More often than not, those who have a loved one who is terminally ill and suffering agonising pain present the most powerful argument in favour of voluntary euthanasia. Unless one is extremely callous, one cannot help but feel genuine sympathy for those who watch a loved one suffer; and one can understand therefore, the rationale behind their demand for a change in the law. Indeed, the more severe a case is, the more plausible the argument appears.
However, allowing difficult cases to create a precedent for legalised killing is most certainly not the right way forward. Apart from anything else, it will open the floodgates and allow in dangerous laws that will have the effect of devaluing human life.
Over the years, difficult cases have invariably been the ones used to erode moral barriers. In a document produced by the Christian Medical Fellowship in 1997, it was emphasised very strongly that hard cases make bad laws: “Legalisation of euthanasia is usually championed by those who have witnessed a loved one die in unpleasant circumstances, often without the benefits of optimal palliative care. This leads to demands for a ‘right to die’. In reality the slogan is misleading. What we are considering is not the right to die at all, but rather the right to be killed by a doctor; more specifically, we are talking of giving doctors a legal right to kill.” The writer then goes on to say that legalised killing is not the answer, but rather ‘the best possible quality of life for patients and their families.’
Heart-rending though the extreme cases may be, it would still be wrong ethical methodology to use their plight to introduce legalised killing. What is required is not the introduction of a bad law, but the improvement and development of our standards of medical care.
16.EUTHANASIA UNDERMINES MEDICAL RESEARCH
Modern medicine is making advances all the time, and can alleviate pain and suffering to a very great degree. This is not at all surprising, because it represents the accumulated wisdom of several generations. Today we have doctors who are skilfully trained in pain management. Indeed, Doctor Twycross, an internationally known expert on pain-relief quotes the World Health Organisation as saying that “a practical alternative to death and pain exists, so that there is now no need for anyone to die in pain.”
Medical research is essential if medicine is to advance further. Until now, one of the driving forces behind modern medical progress has been the desire to develop treatments for the terminally ill. This has been coupled with a desire to alleviate hitherto unmanageable symptoms. If the emphasis moves from curing to killing, palliative medical research will be seriously jeopardised. Rather than being used for research into pain relief, funds will be diverted to develop more efficient ways of assisting suicide. To quote the Christian Medical Fellowship once again: “If euthanasia is legalised we can expect advances in Ktenology (the science of killing) at the expense of treatment and symptom control. This will, in turn, encourage further calls for euthanasia.”
17. DOCTORS LICENSED TO KILL?
Euthanasia is contrary to traditional medical ethics. The work of a doctor has always been to cure not to kill. Historically, doctors have always said ‘No!’ to euthanasia. For thousands of years, the medical profession has refused to aid suicide or participate in euthanasia. In 1988 a report on euthanasia was published by the BMA, in which it reaffirmed its opposition to any attempts to change the law: “We do not, at present, see that any general policy condoning medical interventions to terminate life can be reconciled with commitments to good medical practice.” [P 19] Reading between the lines, the BMA was saying that good doctors kill pain not patients. They did not want to be given the power to end their patients’ lives. Furthermore, the medical profession appreciated that it would be detrimental to society if the traditional role of a doctor as healer of the sick were altered — and they were right.
We do not need doctors who are ‘licensed to kill’. We need good medical practitioners, whose perceived role is to alleviate suffering, not to end the sufferer’s lives. One of the consequences of legalised voluntary euthanasia will be a drastic change in the doctor-patient relationship. The elderly, the handicapped and the terminally ill will no longer feel comforted and reassured by their doctor. Instead they will feel threatened by him.
18. AN OBLIGATION TO DIE!
Terminally ill patients may not genuinely wish to ‘take control of their fate’ by choosing the time of their deaths. However, in certain circumstances they could be made to feel under an obligation to die, so as not to be a burden to their sorrowing relatives. In short, the vulnerable and elderly could conceivably be under pressure to request euthanasia to save their loved ones from what they think is unnecessary anguish.
When considerate people are dying, the last thing they want is to be a burden to anybody. Moreover, they have no desire to be selfish, or even appear to be selfish. If euthanasia is legalised, therefore, vulnerable people will very quickly begin to feel that assisted suicide is something they oughtto request, for the sake of their families. Mr Patrick Kneen, whose condition prompted the euthanasia debate in the House of Keys, said himself that he would rather die by assisted suicide than “waste away in front of my family.”
As has already been observed, terminally ill people may have no desire to die at all, yet may express a wish for assisted suicide solely for the benefit of their loved ones. They wish to protect their families from what they think will be a harrowing death. They may in fact wish very much to live as long as possible. However, such unselfish people would never acknowledge this, because it would defeat their object, which is to attempt to protect their relatives, and loved ones from distress.
