TOPIC GUIDE: Assisted dying

"Physician Assisted Suicide should remain illegal"

PUBLISHED: 01 Sep 2009

AUTHOR: Helen Birtwistle

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INTRODUCTION

The question of assisted dying has not been out of the media spotlight in recent months. In July 2009, campaigner and MS sufferer, Debbie Purdy, won an historic battle for clarity over assisted suicide laws when the Law Lords agreed that her husband would not be prosecuted if he assisted her in her venture to commit suicide by taking her to the Swiss clinic Dignitas [Ref: Dignitas]. A spate of campaigns, sympathetic TV dramas and documentary films on the subject, with Gordon Brown’s announcement that he is firmly opposed to assisted dying, have revived the debate about introducing a change to the law to assist terminally ill patients who request the ‘right to die’. Proponents of assisted dying aim to give people the ability to control their destiny, but there is also concern that loosening the law would be a slippery slope and fear that a change in the law would lead to an increasing prevalence of assisted suicide and could open the door to euthanasia. Critics, both secular and religious, oppose any new legalisation. They emphasise the value of life and argue for a focus on prolonging life or palliative care. Advocates of assisted dying retort that legalisation would allow the practice to be publicly regulated and scrutinised. They point to what they say are successful changes to the law in Belgium, Holland, Switzerland and the US state of Oregon. Ultimately, the debate is a moral one which, aside from the legal and medical issues, asks us to decide whether it is ever right for doctors to assist someone in bringing about their own death.

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Assisted dying DEBATE IN CONTEXT

This section provides a summary of the key issues in the debate, set in the context of recent discussions and the competing positions that have been adopted.

What are the terminological distinctions to be aware of?
Debates over assisted suicide and euthanasia involve a complex array of distinctions; different sides in the debate use different terms to describe the same practice. A useful framework for this debate is provided by the campaign group Dignity in Dying (formerly the Voluntary Euthanasia Society), which campaigns for ‘medically assisted dying’ and was joint author of the Assisted Dying for the Terminally Ill Bill [Ref: BBC News]. When a doctor indirectly assists a patient to die by prescribing medication that will enable the patient to end his own life, it is known as patient assisted dying, also commonly described as physician assisted suicide. When a doctor directly assists a patient to die by administering lethal medication at a patient’s request it is known as voluntary euthanasia. In practical terms some argue that assisted dying and voluntary euthanasia are indistinguishable. Fundamental moral arguments tend to apply to both, but some feel there is less moral responsibility involved, on the part of the doctor, in physician assisted suicide.

Should the law change?
Whilst the proposed amendment to the Coroners and Justice Bill demands a change in law to protect those who help terminally-ill relatives and friends travel abroad for an assisted suicide, campaigners admit that the long term aim is to provide the terminally ill with the choice of a physician assisted death in the UK. The Assisted Dying bill would have permitted patient assisted dying but not voluntary euthanasia. It sought to allow a doctor to give a prescription for lethal drugs to a legally competent patient who had requested them and who was suffering ‘unbearably’ from a terminal illness, likely to result in death within six months. A survey suggested that three-quarters of the public were in favour of the legislation [Ref: epolitix]. Proponents pointed to the Bill’s stringent safeguards and they continue to argue that legalisation would prevent ‘back-street suicides’. Opponents remain concerned about pressure being exerted on the elderly and infirm to choose death. Disability rights campaigners argue that in a society where disabled people are not treated as equal citizens, a ‘right to die’ would endanger disabled people’s right to live and have their lives seen as of equal value.

Would a change in the law undermine the role of doctors?
Many doctors are concerned about assisting people to die, feeling it goes against the idea in the Hippocratic Oath that doctors should not cause harm [Ref: BBC News]. Some doctors feel that a change in the law would turn them into ‘executioners’ and so poison doctor-patient relations. Advocates counter that a major part of a doctor’s role, particularly in terminal cases, is to ease pain. Individual doctors who disagreed with assisted suicide could ‘conscientiously object’, advocates argue, while those who carry it out would be protected.

