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Staying alive

The campaign to legalise 'assisted suicide' will create more pain than it relieves, argues Kevin Young

The international controversy surrounding assisted suicide continues to grow. In Britain in May, Dr David Moor, who admitted before his trial that he had helped up to 300 of his terminally ill patients to die, was cleared of murdering George Liddell, 85, with a fatal dose of painkiller. His trial began just as Jack Kevorkian, the American 'Dr Death', was convicted of second-degree murder after he filmed himself giving a lethal injection to Thomas Youk, 52, who suffered from amyotrophic lateral sclerosis - a fatal and degenerative disease affecting the nervous system.

After Dr Moor's acquittal, doctors' leaders reaffirmed their opposition to legalised euthanasia, while the Voluntary Euthanasia Society said that the case had exposed a 'grey area' in the law. Both assisted suicide (or doctor-assisted suicide), where the patient takes the final action rather than the doctor, and voluntary euthanasia, where the patient simply makes the decision to die, are currently illegal in Britain and the USA. But such laws are now being challenged by campaigns around the world.

In Holland, voluntary euthanasia for those defined as terminally ill has been decriminalised since 1984. In Switzerland, doctor-assisted suicide - in which the doctor prescribes a lethal dose of drugs - has been legal since the late 1970s. Doctor-assisted suicide has also been legal in the US state of Oregon since 1997.

At first glance, it is difficult to see why a law should prevent doctors from carrying out their patients' wishes by allowing them to die comfortably. If assisted suicide were only a case of overcoming a rigid and outdated set of ethics for the sake of compassion in the face of dreadful pain, it would be worth supporting. But there are wider implications of legalising assisted suicide.

Of course there are cases where, in the last few hours of life, prolonging life simply means prolonging suffering. But in the past, when situations like this arose, doctors routinely administered a dose of morphine sufficient not only to stop pain but also to slow breathing to the point of stopping it. Nobody objected. No doctor has ever been prosecuted for such an action in this country. Perhaps the most famous example concerns Lord Dawson, who helped King George V to die in 1936 and then confessed to what he had done in the House of Lords, saying that 'all good doctors did this'. The irony is that campaigners, by thrusting these situations into the limelight, have made doctors nervous of making such everyday humane decisions and have probably prolonged suffering as a result.

The issue of legalising assisted suicide is not simply about sparing people a few hours of agony at the end of life. Very few people request assisted suicide and, when they do, it is likely to be a momentary wish made in the depths of (an understandable) depression about their illness. Prominent campaigners for legalised assisted suicide who are suffering from a terminal disease, such as Noel Early and Dr Timothy Leary, the famous American 1960s acid guru who died last year, all backed out of suicide in the end. In Holland, only about three percent of people who fall within the narrow definition of 'terminally ill' take the option. No study to date in any country has shown that pain plays a major role in requests for assisted suicide. Older generations of people, presumably those facing such decisions most imminently, are the most opposed to legalised assisted suicide of any group.

Statistically, supporting assisted suicide as a legal option is a young man's game. This support seems to bear little relation to the actual problem facing doctors and their dying patients. The internet, which abounds with assisted suicide stories and how-to instructions, gives important clues as to why this issue has risen to prominence.

A key role that church officials once played in people's lives was to 'minister to the dying', providing comfort for them and their loved ones. Now, with the decline of organised religion in the West, a need arises for rituals that can fit in with more individualised notions of spirituality. By concentrating on controlling the circumstances surrounding the moment of departure, assisted suicide enthusiasts seek to comfort themselves in the same way as priests might have done for them in the past.

The Hemlock Society, founded in 1980 and currently claiming 50 000 members worldwide, provides 'chaplaincy teams' in America who volunteer 'to prepare the terminally or hopelessly ill spiritually for self-delivery, and then guide them through a peaceful entry on [sic] the Other Side'. Compassion in Dying, an international pro-assisted suicide campaign, says on its website: 'Assurance of a humane death enhances the celebration of life.' The academic-sounding Project on Death in America says: 'The many diverse cultural communities in this country offer a tremendous amount of wisdom about the ways death can be a less devastating experience for the dying person and his or her care-giver.' Parallels are often drawn with birth, as if to point up some sort of holistic meaning or plan. The younger supporters of assisted suicide seem to base their interest on a need to make sense of the mysteries of life.

The resonance of this issue indicates, above all, the depth of fear and alienation in the world today. As Isaiah Berlin observed: 'The logical culmination of this process of destroying everything through which I can possibly be wounded is suicide...Total liberation in this sense...is conferred only by death.' Mocking the words with which Martin Luther King proclaimed his message at the Lincoln Memorial in 1963, the Last Rights Journal carries a photograph of a skeletal, dying or dead man with the caption, 'Free at last!'. But free to do what, exactly?

There are serious legal and medical implications of a change in the law. But the best reason to resist it remains that legalising assisted suicide cheapens and degrades human life. The assisted suicide movement sanctions and encourages acts of self-destruction that ultimately impact, as the family of anybody who has committed suicide knows, on those left behind. As a working party on the question of euthanasia observed in 1982, the act of taking a life should always be a grave and tragic decision. Nobody should be allowed to take a life simply because they or others judge that life to be wretched.

Reproduced from LM issue 122, July/August 1999

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