Assisted dying

There has been a lot of discussion about this of late, mainly driven by the votes on the subject in Westminster and the York synod. It is a very emotional subject, and one that I find it challenging to comment on. However, I am going to try to discuss it here, because twitter really does not provide the space to explore properly.

I should point out that I am opposed to assisted dying, as a core starting point. I am also opposed to people suffering, which provides an interesting dynamic. So how do I find a balance between them? It is difficult.

There are two categories of people for whom assisted dying might be applicable. The issues are very different between them, very significantly differing challenges for each:

1. Those who are terminally ill. these are people who have an untreatable illness, and who are going to die whatever, within a relatively short time-frame. In some cases, these people are in significant pain, and they might no longer be responding to analgesics.

Is it appropriate that these people should be allowed to die? All they have to look forward to is a few more days or weeks of pain. the difficult challenge is that many of the stronger pain drugs - like heavy doses of morphine - tend to reduce breathing and shorten life. Is this assisted dying? Do I believe that these people should not be given these pain relief medications because there is a good chance of it reducing life expectancy?

No I don't, because the relief of suffering for these people is crucial. The impacts of this - including the earlier death of the patient - are acceptable, because the intention is to relieve pain, while accepting the effects of this. If a patient can be out of pain for their last few days and weeks, that seems to me to be a positive thing, a way of valuing their humanity.

But why not a little higher dose, to reduce the suffering a little more? For me, this is arguing that the persons life is no longer important. It is a fine line, and I would be very cautious about criticising someone for just overstepping this line. It is not a clearly defined position. But to actually plan and decide to take a life is a different thing. I do not believe that doctors or relatives should be put in the position of making this decision. This is killing people, not relieving their pain.

2. Those who are disabled, but not in immanent danger of dying. I should point out that, as I understand it, the discussions at the current time do not cover these situations, and there are no plans to introduce legislation to allow assisted dying in these cases. However these cases are important, because there are those in this situation who would like the right to die. The problem in this case is that the aim is not to reduce pain (suffering yes, but not pain), but to actively terminate life. It is not simply reducing life expectancy by a matter of days or even weeks, but by years.

I do not wish to diminish the suffering that physical disability causes. This is especially the case for people who were active and (maybe through an accident) lose the usage of some parts of their body. This is difficult to come to terms with, as are many changes in life situation. I do not dismiss the difficulty that people have in coming to terms with their completely different way of life that they are facing.

But I still do not believe that they should be allowed to end their own lives. There are two issues with this: firstly that physical ability is not the definition of a worthwhile life; secondly, what does this say about our attitude to disabled people?

There is, from this, the slippery slope problem. If you accept that a quadriplegic can be allowed to die, what about a paraplegic? What about an amputee? At what point does life actually be worth living, something which is different for different people. If you say that certain people can be allowed to die, the implication for others in a similar situation is that they are worthless. If you say that some levels of disability make life meaningless, what does this imply about our understanding of disabled people with lesser disabilities - that they are less meaningful? They they are not proper people?

And no, most people don't argue this, at least not explicitly, but there is an implication here that disability is a less-than-human existence. I cannot accept this, because these are still people, still valid and valuable human beings, who we should value.

"Oh," some people say, "should people not be ale to have the choice to die if they want to? Who are you to tell someone that they shouldn't be allowed to die?" Of course, individual choice is an important aspect of life, but - and for me this is the critical issue - it is not all. I have some free choice, but not in all things. There are aspects of life that I do not have choice and control over, because I am a member of society, of a community. I have relationships with others, which also impacts my freedom to do things. Should I have the right to take my own life? If I were to do so, it would impact on my family, my friends and all sorts of people who might have to deal with this act. I should not be allowed to take my own life, easily and simply, just because I am having a difficult time.

The problem with those who are disabled wanting to take their own lives is that it may ease the challenges for the person suffering, but it doesn't help those left behind. It doesn't help those left behind, because they will always have to accept that they enabled the disabled person to die - they will have to come to terms with the fact that they killed someone. The medical staff in particular will need to accept that instead of caring for a patient, they have to kill them. I am not sure that I would like to put that onto these people, who have quite enough difficult decisions to make.


So assisted dying? I think this is a wrong route to take. I know that others will disagree, and I accept that, but this is my position, my arguments, my conclusions.