Georgia L Gilholy is a freelance journalist.
To the surprise of zero people familiar with his tenure at the Crown Prosecution Service, Sir Keir Starmer recently admitted his support for assisted dying. The not-so-shocking revelation was made in the Labour leader’s phone call with broadcaster and campaigner Dame Esther Rantzen – who has expressed her own wish for an assisted death following stage IV cancer diagnosis.
Now, Rishi Sunak has also told journalists he is “not opposed” to assisted dying in principle. It seems, whatever crop of MPs wind up on the Commons benches on 5 July, our physicians’ duty to offer the “utmost respect for human life” could soon be turned on its head.
Much of the assisted suicide lobby, including figures like Rantzen undergoing their own health struggles, are genuinely motivated by the noble cause of reducing harm. However, jurisdictions where the procedure has been legalised offer a stark warning that this is rarely the result.
There are two forms of ‘assisted dying’: assisted suicide where the patient takes a lethal combination of drugs prescribed by a doctor at the patient’s request; and euthanasia which is the ending of a patient’s life by a medical professional who injects a lethal dose of medication into the patient.
The narrative of mercy could dominate campaigns to legalise both these procedures, but all too often airbrush their grim reality.
Dr Joel Zivot, who researched the autopsies of over 200 executed US prisoners, has emphasised how the common assisted suicide method of ingesting pills can be “horrendous” and often leads to a paralysing injection being administered “because many individuals are not able to swallow”.
Zivot has described this death experience as akin to drowning or being strangled. A patient’s ability to move or breathe has been overridden , but they are not blocked from possible mental awareness. This gives the false impression of someone at ease and who is continuing to consent.
The reality could not be further from this: the final moments of this person’s life are instead characterised by excruciating pain that is in no doubt exacerbated by the psychological distress of physical and verbal paralysis.
This dystopian “procedure” has, due to its obvious cruelty, already been banned as part of capital punishment in most US states that still permit the death penalty. It however remains a staple of assisted dying in the so-called liberal state of Oregon, upon whose framework Baroness Meacher proudly modelled the recent attempt to push for euthanasia in the UK.
While the Bill failed to acknowledge a role for doctors to take over and end life when complications occur (as they do in from 15 per cent to a quarter of cases in Oregon), how long until it is suggested that the law be expanded to facilitate this role? How many medics will do so without fear of an autopsy revealing their criminality, given that the cause of death will be predetermined?
If the supporters insist that the procedure only be deemed legal when consent is offered, why do they laud a system in which consent can surely not be truly secured, as so many patients are entirely deprived of their senses while their life is still in the balance?
In any case, we are wrong to assume that consent and choice are free-floating values, magically disconnected from social realities. Almost all of our choices, from the trivial to the life-altering, are influenced by external factors, including the people we surround ourselves with, and these influences are often exaggerated depending on the gravity of the decision we face.
A 2021 report from the Oregon Health Authority demonstrated just this. In a study that examined the state’s policy of medical assisted death from its introduction in 1998 to 2020, it was found that out of all patients who underwent an assisted suicide in 2020, over half were motivated by concerns that they were a “burden on family, friends/caregivers”.
It is hardly a leap, therefore, to suggest that stresses over social and economic support are an overwhelming factor in the majority of assisted deaths. Shoehorning in the policy as another “form of treatment” NHS doctors are obliged to offer the terminally ill at a time of increasing socio-economic crisis would risk pressuring vulnerable people, especially those with little to zero financial or social support, to end their lives.
Busy doctors will be ill-positioned to reliably detect social manipulation and coercion by families and partners wishing for a death they think will work to their financial or social advantage, and may themselves press upon patients what they think is a merciful death.
Courts in the Netherlands already hold that just as the “relief of suffering” can justify voluntary requests for euthanasia, it can equally justify the termination of those who are in no position to give voluntary consent. There are also plenty of patients who may simply come to see it as their duty to end their life as they become “too” old, ill, or depressed, and will opt for an assisted death due to an internal sense of guilt and obligation.
Meacher’s Bill would not have permitted such a person a voluntary death unless a doctor could estimate that they were already in six months of dying, but given that such legislation has been expanded in almost every jurisdiction where it has been permitted, this Bill if passed, would surely be no exception?
Although the Bill outlined strict preconditions for assisted suicide that do not include “suffering” (unlike in the Netherlands, Belgium and elsewhere), it is clear that the thrust of the euthanasia campaign being spearheaded by Rantzen and other celebrities is based on the premise that suffering is the reason it must be legalised.
Ask the average supporter why they support the procedure, and their first answer will probably revolve around helping people escape pain; even the Sunday Times announcement that it would be campaigning on behalf of Meacher’s Bill, led with the claim that it aims to stop “unbearable suffering”.
So either campaigners for such measures are alleging that mental and physical anguish only qualify as “unbearable” when a patient has a terminal illness likely to kill them within six months, and whom can give “voluntary consent” (the conditions for assisted suicide this previous Bill set out) or these more moderate plans are geared toward getting their foot in the door so they can then argue that it ought to be expanded.
Whatever the truth, they must be stopped.
Given that any measurement of suffering and pain is somewhat arbitrary and subjective, how can one comfortably claim that the anguish of grief or clinical depression, for example, is less painful than an injury or physical disease? These sensations cannot be measured in litres or decibels, and every person reacts differently to them.
It follows that the natural result of permitting state-sanctioned suicide due to ‘suffering’ is the extension of the permission for any person who judges themself to be suffering sufficiently to feel suicidal, whether it be a 90-nine year old with terminal cancer, or a 14-year-old girl starving herself due to anorexia.
The question of obtaining “clear” consent also persists in both situations. Is it even possible for a person with clinical depression, or say, a depressive episode prompted by a major disease, to make an uncompromised choice to pursue death?
This is already a reality elsewhere. In October 2020, a healthy 90-year-old Canadian named Nancy Russell ended her life by euthanasia after stating she wished to die rather than endure another Covid-19 lockdown.
Canada’s Bill C-7, passed in March 2021, further opened up euthanasia legislation to people of any age with disabilities or mental health conditions; Belgian law allows euthanasia if the patient is in a state of constant physical or psychological pain; in the Netherlands doctors can secretly sedate patients who have dementia before euthanising them, and euthanasia for anyone over the age of 16 is legal.
Already, throughout the pandemic, we have seen elements of the health system betray the dignity and right to life of persons with disabilities or mental conditions by issuing “do not resuscitate” orders without consulting patients or their families. These decisions were not just likely to have been unlawful, but are directly connected to several deaths, including that of a 58-year-old woman with schizophrenia and a deaf man in his sixties.
If our strained system has lowered itself to this point while healthcare professionals are still legally required to preserve life, what will be the knock-on impact of further cheapening the regard for human life, and the Hippocratic oath, by legalising assisted death?
The introduction of such policies in the next parliament would fundamentally alter our social fabric, overwhelmingly for the worst.
There are, obviously, a small number of compelling cases that make it easy for people to support euthanasia in theory. However, it is right that a small fraction of individuals in exceptional cases not be permitted to legally access assisted suicide if by doing so we would put vast swathes of vulnerable people at risk of unwanted and unwarranted deaths?
The hypothetical liberties of a select few cannot be permitted to trump all other considerations. Across the world, assisted dying policies are failing the vulnerable and driving them in droves to premature deaths. The UK must thoroughly reject them.