Euthanasia in Europe: a morbid debate

The death of 22-year-old Vincent Humbert – after his mother administered an overdose of sedatives in his intravenous drip on the third anniversary of the car crash that left her son a quadriplegic – created a storm of controversy in France, and across Europe.

Marie Humbert’s attempt to end her son’s life was unsuccessful, leaving him in a coma. Dr Frederic Chaussoy switched off the life support machine on 26 September 2003, causing Vincent to die. Just a day earlier, Vincent’s book I Ask For the Right to Die – which he dictated letter-by-letter to his mother by pressing his thumb against her hand to indicate each letter of every word – was published. In 2002, Vincent had written to President Jacques Chirac, requesting the right to die, but to no avail.

Marie Humbert was arrested and released into psychiatric care. The law considers euthanasia to be wilful homicide or murder, and assisted suicide to be ‘a failure of the duty to rescue’ people in danger of death or grave harm. However, polls suggest that as many as 88 per cent of the French people favour a change in the law. And there is evidence that this recent openness toward assisted suicide and euthanasia is not restricted to France.

Throughout Europe, euthanasia is a big issue. Since April 2002, euthanasia and assisted suicide have been legalised in the Netherlands. Doctors administering a lethal dose must make sure that the request is voluntary and ‘well-considered’ and that the suffering is unbearable, with no possible amelioration. People aged 12 to 18 may be euthanised, on condition that their parents are associated with the decision; if the patient is younger than 16, the parents must agree.

The euthanasia debate in Germany has been rekindled by the case of 53-year-old cancer doctor Mechthild Bach, accused of killing 76 of her patients by giving them excessive doses of morphine. Euthanasia is also illegal in Spain, but one in six doctors privately admits to having helped people to die. One said: ‘We all know what is really going on. Normally it only happens in cases which are very clear, but it would be better for both us and for our patients if it were regulated.’

Belgium legalised euthanasia in September 2002 on a wave of public support. Doctors have registered some 200 cases in the first year. The first person to die under the legislation, 39-year-old multiple sclerosis sufferer Mario Verstraete, broadcast his death live on TV. His illness was not terminal, but he had been a passionate advocate of euthanasia. In Switzerland, euthanasia is outlawed but assisted suicide carried out ‘for non-egotistical motives’ is permitted.

At first glance, Vincent Humbert’s is a tragic case; all those involved deserve our sympathy. The response of the French authorities has been sympathetic, though they remain opposed to changing the law. French health minister Jean-François Mattei refused to countenance legislation, fearing that no amount of legislation can resolve what will always remain ‘a problem of conscience’. However, the openness to a change in the law across Europe is the consequence of an uncritical attitude that needs to be analysed – and challenged.

Firstly, since when were the words of a depressed young man taken as extraordinary wisdom? Vincent Humbert no doubt had much more reason to be depressed than others – but, as with most cases of assisted suicide or passive euthanasia, depression, not illness or pain, lay at the basis of his determination to die. The fact that he was able to write a well-read book gives some indication of the usefulness of whatever sliver of life remained in him. He might have – with much help – adjusted to this existence. Various studies suggest that pain is almost never the primary reason for requests for assisted suicide. It was certainly an afterthought with Humbert, according to his book.

It is increasingly clear that if assisted suicide is allowed, it will become impossible to deny any request. The Dutch law states that patients must face a future of ‘unbearable, interminable suffering’ and that doctor and patient must be convinced there is no other solution (1). But how do the Dutch authorities measure suffering? The truth is that neither they, nor anyone else, can.

Dr Philip Sutorius was prosecuted in Holland over an incident in 1998 when he gave 86-year-old former Dutch senate member Edward Brongersma a lethal cocktail of drugs, which the patient administered to himself. Brongersma, although physically well, had said he was ‘tired of life’. Fear of losing autonomy and decreasing ability to do enjoyable activities were the most reported reasons for Oregonians who requested assisted suicide in 2002. If a patient is articulate and determined, he or she will be able to find a doctor who will cooperate.

Most who support legalisation of assisted suicide and passive euthanasia do not support all suicides. But make no mistake – the widespread legalisation of assisted suicide and patient-led euthanasia will legitimise all forms of suicide, removing a taboo that has existed in every known human society.

The slippery slope argument, where some claim that legalising passive euthanasia will lead to the horrors of involuntary euthanasia, is not convincing – especially when images of Nazi eugenics labs are invoked. But involuntary euthanasia could become a real threat at a time when medical authorities are open about rationing medicine. Helene Gefflot wrote to the French daily Liberation, expressing her horror that doctors kept suggesting euthanasia for her paralysed and mute daughter. ‘For five years, we, parents and friends, fought against those at the hospital who wanted to use euthanasia on our daughter.’ The dangerous implications of a regulated legalisation of euthanasia is that the authorities will increasingly judge who has quality of life and who doesn’t.

Should medical officials be able to determine ‘quality of life’, they would inevitably use this clinical definition to determine who was worth saving and who was not worth saving. This is the concern of disabled activists Not Dead Yet (2) and other groups who disagree that quality of life can be defined clinically. This is no more possible than deciding which are ‘non-egotistical’ suicides, the ridiculous Swiss rule.

At the heart of this removal of the taboo against suicide is a crisis of meaning. In the past, organised religion made sense of life and death, of the travails we faced, and provided a ritualised exit when our time was up. Assisted suicide activists wish to legitimate their own myopic hopelessness, their own disenchantment with the future. They do not simply seek to die quietly but to spread their disenchantment with all human life and their gospel of meaninglessness and futility.

We are being asked to give the proverbial man on the bridge a push rather than to search for the real source of his torment. We should not belittle human suffering – but let’s remember that death is the antithesis of human life, not a potential solution for its problems.

Read on:

Life before death, by Kevin Yuill

Killing to be kind?, by Thomas Szasz

(1) Dutch court upholds euthanasia rules, BBC News, 24 December 2002

(2) See the Not Dead Yet website