Assisted suicide: letters from the front line
As someone entitled to vote on the Assisted Dying Bill in the House of Lords on Friday, I have received a great many emails and letters from each side of the argument, in roughly equal quantities.
The first thing worth saying is that they are good letters. Only a few seem formulaic. None is hysterical or accusatory. They often speak from direct experience of the death of people they loved. They show a depth of thought and feeling. At one point, one correspondent (opposed to the Bill) says how important it is, when talking to the very ill, to show “care in listening and discernment”. That advice applies to these letters. They deserve close attention.
In trying to discern the feelings
of those who favour assisted suicide, and therefore a change in the law, I sense their strongest underlying emotion is one of compassionate disgust. How, they ask, should anyone be forced to undergo agony and indignity, when there is a way out? They often cite examples of dreadful deaths they have witnessed, sometimes with details too appalling to repeat.
To people with this view, it seems plainly logical that those wishing to die have a right to administer that death themselves and should be allowed to enlist people they trust to help them. They see it as a simple matter of choice: “You are born with a body: it is yours, so you should be the person making decisions about your death.”
Underlying the view of those on the other side of the argument, I discern a different way of looking at the sick person. They tend to be profoundly aware of the vulnerability of the very ill and to look at that person in the continuum of a whole life. Patients in pain often beg to be allowed to die, even to be killed, but do they permanently mean it? Might their protest be, as one correspondent puts it, “a cry for better help”? And might a society which promotes assisted suicide be less likely to respond to that cry by improving palliative care?
Opponents of assisted suicide have an alert sense of context. They know that people – particularly old, frail people – like to do what they think is expected of them. One writer refers to statistics on assisted suicide in the US state of Oregon which show that 50 per cent of those following this course cite being a “burden” on others as a reason for doing so. Any jurisdiction which legalises assisted suicide in effect endorses the view that the old and/or incurable or even the mentally ill are indeed a burden. This can be a form of “gaslighting”, deepening the patient’s sense of worthlessness. It can even make a refusal to contemplate assisted suicide seem selfish: if others think it’s all right to go, why are you hanging around wasting the time of nurses, doctors and family? Grimly, health insurers like it too: it costs them less.
The context also extends beyond the sick patient. A person who loves you almost by definition wants you to live. What are the moral and psychological consequences for him or her of having to decide whether to help you kill yourself? Is a person zealous to do so better than a person who does not want to? What must the would-be suicide feel if, say, her son wants to assist her suicide and her daughter wants to prevent it?
Similar questions apply to the professionals involved – the doctors trained to promote life and the high court judges (empowered under the Bill) who will now, long after capital punishment has been abolished, be granted the power of life and death.
When you start to think of the ramifications, which most supporters of the Bill do not, reassuring talk of “robust safeguards” in the Bill sounds sadly inadequate.
We are at an odd cultural moment. More attention is being paid to the harm done by websites which promote suicide. There is growing awareness – I have seen it myself with the recent suicide of a dear friend, Rose Paterson – of how the false logic of self-destruction damages everyone who loved the dead person. Yet at the same time we are gearing up not just to ease the passage of the dying – that is already, under careful rules, permitted – but to institutionalise self-destruction. There is an unmanageable contradiction here. The language of “choice”, used by supporters of assisted suicide, does not confront this profound problem.
Everything I have written above assumes basically good motives. But the law must also consider bad ones.
The most striking letter I have received comes from Ian and Sue Farquhar. Ian’s brother, Peter, was befriended by a young man, Ben Field, who moved in with him, persuaded him he was dying (eventually, he was: Field was poisoning him). He got Peter to change his will in his favour, and inherited his house when he did die. Suspicion arose only when Field tried the same trick on Peter Farquhar’s neighbour.
Mr and Mrs Farquhar write: “Our fear is that assisted suicide could increase instances of fraud of the elderly and the sick … With a statesponsored way of bringing about the death of the elderly and unwell, inheritance fraudsters would be able to take advantage of the vulnerable without fear of consequences.” They cite, by way of concrete example, a recent case in, yes, Oregon.