Alzheimer’s and dementia. The arguments for assisted dying.

This part of the speech deals with the slippery slope argument, of which there are many versions. Among the versions of this argument is that if a law comes in it is sure to be abused. Patients will no longer trust their doctors, and the distinction between voluntary and non-voluntary suicide will be eroded if the law is liberalised. The slippery slope argument argues that patients will be coerced because they feel they are a burden on family or society or the NHS, and that their finances will be squandered on their care. The argument goes that people could be coerced into making this decision by predatory relatives after their money. But this argument forgets a huge part of human psychology, and that is that life has a purpose, and no one wants to be a burden.

As we get older many of us regard our lives as a story, our autobiography. We know, the Baroness argues, where we came from and what we have done, and what we intended our life to be, and dying is the last chapter of our lives. We don’t want our last chapter to ramble on, but to be brought to a conclusive end so that we are not remembered as futile burdens on family.

And of course many people live longer than in the past, so for those that say God has given us an appointed time to die, the fact is that very often doctors take Gods part and enable us to live much longer. The consequences of living longer is that people who are demented and cannot recognise family or friends tends to beg the question what is the point?

I believe that if someone is diagnosed as having the beginnings of dementia – at that stage it is a possible duty that doctors should talk – talk- to the patient about what they want to happen to him or her when the moment comes of steep decline.

It is of enormous importance that people should discuss their death before it happens and write down what they want to happen to them and beseech the doctors to help them to die. When their life to them is worth nothing. I am not saying that other people should make this judgement but the person himself.

The round up of questions at the end. William Crawley enquires why not non-voluntary euthanasia?

  • Dave

    The term ‘slippery slope’ is often a greater fallacy than the arguments it is used to describe, e.g. it is loaded to mean that the argument has been refuted when it has merely been flagged as suspect. Not all suspect arguments are false.

    Those who use it thusly do so knowing that the predictions can only be tested if euthanasia is legalised. Ergo, it requires those who oppose euthanasia to stop opposing it so that euthanasia can then be legalised and the validity of their initial reasons for opposing it can then be tested against the verifiable data. In other words, you must open the stable door and allow the horse to bolt before you can reasonably claim that opening the door will cause the horse to bolt.

    Fortunately, we have the example of Holland to verify that the ‘slippery slope’ arguments are indeed valid:

    The Remmelink Report– On September 10, 1991, the results of the first, official government study of the practice of Dutch euthanasia were released. The two volume report (6)–popularly referred to as the Remmelink Report (after Professor J. Remmelink, M.J., attorney general of the High Council of the Netherlands, who headed the study committee)–documents the prevalence of involuntary euthanasia in Holland, as well as the fact that, to a large degree, doctors have taken over end-of-life decision making regarding euthanasia. The data indicate that, despite long-standing, court-approved euthanasia guidelines developed to protect patients, abuse has become an accepted norm. According to the Remmelink Report, in 1990:

    2,300 people died as the result of doctors killing them upon request (active, voluntary euthanasia).(7)

    400 people died as a result of doctors providing them with the means to kill themselves (physician-assisted suicide).(8)

    1,040 people (an average of 3 per day) died from involuntary euthanasia, meaning that doctors actively killed these patients without the patients’ knowledge or consent.(9)

    14% of these patients were fully competent. (10)

    72% had never given any indication that they would want their lives terminated. (11)

    In 8% of the cases, doctors performed involuntary euthanasia despite the fact that they believed alternative options were still possible. (12)

    In addition, 8,100 patients died as a result of doctors deliberately giving them overdoses of pain medication, not for the primary purpose of controlling pain, but to hasten the patient’s death. (13) In 61% of these cases (4,941 patients), the intentional overdose was given without the patient’s consent.(14)

    According to the Remmelink Report, Dutch physicians deliberately and intentionally ended the lives of 11,840 people by lethal overdoses or injections–a figure which accounts for 9.1% of the annual overall death rate of 130,000 per year. The majority of all euthanasia deaths in Holland are involuntary deaths.

