Earlier this month King Philippe of Belgium signed a law that extends euthanasia to children. His confirmation of the new law comes after both houses of the Belgian parliament overwhelmingly approved the controversial measures. The most recent vote, in Belgium’s lower house, produced a clear majority in favour of the law (86 votes to 44).
Euthanasia is nothing new for Belgians. The process, whereby a doctor injects a lethal drug into a patient, has been legal for adults since 2002. The ‘safeguards’ in their law specify that an adult only qualifies for euthanasia if their illness is incurable and their suffering is unbearable. But a closer look at some recent cases shows that these guidelines are interpreted very loosely.
In September Nathan Verhelst was legally euthanased after his sex-change operation went wrong leaving him with “unbearable psychological suffering”. In December, deaf twin brothers Marc and Eddy Verbessem, who were beginning to go blind, were legally euthanased claiming they couldn’t bear the thought of not being able to see each other again. Now, terminally ill children in Belgium can request euthanasia with parental consent.
These developments represent a clear case of a “slippery slope” whereby small, incremental changes have morphed the original law into something much broader – and more dangerous – than was ever intended.
In the UK there is currently a serious attempt to legalise “assisted dying”. The former Lord Chancellor, Charles Falconer, has introduced legislation that would license doctors to supply lethal drugs to the terminally ill to assist their suicide. His Bill is backed by the campaigning organisation Dignity in Dying (formally the Voluntary Euthanasia Society).
Parliament has debated and rejected this issue on many occasions over the last ten years. This time, however, in order to make the measures appear more palatable, Lord Falconer and Dignity in Dying will emphasise the ‘safeguards’ contained in the bill that would limit assisted suicide to those who are terminally ill with a prognosis of six months or less to live.
But these safeguards – much like those in the Belgian law – won’t work. For starters, prognosis for terminal illness is impossible to predict accurately and the scope for error can extend into years. The truth is that no safeguards will be failsafe. Even Lord Falconer himself conceded this point when he discussed his proposal on Radio 4’s Today Programme, saying: “I don’t think you can ever have a system that is completely watertight…you can’t be sure [that safeguards will work].”
This should set the alarm bells ringing. Perhaps if we were discussing regulations on food packaging we could play the averages. But we are not. This is life and death. Being cautious is not merely advisable, it is vital. When the person sponsoring the law admits the safeguards can’t be watertight, it’s time to think again.
Beyond the legal questions, assisted suicide prompts serious questions about the nature of healthcare. At the heart of the doctor-patient relationship is the understanding that a doctor’s primary duty is to care for and protect his patients. Regardless of the situation, a patient must know that his/her doctor will first and foremost seek to do only what is in the patient’s best interests.
That is why the major medical bodies – the Royal College of Physicians, the Royal College of General Practitioners, the Royal College of Psychiatrists and the British Medical Association – all oppose legalising assisted suicide. As The College of Physicians stated explicitly, a doctor’s duty of care for patients “does not include being in any way part of their suicide“. What’s more, opinion surveys among medical professionals regularly find at least two-thirds against assisted suicide.
Advocates of assisted suicide refuse to admit the real risk of extension. Claims on the Dignity in Dying website state that, “the slippery slope argument lacks evidence and is illogical” and that it does not stand up as “an argument of any real value.” In light of the evidence from Belgium, it’s now hard to see how this response can stand up.
Evidence from Belgium shows exactly how quickly a law, supposedly limited to terminally ill adults, is rapidly extended to any age and any prognosis. Such a law does not extend choice in healthcare or drive up standards of care, nor does it empower patients. Looking at Belgium, the vulnerable are less protected and ending life has become normalised.
As we continue to debate the issue of assisted suicide in the UK, we should be mindful of the Belgian example where the legal ‘safeguards’ are interpreted loosely and the scope of the law has been broadened far beyond its original intent. The slippery slope is very real.