Four Fingers & Thirteen Toes – The Euthanasia Debate
The whole debate about Euthanasia and Assisted Suicide is very topical at the moment. Even though the subject deviates from many of the topics I generally talk about in my blog, I feel nevertheless that it is still very important. Also, I discussed the very issue only last month on my radio programme ‘Telling It As It Is’ on Able Radio.
It is a very deep and emotional subject, and many people feel that it is one that they would rather avoid. Others have firm views on either side of the spectrum. So, please find below the complete transcript from that particular radio programme, where you can find out what my views on Euthanasia and Assisted Suicide are.
You can listen to this programme again, this Thursday evening (16th June) at 8:00 p.m. on www.ableradio.com
**********
Welcome to ‘Telling It As It Is’ with me Rosie Moriarty-Simmonds.
In this programme I will be deviating from our usual format, and dedicating the whole programme to discussing the very topical but contentious issue of ‘Legalising Euthanasia’, Also, called Assisted Dying, Assisted Suicide and Physician-Assisted Suicide’.
As someone who supports the ‘Right to Live’, I have been struggling to remain impartial and balanced in my quest to gather information, and interpret the arguments, both for and against Euthanasia and Assisted Suicide.
I will try to be as informative and honest as I can :-
- What are euthanasia and Assisted Suicide? And what is the current situation? – RMS
- What are the main arguments for euthanasia? – RMS
- The main arguments against legalising euthanasia – RMS
- Comments from our listeners – RMS & MJ
- Has my view changed?- RMS
What are euthanasia and Assisted Suicide?
Euthanasia can be defined as ‘by act or omission, the intentional killing of a person whose life is felt not to be worth living’.
Others say, euthanasia is the “intentional killing of another person at his/her request for compassionate motives.”
Euthanasia can be:
Voluntary – where a competent person requests it
Involuntary – where a competent person is not consulted. The person wants to live but is killed anyway – Do Not Resuscitate Orders by Doctors on medical notes, without consulting people or having any idea of their true quality of life.
Non-voluntary – where the person cannot make a decision or cannot make their wishes known – in a coma, a very young baby, person is senile, has learning difficulties etc.
Euthanasia is usually carried out by a doctor administering lethal drugs, for example, by injection.
Physician-assisted suicide (PAS) is where a doctor prescribes lethal drugs, for the patient to take himself.
In other words, the physician supplies the patient with the means to end his or her life, but does not carry out the actual killing.
Both euthanasia and assisted suicide are currently illegal in Britain.
Yet, proponents of euthanasia want to replace the comprehensive (and independent) House of Lords report that accompanied Lord Joffe’s euthanasia bills in 2005, with a new report compiled by the recently launched “Commission on Assisted Dying.”
This inquiry into the issue of assisted suicide, which is not a formal remit from government, was launched with funding from the author Sir Terry Pratchett, who was diagnosed with a form of Alzheimer’s in 2008.
He is to appear in a BBC documentary about assisted suicide this summer. And says, “I believe everybody possessed of a debilitating and incurable disease should be allowed to pick the hour of their death.”
The same programme will also feature footage of a man with motor neurone disease travelling to the Swiss euthanasia clinic Dignitas and will show him dying on screen.
The ‘Commission on Assisted Dying’, Chaired by Lord Falconer, is expected to deliver its recommendations to MPs over a change in the law this autumn.
But its findings are already a done deal. Lord Falconer is a well-known advocate of euthanasia, who has already tried to introduce it into legislation in the Lords.
At the last count, nine of the 12 “Commission” members are on record as supporting some change in the law to allow some form of euthanasia in the UK, (the remaining three are best described as neutral-to-wobbly, so there are no actual opponents of a change in the law here).
The lobby group Dignity in Dying (formerly the Voluntary Euthanasia Society) is now attempting to build momentum for its next attempt to change the law to allow ‘assisted dying’.
This will not be an easy task. Three attempts to change the law in Britain over the last six years have been singularly unsuccessful resulting in defeats.
Opposition is building all over the world with euthanasia bills being defeated in Canada, Australia, the United States, Israel and France, all in the last twelve months.
What are the main arguments for euthanasia?
There are three main arguments for euthanasia.