In short, loving family members may unconsciously and indeed unintentionally, place a great deal of pressure upon each other.
19. SELFISHNESS MUST NOT PREVAIL
We live in a society that is constantly clamouring for ‘rights,’ one of which is the so-called ‘right to die.’ Many of the letters that have recently appeared in the Isle of Man newspapers have been from correspondents who have been pressing for the sick and disabled to have a legal ‘right’ to assisted suicide. Their argument goes something like this: “If a person is suffering unbearably as a result of a serious illness, he should have a right to be helped to die, if that is what hewants.”
Initially, this argument sounds quite plausible and even compassionate. However, when it is weighed in the balances, it is found wanting. If it is analysed carefully it will be seen that the argument is fatally flawed, because it does not take the third-party involvement into proper consideration. The expression ‘assisted suicide’ presupposes the aid of a member of the medical profession; but is it not selfish to burden a caring doctor with this responsibility?
How do you ask a man or woman who is dedicated to healing the sick, and saving life, to become involved in an assisted suicide? Because make no mistake about it — all doctors will be involved, one way or another, whether they are for euthanasia or against it. It is argued that a doctor who does not wish to take part in an assisted suicide, will be allowed to ‘opt out’ for reasons of conscience. At first sight this seems to be a protection for a doctor who is a conscientious objector. In reality however, it is no such thing, because that doctor will be legally obligated to hand his patient over to another GP who is prepared to assist in the suicide.
It is almost certain that the Isle of Man euthanasia bill will be based on ‘The Patient (Assisted Dying) Bill’ currently going through the House of Lords. This particular Bill contains the following clause: “If an attending physician, whose patient makes a request to be assisted to die… has a conscientious objection … he shall refer the patient without delay to an attending physician who does not have such a conscientious objection.” By handing his patient over to another GP, the conscientious objector becomes involved by implication. He will understandably feel guilty of aiding and abetting the killing of one of his patients, and he will have to live with that for the rest of his life.
When people fight for what they describe as their personal rights, they sometimes do so at the expense of the rights of others, and indeed it is not unusual for the rights of others to be trampled under foot. Doctors who are conscientious objectors have rights too — but the pro-euthanasia lobby doesn’t seem to recognise those rights. Their unspoken reaction is that pro-life doctors should not have such sensitive consciences. They should just do what their patients want, and pay attention to their rights. This is the very point we are seeking to make about the selfishness of many who claim the ‘right to die.’ They manifest a distinct lack of concern for those members of the medical profession who feel that it is their responsibility to save life rather than to destroy it.
Whilst there are many medics who do not want to assist a suicide, there are also many families who do not want to have their loved ones ‘euthanased.’ In a recent edition of Tonight With Trevor MacDonald[First shown 24 Jan 2003 . Repeated 18 Aug 2003 ], viewers witnessed the harrowing scene of Reg Crew’s daughter weeping profusely as her father drank a dose of lethal barbiturates through a straw. Poor Jan did not want her father to die, but because it was what he wanted, the deed was done.
Reg’s wife Win described her daughter’s feelings in a recent issue of a popular women’s magazine: “She thought it was too distressing, that I might get prosecuted. And although Reg was ill, she wanted him around for as long as possible. Everything I’d already thought of. It always came back to the same thing, though — it was what he wanted. We couldn’t refuse the last wishes of a dying man.” [Chat; Issue 36; 11 September 2003 ]
No man is an island, so it is not just what he wants that matters. A person’s decision to take his own life can have a profound and often lifelong effect upon the lives of others. There may be guilt, remorse and even anger and bitterness felt by those who are left behind. It has been well said that personal autonomy is never absolute. The effect, which personal decisions will have on others, must always be taken into consideration.
20. AUTONOMY IS NOT ABSOLUTE
Supporters of voluntary euthanasia and assisted-suicide frequently argue on the basis of what they describe as ‘individual autonomy.’ According to them, a competent individual should have the right to determine how and when to die. It is not unusual to hear the following sentiment expressed: ‘It’s my life, and I should be able to end it when I want to. The law as it stands undermines my autonomy and therefore needs to be changed.’
What needs to be appreciated is that autonomy is not absolute, because as human beings we are interdependent. We all belong to the family of man, and to a great or lesser extent are dependent upon each other. Furthermore, what we do affects other people, so if we decide to take our lives, others will be affected.
The famous quotation from English poet and preacher John Donne illustrates this truth most effectively: “No man is an island, entire of itself: every man is a piece of the continent, a part of the main…Any man’s death diminishes me, because I am involved in mankind.” To be quite honest, the idea of absolute autonomy is absolute nonsense.
