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Medically assisted death for terminally ill patients has been a prominent issue in the media for a number of years. In 2011, Sir Terry Pratchett, who himself suffers from Alzheimer’s disease, produced a high profile and poignant documentary for the BBC. This followed the journey of a man with late-stage motor neurone disease who travelled to the Swiss clinic Dignitas to end his own life. In 2013, Tony Nicklinson and Paul Lumb hit the headlines when their attempts to earn the legal right to an assisted suicide were rejected in the Court of Appeal.
Indeed, 2014 looks set to be another big year in the debate on euthanasia; the Supreme Court is due to deliver its own judgement on the Nicklinson and Lumb case. This will come too late for Mr Nicklinson, who has since passed away, but may provide some important clarity on the legal rights of terminally ill patients, in particular clarifying what exactly doctors can discuss with patients. The most prominent arguments will be had in the House of Lords later in the year as a bill proposed by Lord Falconer, which will allow medical professionals to assist in patients’ suicides under carefully defined safeguards, will be brought to the table.
Why should these people, and their families, who are already struggling with massively life-changing and terminal illnesses, have to fight through costly and stressful litigation? So-called “amateur” assisted dying, where a terminally-ill person is allowed to die with the help of friends or relatives, is practically legal – in 2010 the Director for Public Prosecutions, the body which deals with guidelines for the charging of crimes in the UK, issued a new policy which made a clear distinction between compassionate assistance, which would generally not be prosecuted, and malicious assistance, where it is evident that the patient was put under pressure to take their own life. However, medical professionals who help a patient take their own life, or who even discuss it with them in any real detail, can be punished under the full force of the law – up to 14 years’ imprisonment. This is something which must change. If a terminally ill person has reached the point where they wish to end their own life, it is clear that a doctor is the best person to support them; they will have knowledge of the reality of their illness, and will be in a better position to evaluate their mental state than the majority of the population.
The opinion that assisted dying should be legalised has been widely held in society for decades. In the most recent YouGov poll on the topic, in mid-2012, 69% of those interviewed believed the law should be changed to legalise assisted suicide for someone suffering from a terminal illness. The argument in favour is simple: the right to life is the most fundamental of human rights, enshrined in every international convention, and in the mind of every human being. This right must not only entail a right to live one’s life, but also the entitlement to control it, including the moment at which it ends. It is simply compassionate to allow a terminally-ill patient to spend their last day as they wish, able to say goodbye, rather than suffering until their very last breath.
The arguments to the contrary are certainly not as strong. The idea of the “slippery slope” is used all too often. Its proponents claim that all people with terminal or debilitating illnesses will be pressured, or eventually forced, into ending their lives prematurely. This would be an utterly illogical claim, the only thing being argued for is a right to end one’s life. Some people with terminal illnesses are determined to fight on until the very end, acting as inspirations and role models to many. Some people wish to take back control of their lives and choose their own fate rather than allow their illness to dictate it. Both of these paths are equally admirable.
The vast majority of supporters of euthanasia are not arguing that it is the best option, but simply that we should all have the right to choose, should we find ourselves in such a situation. In places where assisted suicide is legal, such as Switzerland, and Oregon in the USA, there has been no evidence of such a slope. In Oregon, 40% of people who obtain medication to end their lives never use them; it is merely a comfort to have the choice.
It has also been argued that allowing assisted suicide will open up terminally ill people to pressure from relatives, who may wish to pressure them in to taking their own life to gain access to their inheritance, for example. However, legalising medically assisted dying would afford more protection to patients in such a situation, by offering more safeguards against such pressures. Rigorous procedures to establish the dying person’s true motives, and their mental capacity to make such a decision, would make it much more difficult to pressure somebody in such a fashion. As mentioned above, “amateur” euthanasia is already legal, so if somebody were callous enough to push an ill relative to suicide, they would be more likely to succeed under the current law. Religious arguments are often used, with suicide being thought of as wrong in many major belief systems. However, in a country which is a melting pot of cultures, religions and beliefs, it would be incorrect for the law to cater to any particular one over another.
These arguments, among others, cannot overcome the simple notion that only the patient truly understands their own suffering and emotions, and so should not be barred from taking their decision into their own hands with as much assistance as we as a society can provide. Allowing a right to a medically assisted death is the humane thing to do. Just the ability to make that choice will provide terminally-ill people with more protection from pressure, the comfort of knowing that they can take control of their own situation and the ability to say goodbye to their loved ones in the way they wish.