Assisted dying by the backdoor
Quiet developments are shifting the UK law on ending life.
Though assisted dying seems to have been out of the news, several quiet developments have furthered its cause in the UK. First we have the highest judge in the land, Lord Chief Justice Woolf, supporting a move by the Home Office to set gradations of sentences for murder.
When asked about mandatory sentences, Woolf noted the differences in murder: ‘If you intend to kill someone deliberately then a life sentence may be the only appropriate sentence. But you can have someone who has a relative who is suffering pain of severity which someone in my position can only try to imagine, and they feel it’s what that person wants – to be relieved of that misery. To treat that person as you treat someone who deliberately kills for a different purpose is very difficult.’ (1)
It is instructive that Lord Woolf used the example of assisted dying to make his point. Though it surely makes sense to give judges (or even better, juries, as in the USA) discretionary power over sentencing, distinguishing between different gradations of murder really creates a differential approach to human life. If we say that the taking of some human lives in specific circumstances is less important than the taking of others in other circumstances, we undermine an important legal and moral principle that holds that the taking of a life – any life – is a terrible and heinous crime. Some lives are apparently worth more than others. The dire predictions of some disabled activist groups who oppose assisted suicide – that it may lead to involuntary euthanasia – could become legal reality.
Just imagine it: ‘In my client’s defence, your honour, the deceased was elderly, had limited use of his legs, smelled of urine and was not particularly well liked [and supported Manchester United, though he probably played for Man City]. My client felt that the deceased wanted to be relieved of that misery.’ This may be flippant, but recall the case of James Lawson, who suffocated his 22-year-old daughter in 2001 with a plastic bag because she was severely depressed. Protection of life is an all-or-nothing issue. Either we value all life in law – young, old, rich, poor, healthy or ill – and indicate that value by putting an equal penalty for the intentional killing of another, or we must grade it.
A second development is that the British Medical Association (BMA) voted last week to change its position on assisted dying. Previously, the BMA had opposed all attempts at legalising assisted suicide or assisted dying. However, on 30 June the BMA voted for the following motion: ‘The BMA should not oppose legislation which alters the criminal law but should press for robust safeguards both for patients and for doctors who not wish to be involved in such procedures.’ One more determined foe of assisted dying has fallen by the wayside.
Actually, the BMA has simply washed its hands of the issue, declaring that it is for society and parliament to decide. This is another failure to take responsibility for decisions that good doctors must make – which is part of a disturbing pattern (see Ducking life-and-death decisions, by Liz Frayn).
In fact, what made assisted dying more attractive to doctors, as Anne Somerville, Head of Ethics Secretariat of the BMA told the BMA conference, is that the Oregon model, as opposed to the Dutch model, allows doctors to remove themselves from the death-bed scene. Whereas in Holland, doctors must administer the lethal drugs in an assisted dying case, in Oregon they only write a prescription.
This does not bode well for patients. In Oregon, as elsewhere, the main reason for patients requesting information on assisted dying as well as the reason for taking their own life is depression. Thus, doctors in Oregon, faced with a difficult case of a terminally ill person with (fairly understandable) depression, simply write out a prescription for death. Then it is up to the patient, not the doctor, who is only fulfilling the patient’s request. Priests and ministers have already left the deathbed scene; now the doctor’s chair will be empty too.
Perhaps worst is the opt-out clause in the BMA motion – ‘robust’ protection for those doctors who do not wish to be involved. Patients will no longer be able to look their doctor in the eye and know that, when the time comes, the doctor will do the right thing. ‘Oh no’, says the doctor. ‘Clause 48 of Section 3.22 of the relevant legislation protects my decision not to.’ This moral cowardice will further undermine the doctor-patient relationship. When Lord Dawson helped King George V to die in 1936, he confessed to the House of Lords with the justification that ‘all good doctors did this’. This is still the case, I hope; all good doctors will continue to do this.
Assisted dying is slowly being realised not by dramatic debates and public clamour, but by those most concerned opting out, leaving ethics committees to decide these things. Not with a bang, but a whimper of the most abject sort.
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