9 reasons why assisted suicide should not be legalised

Assisted suicide is back on the agenda. Next week, parliament will again debate this divisive issue.

To the casual observer it may appear that the arguments in support of assisted suicide are overwhelming. Several high profile cases in the media combined with a determined campaign from well-funded lobby groups can make it feel like we’ve reached a tipping point. Resistance, it would seem, is futile.

When an argument is clothed in the language of choice, and compassion it can seem hard to resist. But resist we must. Between the savvy PR, large-scale advertising, and celebrity endorsements, we mustn’t forget that the case against assisted suicide is strong and credible.

Here are nine reasons why parliament should resists calls to legalise assisted suicide:

1)      The current law works.

The law acts as a deterrent. It is right for our laws to be devised so as to offer protection to the majority. And yet it is also right for the law to be applied with compassion and understanding. If a person helps to kill another person it is right that the facts of that case are examined. This process prevents people with malicious motivations acting unlawfully. If the facts reveal that a person has acted purely on compassionate grounds, it is highly unlikely that s/he will face prosecution. The recent DPP guidelines have made this clear.

2)      The medical profession doesn’t want it.

If assisted suicide or euthanasia is legalised the responsibility for ending a life would fall to nurses and doctors. And yet, surveys consistently reveal that these medical professionals don’t want to be involved in ending life. The most recent survey of GPs published in February found that 77% of GPs oppose the legalisation of assisted suicide. This makes perfect sense given the very nature of the medical profession is to protect life. The Hippocratic Oath states that medical professionals should “do no harm to anyone” and indeed the Oath goes further to state categorically that doctors should “give no deadly medicine to any one if asked”. Furthermore, the four leading UK medical bodies – the Royal College of Physicians, of GPs, of Surgeons, and the British Medical Association – are all opposed to the legalisation of assisted suicide and euthanasia.

3)      Medical prognosis is not exact.

The question “How long have I got?” is one that many doctors will be sadly familiar with. It is natural to believe that when faced with this question our medical professionals are able to answer very precisely. In reality, however, they can’t. The Royal College of GPs has warned about this stating that the scope for error in predicting how many months a person has left to live “can extend into years”. This means that the clause in Lord Falconer’s bill requiring a six month prognosis is unreliable as a safeguard. The reality is that, despite Lord Falconer’s best intentions, people who have longer than 6 months to live would qualify for assisted suicide.

4)      The law should protect the vulnerable.

For people who are seriously ill or facing death, the security of knowing that the law protects them no matter what their circumstances is hugely significant. A patient requiring regular care can often feel like a burden to those around them. In this case it can be all too easy for the patient to express sentiments along the lines of “everything would be better if I wasn’t here anymore.” In these circumstances the response from doctors should not be, “Ok, let’s talk about assisted suicide; I’ll fetch the paperwork.” We need our doctors to provide reassurance and comfort to their most vulnerable patients. It’s revealing that one of Britain’s most active disability rights campaigners, Baroness Jane Campbell, has said recently, “as a severely disabled person, I fear a change in the law to permit assisted dying.”

5)      Parliament has debated and rejected this several times in recent years.

There is a belief that parliament has deliberately avoided debating this subject. This is wrong. In fact, parliament has debated this issue at length several times in recent years. Three bills seeking to legalise assisted suicide have been considered in the past 10 years and twice the proposals have been put to a vote. Every time this issue has reached a vote, parliament has rejected it. On one of these occasions the debate lasted for over eight hours and included over 90 speakers. In the resulting vote, the proposal was defeated by 148 votes to 100.

6)      The slippery slope is real.

We need to recognise that this measure would be the first step on a very dangerous path. We’ve seen in Belgium (where euthanasia is legal) how quickly the law has been extended. Not only is the Belgian law applied very loosely (specifically to those who are not terminally ill) but most recently it was extended to allow children to be euthanased. I’ve written before on the detail of what’s happening in Belgium.

7)      The ‘Oregon model’ is flawed.