- Ø We want it – the autonomy argument
- Ø We need it – the compassion argument
- Ø We can control it – the public policy argument
The debate in the 1990s centred on the compassion argument, but because of cultural changes and success in palliative care, has moved to arguments based on autonomy.
Autonomy means ‘self-determination’ and the language heard now in the euthanasia debate is often that of choice, control, freedoms and rights.
The euthanasia lobby’s push, has moved from euthanasia as a ‘needed response to symptoms’ to euthanasia as ‘an autonomous choice’ by those with, for example, degenerative neurological disease.
Those in favour of euthanasia often state that euthanasia and assisted suicide should be a matter of free choice.
Autonomy is important but we have laws because autonomy is not absolute . We all value living in a free society but also recognise that we are ‘not free’ to do things which threaten the reasonable freedoms of others.
Supporters of the “Right to Die,” or of the concept of “dying with dignity,” would argue in favour of an individual’s right to, maintain the ability to opt for a humane and controlled end to his or her life, when that life is felt to be unbearable due to physical pain.
Physician-assisted suicide and euthanasia are topics that tend to stir up a lot of emotion in the people advocating or opposing them. The fear of living in unendurable pain, or watching a loved one suffer, is for many an incredibly gripping one.
And of course there have been a number of high profile cases in the past couple of years. Notably Diane Pretty and Debbie Purdy.
Although Assisted suicide remains a criminal offence in England and Wales, (punishable by up to 14 years in prison); The Director of Public Prosecutions, Keir Starmer QC, issued new guidelines in 2009.
These guidelines said that, decisions about prosecution would be based on the circumstances of each case, and would focus on the motives of those assisting the suicide.
Debbie Purdy, who has multiple sclerosis, won an historic judgment in the House of Lords, which ruled that she had a right to know if her husband would face prosecution in such circumstances.
It was ruled that if her husband was judged to have acted with compassion, he would not be prosecuted.
Ms Purdy said: “Two years ago, when we won in the House of Lords I was halfway through preparation to go to Switzerland, because I was losing the use of my arms, and I was terrified of what that would mean for me.
“The thing is I haven’t made up my mind about what I want to do because my life is not unbearable.
“But I would have been dead for two years by now if we hadn’t have won.”
Ms Purdy said following the ruling, she was confident enough to cancel the plans in the knowledge that, her husband would not be held accountable for her death in the future.
British people have travelled with friends or family to the Dignitas clinic in Switzerland, where people suffering from terminal illness can end their lives. Although police investigated the cases, none were taken to court.
In America, the state of Oregon, legalised physician-assisted suicide in 1998.
In the Netherlands voluntary euthanasia and assisted suicide are still criminal offences, but doctors are exempt from criminal liability in certain circumstances.
Those in favour of euthanasia think that there is no reason why euthanasia can’t be controlled by proper regulation, but even they fear that regulations won’t deal with people who want to implement euthanasia for bad motives.
What are the main arguments against legalising euthanasia?
The main reasons given for not legalising euthanasia are that it is:
- Ø Unnecessary – because alternative treatments exist
- Ø Dangerous – putting vulnerable people at risk
- Ø Wrong – contrary to all historical codes of ethics
Those against ‘assisted dying’ and ‘assisted suicide’, like the campaign group Not Dead Yet UK, an international network of disabled people [with physical and sensory impairments, learning difficulties and mental illness,] are actively opposed to moves to legalise assisted suicide, assisted dying and euthanasia.
Not Dead Yet UK say that cases like that of Debbie Purdy, will have far reaching implications in seeking to invalidate the current law, by highlighting a lack of enforcement and legitimising the status quo of generally not prosecuting those who assist another person to die.
Requests for euthanasia and assisted suicide are extremely rare when people’s physical, social, psychological and spiritual needs, are properly met.
Anti-euthanasia campaigners within the medical profession, say that… The key priority should be to build on the excellent tradition of palliative care available in this country, and make it more readily accessible to all who need it.
There is a postcode lottery of palliative care in this country. We should be promoting care rather than killing.
The vast majority of people in the UK, dying from diseases like motor neurone disease, do not want ‘euthanasia’ or ‘assisted suicide’.
