The Assisted Dying Bill is an ethical muddle
On Friday, the Assisted Dying Bill will get its second reading in the House of Commons. If it passes, people can be helped to kill themselves, by law. Nothing like this has ever happened before in this country, which until now has based all medicine and law on the protection of innocent life. If one reads the Bill, the whole subject comes into clearer focus. Here are some points that arise:
1. In order to make people feel safe, the Bill requires the consent of the High Court (Family Division) for an assisted death to take place; the diagnosis of terminal illness by the “attending doctor” and by another “independent” doctor; a signed declaration of the patient’s desire to kill himself, witnessed by someone other than the doctors or a relation; and someone, not necessarily the “attending doctor”, to prepare and deliver the death-dealing medicines, and stay with the potential suicide until he is either dead or has changed his mind.
This whole process is in the charge of the Secretary of State for Health. Section 5 of the Bill provides for conscientious objection, so no one can be compelled to do any of the above. It is hard to imagine, however, that declining to take part would not damage the career of a politician (the Secretary of State), a High Court judge, a doctor or a nurse. Professionals who refuse to operate the law are always considered bores and weirdosand so are surreptitiously punished.
2. The people preparing and delivering the fatal drugs and helping the would-be suicide “ingest” them must, however, make sure “the final act of doing so must be undertaken by the person for whom the medicine has been prepared”. The person administering is not permitted to “have the intention of causing [the would-be suicide’s] death”.
This seems an ethically confused position. If, as the supporters of the Bill believe, it is good for a suffering patient to choose to die, why not – if that really is what he wants – kill him? Why not spare him the physical difficulty and mental anguish (he may be in a poor state, no matter how firm his decision) and do it yourself?
Here comes the well-known slippery slope: after a few years of watching people kill themselves, often with distressing incompetence, the argument for getting the professionals to do it direct will be presented as irresistible.
3. When the “assisting health professional” has delivered the drugs, he must then hang around until the person is either dead or has changed his mind and wishes to live. The definition of remaining with the would-be suicide can include “being in close proximity to, but not in the same room as, the person”.
How vividly one can imagine the scene: the nurse assisting ingestion, then leaving the bedroom to avoid the last convulsions, then re-entering after 10 minutes from the bathroom to check that all is “well”. Most people will surely find this etiquette for suicide-enablers macabre and the mind-bending demands it makes on the professionals cruel.
4. Since the terminal patients wanting to kill themselves must be adults of sound mind and settled will, there is no place, in law, for the next of kin. It could not be otherwise, of course, but it would have remarkable effects. It would be perfectly possible, for example, for the sick person to get the agreement of the court, the inspection and signature of the doctors, the delivery of the drugs and the presence of the assisting health professional, all against the will of his spouse and children. They could carry out the fatal procedure against the wishes of the people who love him most and who are in the house caring for him.
The force of law would be applied to extinguish life in the heart of the family which is struggling to maintain it. Is this a bearable idea in a legal order? Could a spouse be charged with impeding a suicide sanctioned by the state? If not, according to the Bill’s morality, why not?
5. Conversely, how easily could professionals discern the true will of the sick person if he is being bullied by his family? It is, sadly, not unknown for people to want their relations to die. If such people can achieve their end under the cloak of law, some will be ready to do so. This could be a particular factor when the passage of time is involved. Suppose a Jeremy Corbyn-led government had just decided to double death duties – would it be surprising if the assisted dying figures showed a spike in the months before the new rate came into force?