Campaigners in the UK hold up Oregon as the model for us to follow. However, a close look at the Oregon law reveals worrying trends. Assisted suicides in Oregon have quadrupled since the law came into force. Oregon’s death rate from assisted suicide is the equivalent of approximately 1000 cases a year in England and Wales. More worryingly are stories like that of cancer patient Barbara Wagner who was told by her insurer that the chemotherapy drug she had been prescribed was too expensive but if she chose assisted suicide, the cost would be covered.

8)      It’s not just religiously motivated people who oppose assisted suicide.

Some people do object to assisted suicide based on their religious beliefs. Many others object for a variety of other reasons. It is not true to say that the reason this law has failed so far is due to religious motivations. In the last House of Lords vote, 14 bishops voted against the bill. Even if you discounted these votes the measure would still have been comprehensively defeated.

9)      Advances in pain relief & end of life care.

In recent years we have seen significant medical advances in pain relief and end of life care. As such, one of the UK’s leading palliative care specialists, Professor Ilora Finlay has said, “terminally ill patients should no longer have to die with unrelieved pain.” Moreover, we have a first-class hospice movement in this country with a long and distinguished history. That doesn’t mean that they system is perfect – many improvements can still be made – but high-quality care should mean that the vast majority of people can be comfortable in their final days.

 

It’s important, in conclusion, to acknowledge the emotional complexities of this subject. Arguments in favour of assisted suicide can be very persuasive. Real life cases of people in desperate situations are incredibly moving. I can’t begin to imagine what it must be like to watch life slowly slip away from a loved one. I remain convinced, however, that neither assisted suicide nor euthanasia is the answer.

Instead we must continue to invest in palliative care and in hospices so that when death approaches we can face it with dignity, love, and compassion. As Churchill said: “you measure the degree of civilization of a society by how it treats its weakest members.” He was right. May the hallmarks of our society be the care, comfort, and compassion we give to those facing their final days.

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Euthanasia: The Slippery Slope is Real

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).

syringeEuthanasia 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.

Heaven is Real

It isn’t often that one of the world’s leading global affairs magazines publishes a cover story like that. But this week’s edition of Newsweek magazine features, as its lead article, a first-hand account of Dr Eben Alexander, a neurosurgeon who “experienced something so profound that it gave me a scientific reason to believe in consciousness after death.

The entire article is worth reading – whether or not you believe in life after death – but here are a few extracts that stuck out for me:

Very early one morning four years ago, I awoke with an extremely intense headache. Within hours, my entire cortex—the part of the brain that controls thought and emotion and that in essence makes us human—had shut down…I had somehow contracted a very rare bacterial meningitis that mostly attacks newborns. E. coli bacteria had penetrated my cerebrospinal fluid and were eating my brain…

While the neurons of my cortex were stunned to complete inactivity by the bacteria that had attacked them, my brain-free consciousness journeyed to another, larger dimension of the universe: a dimension I’d never dreamed existed and which the old, pre-coma me would have been more than happy to explain was a simple impossibility…

…as far as I know, no one before me has ever travelled to this dimension (a) while their cortex was completely shut down, and (b) while their body was under minute medical observation, as mine was for the full seven days of my coma…

Toward the beginning of my adventure, I was in a place of clouds. Big, puffy, pink-white ones that showed up sharply against the deep blue-black sky. Higher than the clouds—immeasurably higher—flocks of transparent, shimmering beings arced across the sky, leaving long, streamer-like lines behind them.

A sound, huge and booming like a glorious chant, came down from above, and I wondered if the winged beings were producing it…

And the article continues.

Dr Alexander writes as a man still trying to work out the meaning and consequences of his experience. Still battling with reason and science, trying to see how this experience fits in with his understanding of the world.

To me, the most fascinating thing about this story is it’s unlikely hero. Dr Alexander is not a religious zealot looking for validation of his beliefs, he’s not an evangelist, or even a very strong Christian (in his own words, he is a Christian “more in name than in actual belief.”). And this makes his account all the more interesting.

I wish him well. I hope he writes more about it so that we can know how he gets on.

*Update: I notice that the Daily Mail has covered this story today.

*Update 2: And there is a book in the pipeline too.