Why the case for assisted dying is unanswerable By Samuel Brittan

Why the case for assisted dying is unanswerable By Samuel Brittan

Published: August 7 2009 19:26 | Last updated: August 7 2009 19:26

Let me declare, as parliamentarians sometimes do, an interest. I am neither a legal nor a medical expert, but I am a rather inactive member of Dignitas, a British organisation which campaigns for better-quality palliative care for terminally ill people, but also for “the option of medically assisted dying” when such people “are of sound mind and are experiencing unbearable suffering”. My only qualification is that as an economics writer I have some experience of assessing the costs and benefits of alternative courses of action. Nor am I going to detail the sufferings of terminally ill people who have lost all will to live but cannot find a dignified, legal exit.

I have nothing to say to those religious fundamentalists who consider that in no circumstances should life ever be terminated. I leave it to them to reconcile their views with their belief in a merciful God. They also need to be very sure of their convictions to impose them on the rest of humanity. But for the rest of us, some progress has been made. Attempted suicide is no longer a crime in the UK. There is also an instrument known as a Living Will under which I can declare that if I become “mentally incompetent to express my opinion”, and after two independent physicians agree my condition is irreversible, then certain kinds of treatment should not be given. The legal force of such documents is not clear, but many doctors now take them into account.

Most of the present argument is about “assisted dying” for those of sound mind. There have been notable cases of terminally ill people making accompanied visits to Switzerland, where the law is different. In the UK, assisting or abetting suicide is still a crime theoretically punishable by up to 14 years’ imprisonment. No returning companion has been so prosecuted. When the Law Lords were asked for a ruling by Debbie Purdy , a 46-year-old suffering from multiple sclerosis, who wanted to know whether her husband would be prosecuted if he helped her commit suicide overseas, they requested the Crown Prosecution Service for guidelines. An interim report is expected this September.

There is an overwhelming case for the removal of the threat of a custodial sentence for those who help their loved ones die in any country. Opinion polls show large majorities in favour of such changes, but attempts to enact them have so far failed to get through parliament.

There are many reasons why terminally ill people may want help in taking their own lives. They may lack the pharmaceutical knowledge to choose the least painful or quick acting drug. They may not be able to get hold of such drugs legally. Or in extreme cases they may need physical help in taking them. In some cases they may just want to depart this world surrounded by their nearest and dearest. But under present law there is a risk that their relatives and friends could be prosecuted for aiding and abetting.

The secular case against assisted dying can be put crudely as the fear that the procedure would be abused “to put granny away and take over her house”. Statistical surveys in the Netherlands and the US state of Oregon, where the law has been reformed, show no rise in the number of suicides that would have occurred if there had been such abuses on a significant scale. But I do not want to depend on statistical averages. There would undoubtedly be at least some abuses under a reformed law. But these have to be set against the much greater hardship almost certainly inflicted by the present suicide laws.

A more refined consideration is philosopher Bertrand Russell’s view that the remedy for the pains of old age and fear of death is to identify oneself less with personal concerns and more with the future of the human race. He lived up to his counsel, spending a week in jail at the age of 90 for his anti-nuclear activities and dying at 97 still corresponding with world leaders. But we cannot all be like him. Creative artists have often revelled in the pains and brevity of life. Last week, I went to hear Gustav Mahler’s Sixth or “Tragic” Symphony. After two or three literal hammer blows the work ends with a resounding orchestral crash that never fails to shock. Yet it does not, literally, remove anyone’s pain.

Any new law would have to be carefully drafted. What should be done about those who want to take their lives because of what can only be described as Weltschmerz, or world-weariness? An excellent play, Collaboration, by Ronald Harwood focuses on the German composer Richard Strauss and his Jewish librettist, the Austrian Stefan Zweig. The latter fled to Brazil, where he and his wife took their lives in 1942 because he could not acclimatise to life outside Europe. If, however, Zweig had hung on until 1943 when the war turned in favour of the Allies, life might again have seemed worth living. But you cannot expect the law or the medical profession to play God in such matters.

But to come down to earth. The main reason it is so difficult to reform the law on assisted dying is that those on the fundamentalist side will be prepared to base their votes on this issue, while humanist utilitarians will see it as only one of many issues. Or so ministers fear, which comes to nearly the same thing. Meanwhile my best advice is to make your wishes unmistakably clear while you are still in normal mental and physical health.

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