Monday, August 27, 2018

Assisted dying is simply another form of euthanasia.

The Economist, a Magazine that promotes a pro-euthanasia / assisted suicide position recently published a series of articles supporting and opposing assisted dying.

On August 23, 2018, the Economist published the following article by Dr Peter Saunders, the campaign director for the Care Not Killing Alliance UK.

Dr Peter Saunders
By Dr Peter Saunders.

“ASSISTED dying” is a euphemism. It has no meaning in law but it means supplying lethal drugs to people who are terminally ill with the purpose of helping them to commit suicide.

This is opposed in Britain by the British Medical Association, the Association for Palliative Medicine, the British Geriatrics Society and virtually every Royal Medical College.

It is also contrary to every historic code of medical ethics including the Hippocratic oath, the Declaration of Geneva, the International Code of Medical Ethics and the World Medical Association’s Statement of Marbella.

The line between assisted suicide and euthanasia is very thin. If a doctor places lethal drugs in a person’s hands it is assisted suicide, but on his tongue it is euthanasia. If the doctor sets up a lethal syringe-driver and pushes it himself it is euthanasia, but if the patient applies pressure or flicks the switch it is assisted suicide.

In one in seven cases of assisted suicide there are problems with “completion” leaving the doctor to step in to finish the job with a lethal injection, which is why legalising one inevitably legalises the other. There will also inevitably be those who claim that they are being discriminated against because they lack the capacity, even with assistance, to kill themselves, and so need someone to do it for them. Therefore, any law allowing assisted suicide only (and not euthanasia) would immediately be open to challenge under equality laws.

The reality is that assisted dying is just another form of euthanasia.

In Britain we have had myriad assisted-dying bills in various parliaments over the last 15 years. Each one has failed to become law due to legislators’ scepticism about so-called safeguards, and concerns about how these laws might be abused by those who have something to gain financially or emotionally from another person’s death. The three proposed entry criteria of “terminally ill”, “adult” and “mentally competent” have also proved malleable and open to interpretation.

Doctors are notoriously unreliable in estimating lifespans. As a result the definition of “adult” is easily open to extension to 12- to 14-year olds or younger, as seen in Belgium and the Netherlands, whose experience also shows how people who lack mental competence, for example with dementia, quickly get drawn in. Assessing mental competence is a specialised skill that not all doctors have, and depression, which increases suicidal thoughts, can be clouding a patient’s judgement.

In countries that have legalised any form of assisted dying, such as the Netherlands and Switzerland, we have seen incremental extension: an increase in total number of deaths and a broadening of categories of people to be included.

Legalising assisted suicide and/or euthanasia is particularly dangerous because any law allowing either or both will place pressure on vulnerable people to end their lives out of fear of being a burden upon relatives, carers or a state that is short of resources. Especially vulnerable are those who are elderly, disabled, sick or mentally ill. The evidence from other jurisdictions demonstrates that the so-called “right to die” may subtly become the “duty to die”. Feelings of being a burden were cited in 55% of Oregon and 56% of Washington assisted-suicide requests in 2017.

This is especially the case when families and health budgets are under financial pressure. Elder abuse and neglect by families, carers and institutions are real and dangerous and this is why strong laws are necessary.

All major disability-rights groups in Britain oppose any change in the law, believing it will lead to increased prejudice towards them and increased pressure on them to end their lives.

The safest law is like Britain’s current one, which places a blanket prohibition on all assisted suicide and euthanasia. This deters exploitation and abuse through the penalties that it holds in reserve, but at the same time gives some discretion to prosecutors and judges to temper justice with mercy in difficult cases.

Part of living in a free democratic society is that we recognise that personal autonomy is not absolute. And one of the primary roles of government and the courts is to protect the most vulnerable, even sometimes at the expense of not granting liberties to the desperate.

Dr Peter Saunders is the campaign director for the Care Not Killing Alliance

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