Inevitably an MP’s direct personal experience has a strong bearing on his or her views on ethical and moral issues, which are rightly subject generally to a free vote in parliament. My own father’s terminal cancer and death almost twenty years ago, for example, played a fundamental role in formulating my own views on pain relief in the latter stages of life. As his next of kin, I played a role in working with our long-standing family doctor to ensure my father had enough morphine to ward off pain as his illness advanced. That decision may well have shortened his life by a few days, perhaps even weeks. I did not consider this to be wrong. But at the same time, this experience reinforced my instinctive reluctance to see the superficially desirable extension of freedom of action in this area to be enshrined into law.
A more difficult ethical dilemma arises in the case of incapacitating conditions which fall short of terminal illness. One such instance applied to Andrew, an old university friend, who lapsed into a diabetic coma in 1996, spending the next thirteen years requiring twenty-four hour care without being capable of voluntary movement or even the most basic communication. In Andrew’s case it was impossible to assess the quality of his life in any meaningful way – whilst it was clear that he retained high levels of understanding, he was unable to communicate the extent of his daily pain. I genuinely feel he took pleasure from aspects of his life and the dedication of his parents and carers brought huge rewards for all in contact with him. Beyond his nearest loved ones who should have had any right to judge objectively the worth of his existence?
As some readers may know, I have written about this most sensitive of subjects before on this blog. I write about it again not only because Andrew’s recent death brought it to the forefront of my mind but because the move towards a change in our current law on assisted dying seems to be gaining momentum. The Director of Public Prosecutions, Keir Starmer QC, is currently looking at relaxing the guidelines for prosecutions in assisted dying cases and a Bill that has just been published in the Scottish Parliament seeking to give terminally ill people the right to die will no doubt stoke the fires of the debate here.
For MPs, the issue leaves us with a grim dilemma and it is left for us individually to make the call on how best to balance the passionately held views of those on both sides of the debate. I suspect the automatic reaction of many in the face of the deeply moving cases we see every so often in the courts would be to legalise assisted dying. Surely, the argument goes, there is room for compassion in the legal system, provided appropriate safeguards are in place to prevent abuse?
Similar arguments were put forward in the debate which preceded the Abortion Act 1967. Abortion would be reserved for the most desperate and vulnerable. Yet some forty-three years since that law came into place, we now see advertisements inviting women to ‘Walk In. Walk Out’ for lunchtime terminations. I am by no means anti-abortion or indeed lamenting the introduction of that Act back in 1967. Of course for most, an abortion remains a deeply difficult personal decision that can cause lasting emotional trauma. But Lord Steel, the architect of that Act, has himself admitted that he never anticipated ‘anything like’ the current number of terminations and said that ‘parliament never intended the law to be used in that way’.
Do we want to be making those kinds of statements a few decades on from an Assisted Dying Act? Difficult cases make bad law and it should be the first duty of the state to protect the lives of its citizens, not leave them vulnerable to the manipulation of legislation. The reality is that nobody has been imprisoned in the nearly fifty years since the Suicide Act 1961 and in that sense, the current system can work provided we apply a common sense approach.
We must accept too that there can never be sufficient safeguards once the state legalises one type of death at the hands of another. There can never be a safeguard, for instance, which prevents a vulnerable and confused person from feeling they have a duty to ask a doctor in private to end their life prematurely. Nor can you prevent a selfless person from seeing a law permitting euthanasia as an opportunity to cease being a burden – even when they have no wish to die themselves. The current law gives vulnerable people the permission not even to consider whether they should seek a premature death – and in doing so relieves them of a significant burden when they may face enough struggles in dealing with the illness or disability itself.
An acceptance of assisted dying not only carries the risk of the right to die developing into a duty to die. It makes way for the inadvertent sanitisation of death.