person's um tragedy that they're living through, it it's they are woven together in in bonds of love and family. Yeah.

SPEAKER_00

Yes.

SPEAKER_03

Yeah.

SPEAKER_00

There was a another aspect, um I came into conflict with authority quite a lot, and when I was told that I mustn't tell anyone they'd got cancer if they had got cancer, um, I said, Well, just a minute, if we've taken off her breast and I then am told to tell her that it wasn't cancer, the patient knows I'm either incompetent or I'm lying. Right. Uh to have taken the breast off when it wasn't cancer is incompetent.

SPEAKER_02

Yes.

SPEAKER_00

And and so I I'm afraid I couldn't go along with that.

SPEAKER_02

Yes. Yes.

SPEAKER_00

And um it came to a head when um a patient who'd had a mastectomy some years before and had come back in full of secondaries, and she was dying. And I used to go and chat the patients up in the evening, go and sit on their bed and uh and that's when I found out what was going on. And this lady seized a hold of me and she said, I've been watching you, and I think you're a Christian and you won't lie to me. So I said, No, I won't lie to you. She said, I want to know the diagnosis. Please. And I said, I won't lie to you, but I just must go and make a telephone call. And I rang up my chief and said, This lady would be much happier knowing what the diagnosis was. And he said, How on earth can they possibly be happier knowing they're they've got cancer? Then he stopped and said, Unless there's some religious reason. Ah, I said, There is. Oh, well then you go and tell her.

SPEAKER_02

Okay.

SPEAKER_00

And I told her, and I I then realized that it was quite a strain to do that. And I began to understand why people didn't want to do it. Yes.

SPEAKER_02

Yes.

SPEAKER_00

Because then she said to me, Um, will you get a taxi? I need to go home and put my house in order. And I said, Certainly not. I've got my father's car here, I'll drive you there. And so I drove her, and the other uh dinner party, and I found the whole thing very traumatic, and it made me more sympathetic to people's reluctance to tell all.

SPEAKER_03

Yes.

SPEAKER_00

But I I did go telling all.

SPEAKER_03

Yes. What era was this? What what year was this?

SPEAKER_00

Oh, this is fifty um nineteen fifty seven.

SPEAKER_03

And today, what is uh w where where is the medical profession in the UK in in terms of letting people know their diagnosis? Oh they do, yes. Yes.

SPEAKER_00

Uh well, th the legal side has come into it too, of course.

SPEAKER_03

Yes. Yes. And in some senses, the there are all sorts of ways in which um we know more than we can possibly handle in in terms of, you know, if if someone were to map my genome, they might discover all sorts of you know, recessive genes and th they might discover all sorts of things that uh are ticking time bombs. Um you can sort of understand why, you know, too too much knowledge um can can burden a person. But um But if you have cancer, it's it's uh I I I I wonder whether uh so much of that is to do with well, if you think that death is the end, um then that becomes a burden too great to carry. But if i if you feel that you can die well, then understanding a terminal diagnosis is for the good.

SPEAKER_00

Yes. And then I got involved in hospices, uh quite a quite a few really. Um uh we I became they asked me to be president of the Mile May Mission Hospital, and um it had been closed being a surplus to requirement. And um the lady in charge was Helen Taylor Thompson, wonderful lady, who went to um uh the junior minister of health, one Kenneth Clark, and said, We want our hospital back. Um and the civil servants had told Kenneth, on no account are you to give them that hospital back. So Kenneth being said, has said to her, Yes, yes, yes, yes, of course you're gonna have the hospital back, but you'll never get me money to run it. And she said, Well, we believe in prayer, and he said, Well, I wish you all the best. And he used to come to every opening ceremony for years later. Good old child. Because you got the money. Yeah, yeah. And um so the government then asked us, would you look after people dying of AIDS? Because no one will touch them. And so uh we said, well, we certainly try. And so that's how the hospice opened for people dying of AIDS. And um it was interesting how much opposition we got from unusual quarters. It was amazing how many people said, Why are you d treating these terrible people? I thought, well, wait a minute, um I I may be wrong, but I thought they were people for whom Christ died.

unknown

Right.

SPEAKER_00

No?

SPEAKER_02

Right. Right. Right.

