Yesterday TCW reported on moves in Germany to legalise commercial ‘assisted dying’ clinics. It is already permitted there for doctors or relatives to help single patients to die. Today a nurse explains why assisted suicide should not be permitted here.
SEVERAL attempts in the UK to legalise assisted suicide (the precursor of euthanasia) have been defeated. MPs and peers have said that they received more letters on this subject than on any other, asking them to vote against it. Opinion polls, as we know, repeatedly get it wrong, on this issue as on many others.
My experience as a young nurse taught me the danger of the ideology of legalised euthanasia and led me to found Pro-Life Nurses (UK).
We need to offer patients hope and trust in their health professionals, not the fear of being a burden. Patients do not need huge pressure to opt for ‘the way out’ which would inevitably occur. Audits in those countries and states where it is legal consistently show the reason given for it is fear of being a burden.
Here I set out some of the arguments given for euthanasia and assisted suicide, and our responses.
It is argued that euthanasia is a way in which people can willingly choose to end their lives in a dignified and painless manner.
Euthanasia devalues the lives of those who are seriously ill or disabled by saying that such lives are not worth living – that the negative feelings of people suffering these problems are quite appropriate, and that they are right to want to die. In contrast, if we hear about a suicide of a young healthy person who was jilted by a girlfriend/boyfriend, or whose career prospects were poor, euthanasia proponents don’t (usually) say that we should pay doctors to help them to kill themselves.
It is a mistake to think that, on the one hand, euthanasia is dignified and painless, and equally to imply that living with disability or grave illness is inevitably undignified and painful. Experience in Holland, where euthanasia is widespread, reveals that efforts to kill patients often go wrong, and that palliative care (which can enable patients to live through very grave illness in a dignified manner with control of pain and other symptoms) is far less widely available there than here in Britain, where the modern hospice movement began.
It is argued that euthanasia is actually a way to value life, as keeping alive terminally ill patients who are living in constant pain is a perversion of a life, a conscious torment of an innocent person.
This suggests that pro-life nurses take a ‘vitalist’ position, that all people should be kept alive indefinitely by all means. That is not our view – you might say that it is a caricature of our approach – although one that is often put forward by our opponents, and sometimes picked up by journalists. It is nonsense, of course, since it is impossible to keep anyone alive indefinitely.Appropriate life- sustaining assisted food and fluids should not be considered as medical treatment. We do believe it can be perfectly legitimate to withdraw medical treatment that is futile or that entails more burdens than benefits even if one foresees that withdrawing the treatment will hasten death. However, it is wrong to say that a life of suffering is a ‘perversion of a life’: this demeans those whose lives entail great suffering, either for a certain time, or for the whole of their life.
As for the point about euthanasia being a way of valuing life, we would reject this because it suggests that the ‘value’ of life is an abstract or collective value, not a concrete, particular importance, attached to the personal reality of an individual human being. This is an utterly disastrous philosophy, which in the past has been adopted by the most notorious political ideologues who have run states on the basis that the life of the people as a whole could justify eliminating individuals or classes of people who were suffering, or who were a threat to the community. People being pro-euthanasia does not mean they would espouse such an ideology, but I point this out because it results from the idea of promoting ‘human life’ in general as a priority over upholding the individual’s life.
It is often argued that these doctors might be acting as saviours, ending the suffering of innocent human beings, even though putting doctors in the role of killers is contrary to medical ethics.
The word ‘innocent’ here implies that the person’s suffering is being inflicted unjustly (unless perhaps they did something to cause it themselves). I would point out that much suffering arises without anyone seeking to inflict it or negligently allowing accidents to happen. We have a deep-seated need to understand the meaning of suffering, its causes and its purpose, but this does not entitle us to decide that those suffering are better off dead if we cannot come to terms with this aspect of the world. ‘Suffering’ can be caused not only by (uncontrolled) physical pain but by feelings of abandonment, or of being a burden. These feelings may impact on patients who may feel that society values only ‘quality’ or ‘productive’ life. Patients who suffer in this way are to be cherished by those charged with looking after them. A professional’s prime vocation is to show goodwill and compassion in caring for their patients’ physical, emotional, psychological and spiritual needs (holistic care) in liaison with the others who comprise the multi-disciplinary team.
People argue that everyone has the right to liberty and freedom of choice and question whether it is ethical to deny a human being the choice of ending their own suffering if they are mentally capable of making that choice.
We believe that people, in so far as they are able to make free choices, should do so within the scope of what is good and just. A person who has a sore finger should not be able to choose (unless with appropriate, expert advice) to have his hand amputated.
‘Unfinished business’ is a truly relevant concept here. Lack of practical help can increase the ‘suffering’ of those who depend on others’ utmost efforts to improve quality of life and deal with issues that need resolution. This may not always entail physical needs alone.
Supporters of euthanasia or assisted suicide argue that no one should be forced to lead a painful and degrading life.
The comments about understanding the meaning of suffering, above, are relevant in response to this argument.
My experience is that physical pain and suffering are not necessarily all-encompassing when patients feel loved and valued for themselves. Patient dignity is not contingent on physical condition but on trusting relations between patient and carers. Physical pain can be exacerbated by the anxiety caused by lack of support and understanding of true needs. The public have long-held expectations of professional expertise in time of need whether in birth or acute trauma or in the dying phase. Patients, whatever their state and time of life, do not truly expect their professional carers to be able to abolish symptoms together with their lives.
What patients want, in my experience, is competent, compassionate professionals, those who take the trouble to listen attentively to help patients overcome the challenges in life which we all need to face at some time or other, within a relationship of beneficence without threat of harm.