Voluntary euthanasia: a deadbeat solution?

When Holland passed a law in December 2000 that would allow it to legalise voluntary euthanasia, many greeted this as a welcome development.

Legalising euthanasia – or assisted suicide – seems rational, even humane. Why shouldn’t someone terminally ill and in desperate pain be assisted in cutting that pain short by ending his or her life before nature takes its course? Why should doctors be under threat of prosecution for taking what are, after all, humane actions?

But there is far more to the discussion about legalising euthanasia than this pragmatic compassion. The popularity of the euthanasia cause today indicates a darker side to our attitude towards living – particularly among young men.

Of course there are cases where, in the last hours of life, it is only humane to hasten death. This is not a new problem, and euthanasia not a new solution. When situations like this arose in the past, doctors routinely administered a dose of morphine sufficient not only to stop pain but also to slow breathing to the point of stopping it. Nobody objected.

When Lord Dawson helped King George V to die in 1936, he confessed to the House of Lords with the justification that ‘all good doctors did this’. It is likely that this process continues today; yet no doctor has ever been prosecuted for such an action in the UK. By thrusting these situations into the limelight, campaigners risk making doctors nervous of taking such everyday humane decisions, and could prolong suffering as a result.

With today’s modern drugs, there is little pain that cannot be alleviated. Those involved with the hospice movement – in general, fierce opponents of legalisation of euthanasia – point out that no study to date in any country has shown that pain plays a major role in requests for assisted suicide. The problem, they insist, is psychological rather than physiological pain. Those in the hospice movement feel that this pain is curable, whatever the physical disease.

One of the facts lost in this often-heated debate is that there is very little demand for voluntary euthanasia. Though one might suppose otherwise, those most opposed to legalisation tend to be the over-70s. In Holland, where it has been decriminalised since 1986, only two or three percent of all patients with terminal illnesses choose voluntary euthanasia. In the state of Oregon, where voluntary euthanasia has been legal, 23 persons (18 of whom had cancer) received prescriptions for lethal medications, 15 of whom died after taking the medication. Prominent campaigners for legalisation like Annie Lindsell in Britain and 1960s acid guru Timothy Leary in the USA backed out of suicide before dying naturally.

Many of those who wish assisted suicide to be made legal are relatives and friends of a loved one who suffered a prolonged, agonising and progressively wasting death. A once-powerful, vigorous father or energetic and caring mother lapses into helplessness, physically and perhaps mentally wasting away. Children, grandchildren, sisters and brothers who witness the death vow never to allow themselves to get to that state. This is understandable – but as Elizabeth Kubler-Ross, author of the 1960s classic On Death and Dying, argued a few years ago, helping somebody to die can mean ‘projecting your own unfinished business’ on to that person.

A far more disturbing feature of the euthanasia discussion today is that, according to surveys carried out in the USA, those most strongly in favour of legalisation of assisted suicide are males aged between 18 and 44. Anybody wishing to see the case for legalisation forcefully put needs only to type ‘voluntary euthanasia’ as a search term on the internet. Here, the issue of death comes to life.

In this newest medium dominated by the young, well-educated and forward-thinking, one may peruse macabre sites like ‘Deathnet’, ‘LibertyNow’, and the ‘Dying Well Network’, as well as the more established groups like the Voluntary Euthanasia Society. Mocking the words with which Martin Luther King proclaimed his message at the Lincoln memorial in 1963, the ‘Last Rights Journal,’ a pro-euthanasia website, carries a photograph of a skeletal dying or dead man with the caption, ‘Free at last!’. Free to do what, exactly?

Many of the sites reflect a strange sort of new-age religious affectation, suggesting that the clamour for assisted suicide stems from the need to replace the rituals surrounding death within more established, less esoteric religions. For instance, the Hemlock Society – one of the more established campaigning organisations for liberalisation – has a branch in Greater Pittsburgh that provides a ‘chaplaincy team’ who will travel in or out of state ‘to prepare the terminally or hopelessly ill spiritually for self-delivery, and then guide them through a peaceful entry on the Other Side’. The chaplaincy team boasts that it ‘builds on extensive research in near-death experiences’.

Behind the brave calls for freedom, civil rights and autonomy by these campaigners lies a fear of life and living. In the prospect of death many find the certainty that seems to lack in life. Generations past felt able to face any challenge, including disease and death. Today, many feel abandoned by God, alienated from humanity, mistrustful of doctors and unable to cope with the realities of life. Assisted suicide is the comforting arsenic pill to take behind enemy lines for those who view human society as the enemy.

To encourage this dim, solipsistic view of life – that death is a solution to what are clearly problems of living – not only encourages a morbid defeatism among those looking for a way out. It risks demoralising all of us. Whatever those who run ‘Deathnet’ and the ‘Dying Well Network’ want to do to themselves, how much do they consider the impact that suicide – done for whatever reason – can have on those they leave behind?

Some years ago, my friend Collin disappeared from the small Canadian town where we both had grown up. I was 18 when he left, suddenly, on a Friday. On Saturday his mother rang to see if he had stayed the night at our house and he didn’t turn up to a social event in the evening. On Monday, a mutual friend called to say that Collin had been found dead in a hotel room in a nearby American city. He had blown his brains out with a pistol. He left a one-word note saying ‘sorry’.

This event that cast such a deep pall over the town marked the end of my childhood. For weeks and months afterwards, my friends and I could talk of nothing else. Why had he done it? Had we failed him? In the end, we decided that Collin lacked the courage to deal with his problems and, more importantly, respect for those he left behind. His mother literally stopped talking for three months; his father took six months off work. His older brother spent all of his time at the local bar, and his 14-year-old sister would run sobbing from her classroom to her home. Even those who barely knew him talked in whispers and shook their heads when his family’s name was mentioned.

Collin rejected not just those around him but the glorious possibilities of the future, the awe and wonderment of life’s experiences. As a friend put it at the time, ‘Collin pissed all over the rest of us’. Years later, I still feel some sort of anger mixed up with sadness when I remember him.

There is a similarity between the casual disregard for life that Collin felt and the perspective of campaigners for voluntary euthanasia. Our families and friends constitute a large part of our lives; if somebody close dies there is a sense that a part of us dies with them. Even if the wishes of families and friends are taken into account when the question of voluntary euthanasia arises, the question of the relation of the individual to broader society emerges. How much do individuals owe in history and heritage – in the culture, or the cultures that have formed them – to the international communities that have existed among merchants, clerics, lawyers, agitators, scholars, scientists, writers and diplomats? We are all made by our languages, our literature, our cultures, our science, our religions, our civilisation. We owe a debt to the world and to the global community. Human life extends beyond the contours of the body.

The most corrosive effects of liberalising current law would not be a surge in demand for euthanasia, but the implications for wider society. As disabled groups rightly ask, who will define ‘quality of life’, a criterion for decisions regarding voluntary euthanasia? If it is the individual, all suicides, including those like Collin’s, must be allowed and perhaps even assisted. If it is the doctors, what criteria will they use to evaluate an individual’s quality of life? Some terminally ill patients live active and productive lives during their last days, others with the same condition do not.

To relativise life, as if it were no better than being dead, is dangerous as well as stupid. If we do not regard all human life as worth preserving, we will be forced to question laws that regard taking a life as murder, whether that life be an elderly, terminally ill hospital patient or a young person with many years ahead.

Nobody can save Collin from the fatal decision he made, or the impact that had on his loved ones. But we can discourage the view that death remains an attractive alternative to the difficulties of life.