Wednesday, 10 December 2008

Assisted suicide, respect and control

A programme on the assisted suicide of Craig Ewert at the Dignitas clinic in Switzerland was broadcast tonight. The reactions of some opposed to assisted suicide were interesting.

The BBC quoted Dr Peter Saunders, director of Care Not Killing, as saying: "The danger is that we start to believe in a story that there is such a thing as a life not worth living". The BBC also quoted Lady Finlay, a professor of palliative care, as saying: "This programme ... perpetuates a myth that, somehow, to have a good death you have to end your own life and that is just completely untrue". These comments share a reluctance to accept that individuals can think clearly and make up their own minds in ways which we should respect.

Take Dr Saunders' comment first. It is obvious that there are some parts of lives that are, to the individuals concerned, not worth living, for example the last weeks of some illnesses. He clearly does not want us to believe that those parts of those lives are in fact not worth living. But if it is true, we should believe it. The only way to make it untrue is to say that the individual's judgement as to whether his or her life is worth continuing should not be accepted, because the individual must be failing to see that his or her life is worth continuing.

Lady Finlay's comment assumes that if someone chooses assisted suicide, that must be because he or she does not realise that there are other ways for him or her to have a good death. That only follows if we do not accept that someone could reasonably choose assisted suicide when there were alternative routes to a good death. But why should we not accept someone's choice of assisted suicide? There are, for some people, greater evils than immediate death, even if the deferral of death would not bring great pain. It is not for the rest of us to tell someone that his or her priorities are mistaken.

I see this theme of lack of respect for the decision of the individual as connected with a comment one sees occasionally, that some people fear debilitating illness, and will opt for suicide, because they have an exaggerated desire for control and independence. They may have a stronger than normal desire for control and independence, but why should they not? It is not for anyone else to say that someone's desire for control and independence is stronger than it should be.

While I am, as the above line of argument suggests, in favour of assisted suicide's being available, I do respect the desire of many doctors to have nothing to do with it. Indeed it could well be better for our confidence in the medical profession if doctors and nurses were statutorily excluded from involvement, rather than being allowed the choice. That should not be a problem. All that is needed is to supply a dose of the preferred substance which will definitely be strong enough, and which can be administered by the unskilled.

Finally, it is very hard to have any sympathy with the comment made by John Beyer, director of mediawatch-uk: "This subject is quite an important political issue at the moment (a Bill is being brought forard in the Scottish Parliament by Margo MacDonald MSP and there is a consultation currently running on End of Life Policies) and my anxieties are that the programme will influence public opinion". Lots of people make comments on this issue, with a view to influencing public opinion. The broadcaster has contributed to the debate by confronting us with an example of assisted suicide. All such evidence is grist to the mill of the debate. People will consider what they have seen and heard, and will make up their own minds. It really is the most appalling insult to all of us to say that we should be shielded from certain potential contributions to the debate, with the implication that we cannot stand back and think for ourselves.

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