Thursday, 18 June 2015

Time for rational debate about assisted suicide

The assisted dying debate surfaced once again with the well publicised case of Jeffrey Spector, a man terminally ill with cancer, who went to the Dignitas in Switzerland to end his own life.
One of the problems with the debate over assisted dying at the moment is that it seems to be guided by one sensational media story after another. Emotions run high whille cold hard logic comes in a long way behind.
The Spector case raised many of the classic issues — a man with a terminal condition, who stood just to see his life deteriorate and suffer over a number of months if not years before the final release of death. He took the decision not to run that gauntlet of suffering, go to Dignitas and end it all.
The debate here has been about why people like Spector should be forced to leave the country to end their own lives. The campaigning organisation Dignity in Dying has claimed that for every one person going to Dignitas a fortnight, 10 are taking action here behind closed doors. There has also been the scene over recent years of terminally ill people being put through more suffering by the prospect that due to the legal situation in this country their nearest and dearest end up being dragged through the courts after they have gone.
I have to admit from a personal angle my own position on assisted dying has changed over recent years. I witnessed my mother go through years of physical suffering, declaring almost every day she wished she was dead. I remember regularly arguing that there were people worse off than her. My mum’s mind was excellent right up to the end when it came a couple of years ago. However, since her death I have had time to reflect.
Mum underwent a steady physical deterioration over a number of years. She did not have a terminal condition but had had enough. She’d lost most of her sight, hearing and movement.
The lesson of my experience really was to be a little more understanding of those suffering, looking down the barrel of things simply getting worse until that final moment of death comes. It’s not a great quality of life. It is some of these reflections that make me believe that the type of proposals being made by Lord Falconer’s bill maybe should come onto the statute books in this country. People should not be forced to go to Switzerland to end their lives. There has been the claim made that assisted suicide should not just be for the rich.
Falconer’s proposals stipulate that the person must be terminally ill, with six months of life left. They must be of sound mind. Two doctors would  be needed to certify the case and there has to be judicial oversight. The proposal sounds humane and limited.The assisted dying terrain is of course dominated by potential pitfalls. There is the slippery slope argument that once assisted dying is conceded the conditionality will be loosened. So six months will become a longer period, the doctor stipulation reduced and judicial oversight removed.
Doctors will object. Many rightly claim they came into medicine to save, not take, lives.
Then there is the economic argument that has always concerned me, namely that once assisted dying is on the statute book, pressure on NHS resources and staff will contribute to making euthanasia the default position for the sick and dying.
What of the elderly person alone in the hospital bed, without family or friends to fight their corner. Or alternatively, the elderly person in the hospital bed surrounded by greedy relatives just wanting the person to die so that they can get their hands on his or her wealth.
There is also the background concern of a country that increasingly seems to know the price of everything and the value of nothing. This approach can be extended to matters of life and death. There is already the sight of old being pitched against young in terms of who has the houses, the wealth etc. People who do not serve the great capitalist machine in some visible way tend to be regarded as easily disposable. It could be argued that there is a creeping sense of eugenics about much of what informs public policy in areas like health and social care at the moment.
These are all valid concerns when it comes to making changes on the matters of assisted dying. What is clear though is that the present situation serves no-one very well. And nor is the debate being taken forward in a particularly sensible or sensitive manner.
On the one side, there are those who seek legalisation of euthanasia, using one emotive case after another as it hits the headlines to argue their case. On the other side are those — many religious — who oppose any change in the law no matter what.
What is needed is for some rationality to be brought to the assisted dying debate. Perhaps a Royal Commission or similar body to take evidence over a set period of time, then come up with suggestions as to how things can move forward.
The situation as it stands at the moment does not serve anyone particularly well. It seems like we are creeping toward legalising assisted dying but not in a particularly rational or humane way. There should be change but it has to be undertaken after a logical look at the facts and implications. Then maybe the situation can change for the benefit of all.

*published Morning Star - 18/6/2015

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