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A Right To Die Or A Duty To Die?

November 27, 2008

A Right To Die Or A Duty To Die?

To many people’s minds one of the most fundamental human rights is the right to life itself. As a corollary to what extent should an individual be entitled to end his life and how might the law best safeguard such assisted dying?

As recently as September, 23 year-old Daniel James was helped by Dignitas, a Swiss euthanasia group, to die in one of their clinics. A young, highly successful rugby player, Daniel had been paralysed from the chest down after an accident in the scrum. He was left unable voluntarily to move any of his limbs and found himself unable to bear the grim transition from capable, active athlete to tetraplegic. By the time he made his final trip to Switzerland, he had attempted suicide three times.

When his parents, who accompanied him on his last journey, returned to the UK, they found themselves under investigation by the police. Their actions were later defended by Debbie Purdy, a terminally-ill woman who also hit the headlines for seeking clarification from the High Courts as to whether her husband can legally accompany her should she too go to Switzerland to die.

Such desperately difficult cases are naturally greeted with a mix of public sympathy and horror. When a dark and terribly difficult decision is made by a person to die, how can we possibly permit the potential criminalisation of those who wish to help carry out their final wish? Surely there is room for a compassionate law which allows relatives and friends to assist the premature death of a loved one who is crippled by pain, incapacity or mental anguish – especially where the person wishing to end his life cannot physically do so?

As powerful as such arguments may be, however, I believe we should make clear that the emotional issue of assisted dying is fraught with dangers. Any legislator must keep in mind that the first duty of the state is to protect the lives of its citizens. To enshrine in law permission to assist a death, we risk the right to die turning into a duty to die.

Eighteen years ago, I witnessed my father slowly die of terminal cancer. As his next of kin, I had a role in working with a long-standing family doctor to ensure he had enough morphine to ward off the pain. That decision may well have shortened his life by a few days, perhaps even weeks. I did not consider this to be wrong. But at the same time, my instinctive reluctance to see an understandable desire for the extension of freedom of choice to be enshrined into law remained.

My own experiences have led me to develop what may be regarded as a rather hypocritical approach to assisted dying. Whilst the law may not be the right instrument for such momentous change, equally the medical profession and indeed the police should not run the risk of prosecution in trying to ‘do the right thing’ in difficult circumstances.

We must recognise that as a compensation and blame culture becomes more prevalent in this country, medical professionals in particular will be increasingly reluctant to do the right thing if there are laws in place which may be seen to provide safeguards but which in reality simply regulate their lives more strongly.

And what of those elderly folk or those of all ages who feel they are a great burden to their families? They may not wish to die but they could well feel that they should. We tread a dangerous path if we begin to divide lives up into those that are perceived to be worth living and those which are not. An aspect of the Daniel James case that deeply troubled me was the statement from his family that he was living life as a ‘second-class citizen’. His injuries were serious and irreversible but they were by no means life threatening. He may well have lived for decades to come. A notion that some lives are more valuable than others is certainly not something that should be enshrined in law.

Those who desire laws on assisted dying are keen to make clear that any new legislation would contain appropriate safeguards. But there can never be a safeguard which prevents a vulnerable and confused person from feeling they have a duty to ask a doctor in private to end their life prematurely. Nor can you prevent a selfless person from seeing a law permitting euthanasia as an opportunity to cease being a burden – even when they have no wish to die themselves. The current law gives vulnerable people the permission not even to consider whether they should seek a premature death – and in doing so relieves them of a significant burden when they may face enough struggles in dealing with the illness or disability itself.

Put simply, difficult cases make bad law. The reality is that nobody has been imprisoned in the nearly fifty years since the Suicide Act 1961. It is time we accepted that the current system can work provided we apply a common sense approach. The empire of law, fashioned primarily to protect, should rightly have some limits.