Assisted Dying - Misplaced Trust

ASSISTED DYING IS ABOUT MISPLACED TRUST. Today, the House of Commons will discuss a private member’s bill aimed at legalising assisted dying within the UK.

In our time the issue has scaled the walls of cloistered academia, to become very much a real world problem – or opportunity, depending on your point of view.

That this issue, long discussed behind the walls of cloistered academia, should have become an issue of mainstream debate is partly because of advances in medicine. Medical technologies have made longer life a reality for most people in the developed world.

Not only are we able to live longer, however. We are also around long enough to face as yet unconquered illnesses of mind and body.

Debilitation possibly seems more offensive to us today, too, because we place great faith in technology and pharmaceuticals and their capacity to deliver quality of life to the end.

On a philosophical level, the general rapid advances we see in technology encourage the idea that human beings can and should be the sole deciders of their individual destinies.

It is a line of thought which has arguably, in some ways, placed individual rights above social responsibilities.

Compassion must, of course, temper discussions on anything involving human suffering. Yet, while enshrining into law the right to assisted death may sound very tolerant, it is arguably a ticking time bomb, socially and ethically.

Its potential impact on our social structure and the wellbeing of future generations should not be underestimated. Nor should the potential for frail human agencies, be they institutions or individuals, to turn good intention into bad practice.

This is what motivates people like Liz Carr, the UK’s best known disabled actress, to speak against assisted dying legislation.

In the past, she has urged parliament to throw out proposed bills like the one before it today.

Ms Carr says that if it were not for the dedication of doctors she would not be alive today.

‘But I know they are fallible,’ she added, in an interview for The Times last year.  ‘It is very common for someone with a disability to be told they are not likely to live until a certain age – and for them to carry on living.

‘I don’t think doctors are malicious, but there is a prejudice. They wonder how someone they are treating can have any quality of life because they are so dependent on carers or seem to have lost their dignity.

Liz Carr also worries about a gradual blurring of boundaries in the public mind between terminal illness and disability.

To be sure, the proposed laws open up unprecedented moral and legal minefields for the future.

First of all, there is the issue of how assisted death, were it to become institutionalised, would be administered. 

Much has been made of the stories of the few Brits who’ve paid the fees and travelled to the Dignitas clinic in Switzerland to die. Very little is written, though, about the many thousands who stay at home and receive palliative care, passing away relatively peacefully in the hands of caring family members and professionals.

(When did you last see a TV documentary on aged or sick people who die well, in a hospital or care facility or at home?)

Many moderate supporters of assisted dying will argue that it should only be legalised on the condition that procedures are carried out in government-run, publicly owned facilities, by highly trained and accredited professionals.

Yet the private, profit-seeking sector will always look for ways to engage with the growing edges of new social phenomena. What makes us think that we wouldn’t soon see the emergence of a profit-making industry devoted to ending life, where the business of dying is more important than the duty of care? 

They may start by offering a cosy demise only to members of the well-heeled classes. Others would soon follow, offering a scaled back service to the poorer classes.

Though their effect would potentially be far more serious, permanent and, in many cases, damaging to people left behind, these groups would play on the same primal fear of the future that makes payday loan companies so attractive – and eventually so problematic for families and for society.

When interviewed, advocates of assisted dying almost invariably express motivations based on the fear of a worsening physical or mental condition. Let’s be in no doubt about this: it is very often the fear of suffering, not actual suffering itself, that is at the core of the debate about assisted dying.

According to a study undertaken by a Dutch University a few years ago, only five percent of patients who decided to go through with doctor-assisted suicide listed pain as the biggest factor in their decision. The most prominent factor was the fear of suffering – and 24 percent of the people surveyed said that fear of humiliation was their strongest motivation. (At the time of the study, more than a third of all euthanasia cases in that nation were AIDS related.)

Furthermore, an article published in the Journal of Medical Ethics in 2008 showed that 21 percent of people receiving assisted dying in Dignitas did not have a terminal or progressive illness, but rather felt a ‘weariness of life’.

For these people, the organisation merely offers them a sure-fire way of committing suicide. The possibility exists that in future people may opt for this as a matter of convenience rather than necessity.

Hear Mal Fletcher's interview on the BBC, also featuring Professor Stephen Hawking and Paralympic champion Baronness Tanni-Grey Thompson - Click here.

Read Mal’s fuller discussion of the issue here.

© Copyright with Mal Fletcher

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