Tuesday 17 December 2013

Rage Against The Dying Light

Many mornings bring headlines concerning assisted dying or euthanasia, interviews with those campaigning for changes in the law and attitudinal surveys.

Those who advocate the legalisation of assisted suicide – such as the late Tony Nicklinson, a man with “locked in syndrome”, or Francis Inglis, who has just been released from jail having served five years for the murder of her son, described by Inglis as a “mercy killing” – are household names.

A historical overview shows that much has changed, both in the amount of attention given to the question and also in the stance taken towards assisting a suicide. Whilst there is substantial opposition to the various changes suggested, there appears to be increased support for assisted dying in terminal cases.

A YouGov poll last year found that 81 per cent of adults in the UK support the notion of mentally competent individuals with incurable or terminal diseases who wish to end their lives receiving medical assistance to do so, without those assisting them facing prosecution.

In the midst of the emotional debate it is useful to reflect on these changes and ask why have they occurred. As far back as the 4th century BC, the Hippocratic Oath stated: “I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan.”

In the Middle Ages in parts of Europe the act was understood as immoral. The theologian Thomas Aquinas condemned suicide as wrong because it contravenes one’s duty to oneself. In fact, it was only in the 1930s that things began to change, with the founding of the Voluntary Euthanasia Legislation Society and the introduction of a Bill to legalise euthanasia, which was defeated in the House of Lords.

The modern movement emerged in the 1970s when the campaign for voluntary euthanasia changed its language to associate it with autonomy, rights and choice. The idea of “dignity” in death was introduced by Representative Dr Walter W Sackett, Jr in Florida in relation to allowing the severely mentally disabled to “die with dignity” by refusing to treat infections and pneumonia.

It was in this period, according to the historian Ian Dowbiggin, that “[E]uthanasia ceased being defined as active mercy killing, with its disturbing overtones of coercion and social usefulness, and increasingly became viewed as personal freedom from unwanted interference in one’s own life”.

Why did this shift occur then? It’s not a question that has an easy answer and is greatly debated, but it is important to try to make sense of these developments. We are less religious, of course. Are we more compassionate?

It would be nice to think so, but at any point in history there was always someone at the bedside wanting to help. We do know that this was done – dying was “sped up”, that is – just not formalised in law nor spoken of.

Our contemporaries may be more vocal, less inclined to defer to the horrendously drawn-out event that death can be. Certainly, the personal is more political, a development that has gained momentum in the last 30 years. Medical developments have prolonged life; mostly for the better, but not always, and can sometimes be seen as a solution.

These factors have contributed to making it an issue. It’s also the case that people are more inclined to view it as a choice and a right; and there has been a proliferation of all kinds of rights talk in the last few decades, not just concerning suicide.

I want to offer an additional factor. The last two centuries have witnessed all kinds of political movements emerge, fighting for equality, power and better living conditions. Those struggles have not achieved everything they could and should, but instead of continuing, most forms of political activism have diminished.

The one campaign movement that has gathered support is the cause of assisted suicide. Whatever your position, you have to ask why so many hundreds of thousands of people now agitate for the right to die. That cannot be a healthy development.

Rather than the loss of belief in God influencing this state of affairs, perhaps there is also a loss of belief in life. The value of human life is consistently questioned in these campaigns. Indeed, the elderly and infirm are often seen as taking up valuable resources, a waste of space.

In a much-criticised statement, Baroness Mary Warnock said that we have a “duty to die” and that, “if you’re demented, you’re wasting people’s lives – your family’s lives – and you’re wasting the resources of the National Health Service”. Those with a terminal illness are rarely thought to have a good life. What is the point? too many seem to ask. There isn’t one, too many seem to answer.

This lack of faith in life is borne out in the way the campaign has expanded to include terminally ill children and even those who are sick of it all. Just this month the Belgian Senate voted 50 to 17 to legalise euthanasia for terminally ill children. I cannot begin to imagine how unbearable it would be to watch your own child die, but surely there is meaning to their life before they do?

In a poll published this month in the Journal of Medical Ethics, 26 per cent of the respondents in the Netherlands agreed with the idea that a doctor could help an elderly person to die who is tired of living. And 21 per cent agreed with the statement: “In my opinion, euthanasia should be allowed for persons who are tired of living without having a serious disease.” That’s too high.

In October, a Belgian man was killed by medical euthanasia after claiming that a botched sex change operation had turned him into “a monster”. He felt that his life was no longer worth living. Something is very wrong with this case.

Surely there were other solutions to his problems than being administered a lethal injection. It suggests there is a problem with removing the stigma of taking a life and affirming assisted suicide as a choice. It validates death in way that sends a frightening message – it tells people they are better off dead – a sick message for anyone to hear.

It’s possible to feel deep sympathy for the terminally ill and for those who think they have had enough, and not take the position that their lives are not worth living. We have a duty to them and our fellow human beings to rage against the dying light.

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