Put this campaign out of its misery

The publication of a report from the Commission for Assisted Dying last Thursday unquestionably set a cat amongst the pigeons. The commission was set up in 2010 by author Sir Terry Pratchett and Bernard Lewis, founder of the River Island fashion chain, with a remit to consider whether the current legal and policy approach to assisted suicide in England and Wales is ‘fit for purpose’.

Many newspaper reports attacked the commission’s lack of balance, given the boycott by several prominent opponents of assisted suicide and its funding and administration by proponents of a change in legislation. Not surprisingly, it found that, as the title of the report trumpets, ‘the current legal status of assisted dying is inadequate and incoherent’.

But it is the report that is inadequate and incoherent. It skims over huge philosophical issues and breathtaking contradictions, providing excellent reasons for leaving the law alone.

The language used gives a clue to which direction the commission wants us to go in. The world of the commission is not full of people but ‘service users’ and ‘service providers’; the phrase ‘health and social care’ appears no less than 114 times in the report. This report gives the viewpoint of ‘health and social care professionals’ – that’s doctors, social workers and lawyers dealing with health and social work legislation, to me and you – leaving parliamentary change to someone else.

The commission – chaired by the former Lord Chancellor, Lord Falconer – visited jurisdictions where assisted suicide (the report, to its credit, does not dispute the fact that assisted dying is assisted suicide) is legal. However, it dismisses all of them, preferring ‘British gradualism’ even to the system in place in the US state of Oregon, the basis of recent British legislative attempts. In the end, its recommendation is that competent adults over the age of 18 who voluntarily wish to die and who are suffering from a terminal illness with less than 12 months to live (differing from Oregon, where assisted suicide is legal for those with six months or less to live) should be assisted.

The report disingenuously informs us, arguing that present legislation is inadequate, that no prosecutions for assisting a suicide have taken place since the Director of Public Prosecutions set out criteria in 2010. ‘It is now almost universally accepted that there needed to be some change to the terms of the Suicide Act 1961.’ This is not altogether true and, not surprisingly, no evidence of this universal acceptance is included.

Though the report presents the idea that we are presently in legal limbo, what it fails to mention is the fact that then-MP Evan Harris seemed reluctant to report when asked the question in parliament: how many people have been convicted under the Act since it was passed more than 50 years ago? Zero. The DPP guidelines only made formal the informal guidelines used in the past: use discretion if prosecuting a case that looks like a mercy killing. If it ain’t broke…

But this is no good, snorts the commission! We must have ‘open discussion’ so that ‘professional assessment and support’ can be assured. The report expresses ‘significant concern that assisting suicide remains an amateur activity, and that no prospective safeguards are in place to protect those who seek assistance’. Indeed, the term ‘safeguards’ appears no less than 179 times in the report; the term ‘autonomy’, usually a big one for proponents, occurs only 68 times.

Safeguards are meant to assuage critics of assisted suicide who feel that legalising assisted suicide will threaten vulnerable people who might be pressured into an assisted suicide. But this is one area where we need not be worried; the authoritative Oregon Death With Dignity Act (ODDA) Reports indicate that very few people (less than half of one per cent of all those fitting the criteria) take up the option and there is no evidence to show that any vulnerable people have been snuffed out.

But the concern with safeguards chimes with the interests of the commission’s presumed audience of ‘service providers’. The report indicates a sea change in the arguments of proponents. Despite the image of smooth liberal rationality, proponents originally supported assisted suicide (or voluntary euthanasia as it was in those days) as a eugenic option to help rid society of undesirables up until the 1960s. Then it became a ‘right to die’ issue with our ability to make autonomous decisions at the heart of arguments for a change in the law.

This report attempts to move away from autonomy, perhaps recognising the inherent difficulties with the idea of a ‘Right to die’. Respect for autonomous decisions would have to include respect for the wishes of members of religious cults – like those who believed that the comet Hale-Bopp hid a spaceship they could access if they died – as much as the wishes of terminally-ill octogenarians.

Compassion – not surprisingly, given the service-provider perspective of the commission – emerges as an important consideration. But compassion is no less problematic than autonomy. If compassion is the most important criteria, surely it should be euthanasia – someone else doing the act – rather than suicide? The commission rejects euthanasia; it must be the patient’s choice that results in death – or suicide, as taking one’s life is commonly known.

Therein lies the biggest difficulty for proponents. How to justify allowing assisting suicides for some and not others? Moving the qualification point for assistance, from having six months to live to having 12 months to live, is arbitrary and belies the commission’s ‘core principle’ that ‘all forms of discrimination in end-of-life care should be ended as far as possible, whether these are based on geographical location, physical condition, ethnicity or wealth’. Isn’t this 12-month rule discriminatory on the basis of physical condition? Why suicide for some who suffer and not for others? After all, prominent suicides like Daniel James and proponents like Debbie Purdy would not be allowed to be helped to die by the commission’s recommended plan.

Assisted suicide is an either/or question. Either we give the thumbs up to all acts of self-destruction, whether they be for reasons of religious belief, suffering in the throes of a failed love affair or because of the onset of a terminal illness, or we continue to refuse to regard death as appropriate therapy. That is not to say that there are never cases where death is desirable, or that assisting or even causing death is always wrong. But these are individual – as opposed to institutional or bureaucratic – acts of compassion. The existing law generally works in dealing with these situations.

It is unlikely that we will see the back of ‘safeguards’ after this report. After all the admittedly small numbers of actual assisted suicides where it is legal point to the real demand that we be ‘safeguarded’ from the possibility that we may suffer at some point in the future. This report may be a harbinger for the future.

Kevin Yuill teaches American studies at the University of Sunderland in England, and is author of Richard Nixon and the Rise of Affirmative Action. Read a review of the book here, or buy it from Amazon(UK) or Amazon(USA).