Assisted suicide: through the glass window
The assisted suicide campaign has been so successful that many now see suicide as dying with dignity; media coverage, especially on the BBC, has been so uncritical that arguments against it - from disabled and pro-life groups, and from those in the medical and caring professions committed to saving life rather than taking it - have only just begun to make an impact: there is no need for anyone to die in terrible pain, thanks to our excellent hospice system; however, the suicide approach inevitably poses the question, Why go to so much trouble when these people will die anyway? Moreover, in a time of public spending cuts, the expense of keeping such patients alive presents a tempting area for economies; already, some people with terminal cancer have been refused drugs that extend life by a few months because they are too expensive. In Oregon, instead, patients are offered a prescription for a cocktail of lethal drugs; if diagnoses and prognoses can be wrong, this is the one sure way of never finding out. Thus a simple solution becomes fraught with danger; dying and terminal illness become increasingly elastic concepts; and what about Alzheimers? Living wills, in which people declare that they do not wish to be treated should they become mentally incapacitated, are now legally binding under the 2005 Mental Incapacity Act - which does not, however, place any obligation on the NHS to treat those who wish to be treated.
Glass ceiling or glass window?
Media coverage of this issue assumes that the sick or disabled are surrounded by teams of medical experts, selfless carers, loving families, attentive friends - despite instances of disabled people being killed by those closest to them, and even those blessed with the most devoted carers know the pressures it can put on relationships. Sickness, disability and old age can mean isolation and depression; while there is compassion for prisoners, there is little for those who, through no fault of their own, are virtual prisoners in their own homes although, doubtless, the simple solution to their plight would be to offer suicide, using the same twisted logic that sees as an advance the idea of a sick person making an appointment with death, while rejecting as barbaric the idea that a condemned prisoner should choose the date and time of his own execution. Much concern is shown about the glass ceiling that bars the progress of certain people in their chosen careers, but the lack of understanding and empathy for the less able is like a glass window separating the sick from the well: we can see them, but we cannot hear them; however hard we try, we cannot truly appreciate their plight, and we think that we will never be where they are. The housebound are literally behind a glass window that shows us the beauties of nature, but also the life we used to live, now beyond our reach. Dependence on others, be they ever so caring, can engender feelings of being a burden, and it is frightening to think that if a vulnerable person with multiple, difficult to treat problems, perhaps including chronic pain, who may experience transitory (and understandable) depression, should say you would be better off without me, it would take only a seconds hesitation on the part of their carer to seal the fate of a troubled mind.
Right to die?
If the sick live into a social vacuum, so do the well: the most persuasive argument of the assisted suicide campaign is choice: why prevent people opting to die if that is what they want? Accustomed to choosing, constantly bombarded with images of perfect people, lacking direct experience of suffering, they may see suicide as a kind of insurance policy against unimaginable sickness, pain and dependency; paradoxically, the idea of sickness/disability is more depressing to the well than to the sick, but it is the avoidance of the sick by the well that the sick find most depressing. Paradoxically, too, should the well find themselves on the other side of that glass window, they would undoubtedly choose life, like the vast majority of those who have made that transition. As the law stands at present, their lives would be protected, enabling them to get them over the shock of a terminal diagnosis; but if the law should change, when they are at their weakest they may be handed a prescription for a lethal cocktail and, locked behind their own personal glass window, they will no longer find support from their health provider; obliged to remain neutral, he or she will no longer be able to cry, as to a man poised on a high ledge, Dont do it!
The concept of human rights grew out of the appalling atrocities of the Nazi death camps: the United Nations enshrined the right to life, the right to marry, the right to found a family; in contrast, the campaign for assisted suicide, if it succeeds, would usher in a culture of death - the very antithesis of human rights; as I outline in By Their Fruits: Eugenics, Population Control and the Abortion Campaign, the campaigns for abortion and euthanasia were rooted in Malthusianism and eugenics; Hitler and the Holocaust appeared to deal them a death blow, so that even prefacing euthanasia with voluntary seemed to suggest the exact opposite; however, the tide of public opinion began to turn with the notion of choice that had proved so persuasive regarding abortion. The parallel is instructive, for a poorly supported young woman with a newly diagnosed pregnancy is only too vulnerable to the idea of abortion, just as someone with a newly diagnosed terminal disease, unaware of the care options, would be vulnerable to the idea of suicide.
Now the good news
None of this is inevitable, but we must not assume that everyone knows about Oregon, or indeed, Nazi Germany; we must re-state basic arguments again and again, writing to the newspapers, emailing television programmes, contributing to radio phone-ins. Already it is difficult enough to get help for poorly understood conditions even for severe pain; in the 1930s, the Voluntary Euthanasia Society wanted euthanasia for tuberculosis and other diseases that are now treatable; the Nazi euthanasia campaign began with compassionate arguments about unbearable pain and ended in murder; it is clear that the impetus to find cures and treatments would vanish if society got used to taking the way of speedy death. Most people, once they hear the dangers of assisted suicide and euthanasia, will side with the pro-life argument; they can see only too clearly what is on the other side of the glass window: the one that separates all of us sick and well - from what is, and what might be, if the pro-death campaigners ever get their way.