George Bernard Shaw, in his well-known work ‘Pygmalion’ described the notion of total individual independence as “middle class blasphemy.” He went on to say: “We are all dependent on one another, every soul of us on earth.” There is no escaping from the fact that what we do as individuals has a profound effect on our fellow human beings. Thus, when a patient makes a request for assisted-suicide, he instantly involves other people.
A person’s decision to end his life can have far-reaching effects, and indeed repercussions. Those who have been involved in the deliberate ending of a life will never be the same again. Doctors will have to live with the fact that they have become ‘angels of death,’ and family members, who approved the assisted suicide, will have to wrestle with the pangs of troubled consciences.
21. NO ONE HAS A ‘RIGHT TO DIE’
Despite all the talk about ‘rights’ no one has a right to be killed on request. Some see the right to life and the right to die as equally valid expressions of personal liberty. However, as Alison Davies of No Less Human rightly observes: “There is a fundamental difference in the assumptions behind the two concepts. The ‘right to life’ is a well-established term, recognised in international law, reflecting a basic of justice, upheld in ancient and modern religious and ethical codes, that no innocent human being may be deliberately killed. The ‘right to die’, by contract, is merely a play on words which does not reflect a right at all. Death itself is not a ‘right’ but a natural event which comes to everyone eventually. Those who say there is a ‘right to die’ really mean a ‘right to be killed’”.
The fact that people are talking about a ‘right to die’ is a reflection on our society, and perhaps the churches in particular. In this materialistic society people see nothing of any lasting value in life, and become despairing, with feelings of hopelessness and uselessness. People should be shown the value of their lives, and encouraged to appreciate that whatever their circumstances, they can live with dignity and die a natural death.
If euthanasia were to be legalised, many vulnerable people would live in fear. A poll carried out among residents of homes for old people in Holland , where voluntary euthanasia is widely accepted, showed that 68% were afraid that they might be killed without their consent. Over 10,000 Dutch people now carry ‘Anti-euthanasia passports’ because they are so afraid of being killed by euthanasia if they are hospitalised.
If euthanasia in any form became an accepted part of our society, vulnerable people would be afraid to express any unhappiness or discontent for fear that they would be regarded as “better off dead” and killed because they fell within the ‘strict criteria’ drawn up for acceptable killing.
This is an especial concern for the elderly. If assisted suicide is legalised, the elderly could very quickly become prey to the unscrupulous. There are many elderly folk today living in Care Homes, who have no family, and thus no one to protect them. They are at the mercy of health-care professionals. By legalising assisted suicide they will be in an even more vulnerable position.
When you are old, physically weak and alone, who will protect you against unscrupulous people? How can you deal with someone who wants to ‘persuade’ you towards assisted suicide, for his or her own ends? If the law is relaxed it, will become possible for unscrupulous people to manipulate the vulnerable into ‘assisted death’ for their own ends. There are already vast numbers of con artists who exploit the vulnerable for personal gain, and to legalise ‘assisted suicide’ would create another means for them to pursue their devious objectives. If you are old, weak and alone, and your life is in the hands of others, you will do as they say because you have no option.
Statistics show that the birth rate is falling and that there are more elderly people than ever before. As the number of old people grows, and there are increasing demands on NHS funds, there will be more pressure to ‘help’ the old and seriously ill to an early death. An estimated two-thirds of NHS beds are occupied by patients over 65 years of age, and the number of people over 85 has doubled in the past fifteen years. There are now over a million men and women between 85 and 89, and 330,000 over 90. In the next 50 years, these numbers are expected to triple.
It is not entirely beyond the realms of possibility therefore, that doctors may one day be issued with a form entitled ‘Qualifications for Involuntary Euthanasia,’ citing the criteria: ‘Over 75…visited the doctor so-many times during the past year…cost to the NHS so-much…No useful contribution to the State = Euthanasia Recommended.’
We live in a society that has lost its respect for the elderly. Not so many years ago the young would have gone to them for advice and benefited from their wisdom and knowledge of the past. Today many young people possibly considering themselves to be technologically superior either ignore the elderly or treat them with utter contempt. Legalising euthanasia would spawn even more of this attitude because it would encourage the idea that the elderly, infirm and vulnerable are disposable and dispensable.
23. ASSISTING SUICIDE CAN LEAD TO SUICIDE
On 12th September 2003 , the Manx Independent carried an article entitled “30% of Mercy Killers Commit Suicide.” It contained an extract from a report published by the Voluntary Euthanasia Society (VES) on 9th September 2003 , in which it was stated “30% of suspects in reported mercy killing cases end up committing suicide.” The chief executive of VES, Deborah Annetts is quoted as saying, “Behind the statistic of 30% of mercy killers going on to commit suicide, there lies a huge amount of suffering.” Ms Annetts’ interpretation of the statistic is that mercy killers commit suicide because they are fearful of prosecution. However, this is not necessarily the correct interpretation. The person who has assisted a loved one to die may have begun to suffer guilt, remorse and despair, and this is the most likely reason they take their own lives. The fear of prosecution is unlikely to be uppermost in their minds, because it is a known fact that the ‘Powers that Be,’ more often than not turn a blind eye to what they call ‘mercy killing.’