SPEAKER_00

Yeah. And then we were looking after so many Ugandan uh women and children that President Musevni of Uganda came over and uh he asked me if I would set up one of these in Uganda. And um Linda Chalker, who's the Minister for Overseas Development, gave us uh the money to do that. And so that was a great uh great step forward.

SPEAKER_03

Yes. And I guess with with hospice care, you are very attuned to um there it there is a sense in which there is a good death. Uh and literally, you know, as a classicist, you know, euthanasia um is is the Greek for good death. But do you feel like that term has kind of been hijacked as as though the only good death is one that happens on your terms? Um how how would you go about describing what a good death looks like?

SPEAKER_00

Well, I think i for one thing, um the symptoms must be controlled. And Cicely Saunders was uh I succeeded her as president of St. Christopher's and I knew her very well. In fact, we were medical students together. And um she realized that it was no use waiting till they got the pain and symptoms and then giving them medication. What you had to do is to keep them out of it, and you could do that by giving them regular uh uh doses, and it would be a lower dose as a result, and so they'd be more wide awake. So that quality is very important. And you recruit people who have expert in um picking off particular nerves with an injection of alcohol or something. There are all sorts of ways in which you can help people who are dying, and whatever you s do, never say to them there's nothing more we can do, which is not true.

SPEAKER_03

Right. Right. Because you you can alleviate symptoms and you you can become comfortable. Yeah. Yes. What what about when you can't? Because I I I think so much um of the the the sort of pro-euthanasia argument is um there is this story of this unconscionable suffering that somebody had to endure and they just wanted it to be over. Um I mean, obviously I mean your heart, our heart sort of goes out to people in those situations. What do you say when you when you hear the the the the stories of this palliative care that did not or could not relieve those particular symptoms? How do you respond to that?

SPEAKER_00

Well, the the answer is that if you have enough expertise, you can relieve, and you may have to give them doses that um really uh subdue them quite a lot. And if at the end of the day uh you they they may um not be conscious, but you've got to relieve the symptoms. And the euthanasia lobby say, well that's cheating, you're just using words. Um but if you keep your eye on the fact that you must relieve symptoms, that's what a doctor is for.

SPEAKER_02

Right. Right.

SPEAKER_00

But having said that, there are of course some cases where or motor neuron disease very distressful can be a very distressful end. But I think um there's a lot to be said for m moving them into a hospice because they would be able to be uh have constant vigilance to deal with their symptoms.

SPEAKER_03

Yes.

SPEAKER_00

But th but those cases are difficult.

SPEAKER_03

I guess, especially from your experience as a physician, um y you have taken oaths to care for people. And I and the change that it would require to alter the law on that, it would require those whose job had been to um preserve life and care, uh to becoming those who would actually kill. Um what kind of change would that do to the medical profession?

SPEAKER_00

Well, um I I suspect a lot of doctors would refuse to do it. But who knows what might might happen. Yes.

SPEAKER_03

I guess one one way of finding out is going to the experience of other countries, and so countries like Switzerland or the Netherlands or Belgium or uh in the States, I guess Washington and uh Washington State, Oregon, uh have uh euthanasia, Canada as well, it has been in the news quite a lot. Yes. Uh what what do we learn from those overseas experiences?

SPEAKER_00

Well, what I've learned is um and uh horrified when I learned how many of them are getting euthanasia because they're lonely.

SPEAKER_02

Right.

SPEAKER_00

Um and that figure is increasing. It was I think fourteen percent in Canada in uh twenty fourteen, and it rose to one in five in twenty twenty-one.

SPEAKER_03

Goodness.

SPEAKER_00

So it's uh uh I think it's appalling that people are killed because they're lonely. Right. I mean that's not a civilized country at all.

unknown

No, no.

SPEAKER_00

And so I'm um not at all uh very upset about that.

SPEAKER_03

Yes, yes. I think uh thirty thousand have died through the um the MAID um program in Canada, and ten thousand of those were it just in the last year, so it's it's uh I think it came in in twenty sixteen, so it's it's definitely accelerating in Canada and it's it's now becoming one of the chief causes of death. I think I think something something like three point three per cent of of of Canadians died. Yes um through MMS.

SPEAKER_00

And of course, one of the things that all my professional life I've been uh very keen on is dealing with abuse.