    The Remmelink Report figures cited here do not include thousands of other cases, also reported in the study, in which life-sustaining treatment was withheld or withdrawn without the patient’s consent and with the intention of causing the patient’s death. (15) Nor do the figures include cases of involuntary euthanasia performed on disabled newborns, children with life-threatening conditions, or psychiatric patients. (16)

    The most frequently cited reasons given for ending the lives of patients without their knowledge or consent were: “low quality of life,” “no prospect for improvement,” and “the family couldn’t take it anymore.”(17)

    In 45% of cases involving hospitalized patients who were involuntarily euthanized, the patients’ families had no knowledge that their loved ones’ lives were deliberately terminated by doctors. (18)

    According to the 1990 census, the population of Holland is approximately 15 million. That is only half the population of California. To get some idea of how the Remmelink Report statistics would apply to the U.S., those figures would have to be multiplied 16.6 times (based on the 1990 U.S. census population of approximately 250 million).

  • Rory Carr

    Forewarned is forearmed I suppose so just before my faculties slip away allow me to take advantage of this space to record my wishes as to my disposal as I grow more old and more infirm.

    It is this: I wish to grow old quite disgracefully (indeed I am already well into that practice)and my success as to fulfillment of that intent will be measured on just how much of a burden my behaviour is able to impose – on family, on friends, on society in general, but most of all upon the state.

    This I hope will be, not only my racous affirmation of life itself but also my sweet revenge on all those bastards (some loveable, some not so) who have burdened my life during its course.

    As the adult nourishes and cares for the feeble, helpless child from a sense of love and duty so it becomes the grown child’s duty to care for the enfeebled adult who brought them to fruition. The reward for them in that will be in the doing of it as it was for us who, in nurturing our children, found our reward only in the joy of our success in seeing that child grow happily to maturity.

    Now, child – it is your bloody turn – get on with it and stop bloody moaning! And keep that mad witch, Warnock with her dripping needle of cold compassion well away from my bedside.

    And bring me another toddy while you’re at it!

  • Kathleen

    The argument did come accross as pretty cold. A rational argument that on first inspection looked devoid of any human warmth or emotion. Then again the arguments against weren’t based on emotion either. Everything was reason. Making sure you are in sound mind before making the decision, but frankly I find that even to think about your own demise asks if that person is really sound in their own mind. Then again I’ve never faced that decision, where one is faced with a progressive disease and you know what is in store for you.

    I think overall she makes a good case for the person who is facing going into dementia, the problem I have with it is as Will Crawley asks, why stop there, why not simply move on to other cases. So instead of defeating the slippery slope argument, she actually goes on to make it.

  • Rory Carr

    “racous” above should of course read as “raucous”. Apologies.

    See! The bloody Alzheimer’s (not to mention the bloody Tourette’s) is showing itself already. I’m sure glad that Baroness Baleful is over there where she can’t get her mitts on me. For the time being at least.

    But I do pity you, what with her wanting to polish off all the old wans and that David Vance fellow wanting to polish off everybody who disagrees with him (which is almost everyone else) there won’t be many of you left over there. It’s no wonder house prices are tumbling.

  • Dave

    Kathleen, a good tactician will always focus on extreme examples from which a compelling emotional case can be made to support a demand that an accepted principle be violated, e.g. they will argue that pregnancy due to incestuous rape is grounds for violating the right to life of the unborn. The intention, however, is never to confine the practice to the isolated examples but rather to extend it to an ever-increasing litany of examples once the principle has been conceded.

    What is actually being engineered here is a culture that downgrades the right to life from something tangible to something that is subject to the discretion of third parties such as medics, ad hoc committees and quangoes, judges, and being subject to an intangible called the ‘quality of life.’ That is a society that kills the weak and calls it mercy.

    I completely agree with Rory (for once) in that those he cared for in their young age have a reciprocal duty to care for him in his old age, and the rest of us – who form society – also have a responsibility to watch out for the senile old codger that can’t be avoided by the expedient of ‘putting him down’ like a canine.

    As Malcolm Muggeridge noted in his essay, The Humane Holocaust, medical practices that are accepted as the norm today resulted in others being hanged for war crimes at Nuremberg, and that “it took no more than three decades to transfer a war crime into an act of compassion.”

  • liveandletlive

    Sixth commandment “thou shalt no kill”