The very small numbers of high profile cases of ‘assisted suicide’, which are regularly and repeatedly highlighted in the media, are the well-publicised exceptions to the rule.
The real question therefore is, whether we should change the law for a very small number of people who are strongly determined to end their lives.
To do so would place the lives of a much larger number of vulnerable people in danger, and mean that pressure, whether real or imagined, is felt by sick, disabled and elderly people to request an early death.
If the law is ever changed to allow so called ‘assisted dying’ it is possible that economic pressure will be brought to bear on people, openly or more likely very subtly, to request early death in order to save money for the use of relatives, society or a health service short of resources.
Killing is very cost effective – it doesn’t cost much for an ampoule or barbiturate. That is why there needs to be promotion of care, not killing, and hold onto laws which protect vulnerable people.
Some disabled people have become increasingly anxious about the dangers associated with the call for ‘assisted dying’ to be legalised in the UK.
The idea that disabled people, including those who do not have long to live, are “better off dead” is not new.
It is believed that individual disabled people’s suicidal cries for help come from a lack of proper practical, emotional and medical support needed to live dignified lives, rather than from the ‘suffering’ they experience as a result of a medical condition.
Such loss of hope – which forces some to see death as their only option – is easily misinterpreted in a society that continues to see and treat disabled people as second class citizens.
Over the last 10 years there have been 134 British cases of ‘assisted suicide’ at the Swiss Dignitas suicide apartment.
Eight of these have been referred to the Director of Public Prosecutions, for a decision as to whether a prosecution is needed in the public interest.
They include the case of Daniel James, paralysed from the neck down after a rugby accident, who travelled to Switzerland only 18 months after his injuries were sustained.
In that case the Director of Public Prosecutions, took the view that it would be totally wrong to prosecute his mother, who had been punished enough by her experience.
She had tried everything in her power to stop him seeking ‘assisted suicide’ and is still haunted every day by eventually relenting and accompanying him to Dignitas.
The problem here is that his severe impairment was seen as the rationale for his desire for an assisted suicide.
For Daniel, the fact that he would be permanently disabled was seen as justification for the decision of a previously fit, active and outgoing young man.
Not Dead Yet UK believe the majority of people who would be affected by assisted dying legislation, are disabled people.
People already have the right to refuse unwanted treatment. Suicide is no longer illegal.
Making it legal to assist someone to die, does not give that person a ‘new’ human right – it provides a new immunity from justice for those who provide the assistance.
Assisted suicide should not just be another medical treatment option, and it should not be made any part of routine health care.
Opponents to ‘euthanasia’ believe that legalising ‘assisted suicide’ will inevitably lead to increasingly adverse judgements about the quality of life of disabled people.
They say, this will undoubtedly begin to affect the many disabled people who cannot speak for themselves and who have not requested death.
If society as a whole gives in to the demand to assist in a suicide, then they are reinforcing attitudes that say that ‘the lives of disabled people are not worth living – that they are a particular burden to themselves, their relatives and friends, and the state’.
These negative attitudes are faced by disabled people all the time.
This discrimination does not just happen at moments of crisis or imminent death.
It is the underlying reason why society is so inaccessible and systematically excludes and isolates disabled people.
As Baroness Jane Campbell, Convener of Not Dead Yet UK, commenting on the prospect of legalising euthanasia says:
“This is the beginning of a process and policy, that can be steadily opened wider and wider, until any person may assist another disabled person to die without consequence.
We believe state sanctioning of ‘assisted suicide’ will inevitably switch the traffic lights from red to green on this issue.”
Comments from our listeners– RMS & MJ
Rebekah [age 37] says :
I believe that there is no right answer. It is a matter of personal choice. Many people have amazing quality of life with serious physical or mental impairments. I do not believe that these alone are reason enough to commit suicide. However, there are extreme circumstances when I think that if that is the path the person wishes to take, (after counselling and full understanding of the impact their choice will have on their loved ones), they should be supported in their choice. I have seen family members battle cancer and given days to live, see every inch of their life pass by in agony, but as they “hang on”, pleading for peace and ending, I just have to stand by and watch. However, I think it would be very very difficult to actually participate in assisting someone. My own feelings are that I would like to remain in control of decisions about my life. It should be my choice. I plan to “book my ticket to Switzerland” if necessary – but hopefully not for a while yet!!