SPEAKER_02

Right.

SPEAKER_00

And the amount of abuse that goes on is very worrying. I mean, I I can remember one family saying to the older members of the family, you know, it's about time you went, 'cause we need our inheritance. That's a terrible thing to say.

SPEAKER_02

Right, right.

SPEAKER_00

And of course, the pressure on people I think one figure was um thirty-four percent had euthanasia because they felt they were a burden on their family. Well that's not a civilized practice at all. Yes.

SPEAKER_03

And it's a very different conception of humanity as though we were not meant to be burdens, um as though we were not meant to be dependent or to rely on one another. Because we've got this myth of the atomized individual who can uh strongly march through life and when I have decided my time is up, I make the decision and all falls to me. And you sort of lay that against just the reality of our humanity where we're embedded in families, we're embedded in a a wider culture where we rely on people in the beginning of life, we rely on people at the end of life, and that's no bad thing. It's that's it's a very human thing. And it feels it feels to me like euthanasia is is actually a a very inhuman conception of of the human person as though we are atomistic individuals and our choice is everything.

SPEAKER_00

Um there's so many arguments put forward and nonsense. I remember one a distinguished lord who got up in a debate on euthanasia and told the story of a driver of a petrol tanker which crashed and he was trapped in his um seat and he asked a passing policeman to shoot him dead uh so he wouldn't be burnt alive and this uh noble lord said and the policeman quite rightly shot him dead and I couldn't resist getting up and saying well I've heard that story before it's not true and it never will be true because no policeman would be daft enough to fire a gun at the sight of a crashed petrol tank.

SPEAKER_02

Right.

SPEAKER_00

But I think the law as it stands is um like a great dam holding back the enthusiasms and wildest excesses of the wild men and so long as it's there that's great. But the moment you get a crack in the dam as you might with assisted suicide the whole thing can give way that's the problem.

SPEAKER_03

Yes. And do you foresee that in in the UK experience?

SPEAKER_00

Well I I think it's possible.

SPEAKER_03

That's why we must fight it tooth and nail to what degree do you think the arguments against euthanasia are Christian at at at a sort of an explicit level um and and to what degree do you think you can you can argue from a sort of a wider natural law perspective well there are I know quite a few people who are not Christian who are atheists who are opposed to euthanasia on the basis that it's unjust and open to abuse.

SPEAKER_00

I mean I don't think we can force our Christian values on on other people but um I think we can um support the law and keep the law as it is for other reasons like stopping abuse and bullying that uh can so easily occur.

SPEAKER_03

Yes yes absolutely people are in a very vulnerable state at the end of life and and the possibility for bullying is is right there. Yeah. Um so if people were wanting to find out uh more about this particular subject or uh more about um some of the work that you do uh where should they go?

SPEAKER_00

The real answer to euthanasia is to have a much more extensive hospice system throughout the country.

unknown

Right.

SPEAKER_00

And we need to put more money into it. A lot of it is funded privately by donations. And in particular children's hospitals uh hospices um need a lot of support.

SPEAKER_03

That's a very proactive thing that people can do. Uh yes absolutely absolutely that's that's a that's a great place for you to uh point people towards uh well lord mcol thank you so much for for sparing time uh for us and uh I think uh you've got you've got migray matter worrying uh on all these sorts of issues and and I think what we've discussed has all sorts of implications not just for the end of life but but for what we think is a good life and what we think humans are and what our society should be.

SPEAKER_01

So you've you've helped us think through some of the deep stuff in life uh thank you so much well there we go thank you so much for listening I hope you found this conversation helpful in thinking through some of these very complex and very pressing issues of end of life care. If you'd like to find out more about this topic we also interviewed uh Professor John Kion for our Way Back series uh you can find that on our YouTube channel youtube.com forward slash speaklifemedia where we're releasing a series of interviews at the moment called the way back uh in this post-Christian age is there a path back to faith and uh and so Glenn is speaking to a range of thinkers Christian and non-Christian uh on all sorts of issues so those are being released on YouTube we probably will make them available as podcasts at some point but for now the only place you can find them is YouTube so yeah the way back John Keon on the Speak Life YouTube channel if you would like to find out more about this topic. Well that's all from me thank you so much for listening and we will be back soon