On Euthanasia

This post was originally written in December 2008, the product of a BBC Panorama documentary that I watched at the time. It has since been revisited to tidy up the writing, though no substantive changes have been made.

The subject of euthanasia is one of the most charged topics that one could choose to discuss.

The argument goes beyond the simple notions of right and wrong. Ask a person on the street whether it is morally right to kill, and you would expect a reply of ‘no’ (or, perhaps, ‘what did he do?’). But ask that same person whether euthanasia should be legal or not, and suddenly the issue becomes much less black and white.

Why is that? If you take the two questions at face value, aren’t they the same? In essence you are asking whether it is right to end a life, aren’t you?

I think much of the difference lies in the way our culture works; we seem to be able to pick and choose our morality based on a given situation. Or maybe that is unfair. Perhaps we are brought up to obey different morals in different scenarios? In either case, the conflict with regards to euthanasia is a simple one to identify. It is the battle between the sanctity of life (a concept that I will go on to discuss in a moment), and a person’s right to end their suffering.

The majority of UK laws are the product of a time when religion – that is to say Judeo-Christianity – was much more prominent in society than it is today. As a result, these laws reflect those times – and the Christian principles on which they were based. With regards to euthanasia, the Christian religion is very clear. To take your own life (which is essentially what we are talking about when we discuss euthanasia) is just about the worst thing that you can do. God has given you life, and (in the eyes of Christianity) you have no right to take that from Him. No matter what how you are suffering, you must trust that God will call you (i.e. take your life) when He sees fit.

Not being a religious person, as arguments against euthanasia go, I find this train of thought troubling. I personally believe that the ending of tremendous personal suffering trumps the idea of a divine being holding you to an exacting standard. Furthermore, if there is a God, I would like to believe she isn’t so egotistical as to force a person to live in suffering simply because the alternative suggests they are ungrateful for their lot in life.

But I don’t want to make this discussion a theological one. For a stronger argument against euthanasia, I would turn to the idea of protecting the vulnerable. The issue of involuntary assisted suicide is, to my mind, the most convincing argument against. If a person is not in their right mind (I realise this one of those ‘catch-all terms’ for a range of things, and I use the term reluctantly) then how are we to be sure that death is really what they want?

It is well documented by both care-workers and the mental health profession that when people say things like ‘I don’t want to be a burden anymore’, they are actually seeking affirmation. When individuals reach the point of contemplating euthanasia, they are often-times in a position of great vulnerability – whether this manifests physically, mentally, emotionally, or a combination thereof. While not everyone with such thoughts fits into such a category, the law against euthanasia exists to protect those who do.

The question, then – ugly though it is, becomes about whether the collective suffering outweighs the collective need for protection. (This is, of course, something that could be the inspiration for an entire separate thesis; whether laws should exist for the protection of the few at the inconvenience of the many.)

To my mind, arguing for euthanasia is simpler. In the Panorama programme that originally inspired this post, there was an interview with a lady named Valerie. She was suffering for a particularly vicious form of MS, and had decided that euthanasia was the only option for her. Of course, such action is illegal in the UK and so she was making arrangements to visit the Dignitas clinic in Zurich, Switzerland. However she had a dilemna. At Dignitas, they require that the cup containing the euthanasing liquid be lifted by the individual themselves, with no assistance. This was not a concern for Valerie at the time of filming, but her condition was advancing rapidly and soon she would be unable to lift the cup at the clinic. She needed to go as soon as possible, but it would mean leaving before she was ready to say goodbye to her young grandson.

Now, obviously, laws exist precisely to remove the personal attachment to legal decisions. But it is also undeniable that cases such as Valerie’s do make anti-euthanasia laws in the UK seem heartless.

Switzerland is not the only country to have legalised euthanasia. Holland has, for the last 12 years, allowed ordinary GPs to administer lethal doses of medication to patients who wish to take the euthanasia option. It is a move that has a large number of critics, and the movement against it argues that this is making a difficult and unnecessary choice more accessible to people who may otherwise find other ways to deal with their situation.

The statistics, however, don’t actually support this argument. The figures for people wishing to be euthanised have remained pretty consistent. It’s also worth pointing out that not just anyone can stroll into a GP’s office off the street and ask for a lethal dose of diamorphine – and absolutely nobody is suggesting that it should work that way.

Instead the doctors in Holland have to know the patients incredibly well, and for a long time beforehand. Both the patient and the doctor have to want to do the procedure. If either is unhappy with any aspect of the idea, then other arrangements must be made. This holds right up until the plunger is depressed on the needle. The doctor will look the patient dead in the eye and ask ‘Are you absolutely sure this is what you want’. If there is even the slightest of hesitations or uncertainty then the process is stopped and reviewed.

To me, Holland’s approach to the delicate issue is one that makes sense. Humans are a pretty resourceful creature; if someone is determined to take their own life, they will find a way. Surely it is better that they have the guidance and support of a qualified individual – or indeed group of individuals.

Obviously there is another stumbling block here, this one in the form of the Hippocratic Oath. Somewhat ironically (in fact, not ironically at all, but by explicit design), those individuals who are qualified to administer such drugs at such doses are bound not to do so. 

Laws work best when there is a clear line separating what is legal from what is illegal. With euthanasia there is nowhere this line can be drawn, other than to make the action totally illegal. That is to say that in countries where euthanasia is legal, such as in our Holland example, there is an element of subjectivity. The law doesn’t do subjective very well.

And herein lies perhaps the biggest problem with the euthanasia debate. This is an argument that cannot be won with facts and statistics. It requires – demands, even – emotions and personal stories, like Valerie’s, to be considered. This why it is such a difficult subject to agree on. You have either arrived at your conclusion on principle, or because you have personally been affected by it.

If it is the former, it could be argued your viewpoint doesn’t matter. If you haven’t had some experience of it then perhaps you can’t fully understand the implications and complexities of the issue. If it is the latter on the other hand, if you have been personally affected by the issue, then I imagine your position is not likely to be swayed by any argument.

In the interests of concluding this post though, if a referendum on the issue was to be held tomorrow, I would vote in favour of legalising euthanasia. However, I would do so only on the understanding that proper protocols and regulations be put in place. My knowledge on such things is limited, but it seems to me that both anecdotal and statistical evidence supports the way that Holland approaches the issue.

One thing I am certain of: to say that the current system in the UK leaves a lot to be desired is, to people such as Valerie, a gross understatement.