Euthanasia

The latest attempt to de-criminalise assisted dying is making its way through the parliamentary process, with a Second Reading in the House of Lords later this month.

Whilst I recognise the very real issues that it seeks to address, I think that here, as in other arenas, hard cases make bad law.

My objections to changing the law in this way are many, both theoretical and practical.  At a theoretical level, I think it problematic as it is based on an assumption that we can know the future: and in fact, we cannot. In this case, the law presumes that we can know that someone is going to die within six months ('is reasonably expected to die within six months.') Further, it assumes that we (and in particular the individual concerned) knows that their condition will only get more unendurable over that period. 

Here I reflect on the relatively recent death of my mother-in-law. Some years ago, she was bed-ridden, and her continuing pain, allied to the ineffectiveness of drugs, and her mental state of misery, made me really think hard about this issue. Was it fair that people like her should suffer because people like me had doubts about euthanasia? 

But what happened over the last few years of her life was astonishing, and unpredictable. She decided to forego the drugs, and to manage her pain as best she could, on her own terms, by relaxing etc. It was astonishing. She found a peace and sense of tranquility in her last years that had eluded her for (at least) the last few decades. Had she had the choice to end her life earlier, she might well have taken it (not least as she hated the thought that she was a burden on her daughter). But had she done so, she would never have found that final peace.

Of course, that is only one story: but it is a story that illustrates that we don't know what the future holds and we are rash to presume that we do.

And there are other concerns, too, of course. These issues are always framed in terms of the individual - understandably enough, for it is the individual who is suffering. But it is not the individual alone whom such a change in our legal system would affect. Doctors, in particular, would be changed by this. That fundamental orientation to looking after the life and well-being of their patients would be undercut, and so would patient trust, I suspect. Elizabeth Jennings' poem, which I quote below, picks up this theme.

There is also the issue of the patient's family. What pressures might they be under, what pressures might they put the patient under, what regrets might they experience?...

And there's the broader societal impact. At present, we see life as precious. Nobody can take another's life, and we work hard to stop people from taking their own. We know, for example, that in the vast majority of cases, people who are prevented from committing suicide, or rescued from suicide attempts, do not go on to kill themselves later: they realise they are better off alive. But not in every case, of course; the trouble is we (and they) cannot know in advance which are the exceptions. 

We have even decided as a society that we will not take the lives of the most dreadful criminals. The finality of taking someone's life is so absolute, the instinct against it so strong, and the consequences of error are so terrible. But introducing Euthanasia breaks that compact: no longer is life so sacred as all that...

There is also the real risk of a slippery slope. Of course the way the initial legislation is drafted is very tight. Of course, it is only for a small number of extreme cases.  And so on.  Yet we heard all that in 1967 when the Abortion Bill was being debated: now we have virtual abortion on demand. And if we look around the world, at those countries that have already legalised assisted dying, we see exactly that: the criteria are relaxed, the practice is extended. In the Netherlands, a 1994 study revealed that in 1 in 5 cases, doctors prescribed drugs with the explicit goal of shortening the patient's life without the explicit request of the patient.

Also, it seems to me to be an agenda driven by fear, and that in itself is not a good thing. It is easy to stir up fear, but that is a very unhealthy basis on which to run a society. For myself, I hold hope to be a higher value, and to that end, I would counsel anyone interested in this issue to read Kathryn Mannix's book, With the End in Mind: Dying, Death and Wisdom in an Age of Denial. 

Mannix is a palliative care professional of many years' experience, working with the dying and their families. In this book, she tells of many experiences: her main point being that we are in denial about death, and correspondingly ignorant and fearful. If we educate ourselves, by reading her accounts and others, we will find that there is a lot less to fear.   But introduce euthanasia and the work (and funding) that goes in to palliative care are likely to reduce: such has been the experience elsewhere in the world, and we would be naive to assume that we are different.

I return to my earlier question:  is it fair that people should suffer because people like me have doubts about euthanasia? That does seem a fair question; but the opposite question should also be asked: is it right to risk all the harms that people like me envisage, to individuals, families and society at large, by breaching that fundamental principal: thou shalt not kill?

Euthanasia 

The law's been passed and I am lying low
Hoping to hide from those who think they are
Kindly, compassionate. My step is slow.
I hurry. Will the executioner
Be watching how I go?

Others about me clearly feel the same.
The deafest one pretends that she can hear.
The blindest hides her white stick while the lame
Attempt to stride. Life has become so dear.
Last time the doctor came,

All who could speak said they felt very well.
Did we imagine he was watching with
A new deep scrutiny? We could not tell.
Each minute now we think the stranger Death
Will take us from each cell

For that is what our little rooms now seem
To be. We are prepared to bear much pain,
Terror attacks us wakeful, every dream
Is now a nightmare. Doctor's due again.
We hold on to the gleam

Of sight, a word to hear. We act, we act,
And doing so we wear our weak selves out.
We said "We want to die" once when we lacked
The chance of it. We wait in fear and doubt.
O life, you are so packed

With possibility. Old age seems good.
The ache, the anguish - we could bear them we
Declare. The ones who pray plead with their God
To turn the murdering ministers away,
But they come softly shod.

Elizabeth Jennings