Perspectives: Should the law allow assisted suicide?

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Should it be legally possible to help somebody die, if they are chronically ill and suffering great pain?

Colin Harte (left) and Christine Ramsay Colin Harte (left) and Christine Ramsay approach the debate from different perspectives

As part of the Perspectives series, BBC Religion and Ethics asked two contributors to develop some of the issues.

Christine 'Chris' Ramsay is a retired English teacher whose partner Sue, after battling cancer for two years, had an assisted death in Switzerland in 1995.

Chris is a member of Dignity in Dying. She now lives in Devon.

Dr Colin Harte has been a full-time carer for 24 years for Alison Davis, whose suffering caused her to long for death for ten years. She is now grateful to be alive, even though her suffering has not diminished.

Colin's doctorate was on suffering, and he is a supporter of the Care Not Killing alliance that opposes voluntary euthanasia and assisted suicide. He lives in Dorset.

'Much needed improvement'

Chris: I am hoping that Lord Falconer's bill will make a much needed improvement to current legislation on assisted dying. His proposals, as we understand them today, will relate only to the terminally ill with no mention of the disabled or those with lengthy life expectation.

Start Quote

Life is too precious to give up on it, whether it is cut short by years, weeks or even days”

End Quote Colin Harte

My opinion was reinforced years ago when I was living and working in Switzerland and was helped to administer palliatives of such strength that Sue, my love, in accordance with her own expressed wish died days later, gently and in her sleep.

The hospital had admitted there was nothing more that they could do.

According to the Ultra Sound, she had the remains of one kidney, a part of her liver, less and less of her digestive tract still functioning. Her pancreas and spleen were riddled with tumours.

They let me take her home for her last two weeks.

Colin: I very much oppose the suggested change in the law, and those involved with proper palliative care are also opposed to killing. They focus on alleviating distressing symptoms so that patients can both live well and die well.

My views are reinforced by my experience as a carer for 24 years for my friend Alison.

In the mid-1980s doctors thought she didn't have long to live and Alison wanted to end her life. She would have qualified for death under the expected terms of Lord Falconer's bill - but if she had been killed then nobody would have known that Alison could have lived for many years.

Euthanasia: The moral dilemmas

  • Is it ever right to end the life of a terminally ill patient who is undergoing severe pain and suffering?
  • Under what circumstances can euthanasia be justifiable, if at all?
  • Is there a moral difference between killing someone and letting them die?

Life is too precious to give up on it, whether it is cut short by years, weeks or even days.

Chris: I agree absolutely that we hope to live well for as long as possible and then die well. Prue Leith wrote a piece for Dignity in Dying describing how her terminally ill brother was prescribed medication to relieve excruciating pain for a three hour period.

But it was to be administered by a nurse every four hours. For one out of every four hours he was in agony and eventually refused food and drink to escape the 'care'.

Difficult stages

Colin: If there was a defect in care, then we can agree that it must be improved. But, of course, if killing suffering people becomes an option we will soon see that families and society will prefer it to providing the time, effort and expense of caring.

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Even with ideal care, terminal illnesses lead to a point where organs cease to function and the patient dies implacably from the inside”

End Quote Chris Ramsay

It is well known that Holland, which has been the longest practitioner of euthanasia, has the most lamentably insufficient palliative care and hospice provision.

Assisted suicide or euthanasia will not improve provision of care.

Chris: So, current legislation is not adequate and Falconer's bill will need to be extended to embrace radical improvements. But even with ideal care, terminal illnesses lead to a point where organs cease to function and the patient dies implacably from the inside.

Recovery is not on the cards when a body is riddled with tumours.

Colin: The hospice movement does not regard a bill like Falconer's as a way to improve care. On the contrary, it is very much opposed to changing the law to allow vulnerable patients to be killed.

Many terminally ill people have stages when they say they have "had enough and cannot go on." Yet after they have got through the difficult stage - which might last some days or weeks - they are glad to be still alive, and have gone on to have a peaceful death.

A change in the law would make it dangerous for such people to express their feelings. Unless you favour suicide generally for anyone who wants to die it doesn't make sense why you would favour it particularly for vulnerable people who are thought (rightly or wrongly) to be approaching the end of their lives.

Chris: The bill is for terminal patients, not patients at 'a difficult stage'. Two doctors would have to verify the situation independently. Now, those who choose Dignitas need to be fit enough to travel to Zurich.

Our current law is obliging them to choose death before their condition is truly terminal. Our current law needs a sensitive re-think.

A personal choice

Colin: I was talking about patients who were regarded as terminal. The terminal period can last for weeks or months and it inevitably has different stages. In fact, it can even last for years.

I was called to the hospital bedside of a friend who was expected to die imminently - but in fact she died two and a half years later! It is impossible for a bill to specify what 'terminal' means and patients who might have lived many months or years will inevitably be killed by a Falconer-type law.

Two doctors would have certified that Alison was dying in 1985. Had she been killed under the provisions of a Falconer-type law - as she would have chosen in 1985 - nobody would have known that those doctors were wrong and that Alison would still be alive in 2013 .

Chris: I sense we are coming full circle. Where both of us have read and thought and discussed this matter over years, we are both conditioned by our own experiences.

As you know better than I, disability can incur extreme physical and psychological anguish that at least equals the suffering of the sick.

Neither of us has mentioned dementia or those tragically blighted by the effects of war or accidents or insanity. But Lord Falconer's bill is aimed at giving people who have proven mental capacity the right to make the choice about their own death.

Just knowing, were the time to come when I or one of my friends had to face the inevitability of spending our last days on this beautiful Earth in mind-searing agony, that we had the legal right to choose assisted dying as outlined by this week's bill - that knowledge would bring us a tranquillity, a freedom from anxiety.

Colin: Chris, I don't think we are coming full circle, and in fact the serious objections to the Falconer Bill and other similar laws that would hasten the deaths of vulnerable people have barely been aired yet in our discussion.

You haven't explained, for example, why being terminally ill should uniquely be grounds for letting somebody be killed, or how one can define what being 'terminal' is, given that there are well documented instances of people still living years after doctors thought they were going to die.

Far from giving terminally ill patients tranquillity, a Falconer-type law would create anxiety as patients would wonder whether they should do the 'decent thing' and end their lives so as not to be a 'burden.'

It is naive to think otherwise. And we haven't even touched on the insidious financial pressures - whether on the part of the NHS or families not wanting to see their inheritance diminished - that would lead vulnerable people to think they had a duty to choose a premature death.

The sort of law you support would have far-reaching consequences and the most vulnerable would be its victims.

Perspectives is a forum for invited contributors to write about personal and contemporary issues of faith and ethics. The views expressed here are those of the individual authors, not the BBC.

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