A Very Dangerous Path

Kevin Yuill writes:

When faced with a painful and terminal illness, wouldn’t all of us want to avoid the agony of our final days? Why not have a farewell party with loved ones and friends, before going out quickly and peacefully with the aid of painless drugs? This is how Esther Rantzen outlines her case for legalising ‘assisted dying’ in the UK. But her reasoning is deeply flawed.

Rantzen, who presented That’s Life! from 1973 to 1994, which boasted 20million viewers at its peak, announced in a BBC interview this week that she has joined Dignitas, the Swiss organisation dedicated to helping people kill themselves. Rantzen, who has tragically been diagnosed with stage-four lung cancer, explained:

‘I have in my brain the thought [that] if the next scan says nothing’s working I might buzz off to Zurich. But it puts my family and friends in a difficult position because… the police might prosecute them. So we’ve got to do something. At the moment, it’s not really working, is it?’

Of course, nobody wishes for themselves or others to suffer at the end of life. But go beyond the immediate (and very understandable) emotional appeal of Rantzen’s argument and the case for assisted suicide unravels.

First of all, Rantzen is wrong about the law on assisted suicide. Nowadays, it is almost certain that her family would not be prosecuted for helping her get to Switzerland. In 2010, Keir Starmer, who was then director of public prosecutions, instructed the authorities not to prosecute individuals under the 1961 Suicide Act if it was not in the public interest. As a result, from 1 April 2009 to 31 March 2023, only four successful prosecutions have taken place for assisted suicide. None of those concerned the 540 Britons who have died at Dignitas.

The language used by Rantzen and by the media is also misleading. The term ‘assisted dying’ was adopted by those campaigning for assisted suicide and / or euthanasia (ASE) in an attempt to make death by lethal injection or ingestion of poison sound more palatable. Generally, ‘assisted suicide’ describes the act of helping another person kill themselves, while ‘euthanasia’ is when a doctor directly ends someone’s life. ‘Assisted dying’ or ‘medical assistance in dying’, as it is known in Canada, often refers to both assisted suicide and euthanasia. In Britain, parliamentarians have only ever proposed legalising assisted suicide, not euthanasia. Talk of assisted dying muddies the waters.

Legalising ASE in any form is unnecessary in any case. While it is understandable to be afraid of dying in pain, the overwhelming majority of deaths are actually peaceful. And those that aren’t may not necessarily be eased by assisted suicide or euthanasia. In the Netherlands, where both have been legal since 2002, a 2022 study found that between 29 per cent and 43 per cent of ASE patients continue to experience restlessness and pain in their last hours and days.

The best way to procure a good death is through hospice care. Unsurprisingly, hospice doctors, who well understand the complexity of death, are overwhelmingly opposed to legalising ASE. A 2019 survey found that 81 per cent of them were against it.

Assisted suicide is no guarantee of a ‘good death’. After all, it is existential rather than physical pain that motivates those who opt for ASE – motivations that are almost indistinguishable from regular suicide. In official reports coming from the US state of Oregon, where assisted suicide has been legal since since 1998, pain never appears in people’s top five reasons for choosing an assisted suicide. In 2021, the primary end-of-life concerns were: losing autonomy; losing dignity; losing the ability to engage in activities that make life enjoyable; losing control of bodily functions and feeling like a burden on family, friends and caregivers. The strange assumption of pro-ASE campaigners is that, instead of addressing these concerns and providing better care, it is more merciful to let people end their own lives.

What’s more, disability-advocacy groups like Not Dead Yet in the US and Care Not Killing in the UK are right to point out how the assisted-dying debate treats lives unequally. It tends to suggest that disabled people’s lives, for instance, are almost not worth living. Meanwhile, everyone agrees that the suicide of a healthy person should be avoided at all costs.

You can see this play out in Canada, where the criteria for eligibility have relentlessly expanded since ASE was first legalised in 2016. People are choosing (or in some cases encouraged) to die because they are homeless, disabled or incarcerated. And in the Netherlands there is an ongoing campaign to allow over 75s who are supposedly ‘tired of life’ to access assisted suicide. The clear implication is that these lives are not valued.

In Switzerland, anyone can seek out an assisted death. This is a recipe for senseless tragedy. Last year, two middle-aged sisters from Phoenix, Arizona disappeared out of the blue. Both had killed themselves with assistance in a Swiss suicide clinic. The pair were described as ‘healthy, happy medical professionals’. Their deaths totally blindsided their relatives.

It is a natural response, when greeted with the horrific news that one is dying, to try to avoid the unpleasant parts of life in its last stages. But legalising ‘assisted dying’ would take us down a very dangerous path.