Doctors and disabled people’s leaders understand that any law allowing so-called ‘assisted dying’ would place pressure on vulnerable people to end their lives for fear of being a financial or emotional burden on others. Furthermore the evidence from other jurisdictions shows that ‘incremental extension’ or ‘mission creep’ is inevitable.
In the Netherlands there has been an increase of 10 to 20% of euthanasia cases per year since 2006. In 2012 these cases included 42 with early dementia and 13 with psychiatric conditions. Children as young as twelve can already have euthanasia and a 2005 paper in the new England Medical Journal reported on 22 babies with spina bifida and/or hydrocephalus who were killed by lethal injection in the Netherlands over a seven year period.
In Belgium there has been a 500% increase in euthanasia deaths over ten years between 2003 and 2012 including Mark and Eddy Verbessem, the deaf identical twins, who were euthanised by the Belgian state, after their eyesight began to fail; and Nathan/Nancy Verhelst, whose life was ended after a series of botched sex-change operations. They have now legalized euthanasia for children.
At the Dignitas facilty in Switzerland, people who could have lived for decades are ending their lives – with arthritis, blindness, spinal injury, diabetes, mental illness. The numbers include people who could not bear to live without their spouses.
Randy Stroup and Barbara Wagner were told that the Oregon Health Authority would not pay for their cancer treatment but would pay for their (much cheaper) assisted suicide. Is this really the kind of temptation that we wish to put before NHS managers, health ministers and families in cash-strapped Britain? Is it any wonder that over 120 other attempts to change the law through US state parliaments have failed?
Falconer talks about strict safeguards but his bill is both illogical and discriminatory because others will use the very same arguments of ‘compassion’ and ‘choice’ to push the envelope using human rights legislation for other ‘deserving’ cases. If adults can have it why can’t children who are judged to be ‘Gillick competent’? If competent people can have it what about those with dementia who it is argued would have wanted it? If people who are terminally ill why not the chronically ill or disabled who are suffering unbearably? If for those with physical suffering, why not those with mental suffering? Or as Philip Nitschke asks, ‘why not the elderly bereaved and the troubled teen?’
Changing the law would be a recipe for the abuse of elderly and disabled people. It would also give doctors a degree of power over life and death that some will inevitably abuse. It will be doctors who see the patients, fill out the forms, dispense the lethal drugs. Some of them will push the boundaries. Some will falsify certification. But many will simply be too busy, too pressured and facing too many demands to make the kind of cool comprehensive objective assessments that this kind of law requires. And very few will know their patients or their families well enough to be able to detect subtle degrees of coercion.
We have seen this already with abortion. We began with a very strict law which allowed it only in limited circumstances. Now there are 200,000 cases a year. Most of them fall outside the boundaries of the law. There is illegal pre-signing of forms, abortions for sex selection, abortions on demand for spurious mental health reasons; and only one conviction for illegal abortion in 45 years. A similar law for assisted suicide or euthanasia will be just as difficult to regulate.
Society is reluctant to touch and question doctors. The police will be reluctant to investigate. The DPP will hesitate to prosecute and the courts will fail to convict. Parliament will turn a blind eye. It is simply not safe to give doctors this kind of power. Far better not to go there at all.
The best system available is that which we have now – a law carrying a blanket prohibition on both assisted suicide and euthanasia but with discretion given to both prosecutors and judges to temper justice with mercy in hard cases. Our current law has both a stern face and a kind heart; and the penalties it holds in reserve act as a powerful deterrent to the exploitation and abuse of vulnerable people.
It also works – there are very few cases observed (around 20 per year make the trip to the Dignitas facility) but also very few prosecutions. Let’s keep it that way.