What are the moral arguments?

The most straightforward argument in favour of assisted dying is that the right to die at the time and in the manner that one wishes follows directly from the right to choose how one lives. Fundamentally, proponents argue, the case for a change in law rests upon the ideas of mercy and autonomy. Opponents retort that life should be preserved at all costs, that suicide should always be discouraged and that pain and depression are largely resolvable issues. A number of commentators are also concerned about a change in social values, for example, the idea of courage changing from resilience in the face of adversity to ‘giving up’ or ‘letting go’. The concept of dignity is crucial to the debate: opponents insist that dignity must not be reduced to ‘bodily integrity’ whereby life is seen as no longer worth living once someone is no longer able-bodied. In contrast, advocates argue for ‘dignity in dying’ and very often see assisting someone to die as an act of kindness and compassion.

ESSENTIAL READING

It is crucial for debaters to have read the articles in this section, which provide essential information and arguments for and against the debate motion. Students will be expected to have additional evidence and examples derived from independent research, but they can expect to be criticised if they lack a basic familiarity with the issues raised in the essential reading.

Should we legalise assisted dying?: No

Dr Andrew Fergusson The Times 12 December 2008

Should we legalise assisted dying?: Yes

Saimo Chahal The Times 12 December 2008

FOR

Why I’m opposed to legalising assisted suicide

Matthew Parris The Times 1 August 2009

The dangers of dicing with assisted death

Gillian Bowditch The Sunday Times 3 May 2009

Aspirational politics: dead and buried?

Kevin Yuill spiked 11 December 2008

AGAINST

Assisted dying: A Christian argument

John CartwrightGu Guardian 9 July 2009

Finger on the pulse: who can know the pain of wanting to die?

Dr Max Pemberton Telegraph 24 April 2009

IN DEPTH

Don’t book your ticket to Dignitas just yet

Dominic Lawson The Times 2 August 2009

Assisted suicide: Whose life is it anyway?

Brian Appleyard The Times 2 August 2009

Ten years of death with dignity

Courtney S Campbell New Atlantis

KEY TERMS

Definitions of key concepts that are crucial for understanding the topic. Students should be familiar with these terms and the different ways in which they are used and interpreted and should be prepared to explain their significance.

BACKGROUNDERS

Useful websites and materials that provide a good starting point for research.

Suicide and the law: where we stand

The Times 2 August 2009

The law and death

Unreliable Evidence BBC Radio 4 13 May 2009

Euthanasia

BBC Religion & Ethics

Voluntary euthanasia

Stanford Encyclopaedia of Philosophy

Euthanasia and end-of-life decisions

University of San DiegoEthics Updates

Physician assisted suicide

University of Washington, School of Medicine

Q&A: Assisted suicide

David Batty Guardian 6 March 2009

I’ll die when I chose

Panorama, BBC 15 December 2008

The ‘right to die’ is a fashionable nonsense

Dominic Lawson The Times 14 December 2008

Assisted dying on trial

Ray Tallis Times Literary Supplement 24 January 2007

You say murder, I say euthanasia

Claire Rayner New Statesman June 2005

Assisted Dying for the Terminally Ill Bill

UK Parliament 08 January 2004 January 2004

Euthanasia

Guardian October 2001

The history of euthanasia debates in the United States and Britain

Annals of Internal Medicine 121(10) November 1994

Coroners and Justice Bill: Amendments to the Suicide Act

BHA Briefings British Humanist Association

Lords debate euthanasia bill

Today Programme, BBC Radio 4

IN THE NEWS

Relevant recent news stories from a variety of sources, which ensure students have an up to date awareness of the state of the debate.

AUDIO/VISUAL

The law and death

Unreliable Evidence BBC Radio 4 13 May 2009

I’ll die when I chose

Panorama, BBC 15 December 2008

Lords debate euthanasia bill

Today Programme, BBC Radio 4


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