Assisted Dying

There is a play in which an elderly man and his son are facing up to a visit to their local clinic. It is set about 30 years in the future when medicine has advanced to the point where the doctor can tell him not only that he has an incurable condition but that he has exactly  3 years  3 months and 3 days  to live. After seeing the doctor the man goes to see a counsellor who discusses with him at what point he will take the pill which will kill him. She stresses it is very much his decision but the unstated assumption is that at some point he will ask for this. However, the man and his son decide to buck the system. A few years before this the man’s wife had asked for a  lethal dose which had shortened her life, a decision  they had regretted  ever since. So they decide to see out the illness to the end, not hasten the death. [1]

Proponents of assisted dying will complain that this is too far fetched, and that we would never change into a society in which assisted dying became the default position. But they are wrong for the very   reason that drives them to support the present bill: compassion. It is compassion which quite rightly wants to stop the suffering of those for whom it has become unbearable. But why should it be limited to those with just a few months to live? A man with Parkinson’s has already complained that the proposed bill does not go far enough for him. A few years ago a young man  paralysed from the waist down as a result of a rugby accident went to Switzerland with Dignitas to end his life. Who could not feel for him? Rugby had been his passion. What now had he to live for? His prospect, of a lifetime in that condition, would seem to be even more appalling than someone with having to live with cancer for six months. If the present bill was passed there would immediately be pressure to expand it in the direction of the laws in Canada, Belgium and the Netherlands. As Hannah Barnes pointed out recently, in the Netherlands there were 138 assisted deaths last year of people with a mental illness, the majority of them single women under 60 suffering from depression and one was under 20.

Supporters of the present bill focus on a number of genuinely hard cases, urging compassion for those dying of unbearable suffering. But the issue is not just about individual cases. If I was in a jungle and my companion was dying in agony with no means of alleviating their pain and he begged me to shoot him it might indeed be the right thing to do. But we are not dealing with an isolated incident with no repercussions for society as a whole. We are concerned with a change in the law and its effect on society as a whole not just in the immediate future but in the longer term.

It is predicted that there will be 1.4 million people living with dementia in 2040, at a cost of £90 billion. With the fall in the birthrate the cost of this and the care involved on a smaller working population will be huge. There could be great pressures for this burden to be eased by letting people faced with dementia opt for assisted dying. And if our only value is personal autonomy, why not? A distinguished academic for whom the life of the mind has been his raison d’être is diagnosed with Alzheimer’s. For him this is worse than death. He asks for assistance in dying. Compassion and a stress on personal autonomy could combine to accede to his request.

So the question is whether we want to go down that road? Some will say they do, and will press for similar legislation to that in Canada and the Netherlands. Others, like myself, will say no. We do not want a society like that with the real possibility of a  fundamental shift in its attitude to the sick and suffering. What we must  not do is delude ourselves into thinking that the present bill, if passed, will be the end of it. It will inevitably lead on to a campaign to widen it out, and the same compassion which drives the present bill will drive a new one into existence. Compassion is an emotion. It leads one to feel with the other person. But that does not tell us what is right. As a rational ethical principle compassion  simply places ‘the good’ in the front of the mind, the good of the person suffering. But it does not answer that question and it does not answer the question of how one might weigh up the good of one individual, in terms of shortening their suffering, with the loss of a major good for society as whole, by undermining a sense of  the essential worth and dignity of every human being whatever state they are in.

Proponents of assisted dying tend to regard it as just one more step in the great progressive march. But they are simplistic in their relentless focus on the suffering of a few high profile cases without facing the real issue which is about changing the law in a world where an originally tight law could move rapidly to one with a much wider remit. And they are philosophically naïve in refusing to see that a stress on compassion itself does not give the answer, but only opens up the question to a serious weighing of goods and ills.

[1] Declaration of interest: I recently wrote the play, which is called ‘The Clinic’