Georgia L. Gilholy is a Young Voices UK contributor.
Today Lady Meacher’s Assisted Dying Bill will receive its second reading in the House of Lords. As they stand, the plans aim to legalise physician-assisted suicide for patients with a terminal illness and who can be “reasonably” expected to die in less than six months.
Over the past few days, numerous faith leaders including the Archbishop of Canterbury, the Chief Rabbi of the Commonwealth and even former Prime Minister Gordon Brown have spoken against the move, and they are right to do so.
While much of the assisted suicide lobby seems genuinely motivated by the noble cause of reducing harm, jurisdictions, where the procedure has been legalised, show that this is rarely the overall result.
There are two main types of assisted death, and those that end the lives of those experiencing “pain and suffering” are termed euthanasia. Assisted dying generally describes the ending of a patient’s life by a medical professional.
Assisted suicide, though technically a form of assisted dying, involves a medical professional handing a patient the chemical toolkit to end their own life. The narrative of mercy may dominate campaigns to legalise both these procedures, but all too often airbrush their grim reality.
Dr Joel Zivot, a physician who researched the autopsies of over 200 executed US prisoners, has emphasised how the common assisted suicide method of ingesting pills can be “horrendous” and often leads to a paralysing injection being administered “because many individuals are not able to swallow”.
In a process Zivot has described as akin to drowning or being strangled, the patient’s ability to move or breathe is gone, but they are not blocked from potential awareness. This gives the false impression of a person’s ease and consent, while the final moments of their life are characterised by excruciating pain that is in no doubt exacerbated by the psychological distress of physical and verbal paralysis.
This dystopic step has already been banned as part of capital punishment in most US states that still permit the penalty, due to its obvious cruelty. It however remains a staple of assisted dying in the “liberal” state of Oregon, whose framework the Meacher Bill proudly models itself on.
While the Meacher Bill itself does not acknowledge a role for doctors to take over and end life when complications occur — as they do in from 15 per cent to 25 per cent of cases in Oregon — how long until it is suggested that the law be expanded to facilitate this role? How many doctors will do so without fear of an autopsy revealing their criminality, given that the cause of death will be predetermined?
If the supporters insist that the procedure only be legal when consent is given, why do they laud a system in which consent can surely not be truly secured, as so many patients are entirely deprived of their senses while their mortality is set in motion?
In any case, we are wrong to assume that consent and choice are free-floating values, magically disconnected from social realities. Almost all of our choices, from the trivial to the life-altering, are influenced by external factors, including the people we surround ourselves with, and these influences are almost always exaggerated depending on the gravity of the decision we face.
A report published this year by the Oregon Health Authority demonstrated just this. In a study that examined the state’s policy of medical assisted death from its introduction in 1998 to 2020, it was found that out of all patients who underwent an assisted suicide in 2020, over half were motivated by concerns that they were a “burden on family, friends/caregivers”.
Is it hardly a leap, therefore, to suggest that stresses over social and economic support are an overwhelming factor in the majority of assisted deaths and that shoehorning in the policy as another “form of treatment” NHS doctors are obliged to offer the terminally ill at a time of increasing socio-economic crisis would open the door to certain disaster?
Another, disturbing side to this factor is the threat of pressuring vulnerable people to end their lives, and the inadequacy of busy doctors to detect social manipulation and coercion that families and partners wishing for a death they think will work to their financial or social advantage or even doctors who themselves come to see it as merciful to kill.
Indeed, as Professor John Keown, of Georgetown University, explored well over a decade ago, courts in the Netherlands already hold that just as the “relief of suffering” can justify voluntary requests for euthanasia, it can equally justify the termination of those who are in no position to give voluntary consent.
There are also plenty of patients who may simply come to see it as their duty to end their life as they become “too” old, ill or depressed, and will opt for an assisted death due to an internal sense of guilt and obligation. The Meacher Bill itself would not permit such an individual a voluntary death unless a doctor could estimate that they were in six months of death, but given that such legislation has been expanded in almost every jurisdiction where it has been permitted, this Bill if passed, would surely be no exception?
Although, unlike in the Netherlands, Belgium and elsewhere, the Meacher Bill outlines strict preconditions for assisted suicide that do not include “suffering”, it is clear that the thrust of the euthanasia campaign is based on the premise that this is the reason why the practice must be legalised.
Ask the average supporter why they support the procedure, and their first answer will probably revolve around helping people escape pain. Even the article in which The Sunday Times announced it would be campaigning on behalf of the Meacher Bill, led with the claim that it aims to stop “unbearable suffering”.
So either campaigners for the Meacher Bill are arguing — quite irrationally — that mental and physical anguish only qualify as “unbearable” when a patient has a terminal illness likely to kill them within six months, and whom can give “voluntary consent” — the conditions for assisted suicide the Bill sets out — or these more moderate plans are geared toward getting their foot in the door by ensuring we first accept that assisted death is legally and morally permissible before they can then argue that it ought to be expanded? Alas, whether naivety or dishonesty is to blame, they must be stopped.
Given that any measurement of suffering and pain is somewhat arbitrary and subjective, how can one comfortably claim that the anguish of grief or clinical depression, for example, is less painful than an injury or physical disease? These sensations cannot be measured in litres or decibels, and every person reacts differently to them.
It follows that the natural result of permitting state-sanctioned suicide due to ‘suffering’ is the extension of the permission for any person who judges themself to be suffering sufficiently to feel suicidal, whether it be a 90-nine year old with terminal cancer, or a 14-year-old girl starving herself due to anorexia. The question of obtaining “clear” consent also persists in both situations. Is it even possible for a person with clinical depression, or say, a depression prompted by a major disease, to make an uncompromised choice to pursue death?
This is already a reality in places many Britons are so apt to envision as progressive paradises. In October 2020, a healthy 90-year-old Canadian named Nancy Russell ended her life by euthanasia after stating she wished to die rather than endure another Coronavirus lockdown.
Canada’s Bill C-7, passed in March, further opened up euthanasia legislation to people of any age with disabilities or mental health conditions. Belgian law allows euthanasia if the patient is in a state of constant physical or psychological pain; while in the Netherlands doctors can secretly sedate patients who have dementia before euthanising them, and euthanasia for anyone over the age of 16 is legal.
Already, throughout the pandemic, we have seen elements of the health system betray the dignity and right to life of persons with disabilities or mental conditions by issuing “do not resuscitate” orders without consulting patients or their families.
These decisions were not just likely to have been unlawful, but are directly connected to several deaths, including that of a 58-year-old woman with schizophrenia and a deaf man in his sixties. If our strained system has lowered itself to this point while healthcare professionals are still legally required to preserve life, what will be the knock-on impact of further cheapening the regard for human life, and the Hippocratic oath, by legalising assisted death?
I do not doubt that most euthanasia campaigners are likely motivated by a genuine desire to reduce suffering, but I believe they are misled about what the true impact of this legal and cultural watershed would be.
There are, obviously, a small number of compelling cases that make it easy for people to support the theoretical liberty of euthanasia, however, it is right that a small fraction of individuals in exceptional cases not be permitted to legally access assisted suicide if by doing so we would put vast swathes of vulnerable people at risk of unwanted and unwarranted deaths. The hypothetical liberties of a select few cannot be permitted to trump all other considerations.