MERCY KILLING

The debate on mercy killing and assisted suicide continues unabated as the law struggles to find a way through the ethical morass.  The two terms and not synonymous.  Mercy killing requires intervention by a third party, almost always a doctor, where the sufferer is incapable of ending his life unaided.  Assisted suicide suggests the contrary, where the sufferer ends his own life unaided, although with the assistance of a third party, almost always a close relative or family friend.  This is not a distinction without a difference, but a fundamental difference, and one given prominence in the tragic case of Tony Nicklinson.  He has “locked in” syndrome, cannot move, and can only communicate by blinking his eyes. He wants to die, but as the law stands, he has no right to do so.

The debate on assisted suicide has moved on since Debbie Purdy’s case and the helpful ‘clarification’ by the Director of Public Prosecutions.  This ‘clarification’ suggests that relatives and friends of sufferers who take their own lives are unlikely to be prosecuted where it can be clearly shown that they were acting out of compassion and not in anticipation of an expected inheritance.

Mercy killing is far from resolved, and by all accounts, a proposed Bill to address this issue will fail to do so.  It will fail to help Tony Nicklinson, not simply because he is incapable of taking the necessary physical steps to end his own life, but also because he fails to meet the criteria.  These are that he has a terminal illness with a prognosis of only 12 months to live, and he must be able to take the lethal medication himself.  The ability to take the lethal dose unaided also applies to the Dignitas clinic in Switzerland.

Everybody with an opinion wants to ventilate it.  There is the Commission on Assisted Dying, the Care not Killing and the Right to Die lobbies, to name but three of the most vociferous, but surely to God it must be first and foremost the sufferer and his family and friends who should have the right to decide.

If the sufferer, like Tony Nicklinson, can communicate his wish to die, then in the name of humanity, let him die.  The idea that the doctor administering the lethal dose should be paraded in court and accused of murder is abhorrent to all right minded people in a civilised society.

By all means have safeguards and hoops to jump through to protect the interests of the sufferer, but once surmounted to the satisfaction of right minded people, and not lawyers or interest groups or lobbyists, let the suffering end.

Postscript  John Simpson, the distinguished World Affairs Editor of the BBC, is presenting a programme on BBC1 this coming Wednesday at 9pm, entitled “When I Get Older”.  It deals with many of the issues discussed in this article, and well worth tuning in.

AT DEATH’S DOOR

Assisted suicide, mercy killing, euthanasia, call it what you will, simply won’t go away, and it promises to run and run for years to come.

In the recent past, we have been treated to the outpourings of Martin Amis and Terry Pratchett on euthanasia and assisted suicide, and both merit our careful consideration.

Martin Amis, I suspect with tongue in cheek, advocates “euthanasia booths” on street corners where the elderly can end their lives with a martini and a medal. He predicts a “silver tsunami” of increasingly elderly and thoroughly useless people, stinking out the restaurants and cafés and shops, in constant conflict with the younger generation. He has a point, although not attractively made. More and more of our precious resources will have to be devoted to them, from the doctor’s surgery, to the hospitals, to the care homes and finally to the hospices. And as we all know, the state pension was devised to support the elderly into their mid seventies, not into their eighties and nineties.

I live in a retirement area, and although I am not in the first blush of youth, I find that the elderly can be unintentionally irritating on many levels. Driving behind them is an ordeal, queuing behind them at the checkout whilst they count out every penny, dodging their electric carts as they trundle down the pavement with a miserable expression fixed, rictus like, on their faces, all this and more is enough to test the patience of a saint. But beneath these petty irritations lies a deeper malaise. Medical science may well keep us going for longer and longer, but sadly, without the quality of life, it seems so terribly pointless. This is, or should be, the nub of the debate.

Terry Pratchett speaks with greater conviction, as he is in the early stages of Alzheimer’s disease, and in his opinion, a fate worse than death. He is probably right. His aim is for a good and rich life well lived, and at the end of it, in the comfort of his own home, and in the company of loved ones, to have a death worth dying for.

And finally, we now have yet another “clarification” of the law on assisted suicide by Keir Starmer, the Director of Public Prosecutions. It is not his fault, because he has been passed the poisoned chalice, but his “clarification” is meaningless. He simply repeats what we already know, that each case is unique, and each case must be considered on its own merits. We already know that Debbie Purdy’s husband will not be prosecuted if he assists in her suicide, and I like to think that all who fall into this category will also escape prosecution, but there is no guarantee. To put it bluntly, it is not a guarantee that any law officer can give.

All these are noble sentiments, expressed as they are against the backdrop of a society where old age is to be despised, not revered, and where elderly relatives are shipped out at the first sign of inconvenience, not to mention incontinence.

