15 July 2015
Every now and again, politics comes face to face with something it prefers to stay out of. But the debate on the right to die has been pressed on us by many examples of those suffering unbearable pain, and by our pity for people who fear losing their mind and dignity. We are forced to make a decision, knowing that the world doesn’t stop turning even when we refuse to act. By its very nature, politics is transient and changing. Compromise is inherent in democracy and the external world places constraints on our ability to govern. Ethical codes tend not to be so flexible. No political decision will ever be taken twice. Circumstances will always be different. Ethical codes deal in the abstract, and try to be immune to circumstance and expedience. In politics, fallible people make irrevocable decisions with incomplete information and we cannot be immune to circumstance. This realisation could be paralysing. It contains within it the reality that we will never get everything right all the time. We mustn’t let it stop us trying. What we have to let it teach us is that there is a certain temperament that belongs in this debate, and indeed in politics more generally. This is honesty, a sense of proportion and feeling of responsibility. This understanding of politics forces us to be pragmatic. I did not enter this debate with my mind made up. But with this understanding of politics, I recognise that I have a duty to decide. I have decided to support Rob Marris’ bill on the right of patients to choose to end their lives and to be helped to carry this out. I decided this because it offers the best outcome to a terrible reality that most of us are thankfully able to ignore in our everyday lives. My choice is the one that leads to the least suffering, the most honesty and the clearest assignment of responsibility. I judge it on these three measures. The first reason is the easiest and stems from compassion. The people bravely campaigning for a change in the law, and the many who cannot, are suffering with no hope of getting better. They know that it will only get worse and they want to end their lives on their own terms while they still have control and while they can still recognise themselves. Lifting the ban on assisted dying would allow them to end that suffering legally, without their loved ones or doctor facing prosecution for an act born out of love and mercy. This is still the guideline for the Prosecution Service and the cause of a great deal of heartache. Some of my colleagues will point out that the law already makes provision for such circumstance because there is currently the option not to prosecute. But this forces families and doctors into a cruel grey area and doesn’t solve the problem. It is also dishonest and dodges the issue of where responsibility lies. Too many of those resisting this change see nobility in suffering. Anyone who has cared for a loved one in the pain of terminal illness must see this as false. I believe that there is always an imperative to end suffering when someone wants it to be over if the consequences from the act do not outweigh the initial pain and misery. Denying them this option by threatening their loved ones with prison in their pain is not a sign of a decent society. It is from the consequences of this act that the most serious disagreements of the change in the law lie, not on the rightness or wrongness of being able to choose when to die. Whilst the claim that any killing is wrong sounds compelling, it is trumped by the importance of autonomy. Moral agency is a source of the value of life too. At the heart of this is choice. Many of us, whose instinct when first confronted with this debate was that any killing is wrong, come to realise on reflection that they themselves would want the decision to be in their hands if they were ever faced with such a scenario. It would be very wrong of us to deny this right to someone actually facing the prospect of limitless pain. There is of course the practical worry that a parliamentary vote in favour of the right to die is the first step on a slippery slope. People worry that the vulnerable could be threatened or pressured by grasping family members, or that assisted death might become a cheap alternative to palliative care. Fortunately, the experiences of the Netherlands and Switzerland, two countries that have already legalised assisted dying, have shown that our worst fears are unfounded. Countries like ours can manage regulations and build strong safeguards around the right to die just like the Dutch and Swiss. If we legalise the right to die, these safeguards should include compulsory counselling, a waiting period, and a second doctor to confirm the patient’ capacity to make the decision. Establishing clear laws would be a great improvement on the current situation. At the moment, due to the lack of clarity, the decision lies in the hands of the doctor. This is the exact reverse of what the situation should be. If suffering has become intolerable and a person takes an informed decision to end their life, that choice must be in their hands. That this isn’t the case, plays into the hands of scaremongers who fear euthanasia being decided for unwilling patients by doctors. Placing a patients right to choose to die into law is the most honest approach and makes it completely clear where responsibility lies for this enormous decision. The courts have asked Parliament to make a decision and we must face up to it. Failure to legalise assisted dying will not stop it happening. It’s time to put it clearly in the patient’s hands and give their choice the respect it deserves. Any of us would want it in our hands as well.