The case for assisted dying

I have a suggestion for the government.

Having drawn up a Command Paper on abortion, why not also consider drafting one on assisted dying? It’s an emotive issue I know. Even the term is controversial: those in favour of it generally use this expression, while opponents consider it a euphemism and call it “assisted suicide” instead. I prefer the former.

We live in an age of social revolution. Twenty-five years ago homosexual activity was illegal in Gibraltar; today, gay couples can marry and adopt children. Abortion is still punishable in our community by life imprisonment yet as we all know a vigorous debate is ongoing as to whether it should be decriminalised.

Many will oppose assisted dying, as they may abortion, on religious grounds. But there are also cogent arguments against it that have nothing to do with religion.

One is that vulnerable people, especially the elderly and the disabled, could feel under pressure to end their lives in order to cease being a burden on relatives: the right to die becoming the duty to die.

Another is that legalising assisted dying leads to a slippery slope. In Belgium, euthanasia (defined in my Oxford Dictionary as “the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma”) was legalised in 2002. Just 24 people were euthanised that year but by 2016/17 the number had risen to more than 4,300. And whereas at the outset euthanasia was only available to adults, in 2014 the law was extended to terminally ill children of any age.

There’s also the sense that campaigners will always demand more. The Netherlands officially allows euthanasia only in cases of “hopeless and unbearable” suffering, but has reportedly sanctioned it for conditions such as tinnitus and loss of vision. Some years ago there was a citizens’ initiative for assisted dying to be legalised for anyone over 70 who feels “tired of life” and the debate still rumbles on.

But are these powerful arguments sufficient reason to deny someone who is in constant, unremitting pain, with no hope of recovering, the dignity of dying on their own terms?

As Lord Falconer, a former Lord Chancellor and ex chair of the Commission on Assisted Dying says in a recent newspaper article, “It is an inescapable fact that some people who are dying, with full mental and emotional capacity, no longer want to live. Who no longer want to exist for a few more days or weeks or months facing nothing but medical procedures. Who have said their goodbyes. Who hate the increasing indignity of their last illness. Who want to be in control”.

Meanwhile Dr Ellen Wiebe, a GP in Canada with 40 years’ experience who’s provided about 150 assisted deaths since the legislation authorising it was passed in 2016, says when she tells patients they’re eligible, most of them are relieved and grateful. She believes assisted death can be an insurance policy against a bad death and gives people comfort when facing the end of life.

Why should someone have to go to Dignitas in Switzerland to end their days? It’s elitist for a start: not everyone can afford it. And however kind and sympathetic the clinicians may be, the fact is the patient will die among strangers in a foreign country, far away from their friends and family. They may also die sooner than they have to, as they must be well enough to travel and give their formal consent.

Alternatively, patients who are unable for whatever reason to go abroad and instead seek the help of a compassionate doctor or relative will be troubled by the knowledge that whoever helps them will risk prosecution. In the UK the maximum sentence for helping a dying person end their own life is 14 years in jail. Appropriate legislation would remove the need for such drastic measures and provide peace of mind for all concerned.

Across the western world support for assisted dying is growing. An Ipsos/MORI poll for The Economist found that of 15 countries surveyed only two (Poland and Russia) were against it for terminally ill adults. In the UK a survey of 733 doctors indicated that 55% agreed or strongly agreed with it, while 43% were against. Assisted dying is now allowed in eight US States and 69% of Americans in a 2016 Gallup poll said they were in favour when the patient has an incurable disease.

Isn’t it time we in Gibraltar also spoke up about this, just as we’re doing with abortion? The Pro Choice lobby says that only a woman can decide whether to continue with a pregnancy, as the decision involves her body alone. If that’s so, doesn’t the same logic apply to someone who’s terminally ill or in intolerable pain?