Take the case of Reg Crew, for example — possibly the most publicised assisted-suicide case so far. Win Crew was well aware of her situation, and was actually waiting for the police to contact her, which they did. She said: “I knew it was a criminal offence to help someone to die in this country, so I wasn’t surprised when the police came round to Jan’s to interview us both. I had to tell them why I did it. That it was an act of love. They were sympathetic. But the matter was still hanging in the air. But a few weeks later, the police said they’d drawn a line under it.” In the light of the police response to Reg Crew’s assisted-suicide, Win will certainly not be living in constant fear of prosecution. However, only time will tell how she will feel within herself in days to come with regard to her own emotions.
People who have killed loved ones out of ‘mercy’, or have assisted in their suicides, are quite likely to defend their actions to the bitter end. Nonetheless, inside they may suffer deep regret and even remorse. For a number of reasons they may never publicly acknowledge these feelings, nor even admit them to themselves. They may become deeply depressed, without understanding the reasons for their despair. If they do ultimately come to regret their actions, they may feel unable to tell anyone because they know it will cause further distress, particularly within the family unit. One can well imagine that feelings like this can lead to suicidal thoughts.
24.THE MOOD SWINGS OF THE DYING
Terminally ill patients are susceptible to drastic mood swings. This in itself highlights the danger of legalising euthanasia. Canadian researchers from the University of Manitoba , Queens University Kingston and the St Boniface Research Foundation have found that terminally ill cancer patients can long for death one day but cling to life the next. They fear such patients could opt for euthanasia when at an extremely low ebb. The study, published in The Lancet (Vol. 354 p816), looked at 168 cancer patients who were receiving palliative care following a terminal diagnosis. It found that patients who said they wanted to die might say the opposite 12 hours later.
In the recent debate on euthanasia in the House of Lords (06.06.2003), Baroness Finlay of Llandaff, Honorary Professor in Palliative Medicine at The School of Medicine, gave a poignant illustration of the mood-swings of the seriously ill. She described a cancer patient of hers who once pleaded for death, yet now lives a very fulfilled life. “A wish to die is a feature of untreated clinical depression,” Lady Finlay said.
25. DISABILITY IS NOT INDIGNITY
Being disabled is not the same as being without dignity. Many of those who are pushing for voluntary euthanasia argue that they want to ‘die with dignity.’ When pressed, they say that if they became doubly incontinent and extremely dependent, they would consider that to be undignified. The truth is, however, that many people are incontinent and dependent, although they are not terminally ill. Indeed, there are some who have been in this position all their lives, and it would be nothing short of iniquitous to describe these people as undignified.
People’s individual conception of dignity differs. A person who has been fit and well most of his or her life, and then becomes disabled and dependent, may feel a loss of dignity. This does not mean that their perception of dignity is accurate. Others have been disabled all their lives; but without a doubt they are very dignified people. The pro-euthanasia supporters imply that only their concept of dignity is correct. In other words, according to them, anyone who becomes dependent on others and loses control of their bodily functions is undignified.
By definition, to be undignified is to be ‘low in value and lacking in quality.’ This is a most inappropriate description of any human being, not least the disabled. One thinks of the actor Christopher Reeve, who until a few years ago was a fit and powerful man, as is seen from his casting as ‘Superman’ in the films of that name. However, a fall from a horse left him almost totally paralysed, and he is now completely dependent upon others in most aspects of his physical life. Nevertheless, no one who reads his autobiography, or sees him on the television speaking about his life as a paraplegic, would describe him as degraded or undignified.
It is reasonable to assume that many of the pro-euthanasia submissions that are being sent to the Select Committee of the House of Keys, will be drawing attention to “sufferers who have lost their dignity.” These sufferers, in becoming ill, have taken on disabilities, which have allegedly rendered them undignified. A disturbing equation has thus been drawn between having a disability and being undignified. Apparently, a person in good health is dignified, whereas the person who lives with a disability is not. This is the logic of the pro-euthanasia argument, and it is very disturbing to say the least. It is an insult to the disabled and a slur upon those who are not terminally ill, but suffer a chronic and debilitating illness.
26.ASSISTED SUICIDE IS NOT ‘DIGNITY IN DEATH’
In February 2000, an enquiry by the Erasmus University in Rotterdam into 649 cases of assisted suicides in Holland published the following details: —