Suicide was abolished as a crime over 50 years ago by the Suicide Act 1961. The same act ruled against encouraging, assisting or completing euthanasia on another. This latter ruling has been challenged by many UK cases since its creation, all of which have been unsuccessful as the government (and judiciary) remain reluctant to address the issue. But who can blame them when there is so much to consider?

Public opinion certainly seems to support change. Gallup[i] found that 70 percent of Americans support voluntary euthanasia if the patient and their family condone it, 27 percent oppose it and 3 percent have no opinion. The poll shows a clear desire for change, but the desire comes from an ill-advised audience who have little knowledge of this area.

So, let’s make sure we’re on the same page. Euthanasia will never be legalised in the UK. However Physician Assisted Suicide (PAS) may find its way into legislation one way or another. Only a qualified medical practitioner will be granted the power to end a life and only with certain safeguards.

“Death with dignity” is the pro-PAS argument which carries the most weight, presupposing that we all have a right to live with dignity and therefore should have a right to die with dignity. Ultimately preservation (or an extension) of the right to freedom is desired to help those suffering unremitting pain or constant low quality of life to help them end their life in a peaceful manner.

Controversy, however, arises from distinguishing at what stage in an illness or disease a patient should be eligible for PAS. It is estimated that 25,000 Americans[ii] would be relieved of unremitting pain should euthanasia be legalised. Is it fair that this many people live in suffering just because there is such a huge pressure on preserving human life? If an animal was suffering this badly with no sign of recovery, the vet wouldn’t hesitate to offer euthanasia. This essentially implies that in matters of death, animals have more dignity than human beings.

Unfortunately PAS is fraught with immorality. There is a general fear that if legalised, a ‘slippery slope’ will begin heading towards less life-threatening inflictions claiming for PAS and eventually as a way out of disability. Setting boundaries is the main concern government has. And even if boundaries are set, people with lesser inflictions may fear a lowering of the limit. Terminally ill patients are already under enough stress without this thought looming over them. The general public is uneducated in the difference between euthanasia and PAS which could lead them to believe that we’re heading towards assisted suicide for everyone.

Fear of euthanasia itself is a fair assumption. There are reports which cast doubt upon pro-euthanasia social systems. For instance dementia and other mentally ill patients can be granted euthanasia, which questions whether mental capacity is being considered fully. Plus opinions change and a desire to die may change from week to week, even with mentally sound patients.

Problems not only arise from the patient, but also from the administrator. In 2010 Cohen-Almagor[iii] discovered that 12 percent of nurses in Flanders (Northern Belgium) performed voluntary euthanasia and 86 percent were without the presence of a physician. Without official certification the system is open to abuse and more worryingly, a higher risk of complications in the euthanizing of patients.

A proposed alternative to the more extreme physician assisted suicide is suggested by Julian Savulescu. He proposed a doctrine of “voluntary palliative sedation”. This involves a willing patient to refuse any nutrition or fluid and instead is given painkillers to ease the passing off their life. The body will eventually naturally die from starvation but will do so in a hopefully pain free and dignified manner. If the right safeguards were put in place then this doctrine could prove advantageous.

DPP Keir Stamer set out the latest UK reform for euthanasia. However this reform was only a sentencing guideline in response to the controversy that arose from the case of Debbie Purdy. After 5,000 responses were submitted when the case verdict was given, the government was left with no choice other than to address the issue. Judges were previously unclear how they should rule on cases of euthanasia and needed guidance from the relevant authority.

In a hypothetical situation where PAS is legalised, there would be many guidelines and safeguards to consider. Consent must be given in a formal, written manner. A consideration period should be given to allow time for revocation. In this time lapse, the patient should be educated fully on the process of their death and the enormity of their decision should be highlighted extensively. Then the opinion of a second medical practitioner should be considered on each PAS decision. A mental assessment should be conducted to gauge their capacity to reach a decision. The family of the patient should be considered but the patient’s interests should remain paramount. An independent regulatory body should be introduced to oversee the system.

Parliament raise the issue of euthanasia every few months or so and will continue to do so indefinitely. Reform is highly sought after but nearly impossible to regulate in a just manner. For this reason it is unlikely we will see reform for a decade or two yet.

 

Sources:

 

[i] http://www.gallup.com/poll/162815/support-euthanasia-hinges-described.aspx

[ii] “What is the great benefit of legalizing euthanasia or physician assisted suicide?” Ezekiel J Emanuel page 635

[iii] “First do no harm: pressing concerns regarding euthanasia in Belgium.” Raphael Cohen-Almagor