Assisted Suicide; is it dying with dignity?

A good friend invited me for dinner where I met his charming elderly mother and when she established my profession she asked if I would be willing to help her “end it all” when that time came. Certainly, I giggled, and we got down to discussing the upfront fee only to find that she wasn’t joking and she had less restraint and a more pragmatic view on assisted-suicide than I. I politely, and I hope sensitively, back-tracked as I realised that many older people, and perhaps their children too, viewed assisted-dying as a much more attractive option than the prospect of facing the ravages and indignity of senility. It was an insightful encounter as I realised then that this agenda was being promoted with great subtly and degree-by-degree we are likely to have assisted-suicide in the UK within ten years. That was ten years ago and this agenda has not really moved forward.

Gino Kenny, People Before Profit TD, is to introduce a private member’s bill to the Dail. The Dying with Dignity Bill had its first state in the Dail in 2015 but has not progressed much until now. It has the support of many high-profile campaigners; Vicky Phelan a cervical cancer campaigner and Tom Curran the partner of Marie Fleming who was the subject of a High Court case in 2013 and has since died.

TD Kenny states that:

“At the heart of this legislation is compassion, humanity and empathy. Where somebody finds themselves in extremely difficult circumstances in relation to a terminal illness, I think they should have a choice in relation to that particular time of their terminal illness.”

“By any means, it’s not mandatory but it should be a choice and where other jurisdictions that voluntary assisted dying has been implemented, it has worked very well, there hasn’t been – no evidence of it being abused by any means.”

He’s right in that there are no examples of abuse of the law where it exists. Legal self-killing exists in many European countries including, Holland and Switzerland, and in other parts of the developed World. People in the developing world with famines, pestilence and genocides have yet to achieve a life expectancy that would make the concept worthy of consideration. It’s a classic first World problem.

In Australia’s Northern Territory, The Right of the Terminally Ill Act 1995 was passed into law and ensured the dispatch of a few terminally ill patients before being repelled by Central Government in 1996. At least two states currently sponsoring Bills on assisted-suicide have succeeded. It became legal in Victoria in 2020 and it will become legal in Western Australia in 2021. In the USA, Oregon State has had assisted suicide legislation for over 20 years and has chalked up 34 deaths per year (344 in all in the first 10 years) by this means. And assisted-suicide is currently legal in Washington through the Death with Dignity Act 2009. A GP is able to prescribe, but not administer, a lethal dose of a drug and the prescription can only be provided for someone who has been diagnosed with a terminal illness and given six months to live.

So what’s keeping us back the British Isles? UK and ROI residents, in the full glare of publicity, are going to Switzerland to end it all in a Dignitas Clinic. Irish girls going to England for termination comes to mind.

And it’s not just the terminally ill. A young man, a promising rugby play made a paraplegic by an awkward scrum, decided life was not worth living and committed suicide with the blessing of his parents; I can’t imagine the horror of all this.

Debbie Purdy, wheelchair-bound since 2001, has been to the High Court asking the Law Lords for a ruling on what would happen to those who assisted her journey to Switzerland. Initially, they stubbornly refused to give their ruling with a patronising suggestion that she go off do it and then they would deal with anyone who provided support who might or might not be guilty under the Suicide Act 1961 because they bought the plane tickets or folded her wheelchair for the trip. This was appealed as a human rights issues and was successful in that it allowed Kier Stamer, to publish guidance in 2010 greatly reducing the risk to those who support the terminally ill in taking their lives. There were other tragic cases over the year; Diane Petty who died in 2002 and Tony Nicklinson who died in 2012, all denied.

Assisted-suicide is now firmly on the agenda North and South and if you’re for or against you need to speak up now. Proponents have subtle and convincing arguments; there are too many of us on the planet; we cost much too much in our old age; we should be able to die when and where we want to; assisted suicide is a solution to escalating healthcare costs and an ideal solution to global warming.

The Palliative Care movement, over the last 40 years, has made the process of dying much more dignified. They also are the greatest opponents of assisted-dying. The judgement in the Marie Fleming High Court case in Dublin in 2013 gives voice to many of their concerns;

 “even with the most rigorous systems of legislative checks and safeguards, it would be impossible to ensure that the aged, the disabled, the poor, the unwanted, the rejected, the lonely, the impulsive, the financially compromised and emotionally vulnerable would not avail of this option to avoid a sense of being a burden to their family and society”.

Yes, I do worry about this. I do worry that there will perhaps come a time in the not too distant future when a man or a woman who I have known all of their privileged life will look at me in the indignity of my old age and say “Dad, it’s time to do the decent thing”.

Die Elbe” by Leon Bovenkerk is licensed under CC BY-SA