Denis [age 71] says :
I definitely think that euthanasia should be legalised. I have seen too many people suffer, or no longer know who they are. I don’t want to ever get into that situation. If I did, I would want somebody to end it for me.
Kevin Fitzpatrick, from Not Dead Yet UK says :
You cannot legislate for compassion in advance, so it’s a nonsense to try (as though it might even be possible that every time someone was assisted to die, it was only ever a family member helping a ‘loved one’ out of pure(??) compassion). There is no such thing as complete autonomy (no individual patient is purely autonomous but is always influenced in some way, whether negatively or not) the phrase ‘right to die’ is misleading and is really only shorthand for the right to choose manner and timing which already happens and so needs no legislation and that disabled people’s lives will be put at serious risk if some botched attempt is made to legalise euthanasia.
The debate so far has not reached any great depth having focussed on pleading several individual painful cases. We do not wish to enter the ground of using people’s misery this way, so for this and other reasons, we don’t comment on individuals’ lives.
We do want to question the way in which disabled people’s lives are (not) valued by non-disabled people who will ‘assist’ them to die. That’s to say, non-disabled physicians understand nothing about the lived experience of being disabled but still make the judgement that we have lives that ‘are not worth living’! I think we can all tell some of them, until we’re blue in the face, that we are happy to be alive and they won’t ever be convinced – but maybe the majority can be brought to understand that simple fact……..and that they are in no position of any authority whatever to judge our disabled lives as worthless.
Has my view changed?
Even after spending quite some time researching this subject, I still feel that life is precious.
I am relieved to have read that – In 1994 a House of Lords’ Select Committee reported on euthanasia, and unanimously recommended, no change in the law.
Its Chairman, neurologist Lord Walton, later described in Parliament their concerns about such legislation:
‘We concluded that it was virtually impossible to ensure that all acts of euthanasia were truly voluntary and that any liberalisation of the law in the United Kingdom could not be abused. We were also concerned that vulnerable people – the elderly, lonely, sick or distressed – would feel pressure, whether real or imagined, to request early death.’
I agree with Lord Walton that, people who are dying often feel a burden on relatives, carers and a society short of resources.
A law allowing euthanasia would place them under huge pressure.
Like many disabled people I too am in constant pain, and experience frustration, anger, distress and discrimination.
It is difficult to measure pain because it is subjective, and yet experience of pain is one of the main reasons used by advocates in favour of euthanasia.
I don’t know how I would feel in the future, or how I would feel if my circumstances changed or degenerated rapidly.
But at this moment in time, despite being a severely disabled person, who although independent of mind, is quite dependent on other people for physical support – I enjoy life too much to even contemplate ending it.
Some people might say, well it’s okay for you to say that, you are happily married, have a beautiful son, a nice home, a job, a close family, lots of friends, good support and a busy social life.
What they don’t know is that I have had to fight hard, work hard, be determined, brave and forthright in order to enjoy the quality of life that I do have.
It would be all too easy for me to sit back and wallow in self-pity, as are the expectations of some people when they first meet me.
Quite often incorrect assumptions are made about me when others meet me for the first time. Often people say “I feel sorry for you”, or “I would hate to be in your situation”.
Often members of the medical profession are surprised when I tell them about my life and all that I have achieved.
So to have such people make a decision about me and my life, and to have the control and power to end my life legally, would be for me utterly abhorrent.
And as for asking a loved one to assist me to die, it would be unthinkable.
Having experienced the heartache of losing people I love through illness, accident and old age.
I simply could not possibly conceive adding guilt on top of that heartache for the people that I love, by asking them to assist me to commit suicide.
I am firmly of the opinion, that life is for living, life is already too short, make the most of it while you can.
Final sound bite …
“If you want to tell me what you think of today’s programme, then please email me –
Rosie@ableradio.com
So until the next time, its good bye from me, and all the team on Telling it as it is …”
**********
Just to remind you that, you can listen to this programme again, this Thursday evening (16th June) at 8:00 p.m. on www.ableradio.com