But back to the nub of the debate. It matters not to which God we address our prayers, there remains a fear of the unknown, and a fear of dying. It was Edward Fitzgerald who wrote:

“Strange, is it not? That of the myriads who before us have passed the door of darkness through, not one returns to tell us of the road, which to discover, we must travel too.”

But above all, and the strongest argument against euthanasia, or mercy killing, or assisted suicide, is to decide when the time is right, and most important of all, to decide who decides. Those suffering a terminal illness have been known to recover, as have those in a deep and apparently irreversible coma. Those, like Terry Pratchett, may still enjoy a quality of life, even in the advanced stages of Alzheimer’s, and once Terry gets there, and is presumably incapable of deciding when the time is right, who in the company of those he loves decides when to pull the plug? And is it ever possible to escape the suspicion, real or imagined, that this merciful release was not motivated by self interest on the part of those who remain behind? And how is it to be done? On a show of hands?

The same with Martin Amis’s euthanasia booths. If you are well enough to walk into such a booth under your own steam and of your own volition, you are presumably well enough to live another day.

There is no easy answer. I do not hold a torch for either side of the argument, as I can see the strengths and weaknesses of both. But we must ask ourselves one question. When we are old and frail, and perhaps lacking the quality of life we once enjoyed, is it not better to allow the forces of nature to decide our going, even if, to some, we should have gone a long time ago? I am not sure if I am ready to have my nearest and dearest circling my death bed like some carrion crow, ready to pick over the bones of my rotting corpse.

STAND NOT ON THE ORDER OF YOUR GOING

Assisted suicide, once again being ventilated in the courts, is an ethical and legal minefield, and one incapable of easy resolution. Whilst we cling to the questionable belief that in a civilised society human life is sacred, then suicide will remain anathema. To the Catholic Church, it remains a mortal sin, on the basis that God giveth, and God taketh away. To the “Right to Life” lobby, and other interested parties, assisting another to commit suicide is nothing short of murder by any other name.

The dilemma facing the courts is not about euthanasia, although this too raises many serious ethical questions, and in the recent past, the courts have taken a very compassionate approach to all but the most egregious cases where the terminally ill or senile demented have been helped on their way by their loved ones.

But with euthanasia and assisted suicide, leaving aside the ethical questions, it’s all about knowing when the time is right, and this is the dilemma facing the courts in an attempt to clarify the situation. The person wishing to commit suicide today may change her mind tomorrow, by which time it would be too late.

The public stance of the medical profession, for the most part, remains opposed to the ending of life by whatever means whilst the patient is still breathing, so short of DNR, no help there. And of course there’s the occasional well documented miracle, witness the advancement up the beatification ladder towards sainthood of Cardinal Newman, one of ours no less, who has claimed vicariously the miraculous cure of an American supplicant suffering from terminal cancer of the spine. An odd choice, you might think, deep in the sun belt, but who am I to question the wonders of the Almighty?

For the time being at least, those who want to commit suicide ‘with dignity’ beat a path to Switzerland, where they have a special clinic. But to avoid any repercussions from their own licensing authority, this clinic insists that the enrolees are sufficiently of sound mind at the time of departure to know what they are doing, and as importantly, to be able to take the medication by their own hand. These requirements are of little comfort to the terminally ill, who may be suffering from a debilitating disease which makes these requirements impossible to fulfil.

For the life of me [if you’ll forgive the pun], I cannot understand why the criminal law needs to get involved in this distressing area of life and death. The Act in question is the Suicide Act 1961, carrying with it the draconian sentence of up to 14 years imprisonment for those who assist another’s suicide. I can just remember 1961, but I can’t connect the two. What was happening in 1961 to bring about this misconceived legislation? I remember it was towards the end of Harold MacMillan’s tenure of high office, “SuperMac” as he was known in the popular press, and he who coined the phrase “you’ve never had it so good.” I also remember his resignation two years later, on the grounds of ill health, although he went on to live to a ripe old age, became the Earl of Stockton, wherever that is, and had a son who sold Highgrove House to HRH. Did “SuperMac” fear some Machiavellian plot to offer him the poisoned chalice for the good of the Party? I know not, but if anybody out there can throw light on the origins of the Act, then feel free to share it with us.

If the elderly, or infirm, or terminally ill, or senile demented, shake off their mortal coil in suspicious circumstances, then by all means bring in Plod. Rest assured that thorough checks are made on the deceased, as somebody in authority and with the necessary medical qualifications has to sign the death certificate. In suspicious circumstances, there will be a post mortem, so if the assisted suicide turns out to be murder most foul, that is the time to invoke the criminal law. In all other cases, leave those who remain behind to grieve their loss with the same dignity as those who have departed.

 

POSTSCRIPT

 

Nothing I read today [18th October] about the assisted suicide of Daniel James changes my opinion one iota. Such a pity that they had to travel to Switzerland. Time for a long hard look at our laws and the way we treat those most